The rise of “alternative facts” and the end of automatic deference to doctors is creating dangers for global efforts to vaccinate vulnerable children, David Miliband has warned. The former UK foreign secretary, who now runs the International Rescue Committee (IRC), was speaking hours before Donald Trump’s inauguration as the 47th president of the US. Changes to how the US engages with the rest of the world will not only potentially hamper efforts to provide health services and humanitarian aid to the most vulnerable, but could also have an impact on the amount of conflict and other disasters globally, Miliband said.