As former U.S. surgeons general who served during the Trump, Obama, Bush, and Clinton presidencies, we committed ourselves to ensuring the health of all Americans both at home and around the world.

Throughout our careers, we’ve observed the significant consequences of public health emergencies—from wars and natural disasters to the ongoing COVID-19 pandemic—on individuals, communities, and entire nations. We’ve also seen firsthand the tremendous benefits of U.S. leadership, proactive measures, and collaboration in safeguarding the health of Americans domestically and abroad. For surgeons general, there is no greater mission or accomplishment. However, the reality is that when public health is endangered, the fallout affects much more than just physical health. When health security is overlooked, economic stability, job availability, educational opportunities, and overall community well-being suffer. That’s why we call for a renewed focus on America’s leadership and responsibility in global health security to prevent future crises.

Diseases cross borders and enter American lives

The COVID-19 crisis highlighted how a health threat that starts far away can swiftly turn into a challenge for our daily lives. The pressure on healthcare systems, sacrifices made by frontline workers, and the tragic loss of life have left a lasting impact on our society.

The economic consequences of the pandemic have been staggering, with billions lost across the U.S. and global economies.

Looking forward, we must recognize the increasing risk of future pandemics and outbreaks. Infectious diseases cross borders and can spread quickly through modern travel and trade. The health and safety of the United States are closely linked to global populations’ well-being.

Therefore, it is essential to regard global health security as a vital part of national security. Throughout history, surgeons general have led efforts to fight the spread of diseases and advocated for health initiatives that protect all Americans. Successful past investments in global health—from smallpox eradication to combatting the HIV/AIDS crisis—illustrate the importance of working collaboratively with international partners and organizations like the World Health Organization to proactively prevent and address health threats.

Global health security is key to our national security

As the new Trump administration takes office, we urge its leaders to treat global health security and vaccine trust as critical national security issues. A robust public health system and international collaboration are essential for strengthening our defenses against infectious diseases.

By steadfastly supporting global health initiatives, we can ensure the health and safety of Americans living within our borders.

Although we, the former surgeons general of the United States, served under different political administrations, we have— and continue to be—united in the belief that sound science should guide our recommendations. We firmly believe that this principle should, and will, remain the guiding light for U.S. health policy and practice to ensure the health of our citizens and those across the globe.

The importance of global health security cannot be emphasized enough. Diseases do not observe borders and can emerge unexpectedly, as seen with recent outbreaks of H5N1 avian influenza, Marburg disease, and the 2019 measles outbreak in Samoa that resulted in 83 deaths.

It is impossible to effectively promote new administrative priorities while managing preventable infectious diseases and outbreaks. By supporting global health programs and boosting vaccine confidence through evidence-based strategies, we can enhance the health and safety of all Americans and the entire planet.

The moment is now for our new leaders to reaffirm America’s commitment to global health security and uphold our leadership in this vital area.

Dr. Joycelyn Elders, 15th surgeon general, 1993-94. Dr. Richard Carmona, 17th surgeon general, 2002-06. Dr. Jerome Adams, 20th surgeon general, 2017-21. Dr. Kenneth Moritsugu, acting surgeon general in 2002 and 2006-07. Dr. Boris Lushniak, acting surgeon general, 2013-14.