Kate Etue

In 2000, Senator William H. Frist, MD, was a founding co-chair with then Senator John Kerry of the first bi-partisan task force on HIV/AIDS, which led to the creation of the groundbreaking PEPFAR plan and ultimately paved the way for the Global Fund, which is dedicated to fighting AIDS, TB, and malaria worldwide. Just a few weeks ago in Washington, DC, a group of international leaders met, including the President of the United States and Bill Gates, to rally financial support for the fourth replenishment of the Global Fund. Sec. Kerry acknowledge the crucial leadership role that Senator Frist provided in the early days of the fight against HIV/AIDS. 

J. Stephen Morrison and Katherine Bliss of the Global Health Policy Center wrote about this meeting and what it means for the global fund in "Refueling the Global Fund."

(The Hill, May 22, 2013)

By Senator William H. Frist, M.D.

On June 8, the United Kingdom, under the leadership of Prime Minister David Cameron, will host “Nutrition for Growth,” a high-level meeting where donor governments, including our own, will pledge funding and other commitments to address undernutrition and its devastating impact on the long-term health and productivity of millions of people in developing countries.

Sitting side by side with donors and foundations will be representatives of developing country governments, the private sector and civil society organizations, demonstrating the truly complex and multi-stakeholder nature of nutrition.

Malnutrition is one of the world’s most serious, yet least-addressed, development challenges. It contributes to almost 2.5 million young child deaths annually. Malnutrition is a serious drain on economic productivity, costing countries as much as 11 percent of GDP.

Close to 200 million children throughout the world are chronically malnourished and suffer from serious, often irreversible cognitive damage. Physically, undernourished children are stunted—smaller in stature than their well-nourished peers, more susceptible to illness throughout life, including noncommunicable diseases such as heart disease, cancer and obesity.

The case for greater leadership and investments in global nutrition is clear. The Copenhagen Consensus, an expert panel of economists that includes several Nobel laureates, concluded that fighting malnutrition in young children should be the top priority investment for policymakers. In the group’s report, they stated that every $1 invested in nutrition generates as much as $138 in better health and increased productivity. Similar studies have found that undernutrition causes between $20 billion and $30 billion in additional health costs every year to treat the long-term consequences of early childhood malnutrition.

While the problem is complex, the solutions don’t need to be. Cost-effective, evidence-based solutions exist. What we need are the resources and the political commitment to scale up proven nutrition solutions.  Political commitment in the form of presidential leadership and bipartisan congressional support works. We have seen it in the Global Fund, the President’s Malaria Initiative, the Millennium Challenge Corporation and the President’s Emergency Plan for AIDS Relief (PEPFAR).

We can do it again — this time to scale up and align nutrition investments. To follow the proven PEPFAR model, we should target resources to benefit the most vulnerable; align resources across all agencies and programs; focus on countries where we have committed partners and country-led strategies; and coordinate efforts internationally.

UNICEF reports that 1 in 4 children under the age of five is stunted and 80 percent of those children live in just 14 countries. The Lancet’s series on maternal and child health and nutrition highlights the 1,000 days from the beginning of pregnancy to a child’s second birthday as the critical window of opportunity for human health and development.

Like PEPFAR, we can target our interventions to benefit those most vulnerable to undernutrition, namely pregnant women and young children. We have commitments from more than 30 countries, which as part of the Scaling Up Nutrition (SUN) movement — a partnership of donors, developing countries, nongovernmental organizations and the private sector — have identified undernutrition as a severe impediment to economic development. A number of those countries have developed national nutrition plans that offer donors an opportunity to build upon and strengthen the country-led aspect of the investments.

We can begin by working with those committed country partners through bilateral and multilateral channels and offer our government’s technical expertise and best practices to galvanize a concrete investment strategy that includes innovative public and private partnerships and financing mechanisms.

There is an emerging international coordination effort for nutrition: the Nutrition for Growth event in London, last year’s G8 commitment to the New Alliance for Food Security and Nutrition, the UK-led Hunger Summit of 2012 and the growing Scaling Up Nutrition movement. These efforts will help the United States to share with other donors the cost of alleviating this global problem.

This is a critical moment for the U.S. to lead on global nutrition. The June 8 summit in London is the perfect opportunity for the Obama administration to announce a bold global nutrition strategy that outlines a multifaceted and multi-year approach to better coordinate and integrate nutrition resources across sectors and agencies, with clearly defined goals and targets, and with the dedicated resources necessary to achieve the strategy’s stated goals. Bipartisan leaders in Congress must step forward and commit to working with the president to make global nutrition a top priority of U.S. development assistance.

The moment for turning the corner on global nutrition is here, and it is time for our elected leaders to demonstrate anew how American leadership is the driving force for building a healthier, safer and more prosperous world.

William H. Frist, M.D. is a nationally acclaimed heart transplant surgeon, former U.S. Senate majority leader, the chairman of Hope Through Healing Hands and Tennessee SCORE, professor of surgery and author of six books. Learn more about his work at BillFrist.com.

Senator William H. Frist, MD

Originally published in Roll Call.

A decade ago, as I was beginning my time as Senate majority leader, bipartisan consensus in Washington helped launch a new era of progress in global health just when it was sorely needed. Twenty years had passed since I first saw AIDS patients in Boston, though at the time we didn’t even have a name for this savage disease. Advances in treatment and technology were helping control HIV in the United States, but AIDS was decimating communities worldwide. There were tens of millions of infections, yet only 400,000 people in low- and middle-income countries had access to lifesaving antiretroviral therapy, meaning only a tiny fraction were able to escape death.

World leaders united to tackle AIDS and other scourges through an innovative financing tool — the Global Fund to Fight AIDS, Tuberculosis and Malaria. President George W. Bush and Congress made a founding pledge of $300 million to the international initiative. Bush, with bipartisan support from both chambers of Congress, also established the President’s Emergency Plan for AIDS Relief, the largest program ever to combat a single disease. President Barack Obama has similarly embraced this program and America’s role in eradicating this disease.

U.S. leadership at the Global Fund, and bilateral health programs such as PEPFAR and the President’s Malaria Initiative, signaled a renewed commitment to a core facet of our country’s greatness: compassion for those most in need. Understanding that improving global health is good for national security, economically prudent and — most importantly — the right thing to do, the U.S. taxpayers made an unprecedented investment in the world’s future.

That investment is paying off.

As we mark the 10th anniversary of PEPFAR this year, the number of people on lifesaving treatment has increased more than twentyfold. HIV infection rates are down. The number of malaria cases has plummeted by more than 50 percent. Tuberculosis mortality rates are falling steadily. The Global Fund alone saves an estimated 100,000 lives each and every month, working in more than 150 countries. These health gains were once unimaginable.

A new chapter in global health begins this month as visionary leader Dr. Mark Dybul takes the helm as executive director of the Global Fund. With so much gridlock in Washington, Dybul’s appointment is a reminder of what we can accomplish by reaching across party lines.

Dybul, who began as a physician treating AIDS patients in the early years of the pandemic, helped transform the fight against the disease as the architect and leader of PEPFAR. Now at the Global Fund, he will lead the charge to defeat AIDS, malaria and tuberculosis. Armed with scientific expertise and dedicated to a mission that goes beyond political ideology, there may be no one better suited for the job.

Today there is real hope in this fight — but it’s far from over. We have the science to help people with HIV live healthy lives, but millions still lack access to the treatment they need. We can detect and treat TB, but drug-resistant strains represent a growing threat, and disease respects no borders. And malaria still takes countless lives each year, though it can be stopped with basic, incredibly cheap prevention.