One of the hallmarks of American democracy is the peaceful transition of power from one Administration to the next. With that transition comes a transfer of knowledge and resources to ensure continuity in essential government programs. Among these are global health initiatives that have garnered strong bipartisan support and can be counted as major successes for U.S. policy - not least of which is the President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003 by President George W. Bush. PEPFAR transformed the HIV/AIDS landscape by establishing a new way of working in partnership with host countries, donors, multilateral institutions, NGOs, the private sector, academe and others to reduce dramatically the burden of HIV/AIDS around the world.
The new Administration has an opportunity to continue U.S. leadership in global health through smart policy and efficient coordination of the investments allocated by Congress. Here are five key areas to consider:
• Protect hard-won gains in global health. From steadily declining child mortality rates because of increased vaccinations, to crossing the finish line on guinea worm eradication, we should continue to strive toward reaching global targets such as those in the Sustainable Development Goals. Global maternal mortality, for instance, fell by nearly half between 1990 and 2015 - from 385 deaths to 216 deaths per 100,000 live births. Progress, in large part, is due to the persistent efforts of government agencies, multilateral institutions, NGOs, the private sector and communities.
• Increase investments in addressing the increasing challenge of non-communicable diseases (NCDs). The NCD epidemic poses the greatest threat to health globally, yet it continues to attract fewer resources than it should for a set of conditions that causes more than three-fifths of all global deaths. More than 80% of premature, NCD-related deaths occur in low- and middle-income countries. Furthermore, increased levels of air pollution and obesity in rapidly growing cities can lead to a rise in cardiovascular disease, lung cancer and childhood asthma. While recent years have seen greater political commitment to this issue, thanks to the efforts of groups such as the NCD Alliance and the NCD Roundtable, there remains a significant funding gap for programs to prevent, detect and control cancers, diabetes, heart disease, chronic respiratory diseases and mental illnesses.
• Support universal health coverage (UHC). Fostering better health and reducing health costs over the long run depends upon the ability of countries to provide better, more equitable coverage for essential health services as well as protection from financial ruin due to high out of pocket health costs. While each country must chart its own path toward realizing UHC, a greater focus must be placed on identifying ways to provide coverage without compromising the quality of healthcare or access to medicines for people who are not covered by government insurance or subsidies.
• Explore new models for partnerships. When done well, cooperation across sectors leverages complementary capabilities, optimizes resource use and reduces duplication of efforts. Public-private partnerships are evolving from traditional donor-grantee models to more collaborative relationships that focus on efficiency, quality, results and sustainability. The Global Health Security Agenda (GHSA) Private Sector Roundtable, for instance, mobilizes industry around advancing health security, working closely with the more than fifty countries involved in the GHSA. There has also been a rise in private-private partnerships, where companies from different sectors or regions work in tandem to support countries in tackling health challenges. The private sector is playing an important role in meeting global health needs around the world. We need to work with the World Health Organization and countries themselves to optimize the possibilities of new partnerships and address barriers to more systematic collaboration.
• Make the case for investments in health. Ministers of Health need the evidence to articulate more convincingly the relationships between health and economic prosperity. The uncertainty posed by epidemics like Ebola and Zika have a significant impact on tourism and commerce, deter major foreign investments and roll back economic progress for many years. But it's not just infectious diseases that take this toll. NCDs and their risk factors also pose direct and indirect financial costs on patients and their families. Tobacco use, for example, causes over $92 billion a year in lost productivity and $75 billion a year in medical expenditures in the U.S. Greater efforts must be made in collecting health-related economic data and deploying it in the service of more effective policies to make sustainable gains in population health.
As the development community contemplates the prospect of working with a new U.S. Administration, we have the responsibility to support the incoming leadership in assessing and implementing policy priorities and programs in global health. We can do this by fostering collaboration, lending our expertise, sharing technical knowledge and leveraging convening power to inform decisions and identify new solutions. We can marshal our resources and networks to educate, influence, partner, and - when necessary - push and challenge. The work of improving the health of people around the world is critical to U.S. national interests by making the world more prosperous and more secure.
Simply put, global health transcends politics. We have an opportunity over the coming months to help shape a new agenda and maintain the tradition of bipartisan U.S. leadership on global health issues.