A Biden strategy for genuine global health security

In our new roadmap, we highlight the hallmarks of a more strategic approach. Above all, a new strategy’s success depends on understanding what genuine health security means in the world today. It is not only pandemic preparedness for the United States or other rich countries. It is not simply building capacity to detect new disease threats. Genuine health security for America recognizes that we are only as safe as the world’s weakest health system. It depends on working with low- and middle-income countries on their own health security and their own health priorities. 

First off, our strategy must recognize there is no health security for low- and middle-income countries — or richer ones — as long as AIDS, tuberculosis and malaria continue to claim millions of lives and devastate communities and economies. Despite being treatable and preventable, they are still the world’s deadliest infectious diseases. Every country should be concerned that multi-drug resistant TB is now one of the biggest antimicrobial resistance threats globally. In addition, COVID-19 threatens to devastate a decade of progress against HIV, TB and malaria. As a result, stigmatized populations have been left vulnerable to HIV in Malawi, TB is spiking in South Africa, and the malaria response has been disrupted throughout Africa and the Middle East. 

America should rally global partners in a stepped-up effort to end the greatest infectious disease killers of our time. Our hugely successful investments through the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the President’s Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative (PMI) and the USAID TB program will be the foundation of our effort. These programs have strong bipartisan support in Congress and with the public. In particular, the Global Fund epitomizes many qualities needed for the most impactful U.S. investment — it has a focus on results, strong oversight and incentivizing others’ investments. It should be a centerpiece of the Biden administration’s approach. 

The numerous examples of effective African leadership in response to COVID-19 should remind us that the U.S. must be working in true partnership with communities and governments globally. A revised framework for U.S. pandemic preparedness is needed, one that makes results-oriented investments in health systems that better meet communities’ health needs and that can identify new threats and be flexible enough to respond when new emergencies arise. U.S. global health programming must advance human rights-based approaches to health services, attend to the most vulnerable and marginalized needs, and engage and invest in civil society as critical actors in health programming. 

The incoming Biden administration can and must take action immediately. Early priorities should be renewed engagement with multilateral organizations, including rejoining the WHO and returning to the world stage as the catalyst for outcomes-driven global health investment. 

In particular, COVID-19 shows us that the time of underinvestment in global health has got to be over. We urge Congress to provide at least $20 billion in emergency COVID-19 supplemental funding for the international response, including $4 billion over two years for the Global Fund’s COVID-19 Response Mechanism. In its first budget, the incoming administration should pave a path with Congress to double annual global health funding over five years. 

Amid the turmoil of COVID-19, U.S. global health efforts cannot simply seek to return to normal; we must establish a new normal. As President-elect Biden prepares to return the U.S. to values-based, cooperative leadership globally, there is no better place to start than leading the world for genuine global health security. 

Chris Collins is President and CEO and Mark P. Lagon is Chief Policy Officer at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.