Politicizing Global Health

The Washington Post reported today that a key official in the US President’s Administration has been blocking the publication of the Surgeon General’s 2006 “Call to Action on Global Health,” a draft of which is available on the link provided. Specifically the Post noted that, “A surgeon general’s report in 2006 that called on Americans to help tackle global health problems has been kept from the public by a Bush political appointee without any background or expertise in medicine or public health, chiefly because the report did not promote the administration’s policy accomplishments, according to current and former public health officials.”

Reading through the report one does not find specific mention of the President’s Malaria Initiative (PMI) but does cite the President’s Emergency Plan for AIDS Relief. The report does highlight various global efforts such as the Global Fund to Fight AIDS, TB and Malaria, of which the U.S. is a major supporter/donor, the Roll Back Malaria Partnership, and the United Nations Millennium Development Goals. Concerning the MDGs, the draft report states, “Beyond reducing the disease burden, a successful fight against malaria will have far-reaching impact on child morbidity and mortality, maternal health, and poverty, which in turn could increase global stability.”

The draft report emphasizes that, “Malaria treatment, control and prevention should be an integral function of an effective health system, supported by strong community involvement. Sustained success in malaria reduction calls for development of the health sector; improved case management, the use of intermittent presumptive treatment programs for pregnant women, insecticide-treated bed nets, and spraying of households with insecticide.” This recognition of a comprehensive approach to malaria control programming by the United States certainly needs to be shared widely with other donors and endemic country policy makers.

The draft report also touches on an issue that has been politically sensitive to the Administration, global warming. The report explains the link between malaria and global warming as follows: “The distribution of insects and other organisms that serve as hosts to the microorganisms that cause infectious diseases is likely to be affected. This could lead to changes in disease patterns. For example, malaria might appear in areas where it is currently unknown because of the spread of the mosquito that carries the disease.” In another politically sensitive move the report acknowledges malaria research and technical efforts by the French, the Japanese and the Multilateral Initiative for Malaria.

Although the current Bush Administration may have brought attention to malaria to a new level through PMI, the U.S. has been a leader and a champion of malaria control and prevention for decades through the US Centers for Disease Control and Prevention, the National Institutes of Health, and USAID, to name a few. Some sense of balance is needed. One certainly does not want to see a document that is only a self-congratulatory piece, but one would also expect to see adequate recognition of all contributors and stakeholders who promote global health. The report does deserve to have wide circulation to stimulate greater discussion of and commitment to solving global health challenges by US Citizens and their elected representatives.

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