Improve public health and strengthen U.S. national security through global disease detection, response, prevention, and control strategies.
The health of the U.S. population can be affected by public health threats or events across the globe. Recent examples of this include the 2003 SARS epidemic and the 2009 spread of novel H1N1 influenza. Improving global health can improve health in the United States and support national and global security interests by fostering political stability, diplomacy, and economic growth worldwide.
Why Is Global Health Important?
Global health plays an increasingly crucial role in global security and the security of the U.S. population. As the world and its economies become increasingly globalized, including extensive international travel and commerce, it is necessary to think about health in a global context. Rarely a week goes by without a headline about the emergence or re-emergence of an infectious disease or other health threat somewhere in the world. The 2007 World Health Report1 notes that, “since the 1970s, newly emerging diseases have been identified at the unprecedented rate of one or more per year.” The Institute of Medicine’s 2003 report Microbial Threats to Health2 stresses that the United States should enhance the global capacity for responding to infectious disease threats and should take a leadership role in promoting a comprehensive, global, real-time infectious disease surveillance system.
Rapid identification and control of emerging infectious diseases helps:
- Promote health abroad.
- Prevent the international spread of disease.
- Protect the health of the U.S. population.
The large scope of potential global public health threats is recognized in the revised International Health Regulations (IHR )3 with its all-hazards approach to assessing serious public health threats. These regulations are designed to prevent the international spread of diseases, while minimizing interruption of world travel and trade. They encourage countries to work together to share information about known diseases and public health events of international concern.
Global health concerns are not limited to infectious diseases. Noncommunicable diseases, especially “lifestyle” conditions, are among the leading causes of disability worldwide. These conditions include:
- Diabetes and obesity
- Mental illness
- Substance abuse/use disorders, including tobacco use
The World Health Organization (WHO) estimates that tobacco- and smoking-related deaths will increase from 5.1 million each year to 8.3 million each year by 2030 (which will be nearly 10 percent of all deaths globally).4
In the next 10 years, road traffic injuries are expected to become the 3rd largest contributor to the global burden of disease by 2020, with 90 percent of all deaths from road traffic injuries occurring in low-income countries.5
Understanding Global Health
How does the United States help improve global health?
Many U.S. Government agencies provide funding, human resources, and technical support to global health initiatives including:
- United Nations’ Millennium Development Goals
- WHO’s Global Polio Eradication Initiative
- President’s Emergency Plan for AIDS Relief (PEPFAR)
- Programs to address malaria, neglected tropical diseases, and tobacco use
The United States also cooperates with other countries to prepare for and respond to emerging and pandemic diseases, and to conduct research on public health issues. In February 2010, the United States announced a new Global Health Initiative, which invests $63 billion over 6 years to help partner countries improve health outcomes through strengthened health systems, with a particular focus on improving the health of women, newborns, and children.
How does improved global health help the United States?
U.S. investments in improving health in developing countries provide significant public health benefits within the United States. Many global health issues can directly or indirectly impact the health of the United States. Outbreaks of infectious diseases, foodborne illnesses, or contaminated pharmaceuticals and other products, cannot only spread from country to country, but also impact trade and travel. The United States can also learn from the experiences of other countries. Standard health measures of life expectancy and chronic disease, including depression among adults, can be compared to other Organization for Economic and Co-operation and Development (OECD) member countries. For those countries with better health outcomes than the United States, health agencies within the United States can use these comparisons to identify ways to improve the Nation’s public health.
Emerging Issues in Global Health
Globally, the rate of deaths from noncommunicable causes, such as heart disease, stroke, and injuries, is growing. At the same time, the number of deaths from infectious diseases, such as malaria, tuberculosis, and vaccine-preventable diseases, is decreasing. Many developing countries must now deal with a “dual burden” of disease: they must continue to prevent and control infectious diseases, while also addressing the health threats from noncommunicable diseases and environmental health risks. As social and economic conditions in developing countries change and their health systems and surveillance improve, more focus will be needed to address noncommunicable diseases, mental health, substance abuse disorders, and, especially, injuries (both intentional and unintentional). Some countries are beginning to establish programs to address these issues. For example, Kenya has implemented programs for road traffic safety and violence prevention.
Expanding international trade introduces new health risks. A complex international distribution chain has resulted in potential international outbreaks due to foodborne infections, poor quality pharmaceuticals, and contaminated consumer goods.
The world community is finding better ways to confront major health threats. WHO, through the 2005 IHR, proposes new guidance and promotes cooperation between developed and developing countries on emerging health issues of global importance. The IHR require countries to develop appropriate surveillance and response capacities to address these health concerns. All of these issues will require enhanced U.S. collaboration with other countries to protect and promote better health for all.
1World Health Organization (WHO). World health report 2007: Global public health security in the 21st century [Internet]. Geneva, Switzerland: WHO; 2007. Available from: http://www.who.int/whr/2007/en/index.html
2Institute of Medicine, Board on Global Health, Committee on Emerging Microbial Threats to Health in the 21st Century. Microbial threats to health: Emergence, detection, and response [Internet]. Smolinski MS, Hamburg MA, Lederberg J, editors. Washington: National Academies Press; 2003. Available from: http://books.nap.edu/openbook.php?record_id=10636
3World Health Organization (WHO). International health regulations 2005 [Internet]. Geneva, Switzerland: WHO; 2005. Available from: http://www.who.int/ihr/9789241596664/en/index.html
4World Health Organization (WHO). The global burden of disease: 2004 update [Internet]. Geneva, Switzerland: WHO; 2008. Available from: http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html
5World Health Organization (WHO). World report on road traffic injury prevention [Internet]. Geneva, Switzerland: WHO; 2004. Available from: http://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/