For much of the modern era, the United States served as the global anchor of health and life sciences innovation. Robust public and private investment, regulatory leadership, sustained research funding, and an open and globally attractive talent ecosystem reinforced one another over more than six decades to create an environment in which discovery and scale advanced together. This system did not benefit Americans alone. It supported global progress in medicine, public health, and biomedical science. That model is now being fundamentally reset.
Recent shifts in U.S. government priorities have altered the innovation landscape in ways that are largely structural rather than merely incremental. While regulatory agencies that have seen significant leadership tumult – such as the Food and Drug Administration – may eventually stabilize and modernize approval pathways, the broader foundation that supports discovery, translation, and population health has weakened in fundamental ways in the past year.
Erik Ramanathan, who served as U.S. Ambassador to Sweden in the Biden Administration and now serves in board and advisory roles, has observed this transition firsthand. “We are well past the point where restoration to the status quo ante is the right mindset,” he says. “The more honest conversation must be about reinvention.”
A System Under Strain
Ambassador Ramanathan views health innovation as an interconnected system, not a collection of isolated successes. He describes healthcare as resting on four pillars: life sciences, patient care, academic research, and population health. When one pillar weakens, the others follow. “Breakthrough therapies do not exist in a vacuum,” Ramanathan explains. “They depend on research institutions, data infrastructure, public trust, and a workforce that can collaborate globally.” Reductions in research funding, particularly in basic science and politically disfavored areas of translational and clinical work, are early indicators of systemic stress. Universities and research centers that rely on international talent are facing funding cuts, grant clawbacks, overhead caps, and growing friction in immigration and visa pathways. “When the research environment becomes unstable, risk tolerance drops,” Ramanathan says. “That slows discovery long before anyone notices a missing drug in the pipeline.”
The Hidden Cost of Weakening Population Health
While research and innovation often dominate attention, Ramanathan believes the most consequential erosion is occurring in population health and public health capacity. “Population health has always been undervalued and under-resourced because its success is quiet,” he says. “You do not see headlines for the infectious disease outbreak, drug overdose or chronic disease cluster that never happened.” Public health systems in the United States and abroad have experienced sustained reductions in epidemiological surveillance, prevention programs, emergency preparedness, addiction services, and food security initiatives.
And these cuts do not remain contained within national borders. “The United States has played a stabilizing role in global health for decades,” Ramanathan says. “When the funding, infrastructure or expertise is lost, the effects ripple outward.” The warning signs are already visible. And pandemic preparedness has not advanced nearly at the pace many expected after COVID-19.
Chronic disease outcomes in the United States were deteriorating even before recent policy changes. Preventable disease rates are now rising as well. Vaccination coverage has dropped below efficacy thresholds in some regions. Food insecurity is increasing, including among working families ill-prepared to navigate pathways to assistance. “This is not a theoretical risk,” Ramanathan says. “It is measurable.”
From Restoration to Reinvention
Despite these pressures, Ambassador Ramanathan remains pragmatic rather than pessimistic. “This is not about going back,” he says. “The old model is not going to spring back into its previous form. Infrastructure is always far easier to destroy than to rebuild. The opportunity is to build something stronger, more integrated and perhaps even less costly with the tools we now have.” He believes the next phase of health innovation will be shaped by advances in data science, analytics, automation and cross-border collaboration. He points to the Nordic countries as longstanding examples of disciplined data collection and responsible use of clinical and population level information to feed innovation.
“When high quality data is paired with modern analytics, you can make a credible case for prevention,” Ramanathan says. “Not in moral terms, but in economic ones.” Historically, the return on investment for population health interventions has been difficult to articulate because benefits unfold over long time horizons. Better data shortens that horizon by making value visible sooner. “If leaders can see the cost of inaction alongside the benefit of early intervention, the conversation changes,” he says.
Expanding Sources of Insight
Another shift reshaping the landscape is the expansion of real world health data. Ramanathan points to the growing clinical relevance of consumer and wearable technologies that now meet regulatory standards. “When everyday tools generate trusted monitoring, the boundary between clinical care and daily life narrows,” he says. Beyond premium wearables, he sees opportunity in lower cost diagnostics and simple monitoring tools that support medication adherence, early screening, and longitudinal tracking of outcomes. When integrated responsibly, these tools can extend the reach of health systems without proportionally increasing cost. “The impact comes from scale,” Ramanathan says. “Small signals, collected consistently, add up.”
AI as an Enabler of Prevention and Resilience
Ambassador Ramanathan views artificial intelligence as most valuable when it reduces the cost and complexity of systems that have historically required significant manual effort. “AI should be a force multiplier,” he says. “It extends expertise rather than replacing it.” He points to communicable disease surveillance as a clear example. During the COVID pandemic, wastewater sampling became a critical early indicator of community spread. The next step, he believes, lies in automation and integration. “Continuous sampling, faster analysis, and clearer reporting across geographies allow earlier action,” Ramanathan says. “Timing matters when curves begin to rise.” Similar approaches apply to food systems and zoonotic disease monitoring, including livestock and avian health. Early detection protects both public health and economic stability.
“When disruption is avoided upstream, everyone benefits downstream,” he says.
Where Industry and Capital Fit
Ambassador Ramanathan believes that life sciences companies increasingly have strategic reasons to invest in population health. The commercial signals are already emerging. “GLP-1 therapies are a good illustration,” he says. “What began as a diabetes treatment is now being explored across obesity, cardiovascular disease, dementia risk, and addiction.” As AI accelerates discovery and shortens development cycles, links across disease areas are becoming clearer. This creates opportunities for partnerships that align incentives across industry, government, payors, and employers. “When outcomes improve and costs fall together, collaboration and private investment in public health becomes easier to justify,” Ramanathan says.
Not every intervention will meet a traditional business case. In those areas, he sees philanthropy and blended capital playing a growing role. “Philanthropy has never been better resourced or more sophisticated,” he says. “Foundations and family offices are increasingly willing to support discovery, early clinical work, and venture stage efforts.”
A Leadership Agenda
For C-suite leaders, Ramanathan frames the moment as a call to deliberate action. “Population health is not charity,” he says. “It is strategic infrastructure.” He encourages executives to integrate prevention into enterprise risk management, workforce strategy, and long term growth planning. This includes investing in data governance, building partnerships that outlast political cycles, and developing ROI narratives that boards can defend. “Health underpins productivity, resilience, and trust,” Ramanathan says. “When those erode, competitiveness follows.”
Looking Ahead
Ramanathan’s perspective is shaped by diplomacy, crisis management, and decades of board experience. He views the current moment as unsettled, but full of opportunity. “Big impact has never come from capital alone,” he says. “It comes from commitment, collaboration, and the willingness to build when the path is not fully mapped.” The reset in health innovation is already underway. The next chapter will be shaped by leaders who understand that prevention, data, and cross-sector and cross-border partnerships are no longer peripheral concerns.
They are the foundation.
Ambassador Erik Ramanathan, is a global leader in health innovation and cross-sector and cross-border collaborations. Follow his insights and ongoing work on LinkedIn.
