This year, Dr. Atul Gawande started a new challenging job. Former New Yorker staff writer, Dr. Atul Gawande is now head of global health for U.S. Agency for International Development. This agency provides humanitarian and foreign aid all over the globe.
It's been a challenging year so far.
The pandemic continues and many cases are currently rising in many countries. There's also the global monkeypox epidemic, the possible global repercussions from Roe v. Wade being overturned by the U.S. Supreme Court, and other health emergencies that have emerged in the wake the pandemic.
NPR spoke with Gawande about the Agency's top health priorities for low-income countries. These are some highlights from the interview.
His guide is an African proverb:
I have learned to accept an African proverb: "If your goal is to travel fast, you should go alone. But if you are looking to go far, you should go with someone."
It's slow to get everyone together in all our agencies, with Congress and with our political parties. It takes a lot time to get people together, and a lot more time calling. This is the hard part.
The U.S. works to increase vaccination rates in countries with lower incomes:
Health systems in lower-income countries are fragile. They lack a lot staff. They don't have the cold chain or refrigerators [to keep COVID vaccinations cool]. We have assisted a number of countries to get refrigerators in rural areas. Additionally, we have been able bolster surge staffing for vaccination campaigns. Since the inception of the Biden administration, we have been doing this.
However, U.S. resources can be a problem in these efforts, so this is a new challenge.
We are now in a situation where Congress is not supporting the resources necessary to allow this surge in vaccinations, just as these countries are receiving the supplies and resources.
The first is to make sure that the message aEUR” on Capitol Hill and to you aEUR” that COVID is not going away is heard by many. A second reason is that variants are born in these areas without adequate vaccination or control. Our economic loss comes from global supply chains.
We can reduce the number of world-wide deaths by supporting the global effort to end the pandemic.
Monkeypox presents a similar challenge as COVID.
The human-to-human transmission can be stopped by testing for the disease, notifying contacts, and isolating the affected person until the pox rash disappears. The ability to take these precautions has not been possible in lower income countries.
The monkeypox vaccine is available and could be used to help.
To increase supply, the U.S. now gives money to manufacturers. We have ordered enough vaccine to give it to those at risk, or who are already exposed to monkeypox in America. That's all. These capabilities are not available to everyone, even those with the lowest income.
The pandemic has diverted attention from other health concerns:
COVID-19 caused an increase in deaths during the pandemic that resulted the first global decline in life expectancy since the turn of the century.
COVID has only been responsible for a small number of deaths. COVID's effects on the health system have led to deaths. Health-care workers are being fired and COVID aEUR is used to pay for their health care needs. This has also had an economic impact. Malnutrition has soared because of supply chain issues.
Climate events such as heat waves, hurricanes, and cyclones are added to the mix. War has also reduced food supply. You have a situation in which the global death rate has risen to more than 20%.
We must increase the global health care workforce.
We need to be able to see that all our work, whether it's COVID vaccines, being able detect if there is a monkeypox epidemic, making sure that acutely malnourished people get emergency food, and that malaria treatment aEUR's going through primary healthcare.
We are looking to invest in the primary health care workforce as the most crucial place. President Obama has requested $1 billion to fund a health worker initiative that will support low-income countries in the next budget. This is the crucial workforce that can respond to health crises and stabilize the health system. This group can deal with future outbreaks and current COVID requirements. It also provides the infrastructure to address our overall decline in life expectancy.
USAID's work will not be affected by the U.S. Supreme Court decision on Roe v. Wade being overturned
The Biden administration is committed to promoting sexual and reproductive rights and health. This commitment has not been modified in any way. It is crucial that we continue our work in these areas.
USAID will continue to defend human rights
The ruling raises concerns about the rights of gay, lesbian, and transsexual individuals around the globe aEUR" and whether access to contraceptives, family planning, and rights will be restricted.
It is feared that this is just the beginning of a process that will take away privacy rights as well as sexual and reproductive rights. We are working hard to ensure that everyone has access to adequate reproductive health care aEUR and that human rights are protected.