Global Health, Policy, and the Future ( NEED TONIGHT) Review NAS Global Health Report 2017 Recommendations and Actions for Nurses and Other Health Pr -

Global Health, Policy, and the Future ( NEED TONIGHT)
Review NAS Global Health Report 2017 Recommendations and Actions for Nurses and Other Health Professionals on page 95 and the Sustainable Development Goals (SDG) found under Additional Resources. LINK ATTACHE Select one of the global recommendations from figure 5 or one SDG that align with your interests or one you feel passionate about that could significantly improve global health. Review the recommended actions. Consider what steps healthcare professionals can take to advocate for vulnerable people at a global level?
PowerPoint presentation.
Reflect on global issues in healthcare and address the following in your presentation:

Briefly describe the selected global recommendation or SDG and the identified vulnerable population
Analyze current healthcare policies that impact your selected global recommendation or SDG
Explain the reason you selected the global recommendation or SDG and why it is relevant to the vulnerable population.
Discuss why the global recommendation you selected should be implemented or the SDG you selected should be achieved, including why there should be funding to implement the global recommendation or SDG.

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(Sustainable Development Goals (SDG) https://www.undp.org/content/undp/en/home/sustainable-development-goals.html
NAS Global Health Report 2017 Recommendations and Actions for Nurses and Other Health Professionals – PG 95
http://samples.jblearning.com/9781284140392/Chapter5.pdf

Assignment Expectations
Length: 10-12 slide presentation WITH NOTES
Structure: Include a title, objectives, and reference slides in APA format. Your presentation must include an introduction and a conclusion.

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Global Health: A Vision
for Action
Stephanie L. Ferguson

(CVD) and cancer. There are numerous factors that influence health such as the environment, mental
health, substance abuse, and antimicrobial resistance, to name a few. In the 2015 Global Burden of
Disease Study, Forouzanfar and team (2016) found that there are 315 conditions that contributed to
the most global disability-adjusted life years (DALYs). DALYs represent the total number of years lost to
illness, disability, or premature death within a given population (National Institutes of Mental Health
[NIMH], 2017). Other challenges for the world include increases in population growth, which has a
direct impact on climate, food supply, health systems and health workforce, and more. For instance,
by 2035, the World Health Organization (WHO) estimates that there will be a shortage of 12.9 million
health workers (WHO, 2013). Without enough health workers fit to serve in the right place at the right

OVERVIEW

Global health and its challenges remain a top priority for world leaders and health professionals. The
Millennium Development Goals (MDGs) developed by the United Nations (UN) showed us that the
world can set a vision for global health and action, yielding unprecedented efforts and profound
achievements (UN, 2015, p.4). Ban Ki-moon, former Secretary General of the United Nations, wrote it
best in the Millennium Development Goals Report 2015 when he proclaimed that, The MDGs helped to
lift more than one billion people out of extreme poverty, to make inroads against hunger, to enable
more girls to attend school than ever before and to protect our planet. They generated new and
innovative partnerships, galvanized public opinion and showed the immense value of setting ambitious
goals. By putting people and their immediate needs at the forefront, the MDGs reshaped decision-
making in developed and developing countries alike (UN, 2015, p. 3.). However, despite progress
achieved with the MDGs, as an example, the goals of reducing child mortality and improving maternal
health were not realized. Today, we anticipate with new hope the global health goals, indicators,
strategies, and actions set forth in the vision of the Sustainable Development Goals (SDGs) (UN, 2016).

The effects of globalization have been both positive and negative. From a positive perspective,
globalization has increased travel, trade, productivity, and economic growth in many nations.
Globalization has allowed populations to rapidly exchange information and share solutions to
common problems worldwide. However, the negative effects of globalization have led to an increase
in global health security threats such as outbreaks of pandemic influenza, Ebola, Zika, and Middle East
Respiratory Syndrome coronavirus (MERS-CoV ). Nations have struggled to meet the challenges of
these outbreaks due to of a lack of public health infrastructure and preparedness capabilities.

The global health challenges faced today are daunting and range from communicable diseases,
such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS),
tuberculosis (TB), and malaria, to noncommunicable diseases (NCDs), such as cardiovascular disease

(continues)

CHAPTER 5

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The Politics of Global
Health in the United
States of America

Global health, as a field of study, research, and
policy, has grown tremendously over the last

few decades. The United States has achieved a
proven track record and legacy of leadership in
providing foreign assistance, excellence in de-
termining global health policies, and funding
global health initiatives to care for populations
worldwide. As a nation, the U.S. has been a cham-
pion in the fight against HIV/AIDS, malaria,
and TB. For instance, global U.S. investments

time to care for the worlds population, the global quest for Health for All, Universal Health Coverage
and Access, and the realization of the SDGs will not be achieved by 2030.

To learn more about global health challenges and issues facing the world, refer to the latest health
topics, data, publications, country statistics, programs, and global governance structures provided by
the World Health Organization. The WHO is the premier United Nations organization responsible for all
policies and governance activities related to public health worldwide. The WHO website (www.who.int)
provides a wealth of information on health. To learn more about the mission and vision of the WHO, visit
their website at www.who.int/about/en/. The United States has been a champion and global leader in
health at the WHO headquarters in Geneva, Switzerland and at all the WHOs regional offices. To follow
the work of the U.S. in global health, visit the Office of Global Health Affairs (OGA) at the U.S. Department
of Health and Human Services (USDHHS) website (www.hhs.gov/about/agencies/oga/index.html). The
Office of Global Affairs is the diplomatic voice of the USDHHS. OGA fosters critical global relationships,
coordinates international engagement across USDHHS and the U.S. government, and provides
leadership and expertise in global health diplomacy and policy to contribute to a safer, healthier world.

This chapter overview is a snapshot of some of the global health challenges and issues facing the
world today and tomorrow. This chapter is a call to action for all nations to commit to investing in
global health, and for nurses and health professionals to advocate for the investment in global health.
Investing in global health over the next 20 years can save the lives of millions of children and adults,
and result in positive returns on investments for people living and working in lower-middle income
countries (LMICs) (National Academies of Sciences, Engineering, and Medicine [NAS], 2017). The author
of this chapter was selected to participate in the consensus study to determine global health and the
future role of the United States (see the press release: www8.nationalacademies.org/onpinews
/newsitem.aspx?RecordID=24737).

To learn more about Global Health and the Future Role of the United States, read the latest report from
the National Academies of Sciences, Engineering, and Medicine (2017).

OVERVIEW (continued)

OBJECTIVES

Define the politics of global health in the context of the latest National Academies of Sciences
report, Global Health and the Future Role of the United States (2017).

Provide examples of current global health initiatives important for nurses and other health
professionals.

Identify roles nurses and other health professionals can play in global health policy and
advocacy, including ways to get involved and get a seat at the table.

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include the creation of the Presidents Emer-
gency Plan for AIDS Relief (PEPFAR) in 2003
and the Presidents Malaria Initiative (PMI) in
2005. The U.S. has also been a key partner in
leading and funding the Global Fund to Fight
AIDS, Tuberculosis and Malaria and the Global
Vaccine Alliance (GAVI).

Likewise, the National Academies of Sci-
ences, Engineering, and Medicine have been
front and center studying the United Statess
work in global health and, in general, the sci-
ence in the field of global health, as well as global
health risk assessment and security worldwide.
The National Academies of Sciences, Engineer-
ing, and Medicine, also known as The National
Academies (NAS), are the private, nonprofit in-
stitutions that provide independent, objective
analysis and advice to the U.S. to solve complex
problems and inform public policy decisions re-
lated to science, technology, and medicine. The
Health and Medicine Division of the NAS helps
those in government and the private sector make
informed health-related decisions by providing
reliable and objective evidence. To learn more
about the National Academies of Sciences, En-
gineering, and Medicine, visit their website at
www.nationalacademies.org/.

In 1997, the Institute of Medicines (IOM)
Board on International Health was commis-
sioned to produce the first report to address the
United States interest in and commitment to im-
proving human health worldwide. The report,
entitled Americas Vital Interest in Global Health:
Protecting Our People, Enhancing Our Economy,
and Advancing Our International Interests, de-
fined global health issues as health problems,
issues, and concerns that transcend national
boundaries, and are best addressed by coopera-
tive actions (IOM, 1997). Similarly, in 2009, an
independent committee was constituted by the
IOM Board on Global Health to prepare a report
for then-President Barack Obama and his new
administration, entitled The U.S. Commitment
to Global Health: Recommendations for the New
Administration (IOM, 2009). Like the IOM 1997
Global Health report, it was concluded in the
2009 IOM Global Health report that the direct

interest of the citizens of the United States are
best served when the U.S. acts decisively to pro-
mote health around the world. That 2009 re-
port on global health also included a call for
better structuring of market incentives to de-
velop medical products.

Much has been achieved since the two IOM
reports (1997, 2009). For instance, the U.S. Office
of the Assistant Secretary for Preparedness and
Response established the Biomedical Advanced
Research and Development Authority (BARDA)
through the 2006 Pandemic and All-Hazards
Act (Public Law. No. 109-417, 42 US 201). An-
other example is the U.S. Food and Drug Ad-
ministration (FDA)s priority review voucher
program, established in 2007, which provides
our government with the ability to expedite the
FDAs review of new drugs, particularly those
needed in an emergency crisis like the 2014
outbreaks of Ebola in parts of West Africa. A
great case in point was the expedited review of
products to treat Ebola, which became eligible
in 2014. Despite these initiatives and achieve-
ments, there remains a need for drug and vac-
cine development worldwide to tackle some of
the persistent and emerging infectious disease
and other global threats today and tomorrow.

Since the 2009 IOM global health report,
much progress has been made in research de-
velopment in low and middle-income countries
(LMICs) through country-led workforce devel-
opment and the creation of national health plans.
In addition, the formation of the Nursing Educa-
tion Partnership Initiative (NEPI) and the Med-
ical Education Partnership Initiative (MEPI),
developed through the Presidents Emergency
Plan for AIDS Relief (PEPFAR) at the Depart-
ment of State to address the shortage of health
workers in high-burden HIV/AIDS countries.
NEPI and MEPI program efforts improved work-
force capacity in these LMICs.

The other most notable recommendation
that came out of the 2009 IOM Global Health re-
port was the recommendation to create a White
House Interagency Committee on Global Health.
The proposed new agency would be chaired by
a U.S. government senior official designated

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PEPFARs mission and global health mandate re-
main the same or should it be reformed? Better
yet, should the U.S. declare success and move
forward with another government global health
initiative? Other key stakeholders and citizens
questioned what the U.S. should be doing to pro-
tect our nation and the world from persistent
and/or emerging global epidemics and pandem-
ics, outbreaks, and global health challenges like
noncommunicable diseases (NCDs). Moreover,
what should the U.S do to address the unfinished
business in the Millennium Development Goals
(MDGs) and the new business of the Sustain-
able Development Goals (SDGs), particularly
in the context of women and children? Essen-
tially, citizens, government officials, academics,
private and public partners, foundations, busi-
nesses, other nations, and global health policy
organizations such as the United Nations (UN),
the World Bank, the World Health Organiza-
tion (WHO), the Global Fund, and the Global
Vaccine Alliance (GAVI) wanted to know what
the next presidential administration and the
U.S. government should be investing in related
to global health.

Thus, because of the upcoming presidential
elections in the United States in 2016, the timing
was right to ask the National Academies of Sci-
ences, Engineering, and Medicine to conduct a
new consensus study on Global Health and the
Future Role of the US. The 2017 NAS report on
global health, the third of its kind (IOM, 1997,
2009; NAM, 2017), was launched in May 2017.
The NAS global health consensus report was
commissioned to advise the new U.S. president
and administration, whether it be Hillary Clin-
ton or Donald Trump.

In August 2016, the author of this chap-
ter was selected and appointed by the National
Academies of Sciences, Engineering, and Med-
icine (NAS) to serve as a member of the Com-
mittee on Global Health and the Future of the
United States (CGH) (NAS, 2017). This author
is an elected member of the National Academy
of Medicine (NAM), formerly known as the
Institute of Medicine (IOM). The author was
fit for purpose because of her expertise, which

by the U.S. President. The job of the chair of
the new global health agency was to lead, plan,
prioritize, and coordinate the budget for major
U.S. government global health initiatives. Presi-
dent Obama agreed with this IOM 2009 Global
Health report recommendation and he created
the U.S. Global Health Initiative (GHI).

During this time frame, under the leader-
ship of President Obama and through the GHI,
the author of this chapter had the great oppor-
tunity to work with the GHI and the State De-
partment, the U.S. Human Resources for Health
Administration (HRSA), the National Institute
of Nursing Research (NINR) at the National
Institutes of Health (NIH), and the Centers for
Disease Control and Prevention (CDC) to pro-
vide health diplomacy services to strengthen the
research capacity of nurses and other health pro-
fessionals in countries like Bangladesh.

In addition to the author of this chapter,
Dr. Afaf Meleis, former Dean of the University
of Pennsylvania, elected member of National
Academy of Medicine (NAM, formerly IOM),
member of the IOM Global Health Report Com-
mittee in 2009; and Dr. Mary Kerr, former Deputy
Director of the National Institute of Nursing Re-
search at the National Institutes of Health and
Dean of the Frances Payne Bolton School of Nurs-
ing at Case Western Reserve, were a part of the
delegation that worked to strengthen the nurs-
ing capacity in research on behalf of the GHI.

Unfortunately, as time moved forward,
the GHI was not successful. There was a lack
of authority and budget given to the GHI and
its leadership; as a result, the only thing left to
show progress was an internet presence show-
ing some coordinating priority area of global
health programs. Despite the failure of GHI,
there was much progress made through PEP-
FAR, the Presidents Malaria Initiative (PMI),
and the U.S. Global Health Security Agenda.

With the hope of continued change post
President Obama and making America Great
Again, global health continued to be in the fore-
front of the presidential debates of 2016 behind
the scenes. Questions were being asked about
what the U.S. should do with PEPFAR. Should

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safety, air pollution, and water and sanitation
issues), refugee health, and health workforce,
to name a few, the CGH focused on priori-
ties with the potential for catastrophic loss of
life and impact on society, such as pandem-
ics, persistent communicable diseases (HIV/
AIDS, TB, and malaria), and noncommunica-
ble diseases (NCDs), specifically cardiovascu-
lar health and select cancers. As well, the CGH
focused on areas where significant U.S. funds
had been invested and determined what needed
to be achieved with the gains and how these in-
vestments should be consolidated and sustained
in the current presidential administration. The
CGH further agreed to focus the report on pro-
moting women and childrens health, build-
ing capacity, and global health innovation and
implementation.

The Committee identified two over arching
themes:

1. Securing against global threats; and,
2. Enhancing productivity and eco-

nomic growth.

The Committee proposed 14 recommen-
dations in the context of these two themes. As
well, four priority areas for action were iden-
tified to ensure the greatest positive effect on
health. The CGH felt that these two themes with
the 14 recommendations and four priority areas
set the strategy forward to position and main-
tain the United States as a global health leader
worldwide.

The four priority areas recommended
include:

1. Achieve global health security.
The Committee urged the adminis-
tration to create a coordinating body
within the U.S. government with the
authority and budget to develop a
proactive, cost-effective, and com-
prehensive approach to preparedness
for and response to international
public health emergencies. To learn
more about the global health security
priority, read Chapter 3 in the NAS
Global Health report (2017).

ranges from global health security, interprofes-
sional workforce, and leadership development to
health systems strengthening, universal health
coverage and access implementation and eval-
uation strategies, HIV/AIDS, and women and
childrens health. This author has worked in
more than 100 nations over 20 years on behalf
of the U.S. government, WHO, and the Inter-
national Council of Nurses.

The National Academies CGH was
charged to conduct a consensus study to iden-
tify global health priorities in light of emerg-
ing global health threats and challenges and
provide recommendations to the U.S. govern-
ment and other stakeholders for increasing re-
sponsiveness, coordination, and efficiency in
addressing these threats and challenges by es-
tablishing priorities and mobilizing resources.
The NAS received financial and expert sup-
port from a variety of federal agencies, foun-
dations, and private partners such as the U.S.
Agency for International Development (US-
AID), U.S. Department of Health and Human
Services (USDHHS), Centers for Disease Con-
trol and Prevention (CDC), U.S. Food and Drug
Administration (FDA), National Institutes of
Health (NIH), Presidents Emergency Plan for
AIDS Relief (PEPFAR), Rockefeller Founda-
tion, Merck Foundation, Becton, Dickinson,
and Company (BD), and Medtronic.

Like domestic U.S. healthcare policy and re-
form, funding and reforming global health care
and initiatives are highly political. In general,
foreign assistance is often considered a type
of charity, or support for the less fortunate. Al-
though this can be true for the poorest and most
vulnerable populations, most such aid, especially
when directed toward health, is an investment
in the health of the recipient country, as well as
the United States and the world at large (NAS,
2017, p. S-1, S-2). The CGH agreed that asking
the United States for more money alone to invest
in global health challenges was not the answer.

Moreover, realizing that there were many
global health challenges on which to focus, such
as mental health and substance abuse, environ-
mental health (including climate change, food

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coordination of private partners at
the country level and across the U.S.
interagency community to implement
strategies to ensure that CVD risk
factors are targeted for early detection
and treatment and particularly as
it relates to hypertension, cervical
cancer, and immunization against
vaccine-preventable cancers. See
Recommendation 9 (Promote cardio-
vascular health and prevent cancer),
and read NAS, 2017, Chapters 6 and 8,
for more information.

Finally, the report followed three cross-cutting
areas for action to maximize the returns on U.S.
investments to achieve better health outcomes
and use funding more effectively. These three
cross-cutting areas for action included:

1. Catalyze innovation through both the
accelerated development of medical
products and development of inte-
grated digital health infrastructure.

2. Employ flexible financing mechanisms
to leverage new partners and funders
in global health.

3. Maintain U.S. status and influence
as a world leader in evidence-based
science, economics, measurement,
and accountability. To learn more
about the cross-cutting themes, review
Recommendations 10 through 14 and
NAS, 2017, Chapters 7, 8, and 9.

An overview of the Committees recommen-
dations is provided in TABLE 5-1 with actions for
nurses and other health professionals to consider
they advocate for and participate in the develop-
ment of global health policies. To read the full
text of the NAS 2017 Global Health report rec-
ommendations, please see the Recommendations
document available at www.nationalacademies.
org/hmd/reports/2017/global-health-and-the-
future-role-of-the-united-states.aspx. There is
also a Blueprint for Action in Table 10-1 of the
NAS Global Health report (2017), which out-
lines the recommendations pertinent to each
national entity with actions to achieve global

2. Maintain a sustained response to
the continuous treats of commu-
nicable diseases.
The Committee urged the adminis-
tration to maintain a sustained focus
on HIV/AIDS and malaria, as well
as a re-evaluate the commitment to
fight TB. The progress achieved to
combat these communicable diseases
needs to be sustained to prevent
reversal of the gains achieved in the
past decades and avoid the further
spread of resistant strains in all three
diseases. To learn more about this pri-
ority area regarding maintaining and
sustaining response to the continuous
treats of communicable diseases, see
Recommendation 4 (Envision the next
generation of the Presidents Emergency
Plan for AIDS Relief ) and read more
about this in NAS, 2017, Chapter 4.

3. Save and improve the lives of women
and children.
The U.S. commitment to the current
survival agenda should be continued
but also expanded to incorporate
early childhood development as a key
component. The Committee noted
that adding a multisectoral focus
on childhood development to the
current survival-focused programs
can contribute to resilient societies
and growing economies. To learn
more about Recommendations 7 and
8, which address the improvement of
survival in women and children and
ensuring health and productive lives
for women and children, you can
read more about this priority and
these recommendations in NAS, 2017,
Chapter 5.

4. Promote cardiovascular health and
prevent cancer.
NCDs, cardiovascular diseases (CVD),
and cancer are rising in countries
around the world. The committee
urged improved mobilization and

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