In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, Research Fellow Victoria Fan, Director of Global Health Policy Amanda Glassman, and Research Assistant Rachel Silverman of CGD examine what they call the “serious limitations” of a study published recently in the American Journal of Tropical Medicine & Hygiene that looked at the impact of HIV/AIDS funding on Rwanda’s health system. After describing several “shortcomings,” they write, “We understand that the authors likely suffered from significant data constraints; likewise, we recognize the enormous empirical challenges in demonstrating system-wide effects at the national level. Still, it remains important to carefully state results and recognize the limitations of one’s research.” They conclude, “The jury is still out on whether HIV/AIDS funding has displaced or improved efforts on other disease control priorities” (5/10).
Domestic Health Reform Receiving More Attention Than Global Health In U.S. Presidential Campaigns, Lancet Reports
The Lancet examines the domestic health positions of President Barack Obama and Republican presidential nominee Mitt Romney before briefly outlining their positions on global health. “Compared with domestic health reform, global health has received little attention during the [U.S. presidential] campaign,” the journal reports, adding, “[T]he U.S. budget crisis might have more effect on global health initiatives than presidential politics, some experts say” (Jaffe, 9/29).
Secretary of State Hillary Clinton reflects on changes in U.S. global health diplomacy since taking office in this Global Health and Diplomacy opinion piece. “America had been leading the global health fight for decades,” but “we recognized that to sustain the impact of our work, we needed to change the way we did business,” she writes. “For example, while our agencies were providing tremendous leadership in isolation, they could still do more to collaborate effectively,” she writes, adding, “[W]e weren’t doing enough to coordinate our efforts with other donors or our partner countries,” and “we weren’t building sustainable systems to eventually allow our partner countries to manage more of their own health needs.” She says, “We were unintentionally putting a ceiling on the number of lives we could save.”
“With back-to-back Republican and Democratic National Conventions, it’s natural to focus on our differences,” but “I am heartened to see the bipartisan support that exists for U.S. leadership in the world — particularly for our global development efforts,” Dan Glickman, former secretary of agriculture and chair of the Board of the Center for U.S. Global Leadership, writes in a Politico opinion piece. “Through programs like the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, initiatives started [during the administration of] President George W. Bush, nearly four million lives around the world have been saved,” he continues, noting, “President Barack Obama has continued to champion and support global development efforts like PEPFAR and the Millennium Challenge Corporation, which demand results and ensure accountability for U.S. taxpayers.”
“Thirty years after AIDS made its deadly debut, a future without the disease is finally within reach,” a Boston Globe editorial states, adding, “But just as science is on the verge of winning the battle, financial resources and political will are flagging.” The editorial details reductions in HIV spending, a Congressional stipulation that U.S. funds cannot be spent on needle-exchange programs, and new science showing how HIV treatment can help people living with the disease live longer and reduce the risk of them spreading the virus.
“The United States should be more selective about where and how it spends foreign assistance,” according to a new report (.pdf), titled “Engagement Amid Austerity: A Bipartisan Approach to Reorienting the International Affairs Budget,” co-authored by John Norris of the Center for American Progress and Connie Veillette of the Center for Global Development (CGD), the CGD website notes. The report “identifies four flagship reforms that would help U.S. foreign affairs institutions to better reflect national interests and reduce ineffective spending,” including “[a]ccelerat[ing] cost-sharing arrangements with upper middle income recipients of” PEPFAR and “[o]verhaul[ing] U.S. food aid laws and regulations,” according to the website (5/8).
“Each year, nearly 400,000 children are born with HIV globally, and prevention of mother-to-child transmission (PMTCT) is a particular challenge in sub-Saharan Africa, an area characterized by weak health systems,” U.S. Global AIDS Coordinator Ambassador Eric Goosby writes in the State Department “DipNote” blog. “Last year PEPFAR and UNAIDS joined with other partners to launch the Global Plan, an initiative to eliminate new HIV infections among children and keep their mothers alive,” Goosby writes and reflects on a two-day mission to Nigeria with UNAIDS Executive Director Michel Sidibe last week. He concludes, “Preventing new HIV infections in children is a smart investment that saves lives, and the United States is proud to partner with Nigeria and other countries in this cause” (4/30).
The Center for Global Health Policy’s “Science Speaks” blog notes that PEPFAR recently released its 8th annual report (.pdf) to Congress. “The five-page document outlines the program’s progress as of the end of fiscal year 2011 in various areas,” including the provision of antiretroviral treatment, care, and support; HIV testing and counseling for pregnant women; and prevention of mother-to-child transmission services, the blog notes. The report includes sections on “leading with science,” “smart investments,” “country ownership,” and “shared responsibility,” according to the blog (Mazzotta, 5/4).
“In the last 20 years, the world has saved more than 50 million children’s lives and reduced maternal mortality by one-third,” “accomplishments [that] have been the result of good science, good management, bipartisan political support, the engagement of USAID and many other U.S. Government agencies, and the participation of faith-based organizations, civil society, and the private sector,” according to a summary of USAID’s “Global Health and Child Survival: Progress Report to Congress 2010-2011.” The summary states, “With prospects for ending preventable child and maternal deaths, creating an AIDS-free generation, and laying the foundations for universal health coverage, future generations will look back at this period as a turning point in the history of global health” (5/10).
Writing in USAID’s “IMPACTblog,” Dereje Bisrat, monitoring and evaluation adviser for the Supply Chain Management System (SCMS), discusses the PEPFAR-funded program, which is administered by USAID and “works with Ethiopia’s Pharmaceutical Fund and Supply Agency (PFSA), nine regional health bureaus, and more than 1,717 health facilities to improve access to HIV/AIDS treatment” in the country. She tells the story of Neima Mohammed, an Ethiopian refugee who, after living in Djibouti for 10 years, returned to her home country to seek treatment through the program, writing, “This story might have ended with Neima’s fateful decline in health. Fortunately, thanks to friends back home, Neima learned Ethiopia was embarking on efforts to provide free antiretroviral treatment to thousands of people living with the disease” (11/6).