Valentin Fuster, MD, PhD, with his co-chair, Jendayi Frazer, PhD.
Fourteen steps to strengthen the nation’s global-health programs were recommended in a recent report by the Committee on Global Health and the Future of the United States, which was co-chaired by Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.
The special committee of the National Academies of Sciences, Engineering, and Medicine said that global health investment by the United States has long focused on the detection and treatment of infectious diseases such as tuberculosis and HIV/AIDS, with significant results. It found that while these efforts should be maintained, there is a pressing need to meet the challenge of cardiovascular disease (CVD) and other noncommunicable diseases. The report, which was featured in an editorial in The New England Journal of Medicine in September 2017, said that because of improved sanitation and prevention efforts, the burden of disease is shifting from infectious diseases to noncommunicable diseases.
“Chronic illnesses like heart disease and cancer continue to be a worldwide problem,” Dr. Fuster says. Cardiovascular disease was responsible for 18 million deaths in 2015, with the global cost expected to reach more than $1 trillion by 2030 in terms of treatment and loss of productivity. “The cost is huge, and we are not responding,” he says.
The committee was formed to provide “authoritative, independent, apolitical, evidence-based” recommendations, according to the National Academies of Sciences, Engineering, and Medicine. After eight months of research and deliberation, the committee published its 360-page report, Global Health and the Future Role of the United States, making recommendations in four priority areas:
- Ensuring global health security against infectious-disease pandemics
- Addressing communicable threats, like HIV/AIDS, tuberculosis,and malaria
- Investing in women’s and children’s health
- Promoting cardiovascular health and preventing cancer.
The report’s recommendations on cardiovascular disease were the focus of a December 2017 article in the Journal of the American College of Cardiology. The article noted that mortality due to CVD has been growing around the world, rising 12.5 percent between 2000 and 2015. And the increase was largely attributed to lower-middle-income countries, where 80 percent of all deaths related to cardiovascular disease occur.
The report cited “best buy” interventions for noncommunicable diseases that would cost $120 billion over 15 years but would drive a 10 percent decrease in CVD-attributable mortality and produce a $377 billion projected economic benefit due to increased productivity and lower health care costs. The interventions called for targeting risk factors with population-level measures, such as tax increases on tobacco and alcohol and point-of-service measures like counseling and drug therapy for people with a high risk of heart attacks.
The committee—co-chaired by Jendayi Frazer, PhD, a senior fellow at the Council on Foreign Relations—identified three “areas for action” to maximize the return on investments and achieve better health outcomes in its priority areas. They were: accelerating the development of medical products and digital health tools, employing more flexible financing to encourage new partners and funding, and maintaining the status of the United States as a leader in global health.
Investing in global health contributes significantly to economic prosperity and stability and creates more reliable and durable partners in the world, the report said, noting that 11 of the top 15 trading partners of the United States are former recipients of foreign aid. “The health and well-being of other countries directly and indirectly affect the health, safety, and economic security of Americans,” the report said. “The United States must preserve and extend its legacy as a global leader, partner, and innovator in global health through forward-looking policies, country and international partnerships, and most important, continued investment.”