The U.S. Government Engagement in Global Health: A Primer
The U.S. government has long supported overseas health programs as an element of foreign aid and development assistance. In recent years, these programs have grown in size and prominence. In particular, under President Bush, the U.S. government initiated several large bilateral global health foreign assistance programs, most notably, the President’s Emergency Plan for AIDS Relief (PEPFAR), as well as the President’s Malaria Initiative (PMI), and helped create and support the multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund). The U.S. government is the largest funder and implementer of global health programs worldwide, even as U.S. funding for global health has plateaued in recent years in the wake of the financial crisis and continuing fiscal constraint.
Under the Obama administration, support for the main pillars of the U.S. global health effort – from PEPFAR to PMI to the Global Fund – has continued, and the Administration has also focused more attention and funding on other global health programs, including maternal and child health, neglected tropical diseases, and family planning and reproductive health, among others. Most recently, the Administration and Congress have enhanced the U.S. response to emerging infectious diseases following the major outbreak of Ebola that began in West Africa in 2014.
Presently, U.S. support for global health involves many different U.S. government departments and agencies, congressional committees, initiatives, and funding streams.1 As a multi-pronged, multi-billion dollar investment that targets a myriad of global health challenges, countries, and stakeholders, the U.S. global health response is complex. As such, this primer provides basic information about global health and U.S. government’s response. Although this document focuses primarily on the U.S. government, it is important to acknowledge the role played by other countries, multilateral organizations, and private sector actors such as non-governmental organizations (NGOs), foundations, corporations, and others, in the global health response.
The first several sections provide an overview of the field of global health and describe current global health issues. Subsequent sections describe U.S. government support for global health, including the programs addressing global health challenges, the organization of the U.S. response, the budgets and financing of U.S. global health programs, and the U.S. government’s relationship with multilateral institutions and international partners. Additional resources, information, and analysis are available at the Kaiser Family Foundation’s U.S. Global Health Policy Program’s website: http://kff.org/global-health-policy/.