Foreign Assistance Crucial To World Health And U.S. Security

When asked on Face the Nation for specific priorities that might be cut as a result of the economic crisis, Barack Obama offered the possibility that his pledge to double foreign assistance by 2012 might have to be "delayed".

Then Joe Biden during the vice-presidential debate echoed Obama's suggestion to "slow down" foreign assistance.

Meanwhile, though John McCain has talked about his strong support for foreign aid, he has never made a clear commitment on funding levels. In the first debate he suggested that a full freeze on spending was a possibility, which would make it impossible for him to reach his stated goal of stopping malaria by 2015.

Why are both parties, who have repeatedly spoken in favor of increasing foreign assistance, now so quick to propose slowing down or canceling aid that can help fight urgent disease threats and restore America's battered image abroad?

There is no denying that Americans are feeling real pain as a result of the economic downturn. Spending by the next President on health, education and infrastructure, as well as economic stimulation, is an urgent priority. But backing away from foreign assistance is not good policy, it is not necessary, and, even during this financial crisis, it is not good politics either.

Foreign assistance plays a key role in restoring America's image abroad, and many experts, including military leaders, have made clear its crucial role in preventing the emergence of failed states.

After years of failed US policies abroad, now is exactly the wrong time to engage in isolationism. Warning against a tendency toward isolationism in the face of the current downturn, British Prime Minister Gordon Brown also appealed to rich countries not to use the crisis as a reason to not help the poor. "This would be the worst time to turn back," he stated.

Americans should be proud that US assistance programs are saving lives. Take for example, the US global AIDS program (PEPFAR). In July 2008, the United States government reauthorized PEPFAR, the single biggest global public health program in history. In its first five years, PEPFAR supported life-saving treatment for approximately 1.73 million men, women and children, and it has increased countries' ability to better manage health threats using their own resources.

In addition to the many moral and humanitarian arguments for increased foreign assistance, it also is important to protect our own health security. For example, consider tuberculosis and its new variant, extensively drug resistant tuberculosis (XDR-TB). The Department of Homeland Security has called XDR-TB, with death rates approaching 100 percent in some settings, an "emerging threat to the homeland." In the early 1990s, New York City had one of the worst outbreaks of multi-drug resistant TB the country has ever seen, and the city had to spend nearly $1 billion on containment. A delay in providing the relatively tiny amount of increased spending needed to fight all forms of this deadly disease will only further our vulnerability to this serious global health problem.

For the same reason, it would be foolhardy for the US to fail to provide the relatively small amount poorer countries need to address pandemic influenza, which could kill over half a million Americans, hospitalize more than two million, cost our economy a staggering $70-$160 billion in lost productivity and direct medical expenses.

Looked at this way, it is easy to see that foreign assistance is just as important to America's interests as any of the big ticket items in the defense budget. Additionally, foreign assistance amounts to less than one percent of the US budget, so delaying or canceling even a doubling of that will not free up significant money for human needs in the US. Even in the midst of significant and real domestic economic and social conditions at home, the US is positioned to provide that leadership and drastically reduce needless suffering and death from preventable and treatable diseases and save literally millions of lives.

Fortunately, both candidates made it clear at the recent Clinton Global Initiative Annual Meeting that foreign assistance is critical to our security prosperity and reputation in the world and both have also promised reforms in foreign aid to make it more effective:

Senator Obama has said, "The security and well-being of each and every American is tied to the security and well-being of those who live beyond our borders" and foreign assistance is "our best investment in increasing the common security of the entire world."

McCain agreed, stating "True security requires a far broader approach, using non-military means to reduce threats before they gather strength. And this is especially true of our strategic interest in fighting disease and extreme poverty across the globe."

If they truly believe this, they should keep to their promises to increase aid while also making sure the money is well-spent.

As the nations of the world gather to celebrate the 60th anniversary of the Universal Declaration of Human Rights, our leaders must take bold steps towards restoring the United States as a global leader in supporting human rights and international law, while demonstrating the political courage to hold ourselves accountable for promoting human dignity in all walks of life.

In these difficult economic times, it is more important than ever for our leaders to hear from us that keeping our commitments to the world's most vulnerable people is still a priority. A new petition by the ONE campaign calls on Barack Obama and John McCain to do just that.

Comments

[dwils09]

This is a great article. Thanks to the authors.

By investing now in building the health infrastructure in developing nations we can prevent the current shortage in healthcare workers from getting even worse. If we improve the working conditions for the healthcare workers in sub-Saharan Africa, we can decrease the "brain drain" of African health professionals to developed nations. However, if the shortage of healthcare workers is not addressed, even more healthcare workers will leave their home country for safer working conditions, and it will cost even more money in the future to reverse the damage.

Another example of how foreign assistance is making a significant impact is in the fight against malaria. Recent data from the WHO has shown that international aid has enabled the African nations of Eritrea, Rwanda, and Sao Tome and Principe reduce malaria deaths by about 50 percent from 2000 to 2006. With continued funding and effort, the elimination of deaths from malaria is achievable in the near future.

[david bryden]

Investing in global health benefits your state's economy, businesses, and health... besides being the right thing to do. There IS a connection between global health and the economic well-being of YOUR state. Go here for info:
www.familiesusa.org/issues/global-health/publications/global-health-and-your-state.html

[Susan Morgan - Huffpost Blogger]

After watching 2 presidential debates and one vice presidential debate where the discussions focused almost exclusively on the US economic crisis and a war of our own making, I was heartened to read this post regarding our role in helping the majority of the world's population who have problems unimaginable to the average American. While I agree with the authors that foreign assistance is vital to our national security and our own long-tern health, it is important to also acknowledge that this aid is simply the right thing to do as citizens of the world community.

[bts1230]

This is a great article. Thanks so much for explaining and helping me and other readers to understand that foreign aid is in our best interest from many different perspectives. Morally, I believe that America's core values push for helping those less fortunate than ourselves. I also believe that our foreign aid does a lot to improve our image in the world, especially when other factors may bring that image down. From a national security standpoint, I think that foreign aid definitely plays a role in keeping potential attackers at bay, because if we are helping to improve the lives of people in other countries, then it takes away some of the incentives of attackers from those countries who feed on the poor and angry for a support base.

I think that everyone who reads this article should be moved to sign the PETITION mentioned at the bottom. It only takes TWO SECONDS.

Thanks again Jirair and David

[clcurry]

Thanks to the authors for this post.

While it is scary to see the economic issues unfold in the United States, Europe and Asia, I think the authors are right on thinking that if we withdraw or reduce foreign aid, especially foreign aid as it relates to health, we are going to be paying a lot more in the future -in terms of dollars, political and economic stability and our standing in this world.

The examples of HIV and tuberculosis (especially the tuberculosis that is resistant to multiple medicines) are especially important. The money that the US government has invested thus far in prevention and treatment of these diseases has had an incredibly far reach, and has provided access to medicines for millions of people as well as expanded access to primary care services. This money should be seen as going into 'preventative medicine'. What I mean is, not only does this type of aid literally treat and prevent illness, but it also can prevent the social and economic collapse that can follow entire generations taking ill with HIV, TB and other illnesses.

[bpreville]

it is vital to ensure that the process of foreign assistance reform assures a truly beneficial impact for the very poor. It is critical to urge members of Congress to focus on this central component of reform.

We must change our approach to reform from a predictable reshuffling of the current org chart boxes and old ways of doing things--disparate programs, objectives, and initiatives lacking a common direction"and start from scratch. This requires leaders with vision and the courage to break away from this likely course.

There must be an agenda that begins with a discussion establishing the guiding principles and specific objectives of the U.S. foreign assistance program. A firm discipline will be needed to withstand the habitual tendency for the conversation to revert to the perspectives and artifacts of the status quo, especially in those who have helped shape it and have a stake in its continuance, and because what is already in place is familiar.

Such systems change doesn't have to be complicated. For example, Canada passed a bill in May requiring that Canada's foreign assistance contribute to poverty reduction, take into account the perspectives of the poor, and be consistent with international human rights standards. It is all of 3 pages long.

Will our Senators and House Representatives work on true reform of Foreign Assistance, making sure the new Foreign Assistance Act is truly reinvented, based upon articulated principles and objectives?

[PeteWitzler]

I can't find the exact quote, but in a roundabout way last night, Obama began making the connection between or bloated military budget and 10 billion a month in Iraq "supplemental" spending as causes of our current financial woes. He seem's to understand it is not a case of "either", "or", but a case of re-defining the priorities of this country. All the money we are currently spending in Iraq, and money we just spent on the bailout, err rescue plan...is money we should have been spending creating green colar jobs, investing in health care, and providing tax relief to the middle class.

[CAFT]

Speaking of a bloated defense budget, the $620+ billion dollars a year doesn't even include spending for Iraq and Afghanistan! That's all in supplemental spending bills. People who want to reduce waste in our spending should look first and foremost at the defense budget.

I also agree that we need foreign assistance reform so that it focuses on poverty reduction (and thus global security) rather than military aid to many countries (and thus global insecurity). Granted, that will require shifting some of our war inc. economy to focus on peace-time industries, but I think that would be better for us, our children and our world!

[Kpatterson]

The writers are right on target. We will get better results from our meager investment in foreign assistance than we will by increasing our obscene defense budget, which McCain said would not be frozen under his spending freeze. Foreign aid is soft power that raises our moral standing and ability to partner in the world, and makes us safer. Imagine what would happen if the U.S. took a lead in achieving the Millennium Development Goals (MDGs).

But we must also reform how we are conducting our foreign assistance. The U.S. Government Accountability Office (GAO) has evaluated U.S. emergency food aid, education, and child survival programs and in each case has found it nearly impossible to know how much is being spent on these programs and what these expenditures are achieving. GAO estimates that $0.65 per dollar of emergency food aid is being sucked up in non-food expenses. This is crazy. It's not that we are not doing good work in many cases, just that we could be doing so much more.

Either new administration should stay on track to increasing foreign assistance, but Congress must overhaul the Foreign Assistance Act of 1961 so that our foreign aid investments are focused on alleviating poverty, achieving the MDGs, and doing so in an effective, efficient manner.

[Jirair Ratevosian - Huffpost Blogger]

Great point Kpatterson. Thank you for the comment.

In 1968, Lyndon Johnson, upon Signing the Foreign Assistance Act of 1968, said foreign assistance "reflects our hopes for the kind of world our children will live in. It states our conviction, based on experience, that we can take effective steps with other nations to repeal the crushing lifetime sentence of poverty, disease, and ignorance under which most people are born. In a word, foreign aid is America's best investment in world peace."