Why We Invest in International Assistance and Global Health

By Chris Collins

Several months ago, I was in a meeting with a prominent member of Congress who said he wished the funding bill that supports international assistance could be retitled, “the U.S. security bill – because that’s really what it is.” He was speaking of the State, Foreign Operations appropriations bill, the legislation that allocates just 1% of the federal budget to international assistance but is often served up as a prime candidate to slash in order to find budget savings.

Security means many things, and it is ever more precious in this chaotic world. It means strengthening the defense capacity of critical U.S. partners, stopping flows of nuclear materials and illegal drugs, and supporting peacekeeping operations. Security for the U.S. means controlling infectious disease epidemics and improving preparedness against the next pandemic threat. It means investing to educate young people and strengthening accountable governance so that our global partners have more stable, equitable societies and recognize the U.S. as a valuable ally in progress. And it means securing trade with other nations.

U.S. international assistance funding does all these things. That is why President Ronald Reagan increased funding in this account, noting, “The ultimate importance to the United States of our security and development assistance programs cannot be exaggerated.”

The tectonic changes reordering our world mean it is all the more critical that the U.S. make strategic investments in a range of international development priorities. In an increasingly competitive, multi-polar period of history the U.S. has a clear interest in being a visible leader in helping low- and middle-income countries prosper. The global demographic transformation underway, in which it is projected that Africa will represent 25% of the world’s population by the middle of the century, means it benefits everyone to partner with African countries to invest in their domestic health, education and job opportunities. The push back on civil society freedoms and rights in far too many countries also demands investment in democracy and governance.

Some have said that the U.S. has too many of its own problems and with our significant national debt we cannot afford to help other countries. But at 1% of the federal budget, cutting international assistance won’t balance the budget. Even if one is arguing for “America first,” that should also include “America secure.” We are not safe if the world around us is rife with conflict, allies are threatened, and poorer countries feel abandoned by the richest country in the world. Conversely, support to other countries can lead to tangible benefits for the U.S. economy: 12 out of America’s top 15 trading partners were once recipients of U.S. foreign assistance. 

The private sector, famously focused on the bottom line, understands the value of making investments that may not impact the balance sheet this quarter but are critical over the long term. Many hugely successful companies make major contributions to communities where they operate, beyond advertising their products. Thousands of businesses match employee giving for good causes.   

What is the impact of U.S. international development investment? U.S. leadership on global health is one place to look.  Since 1990, the global child mortality rate has been cut by more than half through U.S. and partner investments in immunization and other health measures.  The U.S. is the leading investor in the Global Fund to Fight AIDS, Tuberculosis and Malaria partnership that has saved over 59 million lives since 2002. Our global AIDS program, the President’s Emergency Plan for AIDS Relief (PEPFAR) has saved over 25 million lives and prevented 5.5 million babies from being born with HIV. New medical technology means the opportunities for lifesaving impact are rapidly expanding. New malaria vaccines and next generation bed nets could save millions of more lives and bend the trajectory of that ancient disease. Long acting prevention for HIV could protect millions more people from infection. 

Our global health investments mean greater health security for America and the world. In 2014, as Ebola spread through West Africa, Nigeria quickly contained cases in its capital city Lagos because of the laboratories and systems it had already built with PEPFAR investments. And health investments can advance global security.  The Global Fund has disbursed $15 billion in challenging operating environments, countries torn by conflict and displacement, helping to save lives and support stability.

U.S. politics may be polarized but bipartisan support of the American people for international development endures, as it has for over six decades. Americans care about saving lives and taking a broad view of their own security; we care about sustaining good relations with partners and sharing our values of democracy, civil society voice and equality. A recent Bipartisan Policy Center poll showed that 82% of voters, including sizable numbers of both Republicans and Democrats, believe it is important for the U.S. to take the lead on global health efforts.

At this moment in our history — with fragile geopolitics, multiple and diverse threats, changing global demographics and the huge opportunity to channel technological advances to save lives and prevent pandemics — America must stay engaged in the world. As Congress and the White House consider spending priorities in this year and into the future, they should increase support for strategic, outcomes-oriented international assistance — an investment in our own security and values.

Chris Collins is President & CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria