By former Sens. Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.)

Feb. 29, 2016 | The Hill

As the 2016 primaries unfold, it’s time for candidates of both parties to focus on expanding the big-hearted policies that have made this nation so exceptional.

In recent years, the most effective of those policies has been global health — that is, putting U.S. resources to work saving lives in developing nations by spreading health treatments that work here at home. In a study for the Bipartisan Policy Center last November, we showed how the largest global health project in history, the President’s Emergency Plan for AIDS Relief (PEPFAR), has not only saved millions of lives but also improved America’s national security.

Under PEPFAR, launched under former President George W. Bush and enhanced under President Obama, with bipartisan support in Congress over more than a decade, 9.5 million men, women and children, mainly in Africa, are receiving lifesaving anti-retroviral drugs. Some 68 million have gotten HIV testing and counseling, 5.5 million orphans and vulnerable children have received care and support, and 190,000 new healthcare workers have been trained. In addition, our study found that in PEPFAR countries, political instability and violence have fallen 40 percent (compared to just 3 percent in equivalent non-PEPFAR countries), while economic growth has increased — and so has America’s reputation.

Now, a new survey by the Kaiser Family Foundation, released in January, has discovered that, while Americans are proud of the accomplishments of programs like PEPFAR, a majority (53 percent) believe we are already “doing enough to improve health in developing countries.” And a majority (55 percent) believe that “spending more money won’t make much difference in improving health in developing countries.”

Those are disturbing statistics. They stray far from reality. The truth is that the U.S. has the innovation and the resources to put an end to rampant deaths not only from AIDS but from such scourges as malaria, tuberculosis and hepatitis C. Based on the PEPFAR experience, we have proof that health will be improved dramatically — and Americans themselves will benefit.

The good news is that the Kaiser study provides important guidance on how to persuade Americans that our nation should do more. The starting point is better education about global health.

The public is woefully misinformed not just about the success of U.S. programs but about their cost. The Kaiser survey, taken in December, found that, on average, those polled believed that 31 percent of the federal budget is spent on foreign aid (including health programs). The actual figure is less than 1 percent (correctly estimated by just 3 percent of those polled). Researchers discovered that, when respondents were informed of the correct spending on foreign aid, their support of increased spending on global health improved significantly.

Actual spending on global health by the U.S. government has been steady at between $9.2 billion and $10.2 billion per year since 2009, with the exception of 2015, when an additional $3.7 billion was spent to stem the Ebola crisis that directly threatened the health of Americans. For 2016, global health represents just 0.2 percent of federal spending, or about $10 billion out of $4.1 trillion. Another way of saying this is that just $32 out of the average American’s tax bill will go to global health programs — with about $19 for fighting AIDS, $2 for malaria, $1 for tuberculosis and $2 for maternal and child health.

Kaiser’s national study also asked respondents to give the most important reason for spending U.S. tax dollars to improve global health. In first place, by far, was “because it’s the right thing to do,” chosen by 46 percent. That’s no surprise. This is the most benevolent country in the world. When our 43rd president announced PEPFAR in 2003, he said, “Seldom has history offered a greater opportunity to do so much for so many.”

Our humanitarian instincts are the bedrock of global health programs, but the Kaiser study also pointed to other strong reasons to spend federal money: “to improve our diplomatic relationships,” “to help ensure national security,” “to help the U.S. economy,” and “to improve the U.S.’s image around the world.” In total, these four justifications topped the list for 48 percent of respondents. Another practical reason to improve health abroad is to prevent diseases like Ebola and the Zika virus from spreading through our own population.

As the presidential campaign progresses, we believe that Americans will want to hear candidates appeal to what Abraham Lincoln referred to as “the better angels of our nature.” Wiping out diseases in poorer countries is simply the right thing to do. But Americans are pragmatic people, too, and, as the Kaiser research shows, we want our contributions to be both cost-effective and beneficial to our own nation as well.

As our research has shown, programs like PEPFAR meet all of those tests: humanitarian, practical and self-serving. In this election season, Americans must require candidates for public office who demonstrate the leadership we will need to ensure global — and national — health.

Daschle served in the Senate from 1987 to 2005 and as Senate majority leader from 2001 to 2003. Frist, a physician, served in the Senate from 1995 to 2007 and as Senate majority leader from 2003 to 2007.

This post first appeared in The Hill.

By Senator Bill Frist, MD

Feb. 22, 2016 | The Tennessean

Of the thousands of heart and lung operations I have performed, the most common cause of the underlying disease in these patients was a single voluntary behavior: smoking.

That tragedy is what Tennessee Quit Week (Feb. 22-28) is all about.

Smoking absolutely leads to a shorter, poorer-quality life. It more than doubles a person’s risk of stroke or heart disease, and increases the risk of lung cancer by 25 times!

Each year it causes more deaths than automobile accidents, firearm-related injuries, HIV, illegal drug use and alcohol abuse combined.

The good news is that most smokers want to stop, and there are effective tools to help. The benefits are almost immediate: Within two days of smoking cessation, nerve endings regenerate. In two weeks, circulation improves; after just one year, the risk for heart attack is cut in half.

Tobacco use is the most preventable cause of premature mortality and morbidity, yet one of five Tennessee adults smokes regularly and one of nine adolescents self-report smoking.

That’s why smoking prevention and cessation is the first priority of the new grassroots, community collaborative NashvilleHealth.

Nashville's smoking rates are higher than the national average and that of all our peer cities. We must aggressively address this most preventable cause of premature disability and death.

Governor Bill Haslam has proclaimed the week of Feb. 22 as “Tennessee Quit Week." This effort comes on the heels of a new report from the American Lung Association that found Tennessee flunking tobacco control, receiving a “C” grade for smoke-free air and “F's” for tobacco prevention and cessation funding, access to cessation services and tobacco taxes.

That's our clarion call to action.

First, communities must insist that state government more adequately fund programs on tobacco cessation that we know work.

In 2014 the Haslam administration and state legislature allocated $15 million over three years to county health departments to implement tobacco cessation programs locally.

This funding has a lifesaving impact, but it is too little. The Volunteer State spends just 9 percent of what the Centers for Disease Control and Prevention (CDC) recommends, even though it annually brings in over $400 million in tobacco-related revenue.

Second, we know that secondhand smoke kills. Yet in Tennessee, local municipalities are not permitted to strengthen the state’s smoke-free laws in their region. Communities should be empowered to make parks, playgrounds and venues like Nashville’s new Ascend Amphitheater smoke-free zones.

The CDC reminds us there is “no risk-free level of secondhand smoke exposure; even brief exposure can be harmful to health.”

The Metro Public Health Department (MPHD) is already working hard to provide tools and education to those who need help quitting, and NashvilleHealth is happy to join in.

The MPHD will offer to the public the American Lung Association’s “Freedom From Smoking” cessation course beginning the last week of February. Its “Breathe Easy” campaign is wisely encouraging multi-unit housing to go smoke-free. And it will be rolling out the “Baby and Me Tobacco Free” program, which provides quit assistance to pregnant women and new mothers this month.

What can individuals do?

No amount of prescriptions, operations or doctor’s office visits will correct for our unhealthy behavior. Let's together make Nashville healthier today, by wiping out smoking.

Dr. William H. Frist is a nationally acclaimed heart and lung transplant surgeon. He served as U.S. senator from Tennessee from 1995 to 2007 and as former U.S. Senate majority leader from 2003 to 2007.

This op-ed originally appeared in The Tennessean.