The thing that has surprised me most since I began my job leading foreign assistance for global health at the U.S. Agency for International Development is how much emergencies have defined my work. The bureau I oversee focuses on reducing the global burden of mortality and disease and on protecting the United States from health threats from abroad. Our work is supposed to primarily serve long-range goals — for instance, eradicating polio (after 35 years of effort, we’re down to just a handful of wild-type cases in the world) and ending the public health threat of H.I.V., malaria and tuberculosis by 2030. But from the moment I started, more immediate problems have diverted time, attention and resources.

In January of 2022, when I started this role, Covid was naturally the top priority. Then, in late February, suddenly it was Ukraine. The Russian government’s invasion cut off pharmaceutical supplies, attacked hospitals and the systems they depend on and drove outbreaks of disease among the displaced, potentially endangering even more lives than Russian weapons did. More than 100,000 Ukrainians with H.I.V., for example, were threatened with losing access to the lifesaving antiretroviral medications they needed. We had to move fast to help Ukraine solve how to keep pharmacies, clinics, hospitals and public health capacity functioning.

By Atul Gawande
Dr. Gawande is the assistant administrator for global health at U.S.A.I.D.

Read full article in The New York Times by Dr. Atul Gawande

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