American global health investments
Lagon concludes that American global health investments increase our soft power, economic opportunities, and the ability to promote peace, pluralism and prosperity that are consequential to our national interests. Over the past several decades, there has been marked progress in the alleviation of poverty and suffering. Life expectancy has risen worldwide, child survival has almost doubled, and the global community has turned the tide of deadly diseases.
Yet, at the same time, the spread of urbanization, the speed of global travel and the movement of goods, increased consumption of animal protein, and climate change have facilitated the emergence and rapid spread of infectious diseases, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome coronavirus (MERS-CoV), pandemic influenza, Ebola virus, and Zika virus (Burkle, 2017).
Additionally, drought, famine, war, and country conflicts have led to international humanitarian and refugee crises, creating unstable conditions in which radical ideologies and diseases can thrive (WEF, 2017).
Historically, the United States has made major investments in global platforms and initiatives that have largely enabled containment of threats such as infectious diseases before they reach the United States and promoted global security, stability, and prosperity. Examples of such investments include human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) treatment, infectious disease surveillance and response, vaccine development, and maternal and child health improvement.
These investments have also benefited U.S. businesses both in terms of enabling a growing base of healthy, prosperous customers, as well as ensuring the safety of U.S. multinational operations around the world, and facilitated the continued leadership of the United States in research and development in biomedical sciences and technologies (Daschle and Frist, 2015; Lima et al., 2013; Wagner et al., 2015).
However, competing priorities and demands on government funding create an imperative for the United States to examine the economic benefits of investments in global health for the economy, national security, innovation, and global standing. Shifts in global economies and private-sector engagement are changing the nature of these investments (Sturchio and Goel, 2012). In the past decade, many countries that have historically received foreign aid have begun experiencing economic growth and rising middle classes.
This growth has allowed traditional aid recipient countries to expand their tax base. In fact, through taxation and mobilization of domestic resources, the funds collected between 2000 and 2014 in sub-Saharan Africa rose from $100 billion to $461 billion (Runde and Savoy, 2016).
The growth of many multinational businesses has also forced business executives to adopt a more global perspective regarding long-term planning, workforce development, and safety. As a country plans for both its own future and that of the world, a prudent step is to assess current investments and adapt them to reflect these global changes. Although great progress has been achieved toward the completion of the Millennium Development Goals (MDGs)1 since their launch in 2000, there are still unfinished agendas.
The transition in 2016 to the multidisciplinary Sustainable Development Goals (SDGs) illustrates the continued commitment to end poverty, save the planet, and ensure prosperity for all. There is a chance to save the lives of millions of children and adults by investing in global health over the next 20 years (Jamison et al., 2013).
Furthermore, investing in health has benefits beyond saving lives and is considered to have made the largest contribution to sustainable development (Jamison et al., 2016). According to the Lancet Commission on Investing in Health, achieving a grand convergence in global health by 20352—reducing infectious disease, maternal, and child deaths down to universally low levels within a generation—is estimated to produce benefits that would exceed the costs of investment between 9 and 20 times for low- and lower-middle-income countries, respectively3 (Jamison et al., 2013; Yamey et al., 2016).
This chapter identifies the benefits of global health investment for the United States, discusses the current spending of the United States on global health programs, and explores opportunities for future investment based on trends affecting health such as globalization, the SDG agenda, and private-sector involvement.
