Can we think global and act local on chronic diseases and obesity? At the United Nations General Assembly meeting this week, quite a few people gave it a try – with mixed results. At the end of the day yesterday, no one was terribly surprised when U.S. Health Secretary Robert F. Kennedy Jr. threw a wrench into works.

He showed up to say that the U.S. would reject a carefully crafted declaration on fighting noncommunicable diseases, saying:

“We cannot accept language that pushes destructive gender ideology, and neither can we accept claims of a constitutional or international right to abortion.”

Of course, the declaration about chronic diseases says nothing about gender ideology or abortion. But he had a point to make. The current administration in the U.S. does not want to work with the World Health Organization at the UN on anything.

So instead of being adopted by consensus, the declaration will go to a formal vote in the General Assembly. This will likely happen next month, according to Health Policy Watch.

Global Thinking

Actually, the final declaration is a rather impressive work of building a global consensus on chronic diseases. There are, of course, frustrations with the details. It has been hard to bring a broader understanding of obesity as a complex chronic disease into the process for this declaration. And yet the declaration reflects the fact that obesity is more than a behavioral problem, that it is driven by multiple factors.

Oddly enough, we find striking parallels between RFK’s rhetoric about a crisis of chronic diseases that “does not stop at America’s borders” and this declaration. So there is alignment to be found. But it’s not at all clear that the U.S. will deliver on a promise that, in the words of RFK yesterday, “we will never walk away from the world, or our commitment to end chronic disease.”

Smart observers tell us it seems more likely that leadership on global health issues will increasingly come from Europe and China as American influence fades.

Click here and here for more on the declaration, here for perspective from World Obesity on this process. For the text of the final declaration, click here.

An Orthographic projection of the Earth, illustration by Cmglee / Wikimedia Commons

September x, 2025