The Lancet examines the history of the Obama administration’s attempt to “reform the way the country delivers development assistance for health abroad” by establishing the Global Health Initiative (GHI). “Despite unusual bipartisan support in Congress and broad consensus among development practitioners about the goals of reform, it proved surprisingly difficult for the multiple entities involved in U.S. global health assistance to agree on a way forward,” the journal states, noting that GHI leadership and the three core entities of GHI — USAID, the Centers for Disease Control and Prevention (CDC) and PEPFAR — announced the closure of the GHI office and an end to the initiative’s current phase on July 3. The Lancet outlines several challenges the initiative faced, including collaboration among the three agencies, leadership, and external factors, such as “the austere budgetary climate.”
“Zimbabwe is set to attain ‘universal’ coverage for AIDS treatment thanks in part to an $84 million disbursement [on Tuesday] by the United Nations-backed Global Fund to Fight AIDS, Tuberculosis and Malaria,” the U.N. News Centre reports (10/2). “The new disbursement will cover the cost of life-saving antiretroviral drugs (ARVs) for an additional 10,000 new patients, bringing the total number of people on treatment with Global Fund support to 203,440 by the end of the year,” the Global Fund announced in a press release. The funding also will support a six-month ARV buffer stock to prevent treatment interruptions for the 480,000 patients on therapy in Zimbabwe, the press release notes (10/2). The Global Fund’s announcement to support additional patients comes together with an announcement from PEPFAR to increase the number of patients supported by its program from 80,000 to 140,000, with a goal of having 160,000 patients on therapy by the end of next year, Zimbabwe’s Herald notes.
“Though the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has been touted as one of our nation’s most successful initiatives in global health (and certainly one of President George W. Bush’s most positive legacies) it continues to miss the mark” when it comes to family planning, global gender specialist and freelance writer Jessica Mack writes in KPLU 88.5’s “Humanosphere” blog. “The essential role of contraception, especially barrier methods, in preventing the spread of HIV/AIDS is intuitive, obvious, and also well documented,” she writes. “While earlier PEPFAR rules did not specifically dictate whether or not funding could be used for contraceptive supplies, the language over the last few years has become increasingly restrictive on this point,” she continues, noting that PEPFAR’s recently released 2013 country operational plan (COP) forbids the use of PEPFAR funds to purchase family planning commodities. Mack concludes, “PEPFAR is simply flying directly in the face of the Global Health Initiative’s vision and the stated objectives of the Obama Administration” (10/25).
NPR’s “Shots” blog profiles Vanessa Kerry, a physician and daughter of Sen. John Kerry (D-Mass.), and her work to develop the Global Health Service Partnership to send nurses and doctors to work abroad in exchange for a pay-down in their student loans. The partnership’s goal “is to reduce the severe shortage of medical workers in developing countries,” according to the blog, which adds Kerry “thinks the partnership will also strengthen health care here stateside by infusing U.S. doctors with a worldview centered on making the most of available resources.” The program is working with the Peace Corps and receives funding through PEPFAR, the blog notes (Doucleff, 9/26).
Devex News Analysis Examines Democratic, Republican Party Platforms On Foreign Policy, Including Global Health
A Devex news analysis examines the Democratic and Republican platform positions on foreign policy following the party conventions, writing, “Even as pocketbook concerns continue to overshadow foreign policy issues on the campaign trail, in both Charlotte and Tampa, top-billed speakers made the case for the U.S. foreign aid program.” The article examines the core principles of each platform, notes that neither platform offers specifics on foreign aid spending, and discusses the platforms’ stances on certain foreign policy issues, including global health, food security, climate change, and gay rights.
U.S. Commitment To Foreign Assistance, Global Health To Rise Or Fall With Presidential Election Outcome
In this Lancet opinion piece, Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, examines a number of social, political, and financial issues at play ahead of the November 6 U.S. presidential election and their implications for domestic and global health programs. “Fundamentally, the 2012 election reflects a Grand Canyon scale rift through the national psyche over the importance of government, provision of tax-supported public goods, including health care, and who is responsible for the 2008 financial crisis and ongoing economic doldrums,” she writes. “But the biggest concern for America’s future is the budget,” she continues. Garrett discusses how sequestration might affect foreign assistance and global health programs and states, “U.S. commitment to foreign assistance and such international ventures as the President’s Emergency Program for AIDS Relief (PEPFAR) and Obama’s signature Global Health Initiative are also likely to rise, or fall with the elections” (9/1).
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.”
“The world has lost momentum in the fight against the AIDS epidemic, with millions of new people infected last year, the ONE foundation said in a report,” titled “The Beginning of the End? Tracking Global Commitments on AIDS” and released on Tuesday, Reuters reports. In its annual report last week, UNAIDS said despite advances in access to medicines that both treat and prevent HIV infection, 2.5 million new cases of HIV occurred in 2011, according to the news service. “That is more than double the target of having only 1.1 million people newly infected each year, said ONE,” according to Reuters.
Emmanuel Njeuhmeli, senior biomedical prevention adviser in the USAID Office of HIV/AIDS, writes in the agency’s “IMPACTblog” that the first International Men’s Day on November 19 was an opportunity to “recognize and celebrate the hundreds of thousands of men in East and Southern Africa who are stepping up for Voluntary Medical Male Circumcision (VMMC) to protect their own health and that of their families.” He continues, “We also recognize the political, traditional and community leaders who are leading the charge in their countries and local communities.” According to Njeuhmeli, who describes some VMMC programs of USAID and PEPFAR, “USAID and UNAIDS have estimated that VMMC has the potential to avert more than 3.4 million new HIV infections in 14 countries in Eastern and Southern Africa, and save an estimated $16.5 billion in care and treatment over the next 15 years, freeing up resources for other crucial HIV interventions” (11/27).
The Global Fund to Fight AIDS, Tuberculosis and Malaria Board recently made several decisions that will affect the future of the organization, including appointing former U.S. Global AIDS Coordinator Ambassador Mark Dybul as executive director and adopting a new funding model, Nature reports in an article examining the history and future of the Fund. “It has been a rough couple of years for the Global Fund,” but “[l]ast week’s appointment of Mark Dybul as executive director could signal a fresh start, and has been broadly welcomed,” Nature writes (Butler, 11/22). “As [Dybul] begins his four-year term in early February 2013, current Fund General Manager Gabriel Jaramillo will transition out of his position,” PlusNews reports, noting, “That position, created to guide the Fund through reforms proposed by a 2011 high-level review panel at a time of low donor confidence, will disappear.”