The fight against COVID-19 — a need for ‘soft power’ in health care

In considering our battle against the coronavirus COVID-19, we renew a call for “soft power” in U.S. health care to solve the challenges we face now and into the future.  

The current U.S. health care system is analogous to the U.S. military’s “hard power” —  the acute, advanced, highly effective, highly resource-intensive response to a military crisis (or in this case, the immediate illness threatened by COVID-19). American health care’s “hard power” is immense, powerful and effective, arguably the best in the world. Yet, U.S. health outcomes lag behind nearly every other high-income nation, even though we spend more and more of our national treasure on medical care.  

What the U.S. is missing is sufficient health-focused “soft power”: proactive, vigorous, coordinated, well-funded preventive and public health actions outside of the acute health care system. For the military, soft power includes the nation’s actions on diplomacy, economic development, trade agreements, foreign aid or sanctions, and promotion of education, women’s rights and democracy.

To improve the nation’s health, soft power should include education, surveillance and monitoring, scientific research, public health leadership and infrastructure. Systems for interagency coordination and schools and workplace environments that promote health should be implemented in this soft power approach. 

Additionally, soft power should encompass community urban design, a healthy food system that not only ensures food security but is also sustainable in its production. Moreover, vaccines, tax policy and other economic incentives that reward consumers’ healthier choices and businesses that produce healthier products. Policy should include taxation of hazardous products, child-resistant packaging, product labeling, and quality and safety standards for air, water, housing, food products, toys, mattresses, cars, and much more.

Over several decades, our elected officials, military leaders and intelligence experts have overwhelmingly recognized and endorsed the crucial need for highly coordinated, well-resourced, intensive soft power to identify and address disputes, instability and other national security threats. They’ve managed to do so in a preemptive, cost-efficient and effective manner. 

Accordingly, our soft power infrastructure for national security has been greatly expanded, modernized and coordinated. Yet, inexplicably, this has not happened in health care.

COVID-19 is a powerful reminder of the critical importance of soft power for health: effective surveillance, public health infrastructure, scientific research and expertise, interagency coordination, community efforts, education, business innovation and government policies to maintain and improve health, many of which are belatedly being employed in our battle against this pandemic.

Our hospitals, doctors, nurses and other health care professionals are doing an amazing job fighting on the health care front lines.. Yet, the burden of winning this war cannot be placed on their shoulders. We are recognizing as a nation that our health care system may soon be outnumbered and overwhelmed by patients who contract the disease.

COVID-19 is a stark message that looking beyond this immediate crisis, it is time to assess and develop a proactive, vigorous, coordinated and well-funded preventive and public health strategy and infrastructure to keep our nation healthy and safe into the future.

Dariush Mozaffarian is a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University, and has authored more than 400 scientific publications on dietary and policy priorities for improved health.  He has served as a health adviser to the U.S. and Canadian governments, the United Nations and the World Health Organization.

James Stavridis is a retired four-star U.S. Navy admiral, was Supreme Allied Commander of the NATO Alliance from 2009 to 2013, and dean of the Fletcher School of Law and Diplomacy at Tufts University from 2013 to 2018. He is the author of four books, including “Sailing True North: Ten Admirals and the Voyage of Character” (2019).