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Fall 2009 Vol. 9 Number 2



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Making Good on Global Health

Reports Detail How U.S. Leadership
Can Help Make a Healthier World

The H1N1 influenza sweeping the globe serves as a potent reminder that what happens to the health of people in one country can affect the well-being of people hundreds or thousands of miles away. For decades, American agencies, industries, and nonprofits have laudably dedicated resources to combating disease and promoting health internationally. Doctor listens to the chest of a child at the Navy Hospital in Mexico City on April 29, 2009, ©Ronaldo Schemidt/AFP/Getty ImagesBut the evidence shows that a wide gap remains between the improvements that are possible given the scientific knowledge and resources available today and the actual progress that has been made on the ground.

That’s the message of two recent reports from the Institute of Medicine and National Research Council. The good news is that with the appropriate political will, leadership, and resource commitments, the United States and its international partners could close that gap and fulfill the promise of a healthy global population.

In May the Institute of Medicine laid out a fresh, bold vision for future U.S. investments in improving health worldwide. The report, The U.S. Commitment to Global Health, framed its recommendations within the philosophy that America has a moral obligation to share its medical expertise and resources to promote health worldwide; doing so would accrue subsequent economic, diplomatic, and security benefits.

The report identifies key areas in which U.S.-based groups could have a real impact. Existing interventions are making a difference and should be enhanced to achieve even more. At the same time, stepped-up research on health problems prevalent in developing nations would yield new preventions, diagnostics, and treatments. In addition, American groups should contribute to building the infrastructure and capacity of global partners so they can play a more active role.

All this requires the United States to increase its financial commitment to $15 billion per year by 2012, the report concludes. The current economic crisis only makes this funding boost all the more essential given that developing nations have been affected worst and many of their people blame America for the crisis. U.S. groups can facilitate more effective results by approaching people and institutions in recipient nations as partners to act with rather than act for.

Although the report emphasizes the need for action on health problems of all kinds, new infectious diseases sound the loudest alarms because they can spread worldwide with such ease. The majority of infectious diseases that have recently emerged have been caused by zoonotic pathogens that jump from animals to people.

For too long, the global community has reacted to zoonotic disease outbreaks like firefighters mobilizing to tackle one wildfire at a time. Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases, a report from the IOM and Research Council, lays out the case for a better coordinated and sustained system of monitoring for the earliest hints of new zoonotic disease threats and responding more effectively to contain their spread.

The report emphasizes the urgent need for human health and animal health professionals to work more closely together. It is hardly practical to treat human and animal health as separate spheres when infectious agents ignore species distinctions; the result is missed opportunities to contain new threats.

Zoonotic disease surveillance also requires sustained funding. Current funding is largely sporadic, targeting resources to the “disease du jour” and fluctuating with changes in donors’ priorities. The report calls on the United States and its international partners to make a concerted effort to identify sources of dedicated support.

The United States has the resources to lead international efforts to improve the health of people worldwide and the systems to monitor for new disease threats, the reports conclude. But health is both a universal good and shared responsibility, and it will take all nations acting in partnership to achieve a healthier world.
Christine Stencel


  The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors. Committee on the U.S. Commitment to Global Health, Board on Global Health, Institute of Medicine (2009, 298 pp.; ISBN 0-309-13821-3; available from the National Academies Press, tel. 1-800-624-6242).

The committee was co-chaired by Thomas R. Pickering, vice chairman, Hills & Co., Washington, D.C., and Harold Varmus, president, Memorial Sloan-Kettering Cancer Center, New York City. The study was funded by the Bill & Melinda Gates Foundation, Burroughs Wellcome Fund, Google.org, Merck Company Foundation, Rockefeller Foundation, U.S. Department of Health and Human Services, U.S. Department of Homeland Security, and U.S. Department of State.


  Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases. Committee on Achieving Sustainable Global Capacity for Surveillance and Response to Emerging Diseases of Zoonotic Origin, Board on Global Health, Institute of Medicine; and Board on Agriculture and Natural Resources, Division on Earth and Life Studies (2009, approx. 340 pp.; ISBN 0-309-13734-9; available from the National Academies Press, tel. 1-800-624-6242).

The committee was co-chaired by Gerald T. Keusch, associate provost for global health and associate dean for global health, School of Public Health, Boston University, Boston, and Marguerite Pappaioanou, executive director, Association of American Veterinary Medical Colleges, Washington, D.C. The study was funded by the U.S. Agency for International Development.



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Copyright 2009 by the National Academy of Sciences