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Nils Daulaire brings his fight to Seattle – Global is local!

“Our only chance to keep Americans safe is if the systems for preventing, detecting and containing disease … also stretch across the globe,” Nils Daulaire.

By Lisa Stiffler, special correspondent

Many Americans just don’t get it – Global health is a domestic issue.

That was the main message last night at Seattle’s Broadway Performance Hall from Dr. Nils Daulaire, director of the Office of Global Affairs for the U.S. Department of Health and Human Services.

One might think that Americans would be anxious about the next bird- or bug-borne pandemic, the strength of disease surveillance abroad.

Not exactly. At the “Diseases without Borders” forum Daulaire said that the question he’s most frequently asked is this: “Why does (Health and Human Services), a domestic institution, even have an Office of Global Affairs?”

Luckily, Daulaire makes a compelling case for spending taxpayer dollars on health issues arising outside our borders.

The case for spending

Consider: Fifty years ago, barely 2 million passengers arrived at SeaTac Airport on international flights; last year, 33 million did. More than 1 million people each day are coming into this country by land, air or sea. Half of our produce comes from outside our borders and three-quarters of our seafood does.

“Our only chance to keep Americans safe is if the systems for preventing, detecting and containing disease … also stretch across the globe,” Daulaire said.

Dr. King Holmes, chair of the University of Washington’s Department of Global Health, among other distinctions, moderated the event. After Daulaire’s presentation, Holmes quipped that he wished conservative presidential hopeful Ron Paul could have heard the talk.

“When we hear (Paul) saying don’t spend any money globally, now we have something to respond to him with,” Holmes said.

And to make clear what threats could be sneaking into America, Daulaire reminded the crowd of the recent scares from SARS, H1N1 virus and bird flu, or H1N5. He and Holmes also raised the specter of historic diseases that are evolving to defy every medicine used to fight them, diseases including TB, malaria and gonorrhea.

‘Not about charity’

But rather than terrifying the audience and sending them fumbling for their Purell dispensers, Daulaire spent a significant amount of time explaining the policy interests of the Office of Global Affairs. Their focus includes:

  • Women’s and girls’ health
  • Preventing infectious disease outbreaks
  • Tropical diseases
  • The safety of global supply chains

“This is not about charity,” Daulaire said. “It has humanitarian benefits, but its purpose is to help Americans’ health.”

Close to 100 people attended the event last night, which was hosted by the World Affairs Council. The crowd was eager to hear about the role that Health and Human Services was playing in the global health arena, and some in the crowd had worked with Daulaire in his previous jobs.

Before taking his current position two years ago, Daulaire was president and CEO of the Global Health Council, an international non-profit membership organization; he held leadership positions at U.S. Agency for International Development (USAID); and he conducted field research managing on maternal and child health in Nepal, Haiti, Mali, Bangladesh and elsewhere.

Now he’s helping negotiate policies that will lead to better disease surveillance systems internationally and establishing research collaboration abroad.

But that’s not to suggest that his gig is all smooth sailing.

Daulaire faces controversy at practically every turn. Some countries are seeking U.S. support for health programs as a way to supplant their own national budgets. He’s working more on non-communicable diseases including tobacco use, which could pit him against multinationals seeking to expand their cigarette sales in poorer nations as smoking rates decline in developed countries.

Then there’s AIDS

One audience member last night asked how his agency addresses HIV and AIDS concerns in countries such as Uganda who discriminate against gay and lesbian citizens.

“These are challenging issues to deal with,” Daulaire said, and certainly arise within homophobic governments in parts of Africa and the Islamic world.

He said his agency’s approach is to make the case that “everyone has a right to treatment.”



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