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Useless outside the US? Ignoring the obvious objection, one of the design goals of the initial iteration of the NATO/ICAO phonetic alphabet was that every word in it would be familiar to you as long as you were fluent in either English, French or Spanish.

The phonetic alphabet is very much recognized and used in any English-speaking country around the world, plus airline staff working in any country period.

I have never lived in the US :)