U.S. global health leadership more critical to security, stability and prosperity than ever, National Academy of Science report argues

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As priorities shift under new administration, report makes case that foreign assistance in U.S. interests, but requires improved efficiencies, sustainability

In a report written with an eye to a new administration’s views on the value of foreign aid, and released Monday, the National Academies of Science, Engineering and Medicine makes a case that U.S. global health leadership must continue, but, in a landscape of shifting priorities, also must change.

The report, produced by a committee of 14 nonprofit, think tank, academic and health industry leaders over the course of five months, offers arguments that could be used now to counter White House proposals in its budget outline for the coming fiscal year to slash funding for scientific research and overseas training and clinical trial collaborations. At the same time, the report notes that declining U.S. support for direct global health aid in the last several years have already highlighted the need for greater attention to partnerships, new modes of financing, accountability for results, and, critically, ensuring that efforts lay groundwork for continued progress.

The crux, however, of Global Health and the Future Role of the United States is that continued U.S. leadership in global health responses, infrastructure, research and security is indispensable — essential to global development as well as to American health and security, and that the economic growth that improved public health in countries around the world allows is mutually beneficial.

Noting the shared burden of increasing burdens of noncommunicable diseases worldwide, and the growing public health impacts of increasing global trade and travel, urbanization and animal-to-human disease transmission, the report emphasizes that stronger capacities to prevent, diagnose, treat and control illnesses and illness-causing conditions are universally needed.

News items in the 72 hours leading up to the report’s release underscored its points, report committee member Dr. Michael Osterholm of the Center for Infectious Disease Research and Policy at the University of Minnesota noted during a discussion of the report’s recommendations Monday. Those included updated news of the Ebola outbreak in the Democratic Republic of Congo, Middle East Respiratory Syndrome in Saudi Arabia, the potential for exhaustion of yellow fever vaccine supplies in Brazil, and findings of an expanding range of Zika impacts on infants. Added to those concerns, and the potential for a pandemic outbreak of influenza, Osterholm added, is the “slow-moving tsunami of antibiotic resistance.”

With a focus on leadership to respond to infectious diseases, sustain responses to HIV, tuberculosis and malaria, improve maternal and child health outcomes, and confront the rising worldwide burden of noncommunicable diseases, the report does not address a number of high-profile, and high-impact issues. Those include mental health, substance addictions, climate change effects on health, and shortages of qualified health workers. It does note these, though, and asserts that committed attention to immediate areas of focus will better enable effective responses across the spectrum of public health needs.

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