Global Health and the Future Role of the United States

313 Pages·2017·4.7 MB·English

THE NATIONAL ACADEMIES PRESS
This PDF is available at http://www.nap.edu/24737 SHARE
Ū ſ Ŷ Þ
Global Health and the Future Role of the United States
DETAILS
360 pages | 6 x 9 | PAPERBACK
ISBN 978-0-309-45763-7 | DOI: 10.17226/24737
CONTRIBUTORS
GET THIS BOOK Committee on Global Health and the Future of the United States;
Board on Global Health; Health and Medicine Division; National
Academies of Sciences, Engineering, and Medicine
FIND RELATED TITLES
Visit the National Academies Press at NAP.edu and login or register to get:
– Access to free PDF downloads of thousands of scientific reports

– 10% off the price of print titles

– Email or social media notifications of new titles related to your interests

– Special offers and discounts
Distribution, posting, or copying of this PDF is strictly prohibited without written permission of the National Academies Press.
(Request Permission) Unless otherwise indicated, all materials in this PDF are copyrighted by the National Academy of Sciences.
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
GLOBAL HEALTH AND THE FUTURE
ROLE OF THE UNITED STATES
Committee on Global Health and the Future of the United States
Board on Global Health
Health and Medicine Division
A Report of
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by Grant No. CCO-160111-015127 from the Merck Foundation, the
National Institutes of Health, the President’s Emergency Plan for AIDS Relief, Grant No. 2016
AVH 305 from The Rockefeller Foundation, Grant no. APC-6M-0002 from the U.S. Agency for
International Development, Grant No. HHSP233201400020B/HHSP23337049 from the U.S.
Centers for Disease Control and Prevention, and Grant No. HHSP233201400020B/
HHSP23337048 from the U.S. Food and Drug Administration, BD (Becton, Dickson and
Company) and Medtronic. Any opinions, findings, conclusions, or recommendations expressed
in this publication do not necessarily reflect the views of any organization or agency that
provided support for the project.
International Standard Book Number-13: 978-0-309-XXXXX-X
International Standard Book Number-10: 0-309-XXXXX-X
Digital Object Identifier: https://doi.org/10.17226/24737
Library of Congress Control Number:
Additional copies of this publication are available for sale from the National Academies Press,
500 Fifth Street, NW, Keck 360, Washington, DC 20001; [phone] or [phone];
http://www.nap.edu.
Copyright 2017 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Global
health and the future role of the United States. Washington, DC: The National Academies Press.
doi: https://doi.org/10.17226/24737.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by
President Lincoln, as a private, nongovernmental institution to advise the nation on issues
related to science and technology. Members are elected by their peers for outstanding
contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the
National Academy of Sciences to bring the practices of engineering to advising the nation.
Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D.
Mote, Jr., is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in
1970 under the charter of the National Academy of Sciences to advise the nation on medical
and health issues. Members are elected by their peers for distinguished contributions to
medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering,
and Medicine to provide independent, objective analysis and advice to the nation and
conduct other activities to solve complex problems and inform public policy decisions. The
National Academies also encourage education and research, recognize outstanding
contributions to knowledge, and increase public understanding in matters of science,
engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at
www.national-academies.org.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
Reports document the evidence-based consensus of an authoring committee of experts.
Reports typically include findings, conclusions, and recommendations based on information
gathered by the committee and committee deliberations. Reports are peer reviewed and are
approved by the National Academies of Sciences, Engineering, and Medicine.
Proceedings chronicle the presentations and discussions at a workshop, symposium, or other
convening event. The statements and opinions contained in proceedings are those of the
participants and have not been endorsed by other participants, the planning committee, or
the National Academies of Sciences, Engineering, and Medicine.
For information about other products and activities of the National Academies, please visit
nationalacademies.org/whatwedo.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
COMMITTEE ON GLOBAL HEALTH AND THE FUTURE OF THE UNITED STATES
JENDAYI FRAZER (Co-Chair), Council on Foreign Relations, Washington, DC
VALENTIN FUSTER (Co-Chair), Mount Sinai Medical Center, New York, NY
GISELA ABBAM, General Electric Healthcare, London, United Kingdom
AMIE BATSON, PATH, Seattle, WA
FREDERICK BURKLE, JR., Harvard University, Kailua, HI
LYNDA CHIN, Institute for Health Transformation, University of Texas System
LIA HASKIN FERNALD, School of Public Health, University of California, Berkeley
STEPHANIE FERGUSON, Lynchburg College and Stanford University, Amherst, VA
PETER LAMPTEY, FHI 360, Accra, Ghana
RAMANAN LAXMINARAYAN, Centers for Disease, Dynamics, and Policy, New Delhi, India
MICHAEL MERSON, Duke Global Health Institute, Duke University, Durham, NC
VASANT NARASIMHAN, Novartis, Basel, Switzerland
MICHAEL OSTERHOLM, Center for Infectious Disease Research and Policy, University of
Minnesota, Minneapolis
JUAN CARLOS PUYANA, University of Pittsburgh, PA
Study Staff
MEGAN SNAIR, Study Director
CECILIA MUNDACA-SHAH, Senior Program Officer
EESHAN KHANDEKAR, Research Associate
ELAINE HYNDS, Senior Program Assistant
PATRICK KELLEY, Director, Board on Global Health (until August 2016)
JULIE PAVLIN, Director, Board on Global Health (from November 2016)
Consultants
RONA BRIERE, Arlington, VA
ANNA NICHOLSON, Chapel Hill, NC
PREPUBLICATION COPY: UNCORRECTED PROOFS v
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse
perspectives and technical expertise. The purpose of this independent review is to provide candid
and critical comments that will assist the institution in making its published report as sound as
possible and to ensure that the report meets institutional standards for objectivity, evidence, and
responsiveness to the study charge. The review comments and draft manuscript remain
confidential to protect the integrity of the deliberative process. We wish to thank the following
individuals for their review of this report:
Cynthia Beall, Case Western Reserve University
Paul Biondich, Regenstrief Institute
Charles Carpenter, Brown University
Barbara J. Culliton, The Culliton Group
Sue Curry, University of Iowa
Christopher Elias, Bill & Melinda Gates Foundation
Amanda Glassman, Center for Global Development
Clarion Johnson, Private Consultant
Jennifer Kates, Kaiser Family Foundation
Rebecca Katz, Georgetown University
Ilona Kickbusch, Graduate Institute Geneva
J. Stephen Morrison, Center for Strategic and International Studies
Loyce Pace, Global Health Council
Gerald W. Parker, Texas A&M AgriLife Research
Jeffrey Sturchio, Rabin Martin
Charles D. Wells, Sanofi
Gavin Yamey, Duke Global Health Institute
Although the reviewers listed above have provided many constructive comments and
suggestions, they were not asked to endorse the conclusions or recommendations nor did they
see the final draft of the report before its release. The review of this report was overseen by
David Challoner, University of Florida, and Martin Philbert, University of Michigan. They
were responsible for making certain that an independent examination of this report was carried
out in accordance with institutional procedures and that all review comments were carefully
considered. Responsibility for the final content of this report rests entirely with the authoring
committee and the institution.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
Copyright © National Academy of Sciences. All rights reserved.
Global Health and the Future Role of the United States
Preface
The U.S. government has long been at the forefront of shaping the international policy
agenda and establishing institutions like the U.S. President’s Emergency Plan for AIDS Relief
(PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis (TB), and Malaria, which make the
world safer for America’s citizens by improving health and producing more stable societies in
other countries, and more humane for millions of people facing heavy disease burdens. The
United States has worked with other nations to create Gavi, the Vaccine Alliance, which played
an important role in reducing mortality from vaccine-preventable disease (a major contributor to
the Millennial Development Goals). Working with philanthropies, the United States has also
supported the creation of the Global Polio Eradication Initiative, which has brought the world to
the brink of declaring permanent victory over the polio virus. Furthermore, U.S. industry,
foundations, and nongovernmental organizations have been on the frontlines in responding to
global health emergencies and advancing the research and innovation that has helped curtail the
world’s most dangerous pathogens.
Collaborative international efforts, especially strengthening the capacity of national
health systems, are essential to prevent and prepare for an array of threats, from infectious
disease pandemics to the silent killers of chronic noncommunicable diseases. The committee
grappled with striking the right balance in fulfilling its mandate to examine the United States’
role on the future of global health while reflecting that the United States—as a member of the
global community of states—has common challenges and lessons to learn from others to
influence our future.
The committee prioritized global health challenges with the potential for catastrophic loss
of life and impact on society and the economy—such as pandemics, persistent communicable
diseases (HIV/AIDS, TB, and malaria), and noncommunicable diseases (cardiovascular health
and select cancers)—as well as areas where significant U.S. investment has created gains that
should be consolidated and sustained—such as promoting women and children’s health, building
capacity, and global health innovation and implementation. The Committee on Global Health
and the Future of the United States concluded that the U.S. government should maintain its
leadership position in global health as matter of urgent national interest and as a global public
benefit that enhances America’s international standing.
While additional investment is required, more money alone is not the answer. The report
offers 14 significant recommendations to strengthen U.S global health programs, recognizing
that many other areas are worthy of attention. In order to maximize work toward the prioritized
global health challenges (chapters 3 to 6) the committee focused on how to better leverage U.S.
resources by doing business differently, especially through the use of improved research and
development processes and digital health (chapter 7), smart financing mechanisms to maximize
returns on U.S. investments (chapter 8) and demonstrating leadership within the global health
architecture and governance (chapter 9).
We would like to thank the members of the committee for their devotion of time and
energy to this project. It was a privilege and a pleasure to work with our fellow committee
members, to learn from them in their respective areas of expertise, and to engage with them in
hearty discourse about the issues at hand. Many other experts also gave generously of their time
and expertise to contribute to our information gathering, and their contributions are deeply
appreciated. Specific participants in this process are listed in the acknowledgments on the
following page. We would like to add a special note of gratitude to the National Academies of
PREPUBLICATION COPY: UNCORRECTED PROOFS
ix
Copyright © National Academy of Sciences. All rights reserved.