In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, CGD’s Victoria Fan, Rachel Silverman, and Amanda Glassman examine “the preliminary report [.pdf] on the pilot of PEPFAR’s Expenditure Analysis Initiative, an important and exciting move by PEPFAR towards evidence-based decision making and greater transparency.” Expenditure analysis (EA) “provides an account of where money gets spent and on what,” they continue, adding, “Here’s why it could be a game changer: This seemingly simple tool is essential for realizing huge potential gains in both technical and allocative efficiency, two core components of value for money.” After describing some of the report’s shortcomings, they write that “the report demonstrates the wide range of potential applications for using EA to improve value for money, which is particularly encouraging given PEPFAR’s plans to institutionalize EA into its routine annual reporting” (8/1).
US Global Health Policy
“Health care, taxes, energy, favorite flavor of ice cream — it seems our elected leaders must disagree at every turn. But one issue that has so far repulsed the partisan pressures of the times was highlighted [at the XIX International AIDS Conference (AIDS 2012)] in our nation’s capital last week: the fight against HIV/AIDS,” former Senate Majority Leader Bill Frist (R-Tenn.) writes in an opinion piece in “The Week.” He says, “The conference was a celebration of the remarkable success made because of this leadership, and a call for continued support” in the response against HIV/AIDS. Noting he moderated a panel discussion with Rep. Barbara Lee (D-Calif.) and Sens. Chris Coons (D-Del.), Marco Rubio (R-Fla.) and Mike Enzi (R-Wyo.) on congressional bipartisanship at the conference, Frist continues, “I witnessed what I felt to be an accurate portrayal of how we got to the point where we could celebrate so many successes. Fundamental to the progress has been bipartisanship.”
USAID on Friday released Volume 3, Issue 11 of its online newsletter. The issue highlights the XIX International AIDS Conference (AIDS 2012), held in Washington, D.C., last week, and features a recap of the agency’s humanitarian response in the Horn of Africa over the past year; a report on the second annual Global Diaspora Forum in Washington, D.C., convened by U.S. Secretary of State Hillary Clinton last week; a link to the July/August edition of FrontLines, which focuses on USAID economic growth programs; and a roundup of USAID in the news (7/27).
In her “Global Health Blog,” Guardian health editor Sarah Boseley notes that she spoke with USAID Administrator Rajiv Shah during last week’s XIX International AIDS Conference (AIDS 2012). She writes that though he “has a very clear vision of where USAID is going and what it hopes to achieve … [h]e appears to be a little concerned, however, that Europe may not keep pace — particularly on the finance but perhaps also on the approach.” She continues to say “Shah’s main anxiety is clearly … about the diminishing funding from European allies for the efforts to turn the tide of AIDS … but also about the financial commitment to global health generally.”
Lawrence Altman, former senior medical correspondent for the New York Times, writes in an opinion analysis in the newspaper that while there was much discussion about “ending the AIDS epidemic” and an “AIDS-free generation” at the XIX International AIDS Conference (AIDS 2012) last week in Washington, D.C., “[o]ne obstacle is a failure to clearly define the epidemic or what it means to have an AIDS-free generation.” He continues, “Definitions of terms like these may help determine how many billions of dollars the world devotes to the battle against AIDS and how many millions of lives will be extended. A failure to meet ill-defined goals could lead to public misunderstandings that limit investments and the number of people who have access to the lifesaving antiretroviral drugs in the future.”
Noting “President Barack Obama’s Feed the Future initiative seeks to end hunger through increasing investment in agricultural development, particularly for the vast legion of smallholder farmers in sub-Saharan Africa,” Roger Thurow, a senior fellow at the Chicago Council on Global Affairs, writes in a post in the ONE blog, “Central to this movement is that Feed the Future and U.S. leadership to end hunger through agricultural development become a cornerstone of American policy no matter who is in the White House or which party controls Congress.” He writes that PEPFAR “was embraced and authorized by Congress in an unusual display of bipartisan support,” and says, “Feed the Future is worthy of similar bipartisan support and unity of purpose. It can stand alongside PEPFAR as an example of what America does in the face of crisis and great need” (7/27).
Some members of Congress “are advocating deep cuts to funding for domestic programs such as [the Ryan White CARE Act] and international programs such as the Global Fund [to Fight AIDS, Tuberculosis and Malaria] and PEPFAR,” but “[w]hat these critics fail to realize is that though we have won a multitude of battles, we are still losing the war in many communities,” Rep. Michael Honda (D-Calif.) writes in a U.S. News & World Report opinion piece. “We must continue to find innovative, targeted solutions in the fight against this dreaded disease,” he continues, adding, “There are many of us in Congress who recognize this important fact, chief among those are my dear friend Rep. Barbara Lee [D-Calif.], whose upcoming ‘Ending the HIV/AIDS Epidemic Act of 2012’ targets at-risk populations both domestically and internationally.” Honda concludes, “From legislative action on the federal level to grassroots efforts in state communities, we need to make targeting these communities a top priority in order to move forward. This requires advocacy, this requires commitment, and most importantly, it requires more investment” (7/27).
“Charged by Secretary of State Hillary Clinton with developing a blueprint for the next phase of the [U.S. government’s] involvement in the fight against HIV and AIDS, [U.S. Global AIDS Coordinator Ambassador Eric Goosby] … will lead an interagency effort to give clearer meaning to the term, ‘AIDS-free generation,’ and provide a basis for programming,” Sharon Stash, a senior fellow at the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the CSIS “Smart Global Health” blog. “Clearly the notion of an ‘AIDS-free generation’ within our reach is a powerful one,” she writes, and asks, “Is the meaning it inspires powerful enough to attract and keep the attention of national policymakers, already burdened with competing priorities in a tight economic environment?” (7/29).
GlobalPost correspondents John Donnelly and Charles Sennott interview USAID Administrator Rajiv Shah “about his perspectives on the AIDS fight,” in this entry in GlobalPost’s “Global Pulse” blog. They discuss U.S. Secretary of State Hillary Clinton’s announcement last week that the administration would put together a “blueprint” for achieving an “AIDS-free generation,” approaches to increasing demand for voluntary medical male circumcision in the developing world, and the closure of the Global Health Initiative office, among other topics, according to the interview transcript (7/27).
Sen. Dick Lugar (R-Ind.) “announced Thursday that he would release his hold on the $250 million meant to go from the President’s Emergency Plan for AIDS Relief (PEPFAR) to the Global Fund to Fight AIDS, Tuberculosis and Malaria,” saying “he was swayed by conversations at the International AIDS Conference [AIDS 2012] under way in Washington, D.C.,” The Hill’s “Healthwatch” blog reports (Viebeck, 7/26). “My biggest concern about the transfer was the shortfalls this may cause in our bilateral efforts to combat HIV/AIDS,” Lugar said, according to a press release from the senator’s office (7/26). “‘The leaders I met with this week expressed their confidence that the money is a worthy investment, and, given their strong leadership, I have decided to lift my hold on the transfer funds,’ Lugar, the ranking Republican on the Foreign Relations Committee, said in a written statement,” CQ HealthBeat notes (Ethridge/Cadei, 7/26). In related news, the U.S. Senate on Thursday introduced and passed a resolution “expressing support for the XIX International AIDS Conference and the sense of the Senate that continued commitment by the United States to HIV/AIDS research, prevention, and treatment programs is crucial to protecting global health,” the New York Times’ “Inside Congress” reports (7/26).