Global Health Overview
FY2017 Funding Recommendation:
President's FY2017 Request
InterAction's FY2017 Recommendation
U.S. global health funding through the Department of State and USAID helps reduce child mortality, slow the spread of diseases such as HIV/AIDS, address health emergencies, prevent malnutrition, and support initiatives such as the President’s Malaria Initiative (PMI) and President’s Emergency Plan for AIDS Relief (PEPFAR). Relatively modest investments by the United States have not only saved lives, but also improved the economic growth and stability of developing nations. And since national borders do not stop the spread of disease, addressing global health issues is also important to protect the health of Americans.
U.S. global health programs are providing antiretroviral treatment to 9.5 million people living with HIV and have prevented HIV transmission to millions more. Immunization programs save more than 3 million lives each year. Since its inception, PMI has distributed more than 105 million long-lasting insecticide-treated mosquito nets, sprayed more than 5 million houses with insecticides (providing protection for over 18 million people), and provided 25 million preventative treatments for pregnant women. Programming also addresses diseases such as polio, tuberculosis and neglected tropical diseases – as well as preventing malnutrition, decreasing maternal mortality, improving infant health, developing new health technologies and vaccines, and assisting women with the timing and spacing of pregnancies.
Global health efforts also focus on training capable health workers throughout developing nations in order to strengthen health systems abroad. Building the capacity of country health systems ensures healthier and safer populations, creates more prosperous economies, and reduces dependency on foreign aid. Additionally, greater flexibility in global health funding allows resources to be used for emerging health priorities, such as non-communicable diseases, injuries (such as road crashes), and the increased prevalence of individuals with disabilities.
Global health programs also develop and implement new technologies and tools to help countries get ahead of health challenges. Sustaining U.S. investments in global health is crucial so that these challenges do not become more expensive and difficult to resolve in the future.
For FY2017, InterAction recommends $10.078 billion for USAID and State Department global health programs. Please see the separate Choose to Invest global health pages, which provide more detail sector by sector.
Chlorhexidine for Umbilical Cord Care
Severe infections are a leading cause of newborn deaths worldwide. Many of these infections are caused by bacteria entering the umbilical cord stump due to unhygienic conditions or the application of substances such as cow dung to the cord stump.
Now – thanks to the collaborative efforts of the USAID, the National Institutes of Health (NIH), PATH, and other nonprofit and academic organizations – there is a new tool to protect newborns, an antiseptic called chlorhexidine that is applied to the newly cut umbilical cord.
Chlorhexidine for umbilical cord care has the potential to be a game-changing innovation. It requires no cold chain and is easy to apply with minimal training. Few other inventions have such potential for rapidly reducing newborn mortality at such a low cost. At less than 50 cents per dose, this product has the potential to save an estimated 1 million newborns over the next 15 years.
Early efforts in Nepal
Chlorhexidine has been used for decades in surgical hand scrub and wound care products. Recognizing its potential to reduce neonatal mortality, USAID, NIH, and the Bill & Melinda Gates Foundation co-funded the first study of umbilical cord care using chlorhexidine in Nepal, which included 15,000 infants. It found that 7.1% chlorhexidine digluconate prevented infection and reduced neonatal mortality by around 24% more than care with soap and water or standard dry cord care.
Following these promising results, the Nepalese Ministry of Health approved a USAID-funded pilot of chlorhexidine in four districts. Community health workers educated mothers about the risks of cord infection and chlorhexidine was incorporated into routine newborn care. After the successful pilot programs, the Nepalese government began to scale up the use of chlorhexidine nationwide. USAID is supporting scale-up through their Saving Lives at Birth program. Today, chlorhexidine has been introduced in 68 of 75 districts in Nepal.
Two additional USAID-funded chlorhexidine trials in Bangladesh and Pakistan showed reductions between 20 and 38% in neonatal mortality. These results, combined with the success in Nepal, increased global interest in chlorhexidine. Under the USAID-funded Health Tech project, PATH submitted an application to the World Health Organization essential medicines list (EML) for 7.1% chlorhexidine digluconate, which was added to the WHO EML in 2013 and in 2014 WHO issued new guidance on postnatal care, which included a formal recommendation on chlorhexidine.
Chlorhexidine gains global attention
The Chlorhexidine Working Group, an international collaboration of organizations led by PATH and funded by USAID and the United Nations Commission on Life-Saving Commodities for Women and Children, is working to advance the use of chlorhexidine through advocacy and technical assistance. Currently, chlorhexidine is being scaled up in ten countries, and policymakers in more than 15 other countries have expressed interest in introducing it. Four local manufacturers in Nepal, Bangladesh, Nigeria, and Kenya are already producing high-quality 7.1% chlorhexidine digluconate.
Thanks to the US government’s leadership and investment, chlorhexidine is poised to be an important new tool in ending preventable newborn deaths worldwide.