Global Health

The Background

The rapid spread of the COVID-19 virus and its devastating health, economic, and social consequences have forced governments around the world to treat the pandemic as a national security issue. While healthcare is a human right and that alone should be enough to inspire U.S. global health leadership, we cannot afford to ignore the direct threats that pandemics and infectious diseases pose to our stability, making American leadership in global health security imperative to protecting American interests at home and abroad.

For decades, the United States has been a global leader in fighting infectious diseases and strengthening the health systems of partner states around the world. Thanks to strong bipartisan support from past administrations and Congress, American investments in global health programs have saved the lives of millions around the world. In addition to being an essential expression of humanitarian values, improving health systems strengthen global stability and security. In 2012, the Center for Strategic and International Studies interviewed thirteen diplomatic, political, and national security leaders on the relationship between global health and security. “Nations with high numbers of unhealthy citizens,” the report explains, “are more likely to be poor, badly governed, weak, and prone to instability.”

One example of successful efforts to address global health is the Global Fund, a public-private partnership “designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics.” Since its creation in 2002, the Global Fund has saved over 38 million lives in its fight against these deadly diseases. Another critical global health initiative is the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), established by President George W. Bush in 2003. Since its founding, PEPFAR has saved over 20 million lives and built-up pandemic preparedness in 54 countries. Through these initiatives, the U.S. has demonstrably strengthened global capacity to prevent, detect, and respond to new and existing global health risks.

While the U.S. has led the world in some areas of global health, it has also put up barriers to quality healthcare access. Every Republican president since Ronald Reagan has continued, reinstated, or expanded the Mexico City Policy, also known as the Global Gag Rule, which forbids international organizations that receive any U.S. global health funding from offering abortion or other reproductive health services—including basic counseling and education. U.S. laws already restrict federal foreign aid funds from paying for “abortion as a method of family planning.” Research from the Guttmacher Institute found that the expansion of the Global Gag Rule in recent years has reduced women’s access to safe, quality sexual and reproductive health care while also overwhelming health systems already strapped for cash and resources. Their research also found that the expansion of the Global Gag Rule under the Trump administration posed an indirect risk to an estimated $1 billion in resources for the Global Fund to Fight AIDS, Tuberculosis and Malaria, undermining U.S. foreign policy and multilateral efforts to address global health issues.

The Latest

The rapid spread of COVID-19, highlighted the weaknesses and inequalities within the international community’s global health system, which were laid bare by a lack of coordinated global leadership that precluded the strong multilateral response that the crisis demanded. These dire shortcomings allowed the virus to spread quickly outside of its original epicenter to countries – including the U.S. under the Trump administration, which closed the White House’s pandemic office – that largely failed to prioritize pandemic preparedness. The devastating health and socio-economic impacts of the virus have hit the most vulnerable groups – including women, children, people of color, and migrants – the hardest, exacerbating pre-existing inequalities both in the U.S. and abroad.

President Biden was inaugurated at the height of this once-in-a-lifetime pandemic and global health crisis. The previous administration had withdrawn from multilateral global health organizations (like the World Health Organization) necessary for international coordination, slashed foreign aid, and historically and arbitrarily expanded the Global Gag Rule. These actions, according to the President and Executive Director of the Global Health Council, “jeopardize[d] the long-term effects that U.S. investments in foreign assistance and global health programs have on millions of lives around the world.”

Rather than contend with the crisis based on the science that called for global action, the Trump administration moved to pull out of the World Health Organization (WHO) and cut U.S. funding, threatening both domestic and international public health and security. A Lancet Commission report on the Trump administration’s failures on the domestic stage found that an estimated 40 percent of American COVID-19 deaths under the Trump presidency could have been averted with better policies, and “brought misfortune to the USA and the planet.” The COVID-19 pandemic and the consequences of inaction clearly demonstrate that the U.S. needs a well-constructed strategy to combat the spread of infectious diseases and must properly fund domestic and global health initiatives to prevent future pandemics.

On his first day in office, President Biden signed an executive order to halt the U.S. withdrawal from the WHO and resume funding for it. President Biden also committed to coordinating the American COVID-19 response and recovery with global agencies, setting up necessary infrastructure for U.S. pandemic preparedness and leadership. These actions reflect the administration’s commitment to global cooperation as an essential strategy to ensure health security for all nations; in his first address to the U.N. General Assembly as President, Biden emphasized that “to fight this pandemic, we need a collective act of science and political will” and that world leaders must “choose to do more than we think we can do alone so that we accomplish what we must, together: ending this pandemic and making sure we’re better prepared for the next one.”

The Biden administration has backed up this rhetoric with action by joining COVAX, a multilateral initiative to ensure low- and middle-income countries receive COVID-19 vaccines, and has committed to sharing over 1.2 billion vaccine doses with countries worldwide before 2023. Since making this commitment, the U.S. has delivered over 565 million doses thus far – more than any other country. In addition to being the world’s leader in the global vaccination effort, the administration has supported the WHO’s efforts to negotiate a global pandemic treaty, advanced global health security governance and financing efforts, and provided almost $16 billion in health, humanitarian, and economic global COVID-19 aid in Fiscal Year 2021, in addition to $9 billion appropriated for other crucial global health programs that save lives from diseases like HIV/AIDS, malaria, and tuberculosis.

 The administration has also worked to restore U.S. global health leadership in sexual and reproductive health. In the first month of his presidency, Biden revoked the Trump administration’s expanded iteration of the Global Gag Rule, and reinstated funding for the U.N. Population Fund (UNFPA), which supports the sexual and reproductive health and rights of women and girls worldwide. Despite rollbacks on access to abortion in the U.S. following the Supreme Court’s ruling to overturn Roe v. Wade, U.S. Ambassador to the U.N., Linda Thomas-Greenfield reaffirmed the administration’s commitment to sexual and reproductive health aid and protections around the world.

What You Can Do

U.S. leadership on global health is an essential expression of our humanitarian values, promotes stability, solidifies trade relationships, develops goodwill, and combats the influence of our adversaries and competitors. Therefore, we’re calling on Congress to increase support for global health, including efforts to prevent and address pandemics, and to permanently end the harmful Mexico City Policy, or Global Gag Rule from being reinstated by another presidential administration.

Call your Representative and Senators today at (202) 224-3121 and ask Congress to advance American global health leadership. Here’s what to say:

• The U.S. must engage with the world and our allies to combat COVID-19, which has ravaged the most vulnerable communities around the globe and at home. Members of Congress should support any legislation that cements our rejoining the WHO while also asserting U.S. global health leadership by coordinating with the multinational COVAX effort.
• The Senate should introduce the Global Health Security Act of 2021, which passed the House as H.R.391 after being introduced by Rep. Connolly (D-VA), and was referred to the Senate Committee on Foreign Relations. This legislation would require the implementation of a comprehensive global health security strategy, including by mandating the President to establish the Global Health Security Agenda Interagency Review Council, which would implement the Global Health Security Agenda, a multilateral initiative to collectively combat global infectious diseases.
• Bipartisan support for the President’s Emergency Program for AIDS Relief (PEPFAR) and the President’s Malaria Initiative, each launched by President George W. Bush, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, have saved tens of millions of lives. Congress should continue to fully fund these efforts, which showcase the best of American values and global leadership.
• The Mexico City Policy blocks women from accessing reproductive healthcare and disrupts local health systems. The practical effect has been the reduction of availability of all health services for the world’s most vulnerable people. Ask your representatives to support H.R. 556/S. 142, the Global Health, Empowerment and Rights Act (Global HER Act), to permanently end this dangerous policy.
• Ask your representatives to support H.R.3938, the Support UNFPA Funding Act, which was introduced by Representative Chrissy Houlahan (D-PA) to authorize annual contributions to UNFPA in support of the agency’s essential programs for the five fiscal years after the bill is passed.