The mandate of the U.S. Department of Health and Human Services is to protect the health of the American people. Events in recent years, however, have made it clear that our efforts to protect Americans’ health cannot end at our borders.
Pathogens and other threats to human health are as mobile as we are, and have become more and more dangerous through growing drug resistance and natural mutations. As the world’s population becomes increasingly mobile, and as diseases change, our own health becomes more and more intertwined with the world’s health.
The health of other nations is also closely tied to economic productivity, social stability, and good governance. Such economic, social, and political realities clearly intersect with our national interest, and further compel us to address a variety of global health concerns.
Health-related programming can also hold a special place as a foreign-policy tool for the U.S. Government. Our work to improve global health demonstrates the generosity of the American people. Given the universal value populations place on good health, evidence-based, public-health interventions can help to transcend political boundaries.
Meeting Its Mandate
HHS works to improve global health through direct assistance, technical and program support, training and capacity building, and through research.
Within HHS, CDC works to detect, verify, and quickly respond to outbreaks of infectious diseases around the globe and to control other health threats at their origin to prevent international spread. To maintain the safety of the American people, FDA regulates millions of products produced abroad. NIH addresses global health challenges through innovative, collaborative research and training programs, and through international partnerships. SAMHSA works with postconflict and postdisaster countries to enable stakeholders to work together to address the mental health needs of their peoples. It also helps to administer programs to train and support mental health professionals from developing nations. Building on its leadership of the domestic Ryan White HIV/AIDS Program, HRSA provides training and quality improvement interventions in the President’s Emergency Plan for AIDS Relief (PEPFAR).
HHS has a significant international presence. HHS staff—both civil servants and USPHS officers—serve around the globe. These dedicated professionals work to improve the health of the world—through their work on PEPFAR, the President’s Malaria Initiative (PMI), the Global Polio Eradication Initiative (GPEI), or through work to encourage innovative, cooperative biomedical research with researchers from other countries. HHS also regularly sends its staff to work as health attachés in U.S. Embassies and Missions abroad. These health attachés represent the U.S. Government to host-country ministries of health and to international organizations such as WHO.
Through its work in international health, HHS boasts a number of significant accomplishments. In the first 3 years of PEPFAR, in 15 focus countries in Africa, Asia, and the Caribbean, HHS, through the efforts of CDC, FDA, and HRSA, has played a significant role in the U.S. Government’s support of antiretroviral treatment for 820,000 people living with HIV/AIDS. In its role in PEPFAR, HHS has also joined the U.S. effort in supporting care for almost 4½ million people, including 2 million orphans and vulnerable children, as well as counseling and testing for 18.6 million people.
In the first year of PMI, which HHS and the United States Agency for International Development (USAID) implement jointly, PMI delivered life-saving interventions to prevent and control malaria in the first three countries (Angola, Tanzania, and Uganda). Nearly 1 million long-lasting insecticide-treated bed nets (ITNs) were distributed; approximately half a million ITNs that were not long lasting were re-treated; more than 2 million people were protected from malaria after the interiors of their homes were sprayed with insecticides; and approximately 1.2 million treatments of artemisinin-based combination therapy were procured and distributed.
Through CDC’s participation in the GPEI, HHS has played a significant role in spearheading the global fight to eradicate polio. At the launch of the GPEI in 1988, polio was endemic in more than 125 countries, and paralyzed 350,000 children each year. In 2006, only 1,985 people were paralyzed by polio, and now, only 4 endemic countries remain. CDC continues to provide significant technical expertise and support to governments and international organizations in the fight to eradicate polio.
HHS, through the work of CDC, is a core partner in the global Measles Initiative, which also includes the American Red Cross, United Nations Foundation, United Nations Children’s Fund, and WHO. The work of this initiative has had a significant effect on measles deaths globally. Such deaths have fallen by 60 percent worldwide, from an estimated 873,000 deaths in 1999, to 345,000 in 2005. In Africa, measles deaths fell by 75 percent, from an estimated 506,000 to 126,000 in that same period. A concerted initiative in the Americas since 2002 has eliminated endemic measles from the Western Hemisphere.
We also know that we cannot achieve our global health goals alone. In our work, HHS partners with many other Departments, including the U.S. Departments of State, Defense, Agriculture, Homeland Security, and Commerce. HHS also collaborates closely with USAID and with EPA. HHS also enjoys excellent bilateral partnerships with other governments, as well as good working relationships with multilateral organizations, nongovernmental and faith-based organizations, and with the private sector.
HHS is also committed to working to achieve several of the Millennium Development Goals (MDGs) developed by the United Nations. Eight MDGs were developed in September 2000 at the United Nations Millennium Summit to help provide a framework for leaders to improve the health and well-being of men, women, and children around the world. The intent is to make significant improvement in these areas by 2015. Of the MDGs developed, HHS is particularly focused on MDG 4 (reduce child mortality), MDG 5 (improve maternal health), and MDG 6 (combat HIV/AIDS, malaria, and other diseases).
Important as international health may be today, addressing its challenges will be crucial in the future. If the U.S. Government is to continue its leadership in global affairs, it must continue to foster these high-tech, public health instruments for engaging the world, both to mitigate global health risks and to strengthen U.S. public diplomacy abroad.