Investing in Global Health Enhances US National Security

– Walter O. Ochieng and Tom Achoki
Walter O. Ochieng is a physician and global health researcher at the Africa Institute for Health Policy. Tom Achoki, a former Sloan fellow at MIT, is Co-Founder of the Africa Institute for Health Policy.

NAIROBI – US President-elect Donald Trump’s return to the White House signals a potential break from decades of American leadership in global health. While Trump’s isolationist “America First” agenda may resonate with voters eager to see their tax dollars redirected toward domestic priorities, a US withdrawal from multilateral public-health initiatives would carry serious risks.

To be sure, there is a strong case for health self-sufficiency. Operation Warp Speed, launched during Trump’s first term, accelerated vaccine development and deployment, playing a pivotal role in controlling the COVID-19 pandemic and facilitating America’s economic recovery. But the notion that isolationism could shield Americans from the effects of global health crises is deeply misguided. The 2014-16 Ebola outbreak in West Africa cost the United States $1.1 billion and 12,000 jobs, even with just 11 cases reported on American soil.

The ongoing mpox outbreak, which originated in Central Africa and has since spread to more than 120 countries, serves as a stark reminder of how quickly public-health threats can escalate into global emergencies. A true “America First” strategy would focus on investing in robust surveillance and containment systems.

Investing in global health also makes strategic sense. As US firms seek to diversify their supply chains away from China, they require alternative manufacturing hubs with healthy and productive workforces. Countries with robust health systems are best positioned to fill this role.

Moreover, strengthening health systems in developing countries reduces migration pressures – a key concern for US voters – by addressing the root causes of displacement. Consider, for example, the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by then-President George W. Bush in 2003. With $110 billion in overall funding, PEPFAR has saved 26 million lives and accelerated economic growth in recipient countries since its inception. Studies comparing data from 2004 to 2018 revealed that PEPFAR contributed to a 2.1-percentage-point increase in the rate of per capita GDP growth, leading to a remarkable 45.7% rise in per capita GDP compared to 2004 levels.

Beyond its direct impact, PEPFAR’s disease-surveillance infrastructure has proven invaluable in managing subsequent health crises. It has also bolstered America’s global standing, with countries receiving PEPFAR support consistently reporting higher approval ratings for the US.

But the traditional aid model is long overdue for a radical transformation. Across the developing world, particularly in Africa, market-driven solutions are revolutionizing health care. In countries like Kenya and Nigeria, entrepreneurs are pioneering innovative, profitable models that combine digital systems, standardized protocols, and strategically located clinics to provide quality health care to middle- and lower-income populations.

Such ventures present significant opportunities for US investors seeking to enter the growing market for accessible health care in emerging economies. With some adjustments, America’s development-finance tools could facilitate the transformation of Africa’s health-care systems. The US International Development Finance Corporation, which has $60 billion at its disposal, is well-positioned to de-risk private investments in health ventures and attract additional capital through various forms of financing.

Early experiments appear promising. Stichting Medical Credit Fund, for example, has provided more than $100 million in loans to health-care facilities across the continent while maintaining a remarkable 96% repayment rate. Other innovative mechanisms, such as development-impact bonds, have shown that market incentives can improve health outcomes.

Nearly five years after the start of the pandemic, the world is grappling with several major health threats, from HIV/AIDS to malaria, which kills 619,000 people annually, most of them children. Critics may argue that eliminating these diseases is a pipe dream, but the same was once said about eradicating smallpox. If anything, Operation Warp Speed has demonstrated that American ingenuity, when harnessed effectively, can achieve the seemingly impossible.

The stakes are much higher than they may seem. In recent years, Africa has emerged as a key battleground in the escalating Sino-American rivalry. Through the “Health Silk Road” – an extension of its Belt and Road Initiative – China has funded 400 health-care infrastructure projects across the continent. During the COVID-19 pandemic, it sent medical experts to 17 African countries, using bilateral agreements to deepen trade and diplomatic ties.

America stands to lose far more than influence. To meet the needs of its growing population, Africa must finance massive investments in health infrastructure. The world power that fills this gap will not only reap financial rewards but also will gain preferential access to the continent’s vast reserves of critical minerals – essential for clean-energy technologies and advanced manufacturing. Notably, in African countries and regions where US health programs have been curtailed, Chinese firms have quickly stepped in, building hospitals and providing medical equipment, often in exchange for mining rights.

As competition for these resources intensifies, health diplomacy will become increasingly vital for securing America’s industrial future, a central pillar of Trump’s economic agenda. By focusing on targeted investments in areas where its interests align with global health priorities, the US can generate significant returns while maintaining cost efficiency.

In an increasingly interconnected world where the next pandemic disease outbreak is only a matter of time, investing in global health security is a form of disaster insurance. The choice facing the incoming Trump administration is clear: reclaim America’s health leadership or grapple with the far-reaching consequences of disengagement.

Persuading a skeptical electorate that investing in global health serves US interests will undoubtedly be challenging. But Trump has an opportunity to silence his detractors and create a health legacy that surpasses anything his predecessors achieved.

Walter O. Ochieng is a physician and global health researcher at the Africa Institute for Health Policy. Tom Achoki, a former Sloan fellow at MIT, is Co-Founder of the Africa Institute for Health Policy.