By Tom Daschle and Bill Frist
At a time when many Americans are frustrated with government and partisan politics, we should remind them about one of the great accomplishments of a generation: an ongoing initiative launched by a Republican president, extended by a Democrat, and supported by large, bipartisan majorities in both houses of Congress. It is also saving millions of lives in the world’s poorest countries while helping make the world safer.
PEPFAR, the President’s Emergency Program for AIDS Relief, is a potential example of what we call “Strategic Health Diplomacy,” and a model for smart, effective, and bipartisan foreign policy.
The original impetus behind the creation of PEPFAR was humanitarian. By 2000, over 34 million people were living with HIV/AIDS and nearly 20 million had already been killed by the disease. “Seldom has history offered a greater opportunity to do so much for so many,” President George W. Bush remarked in proposing PEPFAR in his 2003 State of the Union address.
Congress agreed, seizing the opportunity. We headed our respective parties in the Senate at that time, and are proud of the bipartisan cooperation that led to nearly unanimous endorsement of PEPFAR.
Since then, PEPFAR has been renewed twice, with large bipartisan majorities. As of last year, the program supported anti-retroviral treatment for 7.7 million people, mainly in Sub-Saharan Africa, and an astounding 95 percent of at-risk babies were born HIV-free. In 2013, Secretary of State John Kerry announced that the one-millionth baby had been born HIV-free because of PEPFAR-supported prevention of mother-to-child transmission. No nation in history has been responsible for a larger or more successful global health program. Yet it appears PEPFAR has accomplished much more than saving lives.
In 2000, President Bill Clinton called HIV/AIDS a “national security threat,” and, in 2002, President George W. Bush’s National Intelligence Council warned that “countries afflicted by epidemics and pandemics like HIV/AIDS, malaria, and tuberculosis, growth and development will be threatened until these scourges can be contained.”
We looked into that assertion and PEPFAR’s impacts in a new Bipartisan Policy Center study. We found that threats to development, global stability, and U.S. national security were less likely to materialize in countries receiving PEPFAR assistance.
Consider these comparisons between PEPFAR countries in Sub-Saharan Africa and a set of similar non-PEPFAR regional countries:
- Between 2004 and 2013, political instability and violence reduced by 40 percent in PEPFAR countries versus just 3 percent in non-PEPFAR countries;
- Rule of law ratings also increased 31 percent versus just 7 percent;
- Between 2007 and 2011, the average approval rating for the U.S. was 68 percent in countries receiving PEPFAR assistance versus a global average of 46 percent; and
- From 1991 to 2012, there was an increase in average output per worker by a third in PEPFAR countries versus stagnant growth in non-PEPFAR countries.
It is indisputable that global health projects save lives, but we now have evidence to suggest that they can also increase U.S. national security. Healthier populations build more prosperous societies, more competent institutions, and more stable governments. Additionally, when gains in health are made possible by our government, they foster support and goodwill for the United States around the world.
This is why we call PEPFAR a potential example of “Strategic Health Diplomacy”: The idea that when Americans improve the health of people in developing nations, we not only fulfill a vital humanitarian mission, but can also make the world more secure. This is precisely the sort of smart foreign policy that President Obama called for in this year’s National Security Strategy, recognizing that “the United States is safer and stronger when fewer people face destitution.” Moreover, this is a policy that both parties should support—doing good in the world and furthering our interests simultaneously.
When choosing programs to make the most impactful investments, our study shows, we should focus on global health programs that address diseases with the highest prevalence rates; ones that have the most treatment potential; and ones ravaging countries that have strategic value to our national security.
Americans should be proud of our country’s role as the leader in improving health around the world. In addition to fighting HIV/AIDS, we have recently contributed to progress against Ebola, malaria, and cervical cancer. But these investments should only be the beginning: we need a robust strategic health diplomacy plan moving forward. The lives of the poor and sick—and possibly even our own national security—depend on it.
Tom Daschle, a co-founder of the Bipartisan Policy Center (BPC) and founder of The Daschle Group, served as Senate Democratic Leader from 2001 to 2005. Bill Frist, a cardiothoracic surgeon who co-chairs the BPC’s Health Project, served as Senate Republican Leader from 2003 to 2007.
This article appeared on U.S. News on Monday, November 9 to coincide with the release of
"The Case for Strategic Health Diplomacy: A Study of PEPFAR."
Nov 07 2015
Nov. 7, 2015 | The Guardian
Sierra Leone has been declared free of Ebola by the World Health Organisation, prompting nationwide celebrations tinged with sadness over the 4,000 lives the virus claimed. Freetown was transformed into a giant carnival on Friday night as ecstatic crowds took to the streets of the capital in an outpouring of emotion.
Relief that the 17-month outbreak was all but over was reflected in candlelit prayers and spontaneous parties.
In a moving ceremony in Freetown on Saturday morning, the WHO’s country director, Anders Nordström, confirmed that 42 days had passed without any new cases, thereby satisfying criteria that the virus was no longer being transmitted. A speech by Yusuf Kamara, a healthcare worker who lost 16 members of his family and survived the disease himself, brought tears and a standing ovation. “For us, Ebola is not over. We need your help to treat the many, many health problems we still suffer from. And remember those who died at the hands of Ebola, and especially the children who have been affected by this outbreak,” he said.
Sierra Leone’s president, Ernest Bai Koroma, has ended the state of emergency declared during the outbreak, but the country will now enter a 90-day period of heightened surveillance to make sure the virus does not return. The National Ebola Response Centre (NERC) will continue to operate until the end of the year, and the swabbing of all dead bodies for Ebola will be mandatory until June 2016.
Koroma said he was “humbled by the dedication” of 35,000 Ebola response workers “whose heroism is without parallel in the history of our country”. He praised their bravery and said the country mourned their sacrifice, adding: “The disease challenged the very foundations of our humanity.” He called on the community to halt the stigmatisation of survivors and said the focus was now on improved hygiene, healthcare and economic recovery.
Liberia was declared free of Ebola on 3 September, but the region as a whole must wait until Guinea is clear of new infections for 42 days before the epidemic can be declared over. “Since Sierra Leone recorded the first Ebola case in May 2014, a total number of 8,704 people were infected and 3,589 have died, 221 of them healthcare workers, all of whom we remember on this day,” Nordström said.
The atmosphere in Freetown overnight was jubilant, but there was also nervousness about the continuing outbreak in neighbouring Guinea, where four new cases have been recorded in the past fortnight. All four are children of a mother who contracted the disease from a relative and died.
Nov. 9, 2015 | Bipartisan Policy Center
Healthier populations make for more prosperous and stable societies. When the United States helps improve the health of people in other countries, Americans gain goodwill and strengthen U.S. national security. As President Obama’s 2015 National Security Strategy states: “The United States is safer and stronger when fewer people face destitution, when our trading partners are flourishing, and when societies are freer.” Good health is a prerequisite for all of that to happen.
There is no better example of the power of a well-executed global health initiative than the President’s Emergency Plan for AIDS Relief (PEPFAR), established originally by George W. Bush. PEPFAR is also a potential example of what we call strategic health diplomacy (SHD). It is the idea that, by addressing global health, America advances its own national strategic interests. Global health interventions should be a critical element of U.S. national security policy, giving U.S. policymakers a means to improve the lives of people around the globe, and thereby build stronger, more stable, more prosperous, and more capable partners.
PEPFAR’s Strategic Impact
HIV/AIDS is the sixth leading cause of death worldwide, ahead of such scourges as diabetes, hypertension, and vehicular accidents. The disease is also a destabilizing force in some of the world’s poorest and most vulnerable societies. At the turn of the millennium, American leaders recognized that the devastation caused by HIV/AIDS would depress economic development, inhibit good governance, and decrease the size and productivity of the workforce—conditions that breed instability and conflict. In July 2000, President Bill Clinton declared AIDS to be a “national security threat” and, under the George W. Bush administration, Secretary of State Colin Powell warned that the disease posed “a clear and present danger to the world.”
With nearly 37 million people affected by HIV/AIDS, the United States responded to this crisis with the greatest ever example of humanitarian action by a single country in history. In 2003, President Bush announced the launch of PEPFAR and Congress approved it with strong bipartisan support. The initiative established bilateral aid programs to enhance HIV/AIDS treatment in 15 low-and middle-income target countries. PEPFAR was renewed by Congress in 2008—with a near-tripling of its budget—and again in 2013. PEPFAR now reaches 65 countries worldwide.
Nov 01 2015
By Nicholas Carter, FGHLThis month at AIC Kijabe Hospital in Kenya boils down to a joyous encounter with a medical center in the developing world where patients find reliable access to quality surgical services. Here, to a large degree, patients are spared the immense burden of death and misery associated with the myriad of conditions that can be cured or palliated by surgical procedures. Every short-term visitor will view Kijabe through the lens of prior experiences, and I reflect back to 10 months spent in Haiti as a medical student, where preventable deaths were a daily routine. I have seen here in Kijabe a model for expanding access to surgery with tremendous effect for patients and their families.
Oct 22 2015
By Nicholas Kristof
Oct. 22 | New York Times
LUCKNOW, India — What if there were a remedy that could save more children’s lives in the developing world than are claimed by malaria and AIDS combined?
A miracle substance that reduces ear infections while seeming to raise scores on I.Q. tests by several points? Available even in the most remote villages, requiring no electricity or refrigeration? Oh, and as long as we’re dreaming, let’s make it free.
This miracle substance already exists. It’s breast milk.
Current estimates backed by the World Health Organization and Unicef are that optimal breast-feeding would save 800,000 children’s lives a year in developing countries. That would amount to a 12 percent drop in child mortality, a huge gain.
I’m on my annual win-a-trip journey, in which I take a student with me to the developing world to look at neglected issues. The student, Austin Meyer of Stanford University, and I have been reporting in India, where 1.2 million children under the age of 5 die annually — and where nutritionists say that improved breast-feeding practices could save many.
Exclusive breast-feeding for six months, as strongly recommended by the World Health Organization, is practiced by just 46 percent of women in India, 17 percent in Nigeria, and 10 percent in Yemen, according to the latest Global Nutrition Report. (In the U.S., the figure is about 22 percent, according to the Centers for Disease Control and Prevention.)
By Greg Garrison
Oct. 21, 2015 | AL.com
Jenny Dyer, a 1999 Samford University graduate, has become an important voice in promoting worldwide family planning.
Dyer, who has a Ph.D. in religious studies from Vanderbilt University and teaches health policy in the medical school there, serves as the executive director of Hope Through Healing Hands, a global health organization founded by physician and former U.S. Sen. Bill Frist.
With funding from the Bill and Melinda Gates Foundation, Hope Through Healing Hands advocates for continued and increased U.S. government support of family planning worldwide.
The U.S. government currently provides about $680 million in funding to FP2020, an international program to extend family planning to 120 million women worldwide by 2020 with support from governments. The world population now stands at more than 7 billion.
"We contribute more money to family planning than any other nation," Dyer said in a visit to Samford University on Tuesday, where she met with Vestavia Hills Baptist Church Pastor Gary Furr and several community leaders to discuss programs to assist women. Hope Through Healing Hands also works with UAB's Sparkman Center for Global Health to host events on global maternal and child health.
By Rev? Canon Grace Kaiso and Dr Ahmed RA Ragab
Oct. 15, 2015 | The Guardian
As men of faith, we share a deeply held conviction that all families – regardless of their religious beliefs – are entitled to lead healthy lives free from suffering and deprivation. But, tragically, an absence of basic family planning services deprives millions of people of this fundamental right every year.
More than 200 million women worldwide lack access to modern contraceptives – and when families are unable to control the timing and spacing of pregnancies, the cost can be measured in thousands of women’s and children’s lives lost.
Because of this influence, faith leaders worldwide have an unparalleled opportunity – indeed, a moral obligation – to prioritise conversations about family planning and close the contraception gap.
Quality family planning services provide enormous health and economic benefits to families, communities and countries. According to the UN Development Programme, for every $1 spent on family planning, governments can save up to $6 for other development priorities. There is also wide agreement among global experts that people who have access to family planning information, services and supplies are likelier to complete their education, live more prosperous lives and raise healthier children.