Global Health Security

GLOBAL HEALTH SECURITY: INVESTING GLOBALLY MATTERS LOCALLY

This post was written by Anupama Varma, Communications Associate at Global Health Council.

The panel of speakers at the event.

A disease outbreak anywhere is a risk everywhere.” – Dr. Tom Frieden, former Director of the Centers for Disease Control and Prevention (CDC).

In today’s world, when diseases can reach American borders in less than twelve hours, it is more imperative than ever that the global health community open space for dialogue on global health security. The World Bank estimates that the United States could have a loss of $80 billion dollars each year due to a global health security risk. Hence, the country must be prepared. The latest initiative, the Global Health Security Agenda (GHSA), aims to improve transparency through Joint External Evaluations (JEE) and develop lasting multilateral relationships among WHO member nations in order to ensure a world safe and secure from infectious disease threats.

Global health security starts at home – making sure the United States has the tools to prevent, detect, and respond to health threats. It is also critical that efforts address building systems and capacity in low- and middle-income countries with weak health infrastructures that prevent them from adequately responding to disease outbreaks. As Amie Batson, Chief Strategy Officer and Vice President of Strategy and Learning at PATH, reminds us, “We are only as strong as the weakest country in the system.”

Dr. David Smith, Acting Assistant Secretary of Defense for Health Affairs, delivers keynote speech.

In July, Global Health Council (GHC) partnered with one of its organizational members, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, to host “Global Health Security: Investing Globally Matters Locally,” on Capitol Hill focused on current and future global health security efforts. Friends of the Global Fight also released a new brief highlighting how U.S. investments in bilateral health programs fighting HIV/AIDS, tuberculosis and malaria, in coordination with strategic investments in The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), save millions of lives and protect the U.S. from future disease threats. Dr. David Smith, Acting Assistant Secretary of Defense for Health Affairs, delivered the keynote speech, and a panel of speakers from PATH, the U.S. Department of Health and Human Services (HHS), Center for Strategic and International Studies (CSIS), and CDC discussed how investments in global health prevent epidemics at their sources and reduce the likelihood that infectious diseases will undermine public health in the United States.

The key takeaways from the panel discussion include:

1.) Technical expertise for global health security exists, but designated leadership is required.

2.) Epidemic preparedness is critical in order to ensure economic, social, and political security, as well as the stability of all nations, including the U.S.  As Garrett Grigsby, Director of the Office of Global Affairs at HHS, reiterated, “We can pay now, or we can pay a lot more later.”

3.) According to Dr. Nancy Knight, Director of the Division of Global Health Protection at CDC, “The key to successful global health security efforts lies in community-based response.”

4.) The focus of global health security is on four core areas: improving surveillance systems, strengthening laboratory capacity and capability, developing a robust global health workforce, and building a strong emergency operations and response system.

5.) The GHSA has become a model for governments to emphasize ownership of their borders.

6.) It is critical to work not only with governments and international organizations, but also with the private sector to increase the impact of global health security efforts.

7.) According to Dr. Audrey Jackson, Senior Fellow at CSIS’s Global Health Policy Center, tuberculosis (TB) remains a primary health threat to the U.S., and multilateral relationships such as The Global Fund are critical to fight TB.

Ultimately, U.S. leadership is key to the global health security vision and mission, and could help save millions of American lives both here and abroad.

Download the Friends of the Global Fight brief.
View Dr. David Smith’s keynote speech.
Advocate for global health security using facts and figures and success stories from GHC’s Global Health Briefing Book.
Join GHC’s Global Health Security Roundtable. The purpose of the Roundtable is to provide a space for NGOs, private sector organizations, and academia to work together to advance sound policy and advocate for robust investment in global health security. Learn more.

Advocacy Update ~ August 7, 2017

This post was written by Danielle Heiberg, Senior Advocacy Manager, and Melissa Chacko, Policy Associate at Global Health Council.

FY18 Appropriations: House Appropriations Committee Approves Bills
In mid-July, the House Appropriations committee approved the Fiscal Year (FY) 2018 State and Foreign Operations bill, which includes funding for USAID, State Department and other international activities. The House rejected the deep cuts proposed by President Trump earlier this year, signaling continued bipartisan support for foreign assistance. (Funding chart.)

On the surface, overall funding for global health programs at both USAID and State appears relatively flat ($8.32 billion for FY18 compared to $8.72 billion in FY17). However, the House recommended that approximately $322.5 million of unspent Ebola response funds be repurposed for Malaria and the Emergency Reserve Fund (which was also cut from $70 million to $10 million), so new funding for global health is actually down. This is also worrisome as this is bolstering accounts with funding that will not be available beyond FY19.

Most programs are at level funding, with the exception of Family Planning/Reproductive Health, which was recommended at a ceiling of not more than $461 million, a cut of 25%. With the ban on contributions to UNFPA (instituted by the Trump administration earlier this year), all funds would be available for bilateral activities. The bill also includes language expanding the Mexico City Policy to include all global health assistance and restricting voluntary contributions to UNFPA; if the language remains in the final bill, it will legislatively impose these two policies for the fiscal year. During the markup, amendments were offered to remove this language, but were defeated along party lines.

The House recommended the full commitment to Gavi, the Vaccine Alliance at $290 million (a $15 million increase); however, because the increase to Maternal and Child Health (MCH) is minimal, overall base funding for MCH is decreased ($814.5 million for FY18 compared to $814 million in FY17).

Also of note was included language of “extraordinary measures” that would allow the Secretary of State to take funding from other accounts, including ‘‘Global Health Programs,’’ ‘‘Development Assistance,’’ ‘‘International Disaster Assistance,’’ ‘‘Economic Support Fund,’’ ‘‘Democracy Fund,’’ ‘‘Assistance for Europe, Eurasia and Central Asia,’’ ‘‘Migration and Refugee Assistance,” “Millennium Challenge Corporation,” if an “international infectious disease outbreak is sustained, severe, and is spreading internationally, or that it is in the national interest to respond to a Public Health Emergency of International Concern.” This language could be a mechanism to move money from other accounts during an outbreak and avoid passing emergency appropriations.

The Appropriations committee also approved the Labor, Health and Human Services, and Education bill, which includes funding for NIH and CDC, and again the committee signaled its support for these programs. Topline NIH funding was increased by $1.1 billion, with Fogarty International Center and the National Institute of Allergy and Infectious Diseases receiving small increases. The Center for Global Health and Global HIV/AIDS, both in CDC, were flat funded, while recommended funding for the National Center for Emerging Zoonotic and Infectious Diseases was decreased by 14.5%.

Meanwhile, on the other side of Capitol Hill, the Senate has allocated $51.2 billion as the top-line spending for its version of the State and Foreign Operations bill. This is a 1.7% cut if you exclude the ISIS supplemental and famine relief funding that was included in the FY17 omnibus (or 10.8% if you include it). The Senate will not markup this appropriations bill until it returns from August recess.

In addition to following the FY18 process, GHC and the global health advocacy community have also begun work on the FY19 budget. The global health community will be submitting FY19 recommendations to the Office of Management and Budget (OMB) later this month.

Resouces:

Reach Act Reintroduced in Senate
Senators Susan Collins (R-ME) and Chris Coons (D-DE), led a bipartisan group of 10 Senators – Jerry Moran (R-KS), Jeanne Shaheen (D-NH), Marco Rubio (R-FL), Richard Blumenthal (D-CT), Mike Enzi (R-WY), Johnny Isakson (R-GA), Richard Durbin(D-IL), and Chris Murphy (D-CT) – in reintroducing the Reach Every Mother and Child Act (S.1730) on August 2. The Reach Act aims to accelerate the reduction of preventable maternal and child deaths, keeping USAID on track to end these deaths within a generation. The legislation is supported by more than 50 diverse non-profit and faith-based organizations working to end preventable maternal, newborn, and child mortality at home and overseas. Click here for GHC’s statement on the Reach Act.

Senate Confirmed Ambassador Mark Green to Lead USAID
Ambassador Mark Green’s nomination to lead USAID was unanimously approved by the Senate confirmation on August 3. Ambassador Green has previously served as the U.S. Ambassador to Tanzania, as a U.S. Congressman, and as the President of the International Republican Institute. Read GHC’s statement on Ambassador Green’s confirmation.

Statement on Global Health Security Agenda
The current endpoint for the Global Health Security Agenda (GHSA) is 2019. GHC’s Global Health Security Roundtable, Global Health Security Agenda Consortium, Global Health Security Agenda Private Sector Roundtable, and Next Generation Global Health Network released a statement in support of extending the GHSA beyond 2019 for a minimum of five years. In addition to building upon the successes of the GHSA, the statement emphasizes that GHSA “2.0” must focus on meaningful action, political will, and financing strategies to enact national roadmaps and fill existing gaps. Read the joint statement.

Why Global Health Security: GHC’s Global Health Security Roundtable Relaunches

This post was written by Danielle Heiberg, Senior Advocacy Manager at Global Health Council.

A health care worker in Monrovia, Liberia, cares for a young Ebola patient. © 2014 Kevin Sieff/The Washington Post, Courtesy of Photoshare

We live in a highly interconnected world in which goods and people cross borders daily. We also live in a world in which infectious diseases know no borders, and in which they spread at a much faster rate than ever before. We saw this during the Ebola epidemic in West Africa and we saw how weak health systems in the affected countries contributed to delayed detection and a slow and inadequate response to the outbreak.

Following the Ebola epidemic, there is a renewed focus on increasing global health security and building the capacity of countries to prevent, detect, and respond to infectious disease outbreaks and other public health threats.

While the new Secretary of Health and Human Services, Tom Price, has voiced support for U.S. leadership on global health security, President Trump’s proposed budget for Fiscal Year 2018 does not reflect this priority. Budgets for CDC – a primary implementer of global health security-related programs – USAID, the State Department, and other agencies were slashed.

Protecting the health of Americans means investing in global health security around the world. That means supporting programs that increase the number of health care workers, build labs, and improve data sharing practices, all of which are critical to ensuring a faster and smarter response to an outbreak.

We have seen these investments work. At the start of the Ebola epidemic in Liberia, it took more than 90 days from detection of the first Ebola cases to setting up a response. In May of this year, when 11 people died after attending a funeral, it took the Liberian government (with the help of CDC and other partners) less than 24 hours to launch an emergency response. That is an impressive improvement and it happened because of multi-stakeholder support.

Furthermore, global health security is more than just stopping “scary” diseases, it also builds stronger health systems, with the resources and trained health workers that provide quality health services to meet the needs of local communities. We know that healthier communities create stronger economies, which in turn can invest in sustainable health systems.

To raise awareness of the importance of global health security, GHC is relaunching the Global Health Security Roundtable. The Roundtable will provide space for NGOs, private sector organizations, and academia to work to advance sound policy and advocate for robust investment in global health security.

To be added to the Global Health Security Roundtable list serve, email advocacy@globalhealth.org.