Residents of underdeveloped countries who belong to ethnic, racial, sexual, and political minorities usually endure relatively ineffective political voices. More than any other world population segment, these marginalized people are vulnerable to, and suffer from, compromised health and life expectancies. Their immense human tolls have spawned severe global humanitarian, economic, social, political, and security dilemmas contrary to the strategic interests of the United States. Despite recognition of these devastating harms here and abroad, the president as de facto primary U.S. foreign policymaker continues to formulate foreign health policy in an insular policymaking environment. The insularity enables the president to design policy without broad input, transparency, or public scrutiny. This Article suggests the alteration of the presidential policymaking apparatus. It proposes a concrete structure to facilitate a voice for politically marginalized minorities and to enhance public accountability and transparency in presidential foreign health policymaking, thereby collaterally imbuing the process with a new legitimacy.