American leadership against deadly epidemics reaches a decision point

What is the end goal of America’s considerable investment in tackling the deadliest infectious diseases of our time? Americans should be proud that U.S. leadership against AIDS, tuberculosis (TB) and malaria has saved tens of millions of lives and helped dramatically to reduce their devastation. But what should be the long-term objective of these investments?

Whether you are looking from the perspective of lives saved, U.S. health security, global stability, economic growth, or American trade interests, the answer is clear: We need to focus on ending these three epidemics for good.

{mosads}The epidemics of AIDS, TB and malaria are each at a tipping point. Thanks to global efforts over the past 15 years, disease incidence and mortality have been driven downward. Twenty-one million people are now receiving lifesaving treatment for HIV. Between 2014 and 2016 alone, 582 million insecticide-treated nets were distributed globally to protect children and their families from malaria.

An estimated 53 million lives have been saved through TB diagnosis and treatment so far in the 21st century. In the process of scaling up targeted approaches to these diseases, health systems have been strengthened and are now more ready to identify and respond to the next Ebola or Zika. And many of the countries most heavily affected have increased investment in the health of their own people.

Still, there are serious risks of tipping backward. The number of malaria cases actually increased over the past year, recalling the numerous times in history when malaria resurged after policymakers lost interest. Drug resistance is on the rise for first-line medications used to treat each of the three diseases. And with growing global alarm about the threat of antimicrobial drug resistance, it’s important to remember that TB is both the world’s deadliest infectious disease and accounts for more than 1 in 4 antimicrobial resistance fatalities each year.

All this means that American policy is at a tipping point, too. Today the world is underinvesting in efforts to end the biggest epidemics; an expanded effort is needed to get on track. We face a choice: to mobilize partners to accelerate toward the end of epidemics, or stall and permit resurgence and drug resistance to overpower our success. Until we intensify the global response, these diseases will continue to claim millions of lives, drain billions of dollars from economies, and put our security at risk.

Moreover, protecting our health security should be a priority. Rapid spread of an infectious disease epidemic is among the most likely scenarios to result in the unanticipated deaths of tens of millions of people in under a year. We need to end the infectious diseases that are killing millions of people today and, in doing so, be better prepared for the diseases of tomorrow. 

Other countries can and should do more, but American leadership is essential. The U.S. provides unmatched expertise, sizeable resources and — crucially — strategic resolve to tackle the challenge. Our bilateral global health programs, the President’s Emergency Plan for AIDS Relief, the President’s Malaria Initiative, and the U.S. Agency for International Development TB program have produced impressive gains. Our investment in the Global Fund to Fight AIDS, Tuberculosis and Malaria leverages increased investment from other donors, the private sector, and implementing countries themselves. 

At the Tipping Point, a report released today, details U.S. efforts against AIDS, TB and malaria, and calls for a stepped-up, global effort to end the three epidemics. This would include smart new investments by other countries and the private and philanthropic sectors, matched by modest new resources from our own country, where global health funding has been essentially flat for nearly nine years. 

We should not fool ourselves that ending these epidemics will be easy, but it is possible by scaling up what works and investing in the scientific breakthroughs of the future. And if we do not seize this historic opportunity, achievements from U.S. investments to date could be squandered.

“All infectious diseases will revert and come back,” warns Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. “We have seen through multiple experiences over the years; we cannot stop until it’s over.” 

U.S. leadership has catalyzed impressive strides in combatting infectious diseases. Now it is time to focus on ridding the world of the AIDS, TB and malaria epidemics for good, and realize the vast human, economic and security gains this accomplishment will bring. Great nations do great things. Ending these epidemics can be a legacy for the United States. Now is the time to rededicate ourselves to global health leadership, and challenge the rest of the world to join us in a push to the finish line.

Chris Collins is the president of Friends of the Global Fight, which is a U.S. advocacy organization that advocates for the Global Fund to Fight AIDS, Tuberculosis and Malaria.