Interview with HHS Assistant Secretary for Global Affairs
In June, YPFP member Alex Penler sat down with U.S. Department of Health and Human Services (HHS) Assistant Secretary for Global Affairs, Ambassador Jimmy Kolker to talk about global health and national security, as well as the recently released HHS Global Strategy. On August 25th, Ambassador Kolker will join YPFP for a discussion on the future of global health diplomacy.
Q: Why is global health a national security issue?
Amb. Kolker: The trillions of dollars that the world can expect to lose in the next couple of decades due to terrorism, to climate change, and to outbreaks of diseases and epidemics are likely to be of equal magnitude. However, while we’re currently investing—as we should— to fight terrorism, and to prevent and mitigate the effects of climate change, we are not spending near that amount on outbreaks and epidemics. Bioterrorism, or an outbreak of a disease we don’t have the ability to control, is also a threat to our own homeland. If there is a human transmission of pandemic influenza, similar to what has occurred historically, the country will be affected at its roots. The fact that synthetic biology means bioterrorists can get a hold of pathogens much more easily means that the bioterrorism threat is more immediate than it probably was even 15 years ago, when anthrax challenged our surveillance and response capacity.
Q: What is the U.S. government doing now in terms of global health security?
Amb. Kolker: Global health security, in terms of biosafety and biosecurity, has always been a U.S. government priority. What we’ve tried to do in this administration is look at health systems and emergency preparedness for outbreaks in order to prevent and respond to pathogens in a much more systematic way. We looked at the weakest links and how we can build up the world’s response through the Global Health Security Agenda (GHSA). Although started before Ebola was widespread, it is the basis of the response to lessons learned during the Ebola epidemic. With the GHSA and the WHO’s International Health Regulations, we now have a structure in place to prevent the next Ebola-like outbreak from becoming an epidemic. It is within our grasp, we know what to do. We are helping countries and higher risk areas to accelerate their capacity to respond to an outbreak.
As part of the GHSA, the U.S. government has agreed to partner with 31 countries to help build that capacity. It’s a presidential priority and a great example, just as the President’s Emergency Plan for AIDS Relief (PEPFAR) was, of U.S. leadership bringing other nations and multilateral organizations together because we can’t do this alone. PEPFAR was not just a U.S. bilateral project; we are working with UNAIDS, the Global Fund, the World Health Organization and UNICEF. With GHSA, multilateral partnerships have become how we use U.S. leadership to actually achieve results – not just building capacity in countries, but also leveraging other donors and technical partners.
Q: What should be done in the future and what are the next steps moving forward?
Amb. Kolker: The future is now. Adhering to the International Health Regulations is critical. China is a good example. After the first outbreak of SARS, China, in partnership with our Centers for Disease Control and Prevention (CDC), the U.S. government, and other partners, built up their domestic response system. As a result, when H7N9 [bird flu] appeared a couple of years ago, they did everything right. They had the reporting protocols in place, the established partnerships with the WHO, and the WHO collaborating center in China, which collected the information and reported it and had the expertise on site in order to help out. China is a unique case because it is so geographically large and has a huge population at risk if it were to experience major outbreaks, but it’s a case every country can follow. With some basic infrastructure and the protocols, knowledge, and the human resources to mobilize at the appropriate moments, we can respond effectively.
Amb. Kolker is the Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services (HHS). Prior to joining HHS, he had a 30-year diplomatic career with the U.S. Department of State. He was U.S. ambassador to Burkina Faso (1999-2002) and Uganda (2002-2005) and served as the Deputy Global AIDS Coordinator in the Office of the U.S. Global AIDS Coordinator. He also served as the Chief of the HIV and AIDS Section at UNICEF’s New York headquarters.