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Global Health and the Future Role of the United States

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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 Consensus Study Report of THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by BD (Becton, Dickinson and Company), Medtronic, Grant No. CCO-160111-015127 from the Merck Foundation, the National Insti- tutes of Health, 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, Grant No. HHSP233201400020B/ HHSP23337048 from the U.S. Food and Drug Administration, and The U.S. President’s Emergency Plan for AIDS Relief. 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: 978-0-309-45763-7 International Standard Book Number-10: 0-309-45763-7 Digital Object Identifier: https://doi.org/10.17226/24737 Library of Congress Control Number: 2017950553 Additional copies of this publication are available for sale from the National Acad- emies 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. The National Academy of Sciences was established in 1863 by an Act of Con- gress, 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 char- ter 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, En- gineering, 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 Medi- cine at www.nationalacademies.org. Consensus Study Reports published by the National Academies of Sciences, En- gineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gath- ered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opin- ions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. COMMITTEE ON GLOBAL HEALTH AND THE FUTURE OF THE UNITED STATES JENDAYI E. 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 M. BURKLE, JR., Harvard University, Kailua, HI LYNDA CHIN, Institute for Health Transformation, University of Texas System STEPHANIE L. FERGUSON, Lynchburg College and Stanford University, Amherst, VA LIA HASKIN FERNALD, School of Public Health, University of California, Berkeley PETER LAMPTEY, FHI 360, Accra, Ghana RAMANAN LAXMINARAYAN, Centers for Disease, Dynamics, and Policy, New Delhi, India MICHAEL H. MERSON, Duke Global Health Institute, Duke University, Durham, NC VASANT NARASIMHAN, Novartis, Basel, Switzerland MICHAEL T. 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 v Reviewers This Consensus Study Report was 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 National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manu- script remain confidential to protect the integrity of the deliberative process. We 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 vii viii REVIEWERS Charles D. Wells, Sanofi Gavin Yamey, Duke Global Health Institute Although the reviewers listed above provided many constructive com- ments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by David Challoner, Uni- versity 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 the standards of the National Academies and that all review comments were carefully considered. Re- sponsibility for the final content rests entirely with the authoring committee and the National Academies. Preface The U.S. government has long been at the forefront of shaping the international policy agenda and establishing institutions like The U.S. Presi- dent’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis 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 Ini- tiative, 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 capac- ity 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. ix x PREFACE 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
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