"Global public health, by its very nature, is a multilateral effort," says Tommy Thompson, U.S. Secretary of Health and Human Services. Thompson, who also served for 14 years as Governor of Wisconsin, says that the United States "can lead and contribute to the cause of global health, but cannot accomplish its mission alone."
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."
-- American Declaration of Independence,
adopted July 4, 1776
Americans asserted their belief in the dignity of human nature as the nation was founded, and since then have developed a long tradition of helping the neediest people of the Earth in countless ways -- including with soldiers, missionaries, economic advisers, Peace Corps programs, trade, and student exchanges.
Few include public health on this list, yet public health is among the most vital fronts in America's engagement with the world. As secretary of Health and Human Services (HHS), it is my privilege to run a department that performs a critical role in America's mission of compassion abroad. Public health knows no borders and no politics. In recent memory alone, we have seen AIDS leap from Africa into our own cities; we have seen severe acute respiratory syndrome (SARS) spread with shocking rapidity from southern China to North America; we have seen the West Nile virus somehow cross the Atlantic and begin a slow spread across our continent; and we have seen that a key to controlling tuberculosis in the United States is controlling it in potential visitors to and from abroad.
Indispensable to our public health efforts, then, is the cooperation, leadership, and engagement of our partner nations. The United States can lead and contribute to the cause of global health, but cannot accomplish its mission alone.
A prime example of our cooperation with fellow nations was seen in our response to the SARS epidemic. To fight this disease, U.S. health officials cooperated with and worked in places like China, Singapore, Thailand, Taiwan, and Vietnam. We swiftly undertook several measures designed to turn the tide and defeat the epidemic before it became a serious threat on U.S. soil. Among the most crucial was the deployment of medical officers, epidemiologists, and other specialists to China. And on May 7, as part of a presidential initiative to fight SARS, the U.S. Agency for International Development provided $500,000 in emergency funds to help China procure needed medical equipment to deal with the epidemic.
As a result of this experience, the United States is deeply committed to enhancing collaboration with China to strengthen fundamental public health infrastructures and improve China's capacity to manage not only SARS, but also other diseases such as hepatitis, HIV/AIDS, tuberculosis, and cancer. HHS personnel already have a relationship with their Chinese counterparts in the fight against influenza; we hope to build on these ties and the ties established during the SARS crisis to form a lasting partnership for public health.
That's an effective, committed response. And let me emphasize that it is a response that would be impossible without the partnership of our Chinese counterparts. It's just one way that America is working with the nations of the world for the sake of public health.
We're going to build on the lessons we learned from SARS. The ill effects of delay in the identification and acknowledgement of this disease are self-evident and must not be repeated. That's why the United States is launching an Early Warning Global Health Initiative to: train laboratory personnel and epidemiologists; improve management and surveillance; foster communications; and improve laboratory capabilities. This initiative will complement and augment the critical global efforts of the World Health Organization's Global Outbreak Alert and Response Network. We want to provide resources to extend response capabilities to more regional levels. We also want to provide more public health experts from my department to assist with training, mentoring, and technology transfer so we can fill gaps in expertise. Our goal is to build upon pre-existing programs in countries that can show the swiftest progress, for the benefit of entire regions.
We're not stopping with the Early Warning Global Health Initiative. We're also moving forward with the HHS Global Health Security Initiative. This initiative seeks to establish -- in strategic areas outside the United States -- networks of regionally affiliated partners with strengthened clinical, epidemiologic, laboratory, and communications capabilities. This will facilitate more timely and effective detection and response to biological threats and truly make a difference in the security of all peoples.
Again, these efforts would be simply impossible without the cooperation and vision of our partner nations. Global public health, by its very nature, is a multilateral effort.
Moving beyond SARS and early warning, we are also working with our friends and allies abroad to bring basic health care to parts of the world that desperately need it. A tremendous example can be found in the newly free nation of Afghanistan, where the United States is working with the transitional government to bring hope and health to a long-suffering people.
I'm proud to tell you that this past April I was in Kabul to witness the opening of the newly refurbished Rabia Balkhi Women's Hospital. Rabia Balkhi is a critical facility for Afghan women -- it admits nearly 36,000 patients each year and delivers more than 40 babies each day. The refurbishment -- a joint project of HHS, the Department of Defense, and the Afghan government -- is only the first step toward bringing health and hope to all Afghan women.
President Bush has asked Congress for $5 million for further work at Rabia Balkhi and expansion to four additional affiliated facilities outside of Kabul. We will provide training for the medical staff and help to improve the hospital operations at Rabia Balkhi and at the four satellite clinics once the initial needs of Rabia Balkhi have been met. Each one of these maternal and child health clinics will provide direct health care to patients, and training to health care workers at all levels, including physicians, nurses, midwives, and community health workers.
Our goal is to develop a team of trained health care workers who can address the maternal and child health care needs of the entire nation. It's a small first step. But it is just the first.
When we put together those teaching clinics, and when we provide prenatal care to women in remote villages, we won't be helping just the women of Afghanistan. We'll be helping every man, woman, and child of that ancient land who ever looked at his country, loved it, and wanted to make it a better, freer, more decent place. It could not be done without the help of the Afghans themselves or the help of the nations of Europe, Asia, North America, and elsewhere who have committed blood and treasure to securing Afghan freedom. Their staunch support is truly indispensable to our common goals.
I want to address one last facet of America's mission of compassion abroad -- the fight against global AIDS. It's a mission that's particularly important to the President and to the world -- for reasons of simple humanity.
In the developing world, and particularly in Africa, AIDS threatens peace and stability as it wipes out entire generations, orphans whole communities, and cripples nations. Three million people died from AIDS last year, and it is estimated that at least another 68 million will die in the next two decades. Of those deaths, 55 million will be in Africa. Life expectancy is suffering concurrently. A child born in Botswana, for example, now cannot even expect to see his 40th birthday.
That's why the nations of the world, in cooperation with nongovernmental organizations and local community groups, have come together to establish the Global Fund to Fight AIDS, Tuberculosis and Malaria. The extraordinary demands of this crisis demand this extraordinary effort.
The fund is an indispensable component of the worldwide struggle against AIDS. A true public-private partnership, it provides desperately needed financial assistance to nations and communities in desperate straits. This assistance shores up health and medical infrastructures, gives families a fighting chance, and most important, saves lives.
I was honored to be elected chair of the fund this past January. As chair, I am happy to report the fund has approved 153 projects in 92 countries and committed almost $1.5 billion since April 2002. The fund has signed grant agreements with 58 countries amounting to more than $660 million. Of that, approximately $56 million has been disbursed so far, and the pace of disbursement is accelerating rapidly. Just a little more than a year since the fund was established, the first people are receiving anti-retroviral treatment under Global Fund grants in Haiti.
It will take the support and initiative of all nations to see it through. I'm proud to note that the United States is helping to lead the way.
For starters, we are the largest single contributor to the Global Fund. And that's just the tip of the iceberg. In his State of the Union Address last January, President Bush announced the Emergency Plan for AIDS Relief -- a five-year, $15 billion initiative to turn the tide against the global HIV/AIDS pandemic. This commitment of resources will help 14 of the most afflicted countries in Africa and the Caribbean wage and win the war against HIV/AIDS.
We expect to accomplish a lot with the emergency plan:
First, we want to prevent 7 million new infections, representing 60 percent of the projected new infections in target countries. The initiative will involve large-scale prevention efforts, including voluntary testing and counseling. The availability of treatment will enhance prevention efforts by providing an incentive for individuals to be tested.
Second, we want to treat 2 million HIV-infected people. Capitalizing on recent advances in anti-retroviral treatment, the President's Emergency Plan for AIDS Relief will be the first global effort to provide advanced antiretroviral treatment on a large scale in the poorest, most afflicted countries.
Finally, we want to provide care for 10 million HIV-infected individuals and AIDS orphans.
The President's plan will virtually triple our commitment to international HIV/AIDS assistance, which now stands at a government-wide base of $1 billion a year.
Let me emphasize that the president's plan directly assists the mission of the Global Fund. The plan includes an additional $1 billion for the Global Fund, bringing the U.S. pledge up to $1.65 billion. Our efforts, and the bilateral efforts of other nations, provide the foundations for the Global Fund's work. We are all attacking the same problem, we are all serving the same people, and we are doing it together.
Our vision for the world, like our vision for our nation, is expansive, optimistic, and exciting. And our mission of compassion abroad is nothing less and nothing more than the simple impulse of human kindness. History, conscience, and our precious heritage as Americans demand no less from us. As former President Ronald Reagan once said: "It is up to us ... to work together for progress and humanity so that our grandchildren, when they look back at us, can truly say that we not only preserved the flame of freedom, but cast its warmth and light further than those who came before us."
Working together with our friends, allies, and partners across the globe, we will fulfill this charge.