Global Health Initiative

The Obama Administration's $63-billion initiative aimed at advancing global health.


GlobalPost looks at Obama Admin’s “stumbling” Global Health Initiative | 

“A slow, stumbling start.”

That’s how John Donnelly, writing in GlobalPost, characterizes the Obama Administration’s Global Health Initiative. The online international news organization has published a short series called  “Healing the World” (yeah, kind of corny) that critically examines the initiative.

The U.S. government is, in fact, doing a lot when it comes to global health needs on a number of fronts — most of which were launched under President George Bush.

The Bush Administration’s global health “strategery” led to PEPFAR, a massive effort aimed at helping those with HIV/AIDS in Africa, the President’s Malaria Initiative and we remain the largest donor to multilateral initiatives like the Global Fund for AIDS, TB and Malaria.

These are amazingly grand and good things we are doing. But part of the problem with the U.S. approach to global health has been a lack of coordination among these initiatives and the various agencies carrying them out. Continue reading

Obama’s new global health czar | 

Few in the global health community appear to know much about the Obama Administration’s newly appointed chief of the $63 billion Global Health Initiative — which itself remains a bit unclear, but that’s another story.

Lois Quam

Lois Quam is a Minnesota health care executive best known for her work as a businesswoman at UnitedHealthGroup.

Given that the American health care system is the most expensive — and arguably least efficient and equitable in the developed world — Quam’s appointment to head up our nation’s efforts to improve health in the developing world is causing some to scratch their heads.

On Tuesday, as the Kaiser Foundation reports, Quam made her first public statements since accepting the position in January. The Administration also issued a report on its strategy.

Who is Lois Quam?

Continue reading

Obama’s global health diarist gets his goat | 

Is Obama’s $63 billion Global Health Initiative working?


Dr. Zeke Emanuel

That’s the title of one of the initial posts in “Africa Diaries” a series of reports to come by Dr. Ezekiel Emanuel, brother to President Obama’s former chief of staff (and now Chicago mayoral wannabe) Rahm Emanuel.

Dr. Emanuel is a bioethicist at the National Institutes of Health and also a special adviser on health issues to the Obama Administration. He’s doing a series of global health articles for The New Republic magazine based on a recent trip he made to Senegal, Mozambique and Ethiopia.

Emanuel begins his diary:

Is funding for global health a never-ending waste of money in which billions are spent but nothing gets better? Or are we being selfish and grossly unethical, because we are unwilling to spend a few hundred dollars more per year in order to save a life of a poor person half way around the world?

Gee, those are tough questions. I’m going to guess no and yes. Continue reading

The Fantastic Proposal for a Mega-Global Health Fund | 

Flickr, by AMagill

Circle of money

As we continue this week’s celebration (or denunciation, depending upon your perspective) of the world’s efforts to fight poverty, improve health and make the world a better place, it’s worth paying attention to a little side issue that keeps popping up.

Money. Everyone says we need more, of course. And everyone is also talking about making these efforts more “efficient” or “strategic.”

On the health front, some say what we need is a new, comprehensive Global Health Fund — to consolidate all of the various funding mechanisms that are now focused on single diseases or other health problems.

I think that’s just fantastic, as in a fantasy, and maybe even harmful. Continue reading

Obama Policy Will Take Lives, Spread AIDS, Says African | 

Zambian Michael Gwaba, who is HIV-positive and alive today because of access to anti-retroviral drugs, is in Seattle this week to ask that Americans pressure the Obama Administration to keep our nation’s promise to help more Africans gain access to life-saving AIDS drugs.

Despite some creative accounting that allows administration officials to keep claiming they are increasing funding for AIDS drugs in Africa, it’s, uh, well, actually not true. More on that in a bit.

by Tom Paulson

Michael Gwaba with John Fawcett and Bob Dickerson of RESULTS, in Belltown

“I’ve come to appeal to the grassroots,” said Gwaba, who lost his brother, wife and infant son to AIDS-related illnesses. He’s in Seattle thanks to the local branch of RESULTS, a nationwide anti-poverty organization.

Gwaba was not always an activist. He says he once thought HIV/AIDS was not his problem, perhaps like some of us who tend to view Africa’s struggle against the pandemic as not our problem. Continue reading

Gender-based Global Health? | 

Indian Mother and Child

Flickr, DFID

Mother and child, Madhya Pradesh, India

Maybe even asking this question is a bad idea. Maybe it’s just me — either because I’m a man and/or a nerd.

But I can’t help but wonder if the latest trend of focusing the global health agenda on women and girls could actually do more harm than good.

There are many reasons why this would seem an obvious choice, why it just makes sense to focus health efforts on women and girls. Here are just a few of those reasons:

  1. Women give birth to all of us. A healthy birth and childhood prevents a lot of ills.
  2. Girls grow up to be women.
  3. Females often get short shrift in many communities and cultures due to gender discrimination. Putting an emphasis on improving female health and welfare can reduce unhealthy inequities.

I don’t think anyone would argue with those fundamental assumptions. Given these realities, it appears both wise and just to focus global health efforts on women and girls.

But how exactly would this be carried out? Continue reading

America’s Global Health Initiative is American | 

Hilary Clinton

Flickr, by Roger H. Goun

Secretary of State Hilary Clinton

“No nation in history has done more to improve global health,” Secretary of State Hillary Clinton said Monday in a speech celebrating the United States’ commitment to fighting disease, saving lives and improving social welfare worldwide.

“We have led the way on some of the greatest health achievements of our time,” said Clinton to a crowd at Johns Hopkins University’s Paul H. Nitze School of Advanced International Studies.

She cited the eradication of smallpox (which, technically, was achieved by the World Health Organization and PAHO), the Expanded Program on Immunization (also led by WHO, along with UNICEF and the health ministries of many countries) and the fights against AIDS, TB and malaria. I guess we can legitimately take credit for funding much of that last bunch, though arguably these are all more accurately viewed largely as international collaborations.

What Clinton was leading up to with this somewhat parochial view of global health was to pitch the Administration’s $63 billion Global Health Initiative.

The aim of this project, spread over six years, has many parts but is focused on women and children — and measurable achievements in “health system strengthening.”

An earlier Global Health Initiative, launched in 2002 at the World Economic Forum, was focused on fighting AIDS, TB and malaria, and improving health systems. It was launched by the private sector in part to support the ambitious creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

What’s interesting here is how the focal point in global health keeps changing. Continue reading