This study from the Duke Margolis Center for Health Policy, the Duke Global Health Institute, and the Center for Policy Impact in Global Health builds the case for why and how the U.S. government (USG) role should be strengthened. The report identifies catalysts and barriers to USG agency support/coordination and proposes recommendations for reform, based on nine key conclusions. Researchers assessed the current landscape of USG investment by completing a desk review of 147 articles and conducting 36 key informant interviews with both USG and private actors (private industry, foundations, and not-for-profit organizations).