It’s no secret that Americans are growing world-weary. Our role on the global stage is the subject of intense political debate. A recent Pew survey found that only about a third of Americans feel the United States should help other countries with their problems.
Isolationist tendencies pose serious risks – nowhere greater than in the area of global health. The US government is the largest funder and implementer of health programs worldwide. What would happen if this funding is curtailed or this commitment diminished?
Recently, I collaborated with international thought leaders, educators and public health professionals to produce Global Health and the Future Role of the United States, a groundbreaking report for the National Academy of Medicine (formerly the Institute of Medicine) that spells out the challenges, solutions, and risks we face if we fail to move forward.
As the report makes clear, the case for continued US leadership and engagement is one of self-interest. Global health investment protects our welfare. It creates a world that is safer from infectious disease. It fosters economic development and helps spread democracy. It promotes valuable partnerships that lead to shared solutions to common health problems, such as cancer and heart disease.
Simply put, global health security equals national security. So how can we achieve this desired state? Here are the top 5 priorities:
Are we ready for the next worldwide pandemic? Recent events tell us no. The response to outbreaks of MERS, Ebola and Zika were uncoordinated. A string of natural disasters here at home showed our country is ill-prepared to handle the massive needs that will arise in large-scale public health emergencies. The US must lead the way to establish an international coordinating body that can prevent, detect, and respond to such outbreaks.
In order to achieve this level of coordination and rapid response capability, we must improve public health capacity. Pandemics do not recognize borders. In the United States, our first line of defense is a well-built and well-maintained public health infrastructure geared toward prevention and preparedness. This takes money, but public health funding in our country has dropped over the last decade, especially at the state and local levels. It’s time to change that.
With our national focus on the opioid crisis, many people don’t recognize an equally dire threat: antimicrobial resistance. The emergence of superbugs impervious to antibiotics is one of the most pressing issues in our health care system today. We need a coordinated and dedicated effort to educate clinicians, identify resistant microbial strains as they emerge, promote antimicrobial stewardship, and develop alternative therapies.
Healthy women and children are the linchpin for healthy and thriving societies. Improving the health of these populations at home and abroad creates a ripple effect with multiple benefits. Healthy, educated women are more productive, take better care of their families, contribute to greater economic prosperity, strengthen social bonds and improve community resilience.
Around the world, non-communicable diseases are on the rise. Death from heart disease has increased more than 12 percent in the last 15 years, while cancer mortality rates have climbed to more than 8.8 million. Cost-effective and high-impact interventions, such as the HPV vaccine for cervical cancer and screening programs for early detection of heart disease, exist, but are not widely disseminated. These cost-effective, high-impact interventions are key to building healthier societies.
Pandemics. Superbugs. Chronic diseases. Addressing these global health threats has a direct bearing on our nation’s security. In today’s interconnected world, an infectious disease threat anywhere can be a threat everywhere, as this 2017 report from the Global Health Security Agenda points out. A pathogen can travel around the globe to major cities in as few as 36 hours. The report spells out in detail progress and impact from US Government investments to achieve a world safe and secure from infectious disease threats.
We stand at a crossroads. We must take action to ensure that the US remains engaged to achieve global health security and worldwide.