The United States – Leading Collective Action in Global Health Security

The Fact Sheet below was released in conjunction with the United States Government’s participation in the Global Health Security Agenda (GHSA) Ministerial Meetings hosted by Government of Thailand on November 18-20, 2020:

The United States – Leading Collective Action in Global Health Security

“Now is the time to solve this global pandemic and work to take down risks to Americans and people all across the world.” – Secretary Michael R. Pompeo

For over 50 years the United States has been the largest contributor to global health security and humanitarian assistance.  The United States has worked for decades to improve global capacity to contain outbreaks at their source and minimize their impact, and we will remain a leader, partner, and advocate on this issue.  We have made sustained engagements in global health security a cornerstone of our national security policy, including investing over $1 billion since 2014 to support bilateral work with partner nations under the Global Health Security Agenda (GHSA).  In recognition of the November 18-20 GHSA Ministerial Meeting hosted by the Government of Thailand, the United States continues to highlight the critical importance of GHSA work in responding to the current COVID-19 pandemic and addressing preparedness in the future.

GHSA was first launched in 2014 and re-affirmed in 2018 by the United States and other member countries; and it remains a premier model of transparent and accountable global engagement, seeking to achieve a world safe and secure from infectious disease threats, whether naturally occurring, accidental, or deliberately released.  In addition to setting bold targets and providing a forum for information sharing, GHSA leverages host government and donor partner investments to build country-level capacity to prevent, detect, and respond rapidly and effectively to outbreaks.  As one of 69 GHSA member countries, the United States remains a committed leader—currently investing $428 million to strengthen and sustain partner country preparedness in support of GHSA targets and goals.  As part of this commitment, the United States works with 19 partner countries in an intensive fashion—as well as with other nations in a more targeted manner — to prevent, detect, and respond to infectious disease threats at their source.

The United States supports the GHSA 2024 target through bilateral partner country investments and multilateral efforts that seek to unify the world’s approach to global health security.  The GHSA 2024 Initiative Target aims for more than 100 countries to complete an evaluation of health security capacity and demonstrate improvements in at least five technical areas that positively impact their preparedness by 2024.

As outlined in the United States Global Health Security Strategy, the Administration strongly supports GHSA as a mechanism to accelerate progress toward effectively addressing infectious disease threats.  We are committed to advancing the full implementation of the International Health Regulations at the country level by collaborating across borders and sectors.  Importantly, our partnerships through GHSA have and continue to build foundations to prepare for and respond to the current COVID-19 pandemic and help countries more broadly address infectious disease threats.  These successes include:

Across regions:

  • U.S. government investments have supported technical assistance in the implementation and development of molecular assays to detect emerging respiratory viruses at the human-animal interface. These efforts support capacity building that detects animal-to-human transmission of viruses like influenza and coronaviruses.
  • Risk communication programs, active in many U.S. GHSA partner countries, support national health communication programs to disseminate appropriate public health messages to the general population and specialized messages to health care workers.
  • U.S. government investments have strengthened public and veterinary health laboratories in more than 15 countries across Asia and Africa, helping to improve the detection and response to deadly zoonotic diseases (which spillover from animals to people) such as rabies, anthrax, Ebola, as well as novel viruses such as COVID-19.
  • The U.S. government-supported One Health Workforce project in partnership with One Health university networks in Africa and Southeast Asia supports workforce development in 58 universities across nine GHSA Intensive Support countries: Cameroon, Cote d’Ivoire, Ethiopia, Indonesia, Kenya, Senegal, Tanzania, Uganda, and Vietnam.
  • U.S. government GHSA investments have built on a decade of investments in influenza surveillance globally, by also strengthening the capacity of Asian and African countries to routinely detect and rapidly respond to influenza outbreaks. This capacity has buttressed the WHO Global Influenza Surveillance and Response System that is the frontline of global influenza preparedness and response, which is now helping address the present COVID-19 pandemic.
  • U.S. government investments in workforce development have contributed to the development of a cadre of trained public and animal health professionals ready to mobilize quickly at the sign of an outbreak. Within GHSA partner countries, graduates of workforce development programs are helping contain outbreaks at their source.
  • The United States has collaborated with the Democratic Republic of the Congo (DRC) on health for decades, working tightly with the DRC Ministry of Health and others to strengthen local health systems to prevent, detect, and respond to infectious diseases at their source. We were the DRC’s principal partner in ending its 2018-2020 devastating Ebola outbreak in eastern DRC—the second largest in world history and first-ever in an active conflict zone. Despite substantial risk of cross-border transmission from the DRC to neighboring Uganda, the Ugandan government swiftly identified and contained imported Ebola cases with U.S. government partnership and support.  When the DRC announced a new Ebola outbreak on June 1, 2020, the United States quickly deployed health experts to help contain the outbreak and work with neighboring countries to enhance preparedness efforts for potential cross-border spread.  Graduates from the U.S.-supported Field Epidemiology Training Program played an integral role in the national response and case investigations.

The United States and GHSA HELPed countries PREPARE FOR AND RESPOND TO COVID-19:


Burkina Faso*

  • In Burkina Faso, U.S. government GHSA investments supported the establishment of Severe Acute Respiratory Illness (SARI) sentinel surveillance sites across the country.  These sites reinforced the capacity to safely transport specimens and test for over 30 respiratory pathogens.
  • The Burkina Faso government nominated an incident manager and activated its National Public Health Emergency Operations Center (CORUS in French), which was supported primarily by U.S. government GHSA investments.
  • U.S. government GHSA investments supported the Burkina Faso Ministry of Health national Influenza Reference laboratory, which now has the capacity to identify 33 different pathogens including four different types of coronavirus.

Cote d’Ivoire*

  • U.S. government investments helped six regional hospitals establish triage stations for early recognition and control of patients and improve their patient and staff flow.


  • The U.S. government supported the training of rapid response teams in COVID-19 surveillance, response, and infection prevention and control (IPC) standards across all ten regions. Over 1,000 staff were trained in IPC, including doctors, nurses, epidemiologists, laboratory technicians, community health workers, and hygiene and sanitation staff.
  • U.S. government partners trained journalists and other communicators at the national level and in all ten regions of Cameroon to raise awareness on COVID-19 prevention, stigmatization of individuals diagnosed with COVID-19, and appropriate burial of COVID-19 deaths in communities. Over 115 community radio stations continue to broadcast sensitization spots and interactive programs on COVID-19 prevention and collected and addressed complaints from community members.  Populations across the country have received information through these and other media programs since the onset of the outbreak.
  • The U.S. government-constructed Public Health Emergency Operations Center is coordinating national and subnational COVID-19 response efforts. With support from the U.S. government, Cameroon’s National Public Health Laboratory is coordinating testing across the decentralized laboratory network in all ten regions of the country.
  • Health officials trained through the U.S. government-established Field Epidemiology Training Program are conducting COVID-19 surveillance at points of entry and in the community as well as contact tracing and constitute rapid response teams in all regions of Cameroon.


  • The National Ministry of Health Emergency Operation Center (NEOC), developed using U.S. government GHSA investments, was placed on alert mode, began managing a hotline, and immediately developed COVID-19 strategic and operational plans.
  • Measures first implemented during the Ebola epidemic (partially funded by GHSA) were implemented again at the international airport and the major seaports of Conakry, Boke, and Boffa to respond to COVID-19. Support included fever detection equipment, hand sanitizing stations, personal protective equipment (PPE), and training.


  • In response to COVID-19, the U.S. government provided technical support and training to strengthen capacities for case investigation, contact tracing and surveillance data management at national and sub-national levels. Rapid Response Teams were also trained to investigate and verify rumors and alerts at all tiers of the health system.


  • U.S. government support helped reach more than one million people per day with voice and text messages on social distancing, safe hygiene practices, and other measures in partnership with Airtel. In addition, radio scripts on self-isolation, prevention, and fake news were developed and broadcast.
  • U.S. government partner FHI 360, supplied a total of 11,000 COVID 19 reagents to the National Institute of Medical Research (NIMR). Cumulatively, 12,805 COVID tests have been run at NIMR PCR lab since commencement program support.


  • The U.S. government supported the training of hundreds of religious leaders on appropriate COVID-19 messages, mitigating the spread of rumors, and addressing stigmatization. In addition, the U.S. government helped local partners broadcast these and similar COVID-19 messages across a range of radio and TV stations, reaching more than four million persons.


  • The Government of Uganda (GoU) acted quickly to establish guidelines and policies to address the outbreak, and its preparedness plans centered on expanding the existing Ebola Virus Disease (EVD) screening processes to include prevention and response to COVID-19. Activities supported by U.S. government GHSA investments and Ebola response/preparedness resources were mobilized and adapted to confront COVID-19, including establishment of the first ever Border Heath Authority.
  • The U.S. government supported the establishment of handwashing facilities (tippy-taps) using local materials at the household level. To date, more than 500 handwashing facilities have been established. Also, more than 500 health facilities have been provided with guidelines and support to adhere to national infection prevention and control (IPC) best practices
  • The Minister of Health used existing infrastructure such as the National Task Force at the Emergency Operations Center, which is able to convene partners as necessary on issues related to COVID-19. This EOC was supported by U.S. government GHSA investments.
  • A new National Isolation Facility quickly began construction with 30 isolation rooms and is projected to be completed by the end of March. Two hospitals– Entebbe Regional Referral Hospital and Naguru National Hospital – had staff training and isolation facilities built for EVD response that were converted to manage any COVID-19 cases.


  • U.S. government GHSA investments aided Senegal in developing standard emergency management tools. Institut Pasteur de Dakar (IPD), a primary partner for GHSA implementation, now has the capacity to test for COVID-19.  IPD is a critical component of the Senegal national public health laboratory network.
  • The U.S. government supported the training of nurses, midwives, laboratory technicians and health district manager sessions on laboratory specimen collection, integrity, and transport. More than 130 lab technicians alone have been trained since the onset of the outbreak.

Sierra Leone*

  • Graduates and trainees of the Sierra Leone Field Epidemiology Training Program (FETP), supported by U.S. government GHSA investments, are deploying to strengthen surveillance, Infection Prevention and Control (IPC), emergency management, and lab pillars.



  • The U.S. government is supporting risk communication and community engagement activities, such as providing psychosocial support through home-based care and hotline services for COVID-19, COVID-19 awareness campaigns via Facebook, Instagram, SwipeRX, and interactive voice response (IVR) services reaching over 37,000 callers.
  • U.S. government partner Chemonics supported the training of 85 laboratory staff from 24 labs in 19 provinces, facilitated by ten national officials and other organizations.


  • U.S. government GHSA investments supported the Vietnam Administration of Medical Services (VAMS) to conduct training on Sample Collection and Laboratory Testing for Coronavirus across 15 large national and first-tier hospitals, as well as hospitals and public health agencies in 11 central provinces and Ho Chi Minh City.
  • Since 2016, the U.S. government has provided six national referral hospitals with extensive technical assistance on preventing spread of infectious diseases among hospitalized patients. The Ministry of Health quickly began working to extend these practices to other hospitals in the country.


  • As a result of U.S. government support, more than 4.8 million individuals were reached with preventive COVID-19 messaging in July alone through an animated children’s TV series; an additional 1.4 million people were reached (with such messages) through social media channels like YouTube and Facebook.



  • U.S. government investments helped install more than 3,573 handwashing stations in markets, bus stations, religious centers, water points, and other critical locations in 10 target departments, allowing more than 1 million people to wash their hands as a key COVID-19 prevention measure.


  • The U.S. government supported the training of the members of ten “clean clinic” commissions as part of the national “Clean Clinic Approach” to improve infection prevention and control practices in health facilities and help control COVID-19 and other infectious disease threats.



  • U.S. government GHSA investments support key hospitals in Bangladesh on COVID-19 triage, isolation, and infection control processes and procedures through public health fellows.


  • The U.S. government worked with the Ministry of Health and Family Welfare in India to provide Rapid Response Team training to 209 staff across 27 states and began working on a master training of trainers for COVID-19 response.
  • Since 2012, the U.S. government-supported India Epidemic Intelligence Service program has graduated 66 officers across 25 states. Six enrolled officers in the Kerala state government were quickly mobilized to be on the frontline for the response to support surveillance and contact tracing activities.



  • The U.S. government helped the Ministry of Health review and update the Infection, Prevention, and Control (IPC) Pillar of the National COVID-19 Preparedness and Response plan, ensuring consistency with global guidance as adapted to the Jordanian context.


  • U.S. government investments have reinforced the national capacity to test for COVID-19 through the training of 30 staff on biosecurity and biosafety and 14 staff on laboratory techniques linked to the virus.


North Macedonia

  • The United States has made significant contributions to augment the national response to COVID-19 in North Macedonia. S. assistance supported government efforts as well as private sector initiatives, including those led by the Ministries of Health and Education and Science, the State Electoral Commission, and the Red Cross.  U.S. government investments supported training modules for more than 1,300 health professionals on preventing the transmission of infectious agents, the correct use of personal protective equipment, and the prevention of contamination in the clinic.  Our work has also supported government goals for regional health policy coordination and advanced North Macedonia’s plans to join the GHSA.


  • The U.S. government supported 15 online trainings on COVID-19 clinical case management, with more than 3,000 clinicians benefitting. The training topics included infection prevention and control; maternal, child, and adolescent health in the context of COVID-19; non-communicable diseases in the context of COVID-19; home care for elderly people; and training on pharmacovigilance regarding the drugs used in treatment of COVID-19.

Bosnia and Herzegovina

  • Over a four month period, U.S. government investments helped reach over 1.5 million people with materials and information on COVID-19 risk prevention through traditional and social media. Six episodes of the TV series “Kid Scientists” were produced, targeting younger children with tailored content on prevention and protection and COVID-19-themed TV shows that reached 120,000 viewers.

Since 2015, U.S. government GHSA investments assisted countries to prevent, detect, and respond to outbreaks at their source, resulting in:


Burkina Faso*

  • More than 30 percent of Burkina Faso is now covered by trained veterinary epidemiologists, improving the country’s ability to detect outbreaks, especially zoonotic outbreaks, sooner.


  • The institution of a pathogen inventory system in all laboratories that handle dangerous pathogens to ensure a high degree of biosafety and biosecurity. The U.S. government-trained instructors provided guidance on safe containment and access control measures to the national reference laboratories.
  • The national adoption of a set of emergency supply chain (ESC) management tools to plan and receive medical countermeasures during disease outbreaks of public health concern.
  • Over 900 field epidemiologists trained to conduct disease surveillance and rapidly respond to health threats in Cameroon. All of them completed the U.S. government-established Field Epidemiology Training Program.

Cote d’Ivoire*

  • Disease investigation alerts increased from 63% to 80% in three provinces due to a new surveillance program. More than 98% of all cases were investigated in 24 hours or less, resulting in increased detection and reporting of acute flaccid paralysis, yellow fever and measles cases.
  • Conducted an international simulation exercise on avian influenza and demonstrated capacity to report a potential public health emergency of international concern within 24 hours.


  • For the first time in 30 years, a mass animal vaccination campaign against anthrax was implemented in Guinea. Approximately 173,000 animals were vaccinated against anthrax in outbreak prone areas.
  • A mobile phone communication network linking 3,000 community agents and 400 veterinary service agents was established to facilitate reporting of priority zoonotic and animal diseases.


  • Animal disease reporting improved in 13 counties thanks to the introduction of a mobile-based disease reporting tool and, from 2017-2019, training of 307 frontline disease surveillance officers on the use of the tool. Thanks to this new tool and procedure disease reporting rates improved from 25% to 72%.

Sierra Leone*

  • A new Ebola species was discovered in healthy bats roosting in people’s homes. Additionally, for the first time in West Africa, Marburg virus was discovered in cave-dwelling bats from multiple sites in Sierra Leone. These discoveries will help Sierra Leone and neighboring countries (1) update their diagnostics to ensure they can detect all Ebola and Marburg viruses, (2) set up early-warning human and livestock surveillance; and (3) develop communication materials to help reduce people’s risk of exposure.
  • Developed capacity to perform confirmatory testing for viral hemorrhagic fevers like Marburg, Lassa, and Ebola viruses at the Central Public Health Reference Laboratory. This enables Sierra Leone to quickly identify and respond to outbreaks in the future.


  • Senegalese experts managed the public health emergency operations center’s response to a dengue epidemic in the country, preventing spread of the disease to additional areas.
  • The national laboratory system in Senegal can now conduct an array of important diagnostics, including testing for influenza virus and hemorrhagic fevers viruses; virus culture for poliovirus; serology for HIV; microscopy for Mycobacterium tuberculosis; rapid diagnostic testing for malaria; testing for Vibrio cholera, and serology for hepatitis.


  • 65 human and veterinary laboratorians were trained on safe and secure handling of hazardous biological samples.
  • A U.S.-supported national team conducted Ebola virus disease (EVD) vaccinations of 7,900 healthcare workers and contacts as part of national EVD preparedness and response.

East Asia and Pacific


  • The Vietnamese One Health University Network organized training courses on applying multi-sectoral, One Health core competencies to zoonotic disease prevention. Numerous masters in public health students graduated with a specialization in One Health from the Hanoi Medical University.
  • U.S. government-trained local experts led training courses for 32 microbiologists from 16 antimicrobial resistance surveillance labs on bacteria identification. As a result, 3,152 patients were tested and received treatment for antibiotic-resistant pathogens.


  • The Indonesian Biorisk Association collaborated with the U.S. government to begin development of an academic biosecurity program to address gaps and vulnerabilities in institutional laboratories in the country.

South and Central Asia


  • India and its partners have trained more than 150 infection prevention and control (IPC) professionals to conduct hospital-acquired infections (HAI) surveillance, IPC assessments, and HAI outbreak investigations, helping over 38 hospitals with surveillance.


  • Bangladesh now has the capacity to identify and confirm diphtheria outbreaks. U.S. government experts helped establish local capacity for laboratory confirmation of diphtheria, strengthened surveillance in the Rohingya refugee camps, and developed vaccination campaigns and prevention strategies.
  • Civilian health leadership strengthened their working relationship with the military by training military health offices in field epidemiology, outbreak response, and public health management. This also effectively increases the response workforce for future outbreak investigations.


  • Pakistan was able to effectively identify a major outbreak of extensively drug resistant Typhoid and report it as a public health event to the WHO.

*indicates U.S. GHSA partner country receiving intensive support

Read more about our 2019 GHSA Annual Report here.