As U.S. funding for global health has increased, U.S. diplomatic capacity for supporting and leveraging our global health funding remains stagnant and fragmented. This lack of capacity to manage the political aspects of global health is dangerous, because the politics of global health have never been more divisive, and the opportunities for improving health and controlling disease epidemics never more extraordinary.

U.S. diplomatic capacity for global health represents the organization, staffing, and direction necessary to engage, not only on the charitable, technical, and scientific aspects of global health, but on the political and diplomatic aspects as well. The current lack of diplomatic capacity for global health at the Departments of State, Defense (DOD), Health and Human Services (HHS), the U.S. Agency for International Development (USAID), and the National Security Council (NSC) results in continually missed opportunities to support global health efforts and to leverage U.S. global health funding to support foreign policy objectives, and this imperils the success of U.S. global health aid. In a small number of cases, this lack of capacity threatens U.S. national security by undermining negotiations on influenza virus sharing and global health security.

Numerous reports have outlined the goals the Obama administration should pursue in global health. This brief does not seek to add to those or to propose detailed policy solutions to the cases discussed. Instead it seeks to demonstrate that U.S. global health policy has global political ramifications that cannot be ignored and that demand permanent capabilities within the U.S. government. It describes the need for improved U.S. diplomatic capacity on global health, outlines the currently fractured architecture of the U.S. government on this issue, and issues recommendations for building diplomatic capacity for global health.