Kaiser Family Foundation

January 5, 2012
Washington, DC

Thank you, Diane, and good morning, everyone.
I want to begin by saying a few thank you’s. I want to thank our hosts here at Kaiser. I want to thank our panelists from inside and outside government, who are also some of our key partners for our department’s global health efforts. And I especially want to thank the director of our Office of Global Affairs Dr. Nils Daulaire and his team for the incredible work they’ve done over the last few years to refocus and reenergize those efforts.
Our primary mission at the Department of Health and Human Services is to keep Americans healthy and safe, and to provide essential services, particularly to vulnerable populations. Here in the US, that means doing everything from running Medicare to supporting community health centers to securing our nation’s food supply. But in the past, our work mostly stopped at our country’s borders. As recently as 2003, the division that became our Office of Global Affairs had just three employees whose main responsibility was planning the Secretary’s foreign trips.
Of course, the US was still deeply involved in global health during those years. We had a leadership role on major initiatives like smallpox eradication. We were the number one funder of global health aid and assistance programs. And HHS had partnerships around the world in areas like biomedical research and disease surveillance.
But most of these efforts were seen as fundamentally separate from our work to improve health here in America. There were different agendas, in pursuit of different goals, undertaken for different reasons. When we talked then about “global health,” what HHS really meant was the health of all the parts of the globe outside our borders.
Today, we can no longer separate global health from America’s health, and that’s what I want to speak briefly about this morning. About why we need to look beyond our borders to improve health inside our country – and about a new global health strategy for all of HHS that will help us do that.
I was introduced to this new role on my first day on the job. I was sworn in by the President in the Oval Office the evening of April 28^th, 2009, and he wished me good fortune. Then, I was immediately brought to the Situation Room for a briefing that included our neighbors from Mexico on the rapidly spreading H1N1 flu. When I finally made it to my office the following day, the first call I got wasn’t from a Senator or a Governor or an American health official. It was from WHO Director General Margaret Chan, who wanted to discuss how we could coordinate our response.
Global pandemics like the H1N1 flu have always been a threat. But today, they can spread faster and more unpredictably than ever before. Consider that in 1963, 26,000 passengers came through Dulles airport on international flights. In 2010, it was 6.4 million. In total, more than a million people drive across our borders, dock in our ports, or land in our airports every day, and any one of them could be bringing a new virus or bug with them.
And it’s not just people crossing our borders. Nearly half of our fruit and over three quarters of our seafood is imported from abroad. So are many of our medicines, often from countries with fewer safety controls than we have here in the US.
So the first reason we need to look beyond our borders is simple: in a world in which the flow of people and goods stretches across the globe, our only chance to keep Americans safe is if our systems for preventing, detecting, and containing disease stretch across the globe too.
But the case for taking a global approach to improving America’s health is actually much more compelling. Take the single biggest health challenge our country faces today: chronic disease. These illnesses, such as diabetes, heart disease, and cancer, not only kill seven out of ten Americans, but also account for three quarters of our rapidly growing national health care spending.
To reduce the burden of chronic disease, we’ll need a multi-pronged approach, including research innovations like cancer treatments that are personalized, based on individual DNA; care innovations such as better ways of managing their diabetes; and public health innovations like new approaches to help people eat a healthier diet and stop smoking.
That’s a huge challenge. But the good news is we don’t need to develop all these innovations on our own. Everywhere I’ve traveled as Secretary, from Paris to Moscow to Beijing to Nairobi, health leaders are trying to solve the same problems as us. And it’s not just dealing with chronic diseases. Topics from rising health costs to the shortage of primary care providers have become typical agenda items in my meetings with my international colleagues.
Every country is unique, and what works in one may not work in another. But we can learn from each other. Research is already shared around the globe, as is disease surveillance. Now, we need to expand the scope of what we share to include approaches for improving population health, innovations in care delivery, and strategies for lowering costs through better care.
One area in particular where we are learning from each other is the importance of investing in the health of women and girls. This is something I’ve seen firsthand in both the US and in my travels around the globe. When you give women better access to health information and services, there are huge benefits not just for the women themselves, but also for their children, families, and communities. And now, through the President’s Global Health Initiative, we’re bringing a focus on women and girls to all our global health efforts.
These collaborations also bolster America’s stature around the world. One of the striking aspects of my trips outside our country is how much eagerness there is to work together on health issues. When it comes to trade or foreign policy, there are often areas of strong disagreement. But when the discussion turns to tackling our biggest health challenges, there is a broad consensus that nations must work together.
And there is also a wide recognition and appreciation of the critical role the United States plays in these collaborative health efforts. As Secretary Clinton has said: “At a time when people are raising questions about America’s role in the world, our leadership in global health reminds them who we are and what we do.”
Today, it’s clear that to keep America healthy and safe, we need an approach that takes into account both the threats and opportunities we find in the rest of the world. And that’s exactly what our department has put forward in our first-ever Global Health Strategy. This strategy does not represent a radical new direction. Rather, it seeks to provide a new focus going forward so that we can use department’s unique expertise, resources and relationships to make the biggest impact possible.
Guiding this strategy are three goals. First, we will focus on areas where our work abroad helps protect and promote the health and well-being of Americans. Whether it’s building networks that can spot and contain emerging infectious diseases, or creating research partnerships that help bring new treatments and cures to our pharmacy aisles, we will look for opportunities where our collaborations around the world can improve health here in the US.
Second, we will provide leadership in areas where our department has special technical expertise. Given the limited resources available to us, it’s critical that our department not duplicate work that is already underway or that is better handled by another government or NGO partner. So we will focus on the areas where HHS has unique resources and knowledge, starting with the world’s leading researchers at the NIH, its leading epidemiologists at the CDC, and its leading regulators at the FDA.
Finally, we’ll work with our partners across the Administration to advance US interests. America’s global health efforts have always been a partnership between our department, the State Department, US AID, and many others. Our Global Health Strategy is designed to complement these efforts and the President’s Global Health Initiative.
Every day, Americans experience the benefits of greater engagement in global health. We were able to respond quickly and effectively to the H1N1 flu in large part because of strong international cooperation. We’re borrowing public health innovations first tested abroad like graphic warning labels on cigarette packages. And we continue to build closer ties in areas such as biomedical research; partnerships that benefit the US and the world.
We have come a long way. But in a world that contains both more threats to America’s health and more opportunities for productive health partnerships, we need to do more. Our global health agenda cannot be an add-on to our efforts to improve health here in America. It must be an extension of those efforts.
Health is an issue which aligns the interests of the countries around the world. If we can limit the spread of pandemics, all people benefit. A new drug developed on one continent can just as easily cure sick people on another. A safe global food and drug supply chain will mean better health for every country. And a healthier world is one in which every nation will have more productive workers, longer lives, and larger markets for its goods and services.
The US can and should play an active role in shaping these efforts. And our department, working closely with our partners across the Administration and guided by our new Global Health Strategy, will help lead the way.
Thank you.