An America-first global health strategy: Invest globally, benefit locally

November/December 2025 | Volume 24 Number 6

Read recent commentary on global health research issues from current and immediate past directors of the Fogarty International Center.

In September 2025, the U.S. Department of State released the “America First Global Health Strategy,” emphasizing that U.S. investments in global health should directly advance the health, security, and economic interests of Americans. Around the same time, NIH issued updated guidance on maximizing and safeguarding foreign collaborations, underscoring that all NIH-supported research conducted abroad should generate knowledge applicable to understanding, improving, or protecting the health of people in the United States.Together, these policies reflect a broader alignment of federal science and foreign policy—global health engagement must deliver clear value back home.

Fogarty’s longstanding mission and our unique experience place us squarely at this intersection.

Fogarty accelerates innovation

For more than 55 years, Fogarty has supported research, training, and scientific partnerships around the world, yet these investments have never been “charity” or foreign aid. They have always been mutually beneficial. The new policy environment provides an opportunity to articulate this more clearly: Fogarty’s global collaborations have always and will always accelerate American innovation and make America healthier, stronger, and more prosperous.

In fact, the new alignment speaks to the existing concept of reciprocal innovation, a framework that recognizes innovation flows in both directions. Reciprocal innovation promotes a bi-directional exchange of ideas and solutions, driven by real-world needs, operational creativity, and the ingenuity of local researchers and communities across global settings. Traditionally, global health has emphasized the transfer of technologies and practices from high-income countries to low- and middle-income countries (LMICs). Yet LMICs also develop extraordinary innovations, such as community health worker models, mobile health platforms, point-of-care diagnostics, drone delivery networks, and frugal engineering approaches, all of which directly translate to the U.S. environment.

A reciprocal innovation framework fits squarely within the America First Global Health Strategy with its emphasis on strengthening global disease surveillance, accelerating medical innovation, and fostering U.S. leadership through scientific partnership. These goals cannot be achieved in isolation. They require worldwide collaborative research networks that can detect emerging threats, generate new knowledge, and develop scalable solutions long before diseases reach U.S. shores. They also require understanding which global health approaches can be adapted for American challenges, particularly in rural, underserved, or resource-limited areas.

Similarly, NIH’s updated guidance, which asserts that foreign collaborations must produce knowledge that benefits American science and health, does not mean fewer partnerships. It means ensuring research conducted abroad is scientifically rigorous, strategically aligned, and structured to produce insights that advance U.S. biomedical and scientific priorities.

Reciprocal benefits

When we frame global health research around mutual benefit, we make clear how international partnerships advance U.S. health, innovation, and security. Examples already abound. Telemedicine platforms, originally deployed with community health workers in East Africa and other low-bandwidth settings, have also been adopted by U.S. clinics to extend specialist care in underserved communities. Service delivery models pioneered in sub-Saharan Africa, such as differentiated HIV care and community adherence groups, have informed U.S. strategies for managing chronic conditions, including HIV and diabetes, in resource-limited settings. Point-of-care diagnostic innovations from south Asia, including low-cost molecular and rapid testing platforms, have helped shape U.S. approaches to expanding access to tuberculosis, COVID-19, and other essential diagnostics. And drone-enabled medical delivery systems first scaled in Rwanda have since been implemented in U.S. health systems to improve access to essential medical supplies in rural regions. Together, these examples demonstrate that investing in global health research strengthens both global and domestic preparedness.

Fogarty has been the catalyst for many of these advances. Our research training programs build global scientific capacity while embedding U.S. investigators in world-class research networks. Our partnerships support discovery science, implementation research, and training pipelines that directly contribute to domestic preparedness. And our alumni lead major health systems and research institutions around the world creating lifelong scientific relationships that the U.S. relies on during pandemics and other crises.

“America First” does not mean “America alone.” The health of Americans is inseparable from the health of the world. And some of the best ideas for improving U.S. health will continue to come from our partners abroad. By embracing reciprocal innovation and designing global health research with mutual benefit at its core, Fogarty can help lead the way toward a future where scientific collaboration makes America—and the world—healthier, safer, and more resilient.

Updated December 19, 2025

To view Adobe PDF files, download current, free accessible plug-ins from Adobe's website.