We are all in this together

Global health is the weekend theme for National Public Health Week, and World Health Day is Sunday, April 7. Our guest post is by Loyce Pace, MPH, president and executive director of the Global Health Council.

US versus them

Loyce Pace So it turns out America is part of the world. Shocking, I know. But, throughout U.S. public health circles, we still refer to international health programs as “that work over there,” in other countries and separate from our own domestic health priorities. When you step back, however, health initiatives abroad share the same aim as our own: to help individuals and communities attain the highest standard of well-being and, ultimately, thrive as meaningful contributors of society. They are asking the same questions we do every day: What are people dying of and why? Who lacks access to health and how can we close those gaps? Which research, campaigns or services have an impact? Really, global health is just that — global.

That said, of course health and the lack thereof present differently around the world. In emergency settings — those regions or countries facing conflict, natural disasters or other crises — people require basic nutrition, water or sanitation, and other critical resources or services, particularly for vulnerable women and children. On the other end of the spectrum, countries at or approaching middle-income status are facing a dual burden of infectious and chronic diseases. Still a number of countries have both scenarios at play, balancing acute needs with longer-term health challenges across their populations.

A tale of 20 years

There was a major change in global health afoot at the beginning of this century. Advocates and U.S. policymakers mobilized to establish one of the most groundbreaking initiatives on the world stage: the President’s Emergency Plan for AIDS Relief, or PEPFAR. Millions of dollars and lives later, it remains one of the greatest American legacies in international engagement and foreign assistance. PEPFAR continues to pay social dividends, alongside other essential U.S. investments that address equally important global health priorities such as malaria, tuberculosis, immunization, family planning and Ebola. Consider this:

Through PEPFAR, since 2003, more than 2.2 million babies at risk for HIV in Africa have been born free of the disease.
Since 2000, malaria deaths have been reduced by 62%.
Over the past 15 years, preventable child deaths have been cut in half, from about 12.7 million to 5.4 million, and annual maternal deaths have declined from 532,000 to 303,000.
Every $1 invested in family planning and reproductive health saves up to $31 in health care, water, education, housing and other international development initiatives.
The U.S. government has supported one-third of all new global health technologies.

If we continue at this pace, we are on track to realize an AIDS-free generation as well as the end of malaria and preventable maternal and child deaths, but only if we keep doing the work worldwide. Now imagine much of that progress going away and, instead, seeing reverse trends: increasing rates of infectious diseases, child deaths and even more global health issues we’ve all worked so hard to quell. That is what’s at stake, if we lose ground on U.S. funding and leadership. Thankfully, Congress remains supportive. However, we need to rebuild a pipeline of champions on Capitol Hill who understand and speak up for these issues in the same way they promote domestic cancer funding or access to affordable medicines.

Global Health Council is doing this through steady outreach to longtime supporters and newly elected officials. Recently, we launched a briefing book that outlines many of the issues faced by low- and middle-income countries around the world along with recommendations for how Congress should respond. And the message is resonating. Our leaders understand the central role America plays in global health programs in other countries and are able to link various investments to gains here at home.

Strength in numbers

People are increasingly realizing the benefits global health offers to U.S. individuals and communities. As public health professionals, we understand the value of sharing lessons and practices across comparable settings. For example, we have borrowed community health outreach models demonstrated in sub-Saharan Africa for urban interventions in cities around the country. Likewise, telemedicine innovations are being modeled in U.S. rural communities the same way they are being implemented in remote villages within Southeast Asia or Central America. Global health programs also inform how we address higher HIV or maternal mortality rates among specific U.S. groups. Or a surge in vaccine-preventable illnesses such as measles in certain areas. And, beyond the more direct health connections, initiatives and investments in this space also support state economies, by driving local industries that contribute to various programs or services, as well as national security, by mitigating risk and fostering global stability.

But the bottom line is even more simple. Because global health at its core, whether in the U.S. or abroad, is about equity. It’s about giving everyone the same fighting chance at health and subsequent opportunities paved by well-being. This is the impetus behind global health goals agreed at the United Nations and promoted by World Health Organization. Calls of “Health for All” are a rallying cry around the world and reaching a fever pitch this year on World Health Day. As a noble objective with broad appeal, we should all embrace it as a guidepost for our work and a reminder of our common cause.