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It's time to get down to the            of the matter.

(Global Health)

The United States should be committed to:

The continued development of drugs, vaccines, diagnostic tests, and other treatments for diseases that are still prevalent in poorer countries (like tuberculosis and malaria).  Plus, a strong focus on infectious disease prevention and treatment for diseases like pneumonia. 

Funding HIV/AIDS research through PEPFAR to end AIDS as a public health threat for good.  "Working in over 50 countries, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has saved and improved millions of lives, prevented millions of HIV infections, and changed the course of the global HIV/AIDS epidemic.  PEPFAR supports more than 14 million people with lifesaving antiretroviral treatment.  With PEPFAR support, more than 2.2 million babies have been born HIV-free to pregnant women living with HIV, and their mothers have been kept healthy and alive to protect and nurture them. PEPFAR also assists more than 6.4 million orphans, vulnerable children, and their caregivers. PEPFAR is widely regarded as one of the most effective and efficient development programs in history."  Read more here.

A  United Nations resolution to regulate the use of antibiotics (in both humans and agriculture) in order to effectively manage the growing threat of drug-resistant infections.

Supporting the education of - and provide modern contraceptive methods to - women and girls in poorer countries, which can lead to smaller family sizes, lower infant mortality, and potentially lower levels of disease.

The United States must be a leader in the advancement of global health and a champion for making the world a cleaner, safer place.  It matters.  A lot.  The World Health Organization says:


"In 2016, maternal mortality was the second leading cause of death for women of reproductive age, after HIV/AIDS, and was the leading cause among women aged 15–29 years.  Almost all maternal deaths (95%) occurred in low-income and lower-middle-income countries, and almost two thirds (65%) occurred in the World Health Organization (WHO) African Region.

An estimated 5.4 million children aged under 5 years died in 2017, of whom 2.5 million were female and 2.9 million male.  Of these deaths, 2.5 million occurred during the first 28 days of life.  More than half of under-5 child deaths are due to diseases that are preventable and treatable through simple, affordable interventions. The leading causes of death in young children over 28 days of age remain pneumonia, diarrhea, birth defects and malaria (in malaria endemic countries).  Rates of death from all conditions are higher in low-income countries, but children in low-income countries are more than 100 times more likely to die from infectious diseases than those in high-income countries.  Children who die within the first 28 days of birth (neonatal mortality) suffer from conditions and diseases associated with lack of quality care at birth, or skilled care and treatment immediately after birth and in the first days of life.

The main Sustainable Development Goals (SDG) target concerning infectious diseases are HIV, TB, malaria, hepatitis and neglected tropical diseases.  Collectively, these diseases accounted for an estimated 4.3 million deaths in 2016 (1.7 million female and 2.7 million male), down from 5.3 in 2000 (2.2 million female and 3.1 million male).

In 2015, 71% of the world population used safely managed drinking-water services, and 39% used safely managed sanitation services; these percentages have increased progressively since 2000, when the figures were 61% and 29%, respectively.  The WHO African Region again fell far behind other parts of the world, with only 44% of the rural population having at least basic drinking-water and only 21% having basic sanitation services.  Globally in 2016, unsafe drinking-water, unsafe sanitation and lack of hygiene were responsible for nearly 0.9 million deaths, including over 470,000 deaths of children aged under 5 years from diarrhea. 

Recent years have seen improvements in 24 (56%) of the 43 health-related SDG indicators tracked in this report.  However, at a global level, progress has stalled or trends are in the wrong direction for five of those 43 indicators: road traffic mortality, children overweight, malaria incidence, alcohol consumption and water sector official development assistance (ODA)."

Read the report here.

Statista, an advanced analytics company, says:


"In recent decades, advances in technology and medicine have increased the life expectancy and general health of people around the world. However, great inequalities in health and health care based on geography and wealth still exist. For example, all of the twenty countries with the lowest life expectancy in 2016 were located in Africa, while those with the highest life expectancy were found mostly in Europe and the wealthy countries of Asia. Rates of various diseases also differ depending on region and income, but some of the most common negative health conditions around the world include high blood pressure, sleep related conditions, migraines, and high cholesterol.


Just as there are inequalities in life expectancy around the globe, there also exist differences in the leading causes of death based on wealth. While the three leading causes of death in low-income countries are lower respiratory infections, diarrhoeal diseases, and heart disease, the leading causes in upper income countries are heart disease, stroke, and Alzheimer’s. Included in the leading causes of death in low income countries are also HIV/AIDS, tuberculosis, and malaria, all diseases which are not included in the leading causes for upper-middle or upper income countries.  In 2016, the countries with the highest incidence rate of tuberculosis were South Africa, the Philippines, and Mozambique, while Lesotho, Swaziland, and South Africa reported the highest prevalence of new HIV infections."

The Annual Threat Assessment from the U.S. Director of National Intelligence, released on April 9, 2021, says the following:

“The Covid-19 pandemic has disrupted life worldwide, with far-reaching effects that extend well beyond global health to the economic, political, and security spheres. We expect Covid-19 to remain a threat to populations worldwide until vaccines and therapeutics are widely distributed. The economic and political implications of the pandemic will ripple through the world for years. The pandemic is raising geopolitical tensions, and great powers are jockeying for advantage and influence. States are struggling to cooperate – and in some cases are undermining cooperation—to respond to the pandemic and its economic fallout, particularly as some governments turn inward and question the merits of globalization and interdependence. Some governments, such as China and Russia, are using offers of medical supplies and vaccines to try to boost their geopolitical standing.”

Then this…

“The Covid-19 pandemic is prompting shifts in security priorities for countries around the world. As militaries face growing calls to cut budgets, gaps are emerging in UN peacekeeping operations; military training and preparedness; counterterrorism operations; and arms control monitoring, verification, and compliance. These gaps are likely to grow without a quick end to the pandemic and a rapid recovery, making managing conflict more difficult – particularly because the pandemic has not caused any diminution in the number or intensity of conflicts. Covid-19-related disruptions to essential health services – such as vaccinations, aid delivery, and maternal and child health programs – will increase the likelihood of additional health emergencies, especially among vulnerable populations in low-income countries. As examples, the pandemic has disrupted HIV/AIDS treatments and preventative measures in Sub-Saharan Africa, as well as measles and polio vaccination campaigns in dozens of countries. World populations, including Americans, will remain vulnerable to new outbreaks of infectious diseases as risk factors persist, such as rapid and unplanned urbanization, protracted conflict and humanitarian crises, human incursions into previously unsettled land, expansion of international travel and trade, and public mistrust of government and health care workers.”

And this…

“The economic fallout from the pandemic is likely to create or worsen instability in at least a few and perhaps many – countries, as people grow more desperate in the face of interlocking pressures that include sustained economic downturns, job losses, and disrupted supply chains. Some hard-hit developing countries are experiencing financial and humanitarian crises, increasing the risk of surges in migration, collapsed governments, or internal conflict.”

Although global trade shows signs of bouncing back from the Covid-19-induced slump, economists caution that any recovery this year could be disrupted by ongoing or expanding pandemic effects, keeping pressure on many governments to focus on internal economic stability. In April, the International Monetary Fund estimated that the global economy would grow 6 percent this year and 4.4 percent in 2022. This year’s forecast is revised up 0.5 percentage points relative to the previous forecast, reflecting expectations of vaccine-powered strengthening of activity later in the year and additional policy support in a few large economies. The global growth contraction for 2020 is estimated at 3.3 percent.

The resurgence in Covid-19 infections early this year may have an even greater economic impact as struggling businesses in hard-hit sectors such as tourism and restaurants fold and governments face increasing budget strains.

The effects on developing countries especially those that rely heavily on remittances, tourism, or oil exports – may be severe and longer lasting; many developing countries already have sought debt relief.

The economic fallout from the COVID-19 pandemic, along with conflict and weather extremes, has driven food insecurity worldwide to its highest point in more than a decade, which increases the risk of instability. The number of people experiencing high levels of acute food insecurity doubled from 135 million in 2019 to about 270 million last year, and is projected to rise to 330 million by yearend.

This is all a bummer, but the incredibly frustrating part is that our federal government was warned about this, over and over.  The 2019 Worldwide Threat Assessment of the U.S. Intelligence Community, released a year before Covid-19 hit, warned:

“We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.   


Although the international community has made tenuous improvements to global health security, these gains may be inadequate to address the challenge of what we anticipate will be more frequent outbreaks of infectious diseases because of rapid unplanned urbanization, prolonged humanitarian crises, human incursion into previously unsettled land, expansion of international travel and trade, and regional climate change.

The growing proximity of humans and animals has increased the risk of disease transmission. The number of outbreaks has increased in part because pathogens originally found in animals have spread to human populations.”

What’s that annoying thing we are always saying about being proactive as opposed to reactive?

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