In refugee camps and the hallways of ministries of health, UN agencies, such as the UN Children’s Fund (UNICEF), UN Population Fund (UNFPA), UN Refugee Agency (UNHCR), UN Development Programme (UNDP), and World Health Organization (WHO), are working on the ground and committed to building a healthier world.
Their work, often in partnership with local NGOs and faith-based organizations, is critical to the success of many development priorities of the United States and other multilateral organizations. The COVID-19 pandemic threatens to erode decades of progress against infectious diseases. For instance, the pandemic disrupted routine immunization and forced a four month suspension of vaccine campaigns, delaying 60 planned polio campaigns in 28 countries, cumulatively leaving as many as 80 million children unvaccinated against polio and other lifesaving vaccinations.
Many of the systems put in place by global health interventions supported by the UN will be key to the distribution of vaccines and diagnostics. Moving forward, there will need to be significant investments in these interventions to get health systems back on track. Discussed in additional detail below are several areas where the U.S. and UN work together on global health issues.
For more than 75 years, the U.S. has been a key contributor to UNICEF, which partners with country governments, NGOs, and the private sector to reach and save the world’s most vulnerable children from devastating diseases, primarily through vaccines. Childhood vaccination is one of the most successful medical interventions in the last 50 years, responsible for saving the lives of 2.5 million children each year.
In 2019, UNICEF delivered more than 200 million doses of vaccines to 25 countries against polio, measles, mumps, rubella, and cholera. UNICEF also helped governments vaccinate 65.7 million children in 64 priority countries against diphtheria, tetanus, and pertussis. In total, UNICEF procured 2.43 billion doses of vaccines for 99 countries and supplied vaccines to reach 45 percent of the world’s children under five.
UNICEF is also responsible for procuring vaccines for Gavi, the Vaccine Alliance, and purchases vaccines for other global campaigns not covered by Gavi. Due to UNICEF’s large purchasing power, the agency cut in half the cost of the pentavalent vaccine that protects tens of millions of children from potentially deadly infectious diseases, including diphtheria, tetanus, and pertussis.
Many of the systems put in place by global health interventions supported by the UN will be key to the distribution of vaccines and diagnostics. Moving forward, there will need to be significant investments in these interventions to get health systems back on track.
UNICEF works in-country to provide vital services at the community level to ensure that vaccines that reach the country’s borders are efficiently and effectively delivered to children in the most difficult to reach areas.
Thanks to sustained funding by the U.S. government through leading UN partners like UNICEF and WHO and the coordinated efforts of the Global Polio Eradication Initiative (GPEI), the opportunity for a polio-free world is within reach. Because of GPEI donors like the U.S., cases have dropped 99.9 percent globally since 1988, and on August 25, 2020, the African continent was declared free of the wild poliovirus after no wild cases were detected over a four-year period. The polio program has successfully wiped-out wild polio from five of the six WHO regions, leaving only two endemic countries: Pakistan and Afghanistan. In the mid-1980s, there were 350,000 annual cases of wild polio, but during 2020 there were just 169. U.S. investments have driven remarkable results over the past thirty years by:
- Averting 18 million cases of wild polio and saving 1.5 million lives;
- Providing 9 billion doses of oral polio vaccine to children;
- Supporting the vaccination of 220 million children multiple times every year; and
- Training 2 million vaccinators to support polio campaigns.
The U.S. has long been a leader in international reproductive health and family planning (IRH/FP) efforts and is the largest donor to IRH/FP in the world. On a bipartisan basis, Congress has provided bilateral IRH/FP funding, as well as funding for UNFPA, which was originally formed over 50 years ago under the leadership of President George H.W. Bush, then the U.S. Ambassador to the UN. On the ground, our bilateral program and multilateral contributions have empowered women, saved lives, and strengthened families.
USAID’s Family Planning Program ensures 24.3 million women and couples have access to contraceptive services and supplies, which prevents 14,700 maternal deaths and 7.2 million unintended pregnancies every year. For every dollar the U.S. invests in IRH/FP, $6 is saved.
UNFPA takes a human rights-based approach to ensure that we live in a world where every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fulfilled. UNFPA provides 38 million people around the world with access to sexual and reproductive health services, including contraception, and works to end gender-based violence and female genital mutilation. UNFPA also works to ensure that reproductive health is integrated into the response to humanitarian emergencies.
For example, the organization provided maternal care, including equipment and medicines for safe deliveries, emergency obstetric care, and support to address post-partum complications that arise in mothers and newborns, to the people of Mosul, Iraq, and “dignity kits,” which include hygiene products and other important supplies for women, to Rohingya refugees in Bangladesh.
While the world has made important progress on women’s health over the years, significant challenges remain. In addition to historic levels of humanitarian need, there are currently 214 million women who lack access to modern contraception. If we were to reach this unmet need worldwide, we would see 67 million fewer unintended pregnancies, 36 million fewer induced abortions, and 76,000 fewer maternal deaths each year.
The U.S. is one of the largest contributors to the UN Joint Program on HIV/AIDS (UNAIDS). UNAIDS has been an essential partner of the U.S. government since the launch of the U.S. President’s Emergency Plan for AIDS Relief and plays a critical role in global efforts to end the AIDS epidemic. UNAIDS helps articulate the vision and mobilize the political will and resources that support U.S. goals and priorities: saving lives; achieving epidemic control; and increasing global burden sharing. UNAIDS has ambitious targets for expanded prevention and treatment that set the vision for the response to AIDS, while the Program’s annual global reports track progress, drive accountability, and identify opportunities to reach as many in need as quickly and efficiently as possible.
In 2000, catalyzed by the UN Millennium Development Goals, the international community committed to ending malaria for good. Since then, the rate of malaria-related deaths has plummeted by over 60 percent worldwide. This progress was made possible by U.S. leadership through the President’s Malaria Initiative (PMI), as well as U.S. contributions and partnership with WHO, UNICEF, the Roll Back Malaria Partnership, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Hard-fought efforts to alleviate the burden of malaria through rapid scaling up of cost-effective interventions have saved more than 7.6 million lives, averted over 1.5 billion cases of the disease, and decreased the number of malaria endemic countries from 106 in 2000 to 87 in 2019. Investments made into defeating malaria have secondary impacts as well, as health systems, economies, and populations are stronger and more resilient in countries where programs like PMI and the Global Fund are present.
WHO released the 2020 World Malaria Report with a retrospective of the progress made over the last two decades and a warning for the future. Although more countries than ever are nearing elimination and deaths continue to decrease annually, the rate of that progress has slowed in recent years; this is attributable to rapid population growth in high burden countries, insecticide and drug resistance, and internal instability in endemic regions. The emergence of COVID-19 similarly threatens the gains made over the last twenty years. Increased effort and attention are needed irrespective of the current pandemic to put malaria elimination back on track.