By Pietro Paganini
Much to the doubt of its critics, the White House’s policies to improve Americans’ health are taking concrete shape. After the Presidential Fitness Test, a symbolic but also practical tool to put physical activity back at the center of prevention policies, comes a tangible step forward on the digital and technological front. The Trump administration, through the Centers for Medicare & Medicaid Services (CMS), has announced an initiative to modernize the national healthcare ecosystem: an interoperability framework allowing every citizen to securely, directly, and fully access their health data, integrating it with wearable devices, digital platforms, and artificial intelligence agents. Whatever one thinks of the U.S. President, this is an initiative that should also push Europe to embark on a similar path at the EU level, fostering integration and interoperability while safeguarding the independence of national healthcare systems.
This is not just a technical upgrade: it is a paradigm shift. It moves from therapies and generic recommendations to personalized action. It does not impose how everyone should be treated or what they should eat, following the old “one-size-fits-all” model with paternalistic rules that are ineffective and harmful to both freedom of choice and the economy. Instead, it invests in technologies that enable each person to know what is best for themselves, based on scientific evidence and real data: personalized lifestyle and precision nutrition. It is no coincidence that this initiative was announced just as, at the UN, member state representatives are struggling to agree on a common document to tackle non-communicable diseases ahead of the next General Assembly in September and the High-Level Meeting 4 (HLM4). The United States, critical of both the WHO and the UN, once again shows its pragmatism.
The benefits are tangible. A connected wearable can monitor glucose in real time and suggest immediate dietary choices to prevent dangerous spikes. It can combine data on sleep, physical activity, and stress to recommend not only what to eat, but when, optimizing metabolism. It can integrate environmental data, such as air quality, to adjust hydration and nutrient intake. This is true precision nutrition: dynamic, contextualized, and adapted to the individual.
For years, I have argued that, when it comes to non-communicable diseases, it is necessary to move beyond current public health policies, because they are ineffective. Precision medicine, and in particular personalized nutrition, is already a reality, as demonstrated by the enthusiasm of U.S. tech giants ready to invest in infrastructure, interoperability, and new tools for citizens and patients. This is a major prevention initiative: monitoring one’s health and making rational choices can prevent the onset of disease. It is not just about better treatment, but about prevention. And prevention does not mean screening or early diagnosis; it means adopting a lifestyle that reduces the very risk of getting sick, increasing both longevity and quality of life.
In the U.S., 70% of the population is overweight, and 40% of those are obese. One-third already use wearables for physical and mental well-being, but often inconsistently. This is the abandonment phenomenon: buying the device, downloading the app, starting with enthusiasm, then giving up. The market is responding with incentives, such as lower insurance premiums in exchange for daily physical activity, and with more intuitive, engaging technologies. Some of these mechanisms are controversial, but they are accelerating adoption and sustained use. That still leaves two-thirds of Americans to engage and educate: a massive challenge, but the path has been set, and change could be rapid.
And Europe? It remains stuck in old patterns. France, Germany, and especially the Netherlands, historically an innovator in healthcare and nutrition, should be leading the development of secure digital infrastructure, ensuring interoperability, and promoting wearables and AI as tools of empowerment, not control. Instead, they continue to propose labels and taxes, while obesity and non-communicable diseases rise, and life expectancy, according to some projections, risks declining.
Like it or not, the United States is showing that “Make America Healthy Again” is not just a populist slogan but is emerging as a genuine strategy that combines investment, innovation, and freedom of choice. The question for Brussels is simple: will we keep debating labels and taxes as the only tools against non-communicable diseases, or finally give citizens the tools to live better and longer? Of course, this would also mean that we Europeans would have to rely on U.S. technology, and deposit our most sensitive data, including DNA and metabolic information, on the servers of American multinationals.
The US plan is an investment and integration plan that we do not have. I would like personalised medicine, but I would like to avoid uncontrolled algorithms telling me what to do or data centres outside European control.
English version by the Translation Service of Withub
