The U.S. Government Engagement in Global Health: A Primer
Attention to global health by governments, policymakers, media, business leaders, and other institutions has increased markedly in recent decades, with a particular focus on health challenges facing low- and middle-income countries. This has led to growing funding, the establishment of new institutions and global goals, and a burgeoning community of stakeholders.
The U.S. government has long supported health programs as an element of foreign aid and development assistance, and is the largest donor to global health. These programs have grown in size and prominence over time, most notably with the launch of the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI), and the U.S. government support of the creation of the multilateral organization, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), in the early 2000s. Today, the U.S. government remains the largest funder and implementer of global health programs worldwide and global health remains the largest component of foreign assistance, although funding has leveled in recent years. In addition, the current administration has proposed to reduce the U.S. global health budget and pull back from multilateral engagement, creating questions about the future of U.S. support.
The U.S. global health response is complex, a multi-pronged, multi-billion dollar investment involving many different U.S. government departments and agencies, congressional committees, initiatives, and funding streams and targeting a myriad of global health challenges and countries.1 This primer provides basic information about global health and U.S. government’s response in low- and middle-income countries. Although it 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/.