This is the last of three essays that I'm writing as I begin to pivot away from a decade of work in global health. It attempts to answer a question recently asked by one of my staff members: what might this unusual Presidential election mean for future U.S. support of global health and the fights against HIV/AIDS, tuberculosis and malaria?
My response is that the United States government has been a leader in these investments and there is nothing about this election which points to a major pivot away from this. U.S. investments in global health and HIV/AIDS, tuberculosis and malaria have held steady in recent years, for example, despite overall discretionary funding cuts. These investments are undergirded by robust bipartisan and faith-based support. Simply put, investing in global health is the right and moral thing to do.
The platforms of the remaining Republican and Democratic candidates (Donald Trump, Sen. Ted Cruz, Gov. John Kasich, Secretary Hillary Clinton and Sen. Bernie Sanders) illuminate why both parties are likely to continue supporting global health investments.
All three Republican candidates identify a small number of key issues in this election. Their websites mostly emphasize security needs, immigration, and fair trade issues. The websites of John Kasich and Ted Cruz, however, also highlight the sanctity of life as a key value and, when asked about the Global Fund's lifesaving programs at a December rally in New Hampshire, Donald Trump said of the Fund: "It sounds good to me. It really does ... I mean, that's the kind of thing we should be doing."
This belief in the sanctity of life is the same sentiment that led President George W. Bush to initiate the Global Fund and PEPFAR, the global, emergency HIV and AIDS program, alongside the President's Malaria Initiative. As the former President put it in a recent National Review article:
If you say you're pro-life, that ought to be a priority ... So when the AIDS pandemic was destroying an entire generation, (fighting AIDS) became a priority. And I happen to believe that PEPFAR should be good for our soul. Because now people live who shouldn't have.
Hillary Clinton and Bernie Sanders, meanwhile, each highlight more than 25 key issue areas on their websites. They focus on questions of equity and equitable access to resources, like race, gender, human rights, and fair pay issues. Extending access to health for marginalized and disadvantaged populations overseas is entirely consonant with these objectives.
Both Clinton and Sanders, in fact, have recently gone on the record as being supportive of global HIV and AIDS programs. Clinton notes that as Secretary of State she ushered in a campaign for a global AIDS-free generation, and that she remains committed to continuing the march toward increasing the number of people on lifesaving anti-retroviral therapy.
Finally, principals in both parties have seen the phenomenal results of these U.S.-driven investments. The Global Fund has saved more than 17 million lives to date - a number that is expected to grow to 22 million lives by the end of 2016. The Global Fund and the President's Emergency Plan for AIDS Relief account for approximately 80 percent of international HIV/AIDS assistance and are providing antiretroviral treatment for nearly 16 million people. Momentous results have also been achieved through the work of the Global Fund partnership and the President's Malaria Initiative, which account for 75 percent of global malaria funding. The global malaria mortality rate has decreased by 60 percent since 2000. The Global Fund and the U.S. Agency for International Development also work with partner governments to bolster tuberculosis programs and strategies across the globe; there has been a drop in global tuberculosis mortality and prevalence rates by 47 percent and 42 percent respectively since 1990.
Americans should be extremely proud of what we have accomplished with these investments. I fully expect that the future leader of the United States will choose to continue this proud legacy, regardless of his or her political leanings.