Document Type


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Homeland Security; Global Health


The U.S. government's role in global health is long-standing and multifaceted. While primarily involving directly funding and operating programs in low- and middle-income countries, it also includes participation in international treaties, commitments, partnerships, and other multilateral agreements that address or encompass health. Such agreements serve numerous purposes including establishing political and legal commitments, formalizing international relationships, and coordinating roles and responsibilities in an increasingly complex and globalized and interconnected world. The role of the U.S. in international agreements has gained new attention in the Obama Administration, which has stated an intention to reinvigorate multilateral engagement and international partnerships on health and development and this is one of seven key principles of the Administration's new, six-year, $63 billion Global Health Initiative (GHI). To better understand the U.S. role in this arena, this study provides an in depth analysis of the current status of U.S. participation in international health agreements, including those that are legally binding under international law as well as those that are not binding but may confer political, diplomatic, governance, or other expectations. It also reviews the process by which the U.S. becomes party to an international agreement, including the roles of the executive and legislative branches of government.

Open Access


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Health Policy Commons



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