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In this guest post, Beth P. Bell—director of the National Center for Emerging and Zoonotic Infectious Diseases—and Tom Kenyon—director of the Center for Disease Control and Prevention’s (CDC) Center for Global Heath—write about a new initiative from the US government to address global health security. The US government’s recent commitment to global health security recognizes that health security is an essential part of every nation’s national security. As both Department of Health and Human Services Secretary Kathleen Sebelius and CDC Director Tom Frieden have said, “A health threat anywhere is a health threat everywhere.” These threats may come from naturally occurring disease outbreaks, the emergence of drug-resistance, or by the intentional or accidental release of dangerous pathogens. They may occur anywhere on the planet at any time. Mitigation of such threats is greatly enhanced when the nations in which they may arise are able to detect them early, respond rapidly, and prevent them from happening again—or better still, from happening in the first place. In February, the United States joined with 28 other countries, the World Health Organization (WHO), and 3 other international organizations to launch the Global Health Security Agenda. At the launch, the United States made a commitment to working with 30 countries over the next 5 years to establish and strengthen their abilities to prevent, detect, and respond to infectious disease threats. In fiscal year (FY) 2014, a group of 12 nations will accelerate engagement in these global health security strengthening partnerships with US agencies. Pending additional resources, more countries will be added in FY 2015 and beyond. Global health security is embodied in a comprehensive set of specific targets to prevent, detect, and respond to infectious disease threats. These objectives are based in part on the WHO’s revised International Health Regulations (IHR (2005)) which established core requirements for monitoring public health threats globally and responding rapidly and effectively to contain them. Although adopted by nearly every nation on earth, fewer than 20 percent of Member States who signed on to the IHR (2005) are in full compliance. One of the major objectives of the US government’s global health security effort is to greatly increase IHR compliance. Partner countries will develop systems, policies, and procedures to prevent or mitigate outbreaks. Prevention priorities include: Monitoring and slowing antimicrobial resistance (AR), the ability of bacterial and viral pathogens to acquire resistance to antimicrobial drugs. Nations should have at least one reference laboratory able to identify—and to report—at least three of the seven WHO priority AR pathogens using standardized detection assays. Practices and policies to prevent animal diseases from spilling over into human populations. Immunization of at least 90 percent of each nation’s 1-year-olds with at least one dose of measles vaccine (or a combination vaccine including measles). Having this capacity means a nation is able to adequately carry out other immunization and health-care efforts. The United States will also work with countries to create and strengthen real-time networks of information systems to detect outbreaks, and up-to-date rapid diagnostic tests to enable their laboratories to conduct at least five of 10 core tests for high-risk and high-priority diseases. Six of these core tests are for diseases that are among the WHO Top 10 Causes of Death in low-income countries: influenza virus, poliovirus, HIV, tuberculosis, malaria, and typhoid fever. The remaining four tests will be selected by the partner country based on national public health concerns. Other priorities will strengthen countries’ abilities to detect global disease threats including: Surveillance for potential public health emergencies. Interconnected electronic reporting systems. Training for doctors, veterinarians, biostaticians, lab scientists, and field epidemiologists. The United States will also assist partner countries to develop skills and build systems to mount effective responses to health threats. These include establishing emergency operation centers (EOCs) with rapid-response teams and linkage to a network of labs that monitor for disease outbreaks. The goal is for an EOC to be able to activate a coordinated response within two hours of detecting a public health emergency. Nobody knows where the next health threat will arise. In a world linked by international travel and commerce, no nation is more than a plane flight away from any other. Global health security is a key element of every country’s national health security. For more information, please visit CDC’s global health security website at http://www.cdc.gov/globalhealth/security/.

“I deeply believe in the importance, power, and influence of research,” said Senator Chris Coons (D-DE) at GHTC’s congressional briefing. He added, “We all need to ensure that basic science eventually translates into saving lives.” The briefing—GHTC’s fifth annual where we launched our 2014 policy report—brought together leading voices from the nonprofit, philanthropic, public, and private sectors to reinforce the importance of robust support for global health research and development (R&D). For generations, the US government has invested in the lifesaving potential of research and innovation, supporting discoveries that have improved public health around the world. These investments have led to breakthroughs in global health and contributed to the development of remarkable vaccines, drugs, diagnostics, devices, insecticides, and other health technologies. Sen. Chris Coons (D-DE) giving remarks at GHTC's annual briefing Moderator Steve Davis, president and CEO of PATH, opened the briefing by reminding attendees what’s really at stake if the US government does not continue to be a leader in global health R&D: “The United States now stands at a critical juncture. Although the recent budget agreement prevents a second round of sequestration cuts, stabilizing global health R&D will require Congress to preserve funding for global health R&D, and US agencies must protect global health research and programming within their own budgets.” He added, “Halting funding would mean that the world may never benefit from the tools that are so close to development and delivery.” Many US government agencies play a vital role in global health research and product development, including the Centers for Disease Control and Prevention, the Department of Defense, the Food and Drug Administration, the National Institutes of Health, and the US Agency for International Development (USAID). Specifically, USAID has announced several promising developments in global health innovation over the past year. In addition to releasing a report to Congress on its activities in global health R&D, the agency continues to support the critical work of the Center for Accelerating Innovation and Impact at USAID. Panelist Wendy Taylor, director of the Center for Accelerating Innovation and Impact, mentioned at the briefing that USAID is currently involved in about 100 of the technologies currently in the global health pipeline. “Science, technology, and innovation are driving progress in global health,” said Taylor. She added, “Innovation bends the curve of history and makes the impossible, possible.” Critical to the work of the Center for Accelerating Innovation and Impact, as well as global health R&D broadly, are public-private partnerships. The private sector plays an important role in providing expertise and know-how to develop new technologies. Adrian Thomas—vice president of Global Market Access, Commercial Strategy, and Global Public Health at Janssen Pharmaceuticals, Inc.—reinforced the importance of multi-sector engagement: “We have to have the right partnerships and programs…the right incentives in play” to develop tools for low-resource settings. Thomas explained to the audience that incentives are key to getting private-sector engagement. “Without co-financing from donors like the US government, the risk to develop some products would be too high,” Thomas explained at the briefing. Many of the public-private partnerships involved in global health product development are also funded in part by the Bill & Melinda Gates Foundation. While the importance of the Gates Foundation is unquestionable, they fully admit that they cannot be the only funder involved in the development of new technologies for low- and middle-income countries. “The US government is the world’s largest and most important funder in global health R&D,” said Dan Hartman, director of Integrated Development at the Gates Foundation. Hartman continued to explain that without steady funding from the US government, we risk losing the progress we’ve made in research over the last decade. Each of the panelists during this year’s briefing gave very compelling arguments to Congress and the Administration why we need continued and increased support for global health R&D. Yet none were more compelling than Winfred Amoako, a tuberculosis (TB) survivor originally from Ghana. Shortly after moving to the United States in 2010, Amoako was diagnosed with TB. When asked what he would say to US policymakers if given the chance, he said: “I would say…please continue the fight. Continue to be the leader in research so that someday we can eliminate TB and these diseases.” That important message reminds us about the lives that are affected by neglected diseases and global health challenges. As Steve Davis said in his concluding remarks, “We are at the brink of a remarkable time in global health…we can and we must do more.” The stakes have never been higher, which is why the US government must continue its leadership role in supporting global health research and innovation so that essential technologies reach all of the patients who need them.