National Academies Report Makes Strong Case For US Involvement In
Global Health
Calling on the new Trump administration to extend the
proud legacy of US involvement and achievement in global public
health, a panel from the National Academies has identified four
priority areas and made 14 recommendations to guide the future role of
the United States in global health.
Why Global Health and
Why Now?
Before presenting its
recommendations, the NAS report seeks to make the case for why
supporting global health initiatives is important to the United
States. Several rationales are offered by the committee in the
statement released by the NAS.
·
The
increased interdependency of countries, economies, and cultures
resulting from tremendous growth in international travel and trade
over the last several decades has brought improved access to goods and
services, but also a variety of health threats…
·
By
investing in global health over the next 20 years, there is a chance
to save the lives of millions of children and adults…
·
The
health and well-being of other countries both directly and indirectly
affect the health, safety, and economic security of Americans.
·
The U.S.
government should maintain its leadership position in global health as
a matter of urgent national interest and as a global public benefit
that enhances America’s
international
standing.
The four priority
areas containing 14 specific and cross-cutting recommendations
included in the NAS statement and report are listed below:
I. Achieve global
health security
In the last 10 years,
outbreaks of potentially pandemic influenza, Middle East respiratory
syndrome coronavirus (MERS-CoV), Ebola, and most recently Zika have
threatened populations around the world. In each case, global and
national responses, including those of the United States, have been
reactionary, uncoordinated, ineffective, and highly costly. Absent the
establishment of fundamental public health protections and
preparedness capabilities at home and abroad, the world will never be
ready to prevent, detect, and respond to such outbreaks. A solid
commitment in the form of a sustainable mechanism for addressing these
global threats is a critical need. The committee urges the
administration to create a coordinating body within the U.S.
government with the authority and budget to develop a proactive,
cost-effective, and comprehensive approach to preparedness for and
response to international public health emergencies.
Recommendation 1:
Improve international emergency response coordination.
Recommendation 2:
Combat antimicrobial resistance.
Recommendation 3: Build public health capacity in low- and
middle-income countries.
Included on the NAS
panel were at least two epidemiologists, the University of Minnesota’s
Michael Osterholm and Duke University's Michael Merson
who have both had a career focus on global health issues and threats.
In an op-ed essay in the New York Times last March, Osterholm and a
colleague stated “While the Trump administration is proposing
significantly increased military spending to enhance our national
security, it seems to have lost sight of the greatest national
security threat of all: our fight against infectious disease. We
already spend far more on our military than any other country in the
world. To help pay for the increases, President Trump wants to cut
back many federal programs, including those that prepare us to wage
war against microbes, the greatest and most lethal enemy we are ever
likely to face. This is where ‘defense spending’ needs to increase,
significantly.”
II. Maintain a
sustained response to the continuous threats of communicable diseases
Dedicated efforts of national governments, foundations,
and the global community have resulted in millions of lives saved from
AIDS, tuberculosis (TB), and malaria, yet all three diseases continue
to pose immediate and longer-term threats to the health of populations
around the world. More than 36 million people are living with HIV,
with 2 million new infections occurring each year. TB
disproportionately affects the poorest populations of the world,
killing 1.4 million each year, while dangerous resistant strains are
becoming more prevalent and easily spread. The mortality rate due to
malaria has decreased by more than 60 percent in the last 10 years,
but those infected can lose 25 percent of their family’s income as a
result of their lost productivity, affecting the prosperity of the
society at large as well.
Recommendation 4:
Envision the next generation of the President’s Emergency Plan for
AIDS Relief.
Recommendation 5:
Confront the threat of tuberculosis.
Recommendation 6:
Sustain progress toward malaria elimination.
III. Save and improve the lives of children
Although child and
maternal mortality rates have decreased since 2000, each year nearly 6
million children die before their fifth birthday, and more than
300,000 women die from pregnancy- and childbirth-related causes. The
vast majority of these deaths are preventable. The committee urges the
U.S. government to continue its commitment to this survival agenda but
also expand it to incorporate early childhood development as a key
element.
Recommendation 7:
Improve survival in women and children.
Recommendation 8:
Ensure healthy and productive lives for women and children.
IV. Promote
cardiovascular health and prevent cancer.
Infectious diseases
often captivate the media, but an equally important concern is rising
rates of NCDs, such as cardiovascular disease (CVD) and cancer, in
countries around the world, regardless of income level. The costs of
managing these diseases are rising as well. CVD alone is projected to
cost the world $1 trillion annually in treatment costs and
productivity losses by 2030. However, because of their historical
focus on infectious diseases, many health systems in low- and
middle-income countries are not adequately equipped to care for
patients with NCDs. The need to fill these gaps often goes unmet
because of other priorities, but their prevention and treatment can be
built into existing platforms for other areas, such as HIV/AIDS or
maternal and child health.
Recommendation 9:
Promote cardiovascular health and prevent cancer
Cross-cutting topic
areas
To have the greatest
effect in the above priority areas, the committee identified three
cross-cutting areas for action to maximize the returns on investments,
achieve better health outcomes, and use funding more effectively:
Recommendation 10:
Accelerate the development of medical products.
Recommendation 11:
Improve digital health infrastructure.
Recommendation 12:
Transition investments toward global public goods.
Recommendation
13:
Optimize resources through smart financing.
Recommendation 14:
Commit to continued global health leadership
To obtain a copy of the NAS report, visit :
https://tinyurl.com/ybuujxcp ■
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