U.S. global health investment has focused on detection, treatment, and eradication of infectious diseases such as tuberculosis, malaria, and human immunodeficiency virus/acquired immunodeficiency syndrome, with significant results. Although efforts should be maintained and expanded to provide ongoing therapy for chronic infectious disease, there is a pressing need to meet the challenge of noncommunicable diseases, which constitute the highest burden of diseases globally. A Committee of the National Academies of Sciences, Engineering, and Medicine has made 14 recommendations that require ongoing commitments to eradication of infectious disease and increase the emphasis on chronic diseases such as cardiovascular disease. These include improving early detection and treatment, mitigating disease risk factors, shifting global health infrastructure to include management of cardiovascular disease, developing global partners and private-public ventures to meet infrastructure and funding challenges, streamlining medical product development and supply, increasing research and development capacity, and addressing gaps in global political and institutional leadership to meet the shifting challenge.
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Training local researchers promotes sustainable research programs and fosters independence in LMICs through academic partnerships. Such partnerships provide benefits for both the LMIC and the more developed institution. An academic partnership between AMPATH, an Indiana University-led initiative, and Moi University in Kenya provides 30% of medical students with financial aid to increase the number of Kenyan medical professionals. The partnership supports development of a sustainable workforce in Kenya, and creates mentorship opportunities for students and faculty with an interest in global health (3,65) . Funding for such partnerships can be leveraged through the Fogarty International Center at the National Institute of Health (NIH) and the U.S. Agency for International Development (USAID). An NIH-sponsored grant between Vanderbilt University and Zambia, as well as another connecting Vanderbilt University and Tulane University with the Kenema Government Hospital in Sierra Leone, provides training to local researchers (3) . Such programs also provide other benefits: local experts have more success than “outsiders” in influencing health policy in LMICs, and can also act as advisors to aid programs such as PEPFAR. USAID has programs to strengthen local research systems, such as the Partnerships for Enhanced Engagement in Research, which funds international scientists in partnership with U.S. funding (66) , and the Higher Education Solutions Network, which works with 7 U.S. universities to spur local solutions in partnership with international academic institutions (67) . A separate 2017 National Academies report advising USAID calls for continuing partnerships with programs such as both Partnership for Enhanced Engagement in Research and the Higher Education Solutions Network (3) .
- cardiovascular health
- global health
- noncommunicable diseases