The Obama administration's emphasis on global health is reflected in a six-year, $63 billion strategy that emphasizes holistic approaches.
For a new Global Health Initiative, the president asked Congress for $51 billion to fight AIDS, tuberculosis and malaria and $12 billion for other global health priorities.
For fiscal 2010, he requested $7.4 billion for the three diseases, an increase of $366 million over this year.
"In the 21st century, disease flows freely across borders and oceans, and, in recent days, the 2009 H1N1 virus has reminded us of the urgent need for action," Obama said in a statement announcing the initiative.
"We cannot wall ourselves off from the world and hope for the best, nor ignore the public health challenges beyond our borders. ... We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health."
Presidential health adviser Dr. Ezekiel Emanuel, an NIH bioethicist, says the intention is to transition the President's Emergency Plan for AIDS Relief from an emergency program to a more sustainable effort.
"The idea is not to just attack disease by disease but to now begin to think more holistically across many diseases and across the sort of underlying causes of these diseases and to build infrastructure."
Speaking at a Kaiser Family Foundation discussion about the budget, Emanuel said, "One of the philosophies we'd like to get away from is this idea of the stovepipes. ... We want to build more into the infrastructure, build more on the synergistic places. Because you don't just have a patient with HIV, those patients have HIV, they have TB, they get diarrhea, they get parasites. ... To segregate these diseases out, again, is to be too narrow."
In his June 4 speech in Cairo, Obama announced new partnerships with Islamic countries for economic, scientific and technological development.
He said the United States will collaborate with the Organization of the Islamic Conference, representing 57 countries and describing itself as "the collective voice of the Muslim world," on a polio eradication campaign.
He also promised expanded partnerships with Muslim communities to promote child and maternal health and to open centers of scientific excellence in Africa, the Middle East and Southeast Asia.
The 2010 budget proposal for all of NIH was $31 billion, a 1.4 percent increase, not counting the $10.4 billion Congress appropriated for two years under the economic Recovery Act. Fogarty's request was for $69,227,000, an increase of $536,000 over fiscal 2009.
Fogarty Director Dr. Roger I. Glass submitted testimony in support of the Center's budget request, noting that in light of the A/H1NI virus outbreak, "solving health problems in an interconnected world requires greater international collaboration than ever before."
In related actions:
- Obama named Dr. Eric Goosby, a former director of the HHS Office of HIV/AIDS Policy, to run PEPFAR and New York City health commissioner Dr. Thomas Frieden, who once worked for WHO on tuberculosis in India, to head the Centers for Disease Control and Prevention.
- The Senate confirmed Bill Corr, former director of the Campaign for Tobacco-Free Kids as deputy secretary of HHS and Dr. Margaret Hamburg, former New York City health commissioner and one-time assistant director of the National Institute of Allergy as head of the Food and Drug Administration.
- The Senate Foreign Relations Committee voted to authorize the secretary of state to name science envoys "to represent the U.S. commitment to collaborate with other countries to promote the advancement of science and technology throughout the world."
- Reps. Howard Berman, D-Calif., and Mark Kirk, R-Ill., introduced legislation requiring development of a U.S. strategy to reduce global poverty and promote economic growth in low- and middle-income countries.
View the Kaiser Family Foundation discussion.