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Historically, the Oval Office has been a leader in global health assistance. From the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) under the Bush Administration, to the Global Health Initiative launched by President Obama in 2009. However, unlike PEPFAR and PMI, the Global Health Initiative met an untimely end with the launch of a bold new global health measure by the Obama Administration: the Global Health Security Agenda (GHS Agenda). The GHS Agenda aims to “accelerate progress toward a world safe and secure from infectious disease threats” through a US-led diplomatic collaboration with 30 countries, international organizations, nongovernmental organizations, and public/private entities.

The intertwining of global health and security follows a line of international agreements, including the revised International Health Regulations (2005), aimed at improving surveillance and response to public health emergencies of international concern. By mid-2012 however, only 22% of WHO member states had implemented the required core competencies. The GHS Agenda aims to address these global deficiencies in infectious disease preparedness. In doing so, the United States faces formidable obstacles including America’s lack of legal legitimacy in setting global norms, as well as the same domestic coordination difficulties that resulted in the dissolution of the Global Health Initiative, and the potential impediment of passing the President’s budget through a hostile Congress. While the securitization of global health has its criticisms, it also has the potential to be transformative, succeeding where international organizations have not always been able to, building a safer and healthier world.

Publication Citation

312 JAMA 27-28 (2014)