Infectious disease outbreaks can start anywhere and do not respect borders. So our efforts to prevent and combat them must transcend those borders as well.
As Prepared for Delivery
Dr. Bollard, Minister of Health Tien, fellow Ministers, and distinguished leaders: It is truly an honor to join you today for the 7th Annual High Level Meeting on Health and the Economy and my first visit to the Asia-Pacific Economic Cooperation [APEC].
To the people of Vietnam, on behalf of the United States government, thank you for welcoming us to your beautiful country and for hosting this gathering in this wonderful city.
President Trump sends his greetings. He looks forward to visiting Vietnam and participating in the APEC Economic Leaders Meeting in Danang in November.
President Trump is a builder, which means he appreciates the vision, commitment and hard work it takes to build an institution as large and influential as the Asia-Pacific Economic Cooperation.
Less than 30 years ago, a generation of leaders in the Pacific Rim looked to the future and saw that the next wave of growth and prosperity would be built on cooperation – not conflict – among economies.
So they joined together to establish the Asia-Pacific Economic Cooperation forum. They did so, not just to prepare for the economically integrated and dynamic Pacific region that we know today, but to help build it.
By improving trade relationships, harmonizing regulations, simplifying customs procedures, and promoting the free flow of capital, APEC catalyzed a surge in growth and development in the Pacific Rim. Between 1989 and 2015, per capita income rose 74 percent for the people of APEC’s member economies, fueled by a nearly sevenfold increase in trade flows throughout the region.
From the outset, the United States has been a strong and eager partner in this effort to foster regional cooperation and promote broad economic prosperity. And under the Trump administration – with a builder in the White House – we will continue to support APEC and take a leading role in strengthening the partnerships on which it is built.
The United States recognizes that the only way to tackle common challenges is for everyone to work together. That means inviting all Pacific economies to the table, and it means actively engaging with the private sector.
The truth is that APEC would not be the success story it is today – and the United States’ support would not be as strong as it is today – were it not for the robust participation of the private sector.
As our economies have become more integrated, the need for collaboration in other areas has become more obvious. Protecting against infectious disease pandemics and promoting global health are critical examples.
Since the turn of the century, we have seen a number of these threats all across the globe. They range from our recent experiences with Ebola in West Africa, to SARS in Asia, Zika in the Americas, and MERS-CoV in the Middle East. Some of these, of course, are ongoing threats today. And some others may be lurking over the horizon, with new strains of influenza always presenting a risk.
Infectious disease outbreaks can start anywhere and do not respect borders. So our efforts to prevent and combat them must transcend those borders as well.
Having the right preparation for these threats will lead to fewer deaths, less suffering and less disruption for our economies. That is why the U.S. has been a leader in global health, in the implementation of the Global Health Security Agenda, and in building capacity to implement the International Health Regulations. It is why we performed a Joint External Evaluation of our capabilities and why we continue to encourage others to do the same. Our host and APEC chair, Vietnam, is to be commended for its commitment to this process and for completing a JEE. The U.S. is committed to continuing to play a leadership role, working in collaboration with other economies to protect our people and communities.
But preparing for global threats goes beyond the right domestic and international public policies. It also requires effective engagement of the private sector and civil society. During the Ebola crisis, we saw how effective the private sector can be in leveraging its resources, technical expertise and innovative solutions to help win these fights.
Non-governmental actors can offer unique international networks and cultural sensitivity that is so crucial to staving off threats to our health. All of these efforts came together at the epicenter of the Ebola outbreak in Monrovia, Liberia, where the American government, the Liberian government, other governments from around the world as well as the World Health Organization, the United Nations, and local NGOs and churches joined together to put a stop to a disease that threatened to consume West Africa.
That level of coordination proved critical to achieving success in that instance. It is a level of coordination that is also necessary to address another of the most dangerous global infectious threats – one that can come out of our own health systems: antimicrobial resistance. This is one of the most serious health challenges of our time, and it will require every tool we have to combat it. We have been impressed by the concerted effort made by APEC to bring the private and public sectors together to share best practices about antibiotic stewardship and strengthen reporting capabilities.
There are other challenges that demand our attention and benefit from international engagement. One of them is the HIV/AIDS pandemic. Through international cooperation, many countries have made considerable progress toward achieving epidemic control.
PEPFAR, the President’s Emergency Plan for AIDS Relief, has helped empower governments and civil societies around the world to respond effectively to the serious threat HIV represents. Here in Vietnam, thousands are alive today because of the antiretroviral treatment they are receiving through PEPFAR. Perilous challenges remain, especially among populations who are most vulnerable to infection, but Vietnam, as an example, has achieved tremendous, laudable progress in the fight against this pandemic, and new cases of HIV are now gradually declining.
Of course, this is not the only way PEPFAR has grown into a true partnership. Scientists, researchers and healthcare providers around the world well know that when we discover a way to apply solutions to one set of challenges, quite often we open doors to opportunities to solve other challenges. For example, the Substance Abuse and Mental Health Services Administration – a part of our Department of Health and Human Services – works through PEPFAR to provide technical assistance to expanding drug-treatment programs here in Vietnam, which are rapidly advancing in terms of quality and effectiveness.
At the same time, as we speak, the model PEPFAR is using to fight the HIV/AIDS pandemic in Vietnam is evolving to keep up with the changing challenges and opportunities on the ground. American support is shifting from direct service delivery to capacity building and technical expertise. In some areas of Vietnam, that shift is already complete, and it is a great honor for America to play a role in building capacity here. It is a reminder to the world that such collaborations shift positively over time and constructive relationships are developed.
In building partnerships, nations can positively leverage capacity and commitments to better address threats to public health. For example, the Asia Pacific Leaders Malaria Alliance signed at the East Asia Summit in Brunei. When 19 Asian and Pacific heads of government, representing over half the world’s population, join together due to concerns over the rising risk of drug resistance and a goal of a malaria-free Asia Pacific by 2030, it speaks volumes about the leadership commitment to catalyze and coordinate regional action against malaria and improve health security in the region.
Another health challenge that we can – and must – overcome through multilateral cooperation is securing access to lifesaving medication. Making this happen is not always simple. But APEC can play a significant role in helping to harmonize regulations across the world and enable innovations to spread as quickly as possible.
On Monday, members of our U.S. delegation participated in the High Level Dialogue on Innovation, Regulatory Systems, and Regulatory Convergence. This meeting highlighted the important work that APEC has done in promoting harmonization and common standards for pharmaceuticals. Regulatory convergence, networking among stakeholders, and sharing of best practices are key steps in promoting global health.
In part, these efforts work so well at APEC because we actively engage the private sector. It is the private sector where incentives drive the development of tomorrow’s lifesaving therapies. Welcoming their perspectives enables us to do so much more. That is why the United States has been and is committed to remaining an international leader in encouraging private sector innovation – innovation that can, for example, help combat the proliferation of substandard or counterfeit medications and protect access to safe medications. APEC’s work on this front is an important step and a model for how governments and industry can partner together to improve the health and well-being of our people.
From our earliest days, the American people and their institutions have recognized that the true source of economic growth, prosperity and dynamism is mankind’s boundless creative genius and desire to make the world a better place. Governments can and should protect the incentives for innovation and industry – by safeguarding intellectual property rights, for instance.
In the field of medicine, the free-enterprise forces of the U.S. healthcare financing system have helped produce some of the world’s greatest advances in knowledge and innovations in technology. Today, we are on the cusp of radical new breakthroughs that will make the practice of medicine of tomorrow more precise, user-friendly, personalized, and cost-effective than ever before. And it would not have been possible without the private sector’s ingenuity and endless quest for discovery.
As everyone here knows, ill health – particularly the burden of chronic disease – can have serious economic consequences, which is one reason this High-Level Meeting on Health and the Economy is so important.
Health and economics have always been bound up with one another. Whether you look at the individual, the community, the economy or the world, economic prosperity and the pursuit of happiness have always depended on good health. No matter who you are or where you live, your ability to pursue your dreams and fulfill your God-given potential is directly tied to your health.
But only recently have we been able to quantify just how important health is to economic and personal success.
For instance, the U.S Centers for Disease Control and Prevention estimates that the average annual cost of cardiovascular disease in America is $316 billion. And more than one-third of that figure comes in the form of “lost productivity costs” from premature death. Likewise, diabetes costs the U.S. economy an estimated $69 billion every year by causing people to miss work, be less productive while at work, or stop working altogether.
These figures are staggering. But they cannot begin to capture what health challenges really mean, and why we must dedicate ourselves to fighting them. The men and women who dedicate their lives to healing the sick do so not because they want to boost worker productivity, but because they are called to relieve those who are suffering and bring comfort to the afflicted.
The health of a population may have macroeconomic implications, but let’s not forget that the actual practice of medicine occurs on the micro level – the human level – where doctors treat patients, individuals and families build healthy habits, and members of a community work together so all can lead healthy, happy lives.
Both my father and grandfather were doctors, so from an early age I witnessed up-close the boundless compassion that motivates healthcare providers and the personal responsibility that determines so many of our health outcomes.
The lessons I learned from them and their patients inspired me to pursue a career in medicine. And they taught me that the true costs of poor health can’t be measured in dollars or hours of lost productivity. They are measured in the immense sorrow of losing a loved one, the physical pain of battling disease or struggling with poor health, and the anguish of not being able to reach your full potential.
Prime life years are just that – some of the most important years of our lives. But too often they are stolen by disease. These are years that children spend growing up without a parent, years lost where a family struggles to make ends meet. The tragedy of an illness that lessens our ability to work goes even deeper than income statistics – it manifests in the tragedy of not being able to provide for our families, or struggling to raise our children.
The United States commits to continuing to do our part in leading this effort to protect and promote the health and well-being of the people of the Asia-Pacific region. And we ask all of you, and the people you serve, to join us. We are ready and willing to be a strong partner with those who share our commitment to addressing these challenges.
At the same time that we continue to engage in global health security initiatives, each of us must continue to invest in our own preparedness capabilities, and not rely primarily on other parties for that protection – or mitigation after an outbreak occurs.
And as we work together to bring lifesaving medications to every corner and community of the world, we call on all to nurture the innovative spirit that will produce the next generation of medical treatments.
Promoting the health and happiness of our communities is what brings us here today. Let us remember the individuals we serve and the people whose lives we are dedicated to healing.
Thank you for all you do in that cause, and thank you for allowing me to join you today.
