Congress is actively engaged in budget discussions to fund our government for the 2018 fiscal year. And a broader debate about how the America should engage with global institutions is needed. The U.S. government and stakeholders now have a real opportunity to work toward concrete reforms at the global institutions we support.

Recent polling shows that most Americans believe in the important role of these international organizations that the United States helped create, such as the United Nations (UN) and the Organization for Economic Cooperation and Development (OECD). Manufacturers and voters agree that it is imperative for the United States to keep our seat at the table in all these organizations.

But they also want government to defend American interests and promote more accountable outcomes from them. The frustration among voters, government officials, and the private sector who have long supported U.S. engagement will continue to grow unless effectively addressed by leadership at these organizations.

Americans' frustrations over these institutions stem from failures of accountability and transparency -- repeated process fouls that fuel harmful initiatives and policy recommendations that are not based on sound science or good regulatory practice. What's more, their activities often stretch far beyond their agencies' core missions, negatively affecting U.S. interests, industries and workers while still failing to propose or accomplish sustainable global solutions.

A shining example of these challenges was last year's U.N. High-Level Panel on Access to Medicines. This panel hijacked a critical conversation on a global concern – access to affordable medicines around the world – to instead undermine global innovation and target U.S. companies and high-paying jobs. Its report, which demanded a rollback of intellectual property protections for the research and development of lifesaving drugs, was condemned by the U.S. government and went unendorsed by the U.N. Secretary-General, who had created the panel in the first place. Yet because the panel's report starts with the letters "U.N.," it has taken on a life of its own. A handful of member states and interest groups are using it to foist a narrow regulatory agenda that threatens to curtail future life-saving innovations.

Other agencies have similar track records with outcomes again not based on sound science. The International Agency for Research on Cancer (IARC) is a good example. This specialized agency, charged with promoting cancer research, is best known for releasing research reports on whether various substances and activities cause cancer. Yet of the more than 1,000 monographs released since the early 1970s, on everything from chemicals to red meat to cell phones to sunshine, only one has ever been ruled not to be a cancer risk. The agency's studies have often been criticized as non-transparent and not based on open scientific inquiry. Yet they still have a direct effect on national regulations, in addition to harming U.S. companies and confusing U.S. consumers.

International organizations in many of these areas are aggressively pressuring national governments to adopt their recommendations. In 2013, the World Health Organization released an ambitious plan to reduce and combat non-communicable diseases such as cancer and diabetes. This seven-year action plan outlined approaches to engage with national governments and other groups to achieve this laudable goal.

Yet buried in the plan were a series of proposed policies, such as marketing restrictions and increased taxes that would harm consumers and impede the legitimate business activities and exports of U.S. companies. While the United States and a handful of other governments have raised concerns, the WHO has aggressively lobbied national governments to change their laws and regulations to adopt its approach. Such efforts go well beyond the agency's chartered advisory and research roles to target private interests, threatening its own credibility.

These problems show no sign of abating. The United States must take a new approach to ensure we are receiving the greatest value for our participation in global institutions. Other nations are already adopting measures to spur reforms. The United Kingdom, for example, recently implemented a performance agreement with the WHO that mandates specific reform milestones that must be met.

Congress has an opportunity to strike a positive balance between adequately supporting multilateral institutions and ensuring they are operating efficiently and effectively within the bounds of their core priorities. At the same time, global institutions like the U.N. and OECD must realize that the time for platitudes is over, and that we must begin seeing concrete steps toward necessary reforms soon. Only then can we begin to address global problems in a way that maximizes positive outcomes for all.

Linda Dempsey is the vice president of international economic affairs at the National Association of Manufacturers, the nation's largest manufacturing industrial trade association.

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