Strengthening Global Health Preparedness

The world has entered an era in which the numbers of new and reemerging global health threats argue for a longer-term, more strategic, and more coherent U.S. approach to global health preparedness. The ongoing threat from emerging infections such as SARS, extensively drug-resistant tuberculosis (XDR-TB), H5N1 (avian) influenza, and most recently, H1N1 influenza has raised awareness within the U.S. government and other partner states and multilateral institutions of the global interdependence of human security and global commerce. This awareness has spurred more systematic efforts to identify and respond to sudden global public health emergencies stemming from infectious diseases, natural disasters, and other public health emergencies. Recent experience has also illustrated the potential damage that can result from unresolved controversies over the global sharing of biological specimens, as well as the closely related and equally sensitive imperative to mitigate stark inequities experienced by poor countries unable to obtain medicines, vaccines, and other commodities in timely, affordable volumes to meet public health crises.

This brief analysis of U.S. roles in global health preparedness is not intended to be an encyclopedic review. The goal is more modest and preliminary. The authors review the recent history of health preparedness efforts; examine the key leadership roles played by the United States, including promising models for building capacity in partner governments; discuss important initiatives by the World Health Organization (WHO), nongovernmental groups, and other donors; acknowledge innate difficulties in strengthening global preparedness; and lay out core recommendations for a long-term strategic U.S. role and approach.