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Global health smarts

What makes global health smart?

As President Clinton’s former Deputy Secretary of Defense John J. Hamre said Monday at a forum on “smart global health,” some of the most effective tactics the military uses today are vaccines, food, water and shelter in a crisis.

“After Sept. 11, our response was anger … fear,” said Hamre, now president of the D.C.-based Center for Strategic and International Studies. While a military response is obviously sometimes the right response, he said “smart power” is often much more effective than brute force at winning overseas in the long run.

After the 2004 massive earthquake that devastated parts of Indonesia, the U.S. military orchestrated a massive relief effort. Prior to this, Hamre noted, the approval rate for Americans in this predominantly Muslim nation was in the low teens. After the relief effort, he said, 70 percent of all Indonesians ranked the U.S. favorably.

And yet, Hamre noted, the federal government is now looking to cut foreign aid. The political push for cuts, many have noted, may come from American ignorance of how little we really spend.  Within the foreign aid budget, Hamre estimated we spend maybe $10 billion on global health projects — AIDS prevention and treatment in Africa, malaria prevention, children’s vaccines — every year.

“We spend $10 billion a month (on the military) in Afghanistan,” Hamre said.

To make the case for global health, advocates of the Obama Administration’s Global Health Initiative met with Hamre’s gang at the DC-based CSIS think tank on Monday to discuss their proposal for “smart” global health. Here is a copy of the smart global health strategy paper.

Seattle folks, from the Gates Foundation to PATH, play a big role in this push for smart global health. I’ve written about (and poked fun at) this before, mostly by asking the advocates to first define for me “dumb” global health. Here’s my post from when the CSIS gang came to Seattle to make their pitch.

And here’s the smart global health gang’s pitch on video:

There are a lot of arguments being made here, by folks like Hamre who contend that smart power efforts like disaster relief, health programs and poverty mitigation do more to advance our national interests than anything we can do with a tank or a bomber.

There are long-term economic benefits as well, many say, to improving health and reducing global poverty.

And as the Minnesota Democratic Congressman Keith Ellison (who participated in the forum) said yesterday:

“Let us not fail to make the argument that this is just the right thing to do.”

I can’t go over them all, but watch the video and read the CSIS report for the many compelling arguments to be made in support of not just sustaining our global health spending but even of boosting it.

What remains unclear to many is what exactly is meant by “smart” global health policy, precisely how the Obama Administration’s new Global Health Initiative will be implemented and if the American public can be convinced that spending taxpayer dollars to help the poor overseas is a good investment.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.