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Every U.S. President in recent decades has had to respond to at least one pandemic disease. Political leadership has proven decisive. In the coming years, U.S. foreign policy will face at least three inter-related issues: today’s major pandemics of AIDS, TB, and Malaria; future outbreaks with the potential to become pandemics; and rising risk from infectious diseases associated with climate change. A review of epidemiologic data shows global progress on each issue is threatened. A coordinated U.S. effort, across agencies and engaged with national and multilateral partners, could save lives and address significant foreign policy interests. Such an effort could boost economic prosperity by reducing disease-related lost productivity, which we estimate at $1.7 trillion, with returns to investment in pandemic-related global health efforts averaging 17–20 to 1. Foreign policy focus on pandemics could also address gender and social inequalities and support climate adaptation and mitigation. Pandemic-related global health spending is 0.19% of the U.S. budget—a figure that has been flat in recent years even with growing needs and significant potential gains from investment.

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Journal of International Affairs Online.