Global health is the last bastion of bipartisan foreign policy

Politics, and especially foreign policy, has always been the realm of strange bedfellows.

As we near the end of a contentious year in U.S. foreign policy, global health stands out as the last realm of rock-solid bipartisan cooperation with real successes to highlight. 

Bipartisanship on global health aid in its current form owes much to the unique circumstances surrounding the creation of the Global Fund the Fight AIDS, Tuberculosis and Malaria, the global public, private partnership dedicated to ending the three deadliest epidemics, to which the United States is the largest funder and the President’s Emergency Plan for AIDS Relief in 2001 and 2002 (PEPFAR).

The Global Fund is the largest funder of efforts to end tuberculosis and malaria, and second only to PEPFAR in efforts to end HIV/AIDS. Bipartisan support for the Global Fund in Congress led to the U.S. increasing its contribution by 15.6 percent this year (assuming the eventual finalization of the Fiscal Year 2020 funding).

The creation of PEPFAR and the Global Fund brought with it the most unlikely of collaborators, an alliance including President George W. Bush and then-House Minority Leader Nancy Pelosi (D-Calif.). Pelosi represents one of the areas hardest hit by the HIV/AIDS epidemic in the U.S. and is a lifelong supporter of a robust response to AIDS in the U.S. and globally. 

Bush fashioned a cohesive policy toward sub-Saharan Africa’s stability and growth and championed the massive PEPFAR project. Giants like Tom Lantos (D-Calif.), Sen. Bill Frist (R-Tenn.) and Tom Daschle (D-S.D.) took to the floors of the House and Senate in support of the authorizing legislation. 

Rep. Barbara Lee (D-Calif.), one of the original authors of the PEPFAR legislation, led the Congressional Black Caucus in calling for a comprehensive global policy to fight the epidemic.

Sixteen years later, Republicans and Democrats continue to champion the programs, and PEPFAR and the Global Fund have proven to be definite successes.

As Mark Dybul, one of the architects of PEPFAR, the former U.S. Global AIDS Coordinator and former executive director of the Global Fund, said, “At one point, 75 percent of pregnant women had HIV in Botswana. Most diseases kill the very old and the very young. But this disease was killing the most productive and reproductive parts of society.” 

Because of the work of the Global Fund and PEPFAR, in 2018, the prevalence of HIV/AIDS in women aged 15 to 49 in Botswana was less than 25 percent, and there were fewer than 500 new infections in children under 14.

Global health programming has long since expanded beyond PEPFAR to include programs like the President’s Malaria Initiative, also launched by President George W. Bush, and USAID’s tuberculosis program, which both still enjoy significant bipartisan support.

In 2019 alone, members of Congress on both sides of the aisle have championed global health aid as critical to U.S. interests abroad.

Ami Bera, a senior House Democrat, and doctor has positioned himself as a critical champion for global health security, saying in a letter to colleagues, “The United States has devoted enormous and commendable efforts in making our nation and the world a safer place from emerging infectious disease. We must continue those efforts. As one public health expert noted, withdrawing funding now would be like building fire stations around the world without having trained firefighters to put out the fires.”

Bera is by no means alone. Martha Roby, a conservative Republican from Alabama, is similarly supportive of global health aid programs. In an extension of remarks filed in May, she said, “It is important that we remain engaged and not become complacent, especially as life-threatening diseases begin to advance and mutate.”

The Global Fund and its partners have saved the lives of more than 32 million people at risk of dying from AIDS, tuberculosis, and malaria. The Global Fund’s most recent Replenishment pledge conference, in October 2019, saw pledges of over $14 billion for the next three years from 58 countries.

The U.S. increased the contribution, championed by those above and many more, was matched by similar increases from other donors, including Canada, the United Kingdom, Germany, France, and more. This fantastic support from donors across the globe will mean saving more than 14,000 lives a day. 

There are very few issues that can call on support from conservative Christian groups LGBTQ activists, the private sector, and sitting members of Congress across the aisle and spectrum. As Sens. Frist and Daschle said recently in a letter to congressional appropriators, global health “is a matter of global security. 

And it is a matter of precise results, a sound business approach, and return on investment.” They were joined on that letter by Elton John, Pastor Rick Warren, and former chair of the Joint Chiefs of Staff, General Richard Myers. 

Support from members of Congress from both parties is critical to guide U.S. policy and funding to end these epidemics for good. With much work left to do, there may be no better time for strange bedfellows, in Congress and out. 

Shannon Kellman is the policy director at Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria.