A new report by David P. Fidler, of the Council on Foreign Relations, urges a radical shift in U.S. global health policy, prioritizing pandemics and climate change to safeguard national interests amid differing political strategies. Fidler is a senior fellow for global health and cybersecurity at CFR.
"The United States was unprepared for a pandemic and is not ready for climate change — despite global health involvement, warnings about both threats and no competition from authoritarian countries for global health leadership," Fidler said in the report.
Fidler urged the U.S. to radically reshape its foreign policy on global health. The report, entitled "A New U.S. Foreign Policy for Global Health: COVID-19 and Climate Change Demand a Different Approach," contends the twin challenges of pandemics and climate change necessitate a fresh perspective on safeguarding national interests.
Tracing back the evolution of U.S. global health policy since the creation of the World Health Organization in 1948, Fidler said it took until the post-Cold War era for policymakers to integrate global health seriously into foreign policy, the report noted. This renewed emphasis was partly driven by concerns about bioterrorism, especially in the wake of events like the September 11 attacks and the subsequent anthrax incidents.
High-profile outbreaks, including the severe acute respiratory syndrome (SARS) in 2003, augmented worries about global pandemics and led to both national and global policy modifications. Moreover, significant humanitarian programs, like PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria, were set into motion, bolstering the U.S.'s leadership in global health by the mid-2000s, the report said.
The report contrasts the different strategies adopted by the Trump and Biden administrations. While Trump used the pandemic for domestic and geopolitical advantage, leading to disruptions in global partnerships, Biden emphasized restoring U.S. leadership in global health, climate change mitigation and bolstering public health initiatives.
Among the key political lessons Fidler listed are the past U.S. foreign policy on global health failed to fully protect national interests. There was a significant gap in addressing the threats posed by climate change, the report said. Despite its global health leadership, the U.S. struggled to protect the liberal international order. The biotechnology and pharmaceutical sectors played a pivotal role in safeguarding vital national interests. The current health and climate crises underscore the urgent need for a change in foreign policy, even though political hurdles remain high.
Fidler concluded with a set of recommendations aimed at reinforcing both domestic and international health policy. He advocated for the bolstering of the federal government's command-and-control structure for biosecurity and the transformation of the Global Health Security Agenda into a more robust alliance, according to the report.
Additionally, he suggested the creation of state-level health security fusion centers and the establishment of a Foreign Health Service to fortify U.S. diplomatic capabilities in health, per the report.
He further underscored the importance of ensuring financial backing for health and climate change initiatives under the G7 Global Infrastructure and Investment Partnership and advocates leveraging the capabilities fostered by Operation Warp Speed to collaborate with countries in response to health emergencies, the report said.
