Legislators should focus on complementary roles of defense and global health

Legislators should focus on complementary roles of defense and global health
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In late December, President TrumpDonald John TrumpArizona GOP Senate candidate defends bus tour with far-right activist Alyssa Milano protests Kavanaugh in 'Handmaid's Tale' costume Bomb in deadly Yemen school bus attack was manufactured by US firm: report MORE released his National Security Strategy — his vision for keeping Americans safe and protected from foreign and domestic threats. Importantly, this vision went beyond protecting U.S. borders and combating terrorism — it also addressed health as a security issue, and how American investments in global health, epidemic preparedness, and innovation are essential to keeping Americans safe and healthy at home and preventing destabilizing health crises around the world.

This discussion on health and security, however, is largely absent in Congress, where current debate over government funding hinges on the distinctions — and relative merits — of defense vs. non-defense spending. Domestic and global health accounts are supported by non-defense discretionary funding, which are under immense pressure for budget-balancing cuts.

More conventional, “hard” security initiatives are funded through defense accounts, which have greater prospects for growth. However, as articulated by President Trump, in the area of global health, there are no such hard distinctions between defense and non-defense spending: “Biological threats to the U.S. homeland… are growing and require actions to address them at their source.”

Action requires funding, and appropriate funding warrants strong investments in both non-defense discretionary and defense spending (which has some funding for global health, although much less than the non-defense discretionary account). If Congress allows non-defense spending to backslide, and focuses increased spending only in the areas of “hard” defense, Americans and the world will be less safe and healthy.

Global health programs at the U.S. Agency for International Development (USAID), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH)—all funded through non-defense discretionary accounts — are critical to a national security vision where biological threats to Americans are rapidly detected, prevented, and mitigated.

Funding for these crucial programs support research, surveillance, and response efforts in the United States and around the world. They help keep Americans safe from infectious diseases before they reach our shores.

The President’s Emergency Plan for AIDS Response (PEPFAR), for example, was critical in containing Ebola in Nigeria. Its programs supporting disease detection and surveillance helped the country quickly identify and isolate Ebola infection, as well as conduct contact tracing to effectively contain the disease.

CDC’s Global Disease Detection Centers provide support to more than 50 countries, and over the past 10 years have responded to more than 2,000 disease outbreaks and public health emergencies. NIH is advancing critically needed research into new drugs, vaccines, and other countermeasures for looming threats like Ebola, Zika, and drug-resistant tuberculosis.

President Trump’s security strategy also calls on the United States to support food and health assistance during times of humanitarian crises, and to address the root causes of hunger and disease. Recent outbreaks of diphtheria in Rohingya refugee camps in Bangladesh or the spike in polio cases in Syria, underscore the relationship between health and political instability, as well as the critical importance of delivering health services in all circumstances. Minimizing these health threats at the source can help prevent further destabilization in already fragile settings and prevent localized outbreaks from becoming global epidemics.

Global health programs through non-defense discretionary spending contribute to security in several other ways. Efforts to combat HIV/AIDS, malaria, tuberculosis, and neglected tropical diseases, as well as improve maternal and child health and ensure access to safe water, have had an impact on millions of lives around the world. By investing in these programs, the United States is helping to build healthy communities and greater economic, political, and social stability.

The president’s vision for national security goes beyond “hard” defense and recognizes the need for health, development, and diplomacy to keep Americans, and the world safe. As the debate on funding levels continues, legislators should keep in mind the vital and complementary roles of defense and global health. Investing in both is critical to ensuring our security and strengthening the role of the United States in the world.

Courtney Carson is a policy and advocacy officer at Global Health Technologies Coalition; Danielle Heiberg is a senior advocacy manager at Global Health Council.