26 JULY-AUGUST 2025 | THE FOREIGN SERVICE JOURNAL U.S. investment in global health security doesn’t just save lives. Preventing diseases from entering our borders costs far less than responding to them when they come. BY NIDHI BOURI Nidhi Bouri is the former deputy assistant administrator for global health at the U.S. Agency for International Development (USAID), where she oversaw the agency’s work in global health security and health emergencies. She served on the National Security Council staff from 2021 to 2023. Bouri has led response efforts to some of the largest and most deadly outbreaks, including COVID-19, Ebola, Marburg, and mpox. She is founder and director of the new strategic communications group Stand Up for AID. With an average of 45,000 flights taking off and landing in the U.S. each day, there are dozens of diseases—from dengue to novel influenza and mpox—that could have easily hit our shores. But because of American investments in global health security (namely, in efforts to prevent, detect, and respond to health threats around the world), these outbreaks were contained before they ever had a chance of coming to the U.S. Since 2015, the U.S. government has invested more than $2 billion in partnership with other countries to build national health security capacities that address deadly diseases. This includes strengthening disease surveillance and laboratory capacity, training health workers on how to identify and handle potential cases, and working with the agriculture sector to minimize the spillover of diseases from animals to humans. To some, $2 billion—even spread across a decade—probably sounds like a lot of money. The reality? Over 10 years and 165 million American taxpayers, these expenditures amount to about $1.21 annually per taxpayer. What does that $1.21 a year buy every American? This small investment stops disease outbreaks at their source, preventing illness and deaths, mitigating strain on health systems, reducing economic risks, and stopping deadly diseases from coming to the United States. This is important because when outbreaks do happen, they come with a major cost. Americans already face health Putting America First by Stopping Outbreaks at Their Source FOCUS ON GLOBAL HEALTH DIPLOMACY
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