Impact and Influence: Examining the U.S. Role in Global Health

2025 Symposium

Panel Description

What happens when the U.S. has a reduced global health presence? The United States has long been at the forefront of global health, driving impactful initiatives that have improved health outcomes worldwide. The U.S. has actively worked to prevent, detect, and respond to infectious disease threats globally; From PEPFAR and PMI to USAID, the U.S. has made significant progress in the fight against HIV/AIDS, malaria, and tuberculosis. Additionally, global health security has remained a key focus area of the U.S., and agencies like the Department of State, Department of Defense, and Department of Health and Human Services have played a critical role in expanding public health infrastructure globally.

In this plenary, our esteemed panelists will discuss the U.S.’s historical contributions to global health, examining the significance of its funding, leadership, and participation in key health organizations. They will participate in thoughtful dialogue, exploring why the U.S. has been a financial powerhouse in global health, what the potential impacts on health systems in low and middle-income countries are if U.S. support reduces, and how such a reduction could affect the health security of Americans and the efficacy of multilateral organizations. Together, we will delve into the ongoing importance of U.S. involvement in global health initiatives and why continued leadership is vital for tackling ongoing and emerging health challenges worldwide.

Key Takeaways

The U.S. has historically led bold moves in global health, setting a tone that others followed. Its presence strengthened multilateral efforts, while its absence signaled retreat and weakened global cooperation.
The U.S.’s abrupt withdrawal from global health funding caused avoidable disruptions, especially in countries unprepared for the transition due to development challenges and deep reliance on U.S. support. While some nations were making responsible progress toward self-sufficiency, others lacked viable alternatives. Policymakers must distinguish between these divergent realities and avoid assuming all countries can sustain progress without continued partnership and strategic investment.
U.S. global health investments like PEPFAR often prioritized parallel systems through NGOs over direct government partnerships. Although the strategy saves lives, it misses the critical opportunity to strengthen national health systems. Responding to the true burden of disease in a country could be a helpful future approach that also helps rebuild trust through shared accountability.
Governments must increase investment in their own health systems and link spending directly to disease burden. When budgets reflect local health needs, they create powerful accountability loops, ensuring political leaders answer to their citizens, not just to donors. Without this alignment, external agendas often take precedence, eroding national ownership and undermining long-term system resilience.

Panel 2 Members at the HGHI 2025 Symposium in Cambridge, MA.

“Global health equity is for the future of humanity. No country is safe, until all countries are safe. So, we need shared solidarity and shared responsibility to continue as partners not as recipients.” – Sheila Tlou

Speaker Details

Eric Goosby, MD

Professor of Medicine and Director of Global Health Delivery and Diplomacy, Institute for Global Health Sciences, at the University of California, San Francisco

Dr. Eric Goosby s an internationally recognized expert on infectious diseases, with a specialty in HIV/AIDS clinical care, research, and policy. During the Clinton Administration, Dr. Goosby was the founding director of the Ryan White CARE Act, the largest federally funded HIV/AIDS program in the U.S. He went on to become the interim director of the White House’s Office of National AIDS Policy. In the Obama Administration, Dr. Goosby was appointed Ambassador-at-Large and implemented the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which significantly expanded under his tenure life-saving HIV treatment to millions in Sub Saharan Africa, SE Asia, and Eastern Europe.

After serving as the U.S. Global AIDS Coordinator, he was appointed by the UN Secretary-General as the Special Envoy on Tuberculosis in 2015 where he focused on the first-ever UN High-Level Meeting on TB in 2019. Most recently, he served as a member of the Biden-Harris Transition COVID-19 Advisory Board. He is currently a Professor of Medicine at the UCSF School of Medicine and leading the Center for Global Health Delivery, Diplomacy and Economics, Institute for Global Health Sciences. He is a member of the Western States Scientific Safety Review Workgroup, and serves on the San Francisco Dept. of Public Health, Policy Group for the COVID-19 Response.

Loyce Pace, MPH

Former Assistant Secretary for Global Affairs, U.S. Department of Health & Human Services; Biden-Harris COVID-19 Advisory Board Member

Ms. Loyce Pace (she/her) is an outspoken advocate and expert on domestic and international health issues, from AIDS to Zika. With more than 20 years of experience in policy, programs, and funding, she has lobbied decision–makers worldwide on the value of investing in emerging priorities. Having lived and worked on the ground in more than 15 countries across 3 continents, her efforts are rooted in experience partnering with a wide range of global stakeholders, including government officials, multilateral bodies, corporations, nonprofit organizations, and universities as well as community-based and grassroots leaders. She is a proud member of several boards dedicated to foreign service and solidarity. A resilient daughter of the inner city who has worked her way into the halls of Congress and the UN, she is keen to pass the baton to other champions for equity and justice that challenge the rollback of rights and progress.

Sheila Tlou, PhD, RN, FAAN., FCAN

Co-Chair, Global HIV Prevention Coalition, Special Ambassador, African Leaders Malaria Alliance, Champion, Nursing Now Challenge, Chancellor, Botswana Open University, Member, Pontifical Academy for Life, Trustee, Society for AIDS in Africa (SAA)

From 2010-2017, Prof. Tlou was UNAIDS Regional Director and provided leadership for a sustainable AIDS response in 21 African countries. She is a former Member of Parliament and Minister of Health of Botswana (2004-2008). She is also former Professor of Nursing at the University of Botswana and Director of the WHO Collaborating Centre for Nursing and Midwifery Development in Africa. As Minister of Health, Prof. Tlou led a comprehensive HIV/AIDS prevention, treatment, and care program that led to significant reductions in HIV mother-child transmission and maternal mortality. She holds a PhD in Nursing from the University of Illinois at Chicago., a Masters in Nursing Education from Columbia University, and a Master of Science from the Catholic University of America. She has many publications and has received over 30 international awards for Leadership in Global Health.

Ole Norheim, MD

Mary B. Saltonstall Professor of Ethics and Population Health, Harvard T. H. Chan School of Public Health

Ole Norheim is a physician and Mary B. Saltonstall Professor of Ethics and Population Health at the Department of Global Health and Population, Harvard T. H. Chan School of Public Health. He co-founded the Bergen Centre for Ethics and Priority Setting in Health at the University of Bergen, Norway, and is an Adjunct Researcher at the centre. He is the Lead Series Editor of Disease Control Priorities (fourth edition) and a member of the Lancet Commission on Sustainable Healthcare. Norheim chaired the World Health Organization’s Consultative Group on Equity and Universal Health Coverage (2012–14) and its Technical Advisory Board on Health Benefit Packages (2019-21). Latest article: Norheim, Chang et al. “Halving premature death and improving quality of life at all ages: cross-country analyses of past trends and future directions.” Lancet 2024.