Global health featured as a part of President Barack Obama’s final State of the Union address last night. His remarks on the subject manage to both overstate U.S. accomplishments and unveil an area that will garner greater focus during the administration’s final year in office. It encapsulated the mixed record for an administration that is prone to, at times, both over-hype and under-deliver on global health.
Domestic issues and national security have always received the most attention in Obama’s addresses. Global health and development tend to get a passing mention in the latter third of the nearly one-hour speech, and last night was no different. It is also an opportunity to boast about administration accomplishments. One victory claimed by Obama was the end of the Ebola outbreak in West Africa.
“America will always act, alone if necessary, to protect our people and our allies; but on issues of global concern, we will mobilize the world to work with us, and make sure other countries pull their own weight,” said Obama. “That’s how we stopped the spread of Ebola in West Africa. Our military, our doctors and our development workers set up the platform that allowed other countries to join us in stamping out that epidemic.”
Barring the discovery of a new case, the World Health Organization will declare an end to the outbreak when Liberia passes 42 days without a positive test, tomorrow. The official announcement is expected to come Friday, marking the end to the two-year-long outbreak that killed more than 11,000 people. It spiraled out of control in the middle of 2014 due to failures of national health systems, missteps by the World Health Organization and a late international response.
— The White House (@WhiteHouse) January 13, 2016
Obama’s request of $6 billion from Congress for Ebola came months after cases and deaths spiked. The nearly 3,000 troops deployed by the U.S. to West Africa were too late and built health facilities that were barely used. A New York Times report in April 2015 said the 11 military treatment units had seen only 28 Ebola patients. Despite this, Obama’s speech claimed that the U.S. made far more of an impact.
Credit should have gone to the heroic effort led by local front-line health workers in Sierra Leone, Guinea and Liberia who turned the tide against Ebola. Their impact was widely recognized and garnered the honor of Time “Person of the Year.” As was their selfless response, despite the danger they faced and the lack of compensation for their work. And more than 500 of those workers died as a result.
“West African health workers have selflessly treated Ebola patients without proper equipment and worked grueling shifts, sometimes not knowing when their pay would come,” Julia Bluestone, senior technical adviser at Jhpiego, said in March.
In his speech, Obama built on the idea of American leadership and concluded the section with his global health priorities for 2016.
“When we help African countries feed their people and care for the sick, that prevents the next pandemic from reaching our shores,” he said. “Right now, we are on track to end the scourge of HIV/AIDS, and we have the capacity to accomplish the same thing with malaria – something I’ll be pushing this Congress to fund this year.”
Last February Obama acted to extend George W. Bush’s President’s Malaria Initiative by six years. The initiative hasn’t gotten past its rocky start. It is one of the least-discussed global health programs supported by the U.S. government, and one with the greatest impact for its investment.
— Laurie Garrett (@Laurie_Garrett) January 13, 2016
The goal is to eliminate malaria by 2050, and the funding Obama seeks from Congress would support the initiative to that end. A new report from the World Health Organization shows that the number of malaria deaths have dropped by nearly half since 2000. With millions of cases each year and the emerging resistant strains of the parasite in Southeast Asia, there is a lot more work to get to zero.
And speaking of zero, tuberculosis did not manage to make its way into Obama’s speech. Despite being one of the priority diseases for the Global Fund, which the U.S. is the leading funder, TB was ignored. That is despite the fact that the White House launched a new plan to address the disease that kills more people (1.5 million) than both malaria and HIV/AIDS each year.
The fact that TB wasn’t mentioned is notable. Advocates and champions in Congress are worried by the lack of financial commitment, despite an event held to highlight the new plan.
“Too often Washington has failed to give TB the attention and the resources that it demands,” said Sen Sherrod Brown. “Without funding, it’s just another plan on the shelf.”