Sep 21 2009
In May, Senator Frist co-led a conference at CSIS entitled U.S.-Russian Global Health Collaboration. Given the outcome of discussion at the conference, the Senator produced this Op-Ed recently published in Foreign Policy.
What the Doctor Orders
The United States and Russia face strikingly similar health-care challenges -- providing a rare opportunity to strengthen their bilateral relationship.
BY WILLIAM H. FRIST | SEPTEMBER 11, 2009
On Wednesday night, U.S. President Barack Obama made a historic address to a joint session of Congress on the issue of health-care coverage and affordability. It is the banner issue of his first year in office, and Washington's top domestic priority. At the same time, nearly 5,000 miles away, in Moscow, legislators are undergoing a strikingly similar process to reform their health-care delivery system. Given the importance of the U.S.-Russia relationship and the similarity of the challenges confronting us, our two countries have a historic opportunity to expand our health collaboration and, in so doing, improve our diplomatic ties.
Thankfully, this process is already underway. At a summit in early July, Obama and Russian President Dmitry Medvedev announced a memorandum of understanding to expand cooperation on public health and medical sciences. The meeting also produced an agreement for Secretary of State Hillary Clinton and her Russian counterpart, Foreign Minister Sergei Lavrov, to co-chair a forthcoming bilateral commission on health collaborations.
But both countries can and should continue to do more. In May, Dr. Nikolai Gerasimenko -- vice chair of the Duma's Committee on Health Protection -- and I hosted a daylong discussion on the topic at the Center for Strategic and International Studies. Our objective was to generate a blueprint for a future strategic collaboration on health. The conference revealed a strong desire to build genuine partnerships around health on the basis of two key challenges.
The first is national demographics. Both Russia and the United States grapple with rapidly aging populations, with all that implies for the provision of health care and social services. Russia's problems are compounded by alarmingly high middle-aged male mortality and birthrates that are too low to sustain the current size of the population. Demographic regression, the Russian delegates emphasized, is the top health-policy priority. In each of our societies, efforts to encourage healthier lifestyles -- in diet, and alcohol and tobacco use -- will reduce chronic disorders, extend lives, and make for a healthier next generation.
The second challenge is the pressing need for health-care reform. Both of our countries struggle to balance the competing imperatives of high quality, equity in access and affordability, and containment of health-care costs. We are each in the midst of a historic effort to reform our health systems, bring about greater efficiencies in complex federal systems, and produce better health outcomes as a return on substantial investments.
Our dialogue also identified five choice opportunities that I hope will inform the next steps by the United States and Russia in building health cooperation.
First, there is much to be learned from each other with respect to lowering health risks associated with tobacco and alcohol use, especially among young people, including through public-education strategies and community engagement.
Second, in the face of the H1N1 pandemic flu threat, there is much we can do to improve surveillance and data use to bring about better global detection and response to emerging infectious disease threats. Even at the height of the Cold War, the Soviet Union and the United States worked together to create vaccines. Our countries could certainly benefit from such collaboration today.
Third, we should launch an annual U.S.-Russia forum on the reform of national health systems, with a special focus on financing, cost controls, and evaluation. Comparative effectiveness research across national boundaries is a vitally important undertaking. In particular, a U.S.-Russian initiative could include joint exploration of innovative approaches such as e-health and electronic medical records.
Fourth, we should engage in a discussion on how to best leverage our mutual efforts to support global health programs in those countries most affected by infectious diseases such as HIV, tuberculosis, and malaria. The Obama administration recently committed to billions in donations in this area, and Russia is emerging as a significant global health donor as well. Thus, the time is right for our two countries to more closely collaborate.
Lastly, substantial ongoing joint research, institutional twinning and professional exchanges could be expanded. This includes research and research training in alcohol abuse and related disorders, cardiovascular disease, cancer, and tuberculosis. These efforts could be broadened to encompass chronic-disease prevention and management and national health-care reform as well.
Health collaboration is a surprisingly powerful foreign-policy tool and one where U.S. and Russian interests converge. Expanded communication and cooperation will build on a history of collaboration that survived periods of acute strain. There is active interest in both our societies -- among universities, medical schools, research institutions, and private businesses, as well as key government agencies -- in joining such an enterprise.
I urge Secretary Clinton and Foreign Minister Lavrov to commission in the coming months a joint organizing committee charged with prioritizing issues, laying down a timetable, and agreeing upon some early concrete products. It could prove a vital platform for the health of our countries and the health of our bilateral relationship.
William H. Frist, M.D., is a former two-term U.S. senator from Tennessee and was the U.S. Senate majority leader from 2003 to 2007. He is a member of the Center for Strategic and International Studies' board of trustees.