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America’s Global Health Initiative is American

Secretary of State Hillary Clinton
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.

At one point, the international community thought it could get the biggest bang for its bucks by targeting the major killers AIDS, TB and malaria. Now, the Obama Administration appears to believe the biggest bang will come from focusing on women and children.

Though Clinton contended the Obama Administration’s Global Health Initiative represents a continued commitment to the fight against AIDS, some see this as stepping away from the costly obligation of paying for AIDS treatment for the millions of people who need these drugs.

Obama’s Global Health Initiative also hints at stepping away from international collaboration in that it stresses funding U.S. assistance programs such as PEPFAR and the President’s Malaria Initiative (two highly successful programs launched by the latest President Bush) rather than the Global Fund, GAVI and other such truly globally run programs.

Finally, it’s worth noting that this $63 billion initiative is actually small potatoes, given the scope of the problems out there. This might sound like a lot of money, but it’s only $10.5 billion per year.

Still sound like a lot to you?

The U.S. military in Iraq and Afghanistan spends $20 billion every year just on air-conditioning.

(You have to listen to the audio interview of retired Brigadier General Steve Anderson, about a minute into it, on PRI’s The World.)


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.