Remarks at the "Role of Innovation in Addressing Global Health" Symposium

Jonathan Margolis, Acting Deputy Assistant Secretary, Bureau of Oceans and International Environmental and Scientific Affairs
Washington, DC
March 17, 2011

The public health challenges confronting us today are complex due to our changing and globalized world. We face climate change, food insecurity, and an increasingly interconnected world with unprecedented, travel and trade. These new factors, as well as familiar ones such as poverty, conflict, and extreme weather events, are contributing to increases in new and re-emerging infectious diseases.

Dengue, for example, has increased at a steady rate for more than 50 years, with an estimated 50 million infections and 20,000 deaths, occurring worldwide every year. The 2009 H1N1 influenza pandemic is another example of how diseases do not respect borders, and can spread rapidly from one country to another. One of the challenges we faced during the pandemic was a vaccine shortage. Current technologies are simply inadequate to produce enough vaccine to meet global demand. The pandemic highlighted the need for improved technologies and for access to new and existing technologies on the part of emerging economies.

We look to the science and technology community to engage in the research and come up with the innovations needed to develop new technologies and treatments. In our interconnected world, science and technology is not only the work of teams of top scientists. Increasingly, the diplomatic community is involved in paving the way for research to be conducted across borders and information -sharing.

The State Department has made a priority of science and health diplomacy in order to promote the advancement of technologies and innovations to improve health systems internationally, especially in the developing world. Here in Washington and in our missions abroad, the State Department – alongside other U.S. departments and agencies – engages bilaterally, multilaterally, and in international diplomatic fora to promote U.S global health priorities, projects, programs, and public-private partnerships worldwide.

I want to highlight three examples of how the Bureau of Oceans and International Environmental and Scientific Affairs (OES) is promoting innovation, science, and diplomacy to advance global health.

The first is our work through international treaties such as the Montreal Protocol on Substances that Deplete the Ozone Layer. One of the main treatments for asthma and chronic obstructive pulmonary disease uses metered dose inhalers, or MDIs. But for decades metered dose inhalers used chlorofluorocarbons (CFCs) as propellants. As we now know, these are also powerful ozone-depleting substances.

OES and other U.S. agencies worked in close cooperation with MDI manufacturers, to persuade them to develop alternate aerosols using ozone-friendly propellants. And the companies stepped up to the plate by developing propellants that not only helped those with difficulty breathing, but were also safe for the environment. This demonstrates the potential for innovation that can arise from cooperation between government and industry, but MDIs were just part of the success story behind the Montreal Protocol, a treaty which OES and the State Department spent a lot of time and effort negotiating. Today, it is widely considered one of the most successful multilateral environmental agreements, phasing out almost 100 ozone-depleting chemicals and placing the ozone layer on the path to recovery by mid-century. To give you a sense of what this means in terms of health benefits, the U.S. EPA has estimated that this will result in at least 22 million fewer cases of cataracts for Americans born between 1985 and 2100. And that is just the number of cataract cases avoided in the U.S.; the global number is much higher.

The story here is not just about the ozone layer. The Montreal Protocol is also the most successful climate treaty to date because many of the ozone-depleting chemicals it has phased out were powerful greenhouse gases. The innovation that made it possible to replace those gases resulted in climate benefits that are about five times larger than those achieved in the first commitment period of the Kyoto Protocol.

Geospatial technology offers another example of how innovation and science diplomacy can work together to improve human health. Geospatial technology incorporates remote sensing, geographic information systems (GIS), global positioning systems (GPS), and web-based mapping tools. Geospatial technologies show great promise in improving disease surveillance systems, visualization tools, and early warning systems. This will help us understand the link between the natural environment and diseases with environmental triggers or vectors, such as asthma, cholera, malaria, and yellow fever, as well as communicable diseases including AIDS, TB, and influenza. Better knowledge and understanding of diseases helps us develop and apply more effective policies and programs to reduce the exposure of human populations to disease.

Today, epidemiological surveillance frequently uses geographic information systems (GIS). For example, the President’s Emergency Plan for AIDS Relief (PEPFAR) employs a high-technology feature that provides geographically-linked HIV-related data. PEPFAR has generated tools such as the on-line HIV Atlas for East Africa which have helped decision-makers understand the spatial and temporal patterns of HIV infection, and have allowed program managers to target their limited resources for greater efficacy in combating HIV/AIDS.

Public-private partnerships are an important tool to address today’s global health challenges. Successful public-private partnerships are structured in a way that encourages flexibility, cooperation, and innovation. The OES Bureau has played a key role in creating and sustaining numerous partnerships, including the recently-formed Global Alliance for Clean Cookstoves.

The World Health Organization considers smoke from open fires and rudimentary cookstoves to be one of the five most serious health risks in poor countries – a problem affecting billions of women and children in the developing world.

For the first time ever, the Alliance will develop and lead a global strategy to achieve global-scale progress, and with the cooperation of all major donors, cookstove businesses, non-profit organizations, foundations, academic institutions, corporate leaders, governments, and UN agencies engaged in this work. Working in partnership, the Alliance will overcome the barriers that impede the large-scale adoption of clean cookstoves in the developing world, with the goal of saving lives, empowering women, improving livelihoods, and combating climate change.

The United States is proud to be a founding member of this effort – we have made a 5-year, more than $50 million commitment that currently spans six federal agencies. Some of the early activities for the Alliance will include: setting up international standards for cookstoves; designing and capitalizing innovative financing mechanisms; championing clean cooking technologies across the donor and development communities; field testing clean stoves and fuels; and conducting applied research to answer the field’s most pressing questions.

The Alliance has an interim milestone goal of ‘100 by 20’ which calls for use of clean and efficient stoves and fuels in 100 million homes by 2020, as a start toward a long-term vision of universal adoption of clean and efficient cooking methods.

In summary, though we face new and emerging health challenges in a rapidly changing world, the power of innovation through international science and technology cooperation is one of our strongest tools for addressing these challenges. Diplomacy is central to coordinating these efforts and building political momentum in support of innovation for global health. Cooperation between the U.S. and the private sector through public-private partnerships helps us leverage resources and increase access to resources for those in need.

I hope this event will provide us the opportunity to discuss successful areas of cooperation as well as potential areas for partnership in global health

Thank you.