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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; (800) 624-6242 or (202) 334-3313; 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.

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