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Back to the fuzzy future in global health | 

Analysis

Globe kid
Flickr, woodleywonderworks

The global health community seems at a loss these days, as indicated by two conferences yesterday I web-participated in devoted to coming up with a future game plan for the field. I’ll get to those, but first some context:

I am long-in-tooth enough to remember when ‘global health’ didn’t exist, not by name anyway, before Bill Gates got into philanthropy and when the only ‘Third World’ disease most of us in the West cared about was AIDS.  And we cared only because that disease figured out how to spread beyond its original confines in Africa. Today, it can seem like everybody and their mother wants a piece of the global health bandwagon.

Or they did anyway, when funding for fighting diseases of poverty in poor communities (my definition of global health, which is debatable) was increasing at the rate of Starbucks franchises.

Global health’s golden age began somewhere around the year 2000 and was due in part to the meteoric rise of the Bill & Melinda Gates Foundation. I think it’s fair to say the Seattle philanthropy revolutionized and resurrected many neglected areas of international health by greatly expanding efforts in children’s immunizations worldwide as well as reinvigorating many moribund fields like malaria and tuberculosis research.

But it wasn’t just because of the Gates Foundation that global health took off. The now almost unimaginable toll taken by AIDS in Africa and other parts of the developing world had become intolerable, at least for many AIDS activists, human rights groups and public health experts. Continue reading

News flash: Global health continues to stagnate under Obama | 

The Kaiser Family Foundation yesterday held a briefing on the Obama Administration’s ‘new’ approach to global health featuring, as keynote speaker, U.S. Health and Human Services Secretary Kathleen Sibelius.

Nothing much of substance seems to have happened, which some will say is in keeping with the Obama Administration’s strategy for global health. Sibelius claimed that the U.S. has always been and is today a leader in the fight against diseases of poverty, quoting Secretary of State Hillary Clinton:

“At a time when people are raising questions about America’s role in the world, our leadership in global health reminds them who we are and what we do.”

True enough. America has been a leader in many aspects of global health, such as the fight against AIDS and malaria. But none of that lead was established by the Obama Administration. It was mostly President George W. Bush’s leadership (especially on AIDS in Africa) — and to a great extent a small, private operation based in Seattle run by a software tycoon — which gave us the lead.

The Obama Administration, as documented in this excellent series of articles (also funded by Kaiser) in GlobalPost called Healing the World, hasn’t really accomplished much of anything … besides a lot of talk, new reports and announced ‘new’ shifts in strategy.

You can see for yourself, if you want to watch Kaiser’s video of the two-hour Beltway confab:

Two news organizations tried to cover the Kaiser event but I don’t know what they said since both, Congressional Quarterly and Politico Pro, are hidden behind a subscriber paywall. Kaiser quoted from one of the reports, by CQ’s Rebecca Adams:

“The strategy identifies 10 major objectives but does not include metrics for gauging success,” the news service writes, adding Sebelius “said the plan ‘does not represent a radical new direction but seeks to provide a focus to ongoing efforts.”

That doesn’t really sound new, or maybe even like much of a strategy. Most folks seem to have stopped paying much attention to the Obama Administration’s global health strategy — because it seems like mostly just rhetoric with no new funding and little in the way of substantive action.