US publishes first global health strategy to improve health of Americans and rest of the world

BMJ 2012; 344 doi: (Published 10 January 2012) Cite this as: BMJ 2012;344:e308
  1. Bob Roehr
  1. 1Washington, DC

The US Department of Health and Human Services has published its first ever global health strategy, recognising the fact that the health of its citizens is more closely linked to the health of people in the rest of the world than ever before.

The strategy, published on 5 January, says, “This interconnectedness offers both opportunities and challenges. A disease outbreak in a distant country can threaten the health of Americans at home, just as a discovery made in a foreign country can lead to better treatment for diseases affecting Americans. Greater movement of people and of products—including foods, feed, drugs, and medical devices—can increase exposure to potential health risks originating outside the United States. But this mobility can also make life-saving care more readily available for all.”

Launching the strategy, the US health secretary, Kathleen Sebelius, said, “No country can protect the health of its citizens alone.

“We want to focus on areas where our work abroad helps to protect and promote the health and wellbeing of Americans. Second, we want to provide leadership in areas where our department has special expertise . . . Finally, we want to work with our partners across the administration to advance US interests [in international diplomacy, development, and security].”

Underlying these three goals are 10 critical objectives, accompanied by a list of priority actions, which focus on protecting the US people and populations elsewhere across the globe. The objectives include enhancing global disease surveillance systems, preventing infectious diseases and other health threats from crossing borders, and preparing for and responding to international health emergencies.

Also among them are the need to safeguard manufacturing and supply of medical products and food, to strengthen international health and safety standards, to promote research and innovation, and to identify and exchange best practices to improve health and healthcare systems.

The strategy is not a significant change in direction and represents an attempt to better coordinate activities that have been evolving over many years. Kerri-Ann Jones, assistant secretary of state for oceans and international environmental and scientific affairs at the US Department of State, said that many US agencies were engaged in global health issues, such as the military, the National Institutes of Health, and the Food and Drug Administration, and they had different cultures, perspectives, and missions. The strategy is an attempt “to integrate all of the moving parts,” she said.

Harvey Fineberg, president of the Institute of Medicine, said that there had been an important shift in thinking towards a global health construct. It is “a difference between thinking about the problem as a problem of ‘the other,’ where the US was giving help in other places, to a notion of global health, which is not the opposite of domestic health but integrating mutual needs and understanding the shared destiny in health in the world,” he said.

Helene Gayle, president of the international charity Care USA and a former senior executive of the Bill and Melinda Gates Foundation, said, “Strategy is just a beginning. How this rolls out is going to be incredibly important.”

She warned of “the potential for US politics” to have “an impact on our global health agenda,” citing HIV prevention and family planning as examples where domestic religious and ideological views had brought about policies in other countries that the US government would support. It is important to make sure “that US politics do not trump what the needs are” in the local partner country, she said.


Cite this as: BMJ 2012;344:e308


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