The largest foreign policy issue for FSM is its relationship to the United States following the end of its Compact of Free Association. In 1999, chief U.S. negotiator Allen Stayman said the FSM had done well in its political transition, developing into successful self-government, but the islands had not met economic expectations. The United States, with a new CFA, was prepared to continue helping the FSM by promoting growth, reforms, and good government. Stayman, however, warned that U.S. legislators and federal officials would ask tough questions before approving a new compact. First, several members of Congress wanted the FSM to account for all the money invested by the United States in the islands during the life of the CFA. Those same officials wanted a strategy for advancing economic self-sufficiency before more funding would be approved. In 2003, the FSM and the United States were negotiating the details of a trust fund and annual aid package. As FSM has grown further apart from the United States, it has increased its relations with China, Australia, and other Asian countries. Falcam claims he will continue to ask for aid from the United States, but the willingness of the United States is in question.
In July 2000, FSM saw the worst cholera outbreak in decades, prompting the president to request over AS $41,000 in aid from the Australian government to produce preventative and educational programs about the disease. Several countries, including the Northern Mariana Islands and Guam, enacted quarantines on FSM and banned produce from the country for fear that the cholera would spread. The epidemic was worst in Pohnpei, Falcam's home-island.
In July 2002, forty-seven people died in landslides caused by severe rains from Tropical Storm Chata'an on Chuuk. It was the deadliest disaster of Chuuk's history.
In January 2001, Falcam was elected chairman of the Pacific Islands Conference of Leaders. In November of that same year, he signed the UN's International Convention for the Suppression of the Financing of Terrorism.