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Opinions: Reforms At USAID; Focus on Disease Prevention, Not Earthquake-Related Death Prevention; Fight NCDs In Developing Countries; Cash On Delivery; Destroy Smallpox Stocks; Global Health Funding Cuts’ Affect On Women; Budget Cuts Will Erode Family Planning Programs « » The Henry J. Kaiser Family Foundation

Opinions: Reforms At USAID; Focus on Disease Prevention, Not Earthquake-Related Death Prevention; Fight NCDs In Developing Countries; Cash On Delivery; Destroy Smallpox Stocks; Global Health Funding Cuts’ Affect On Women; Budget Cuts Will Erode Family Planning Programs

USAID Needs Time, Resources To Succeed

During these tight fiscal times, “we need to modernize our International Affairs programs with a greater emphasis on transparency, accountability and effectiveness” in order to “be fiscally responsible and still make the critical investments we need in our International Affairs Budget,” former Rep. Mark Green (R-Wis.) writes in an opinion piece on the Hill’s “Congress Blog.”

USAID is undergoing reforms that “are just the beginning, and much more work will need to be done if we’re going to ensure that it’s no longer ‘your father’s USAID,'” Green writes, adding, “But we must give these reforms every chance to succeed, and this cannot happen without the right resources. Drastic cuts to the International Affairs Budget, as some have proposed, would cut reform off at the knees, and tie us down to the old way of doing business.” In today’s global society, there is “broad consensus” that we must effectively and efficiently “use both our civilian and military tools to keep our nation safe. … Reforms underway will help us get there, but they need the opportunity – and the resources – to succeed,” Green concludes (3/14).

Focus On Disease Prevention, Not Fortifying Buildings Against Earthquakes

In a Foreign Policy opinion piece, Charles Kenny, senior fellow at the Center for Global Development, compares the high costs associated with “strengthening buildings that my never be put to the test” of an earthquake to the low-cost solutions of preventing and treating illnesses that continue to plague developing countries. “Earthquake deaths aren’t ‘acts of God’ – they are the result of poverty and weak governance. And in poor, weakly governed countries, there are a lot of deaths cheaper and more straightforward to prevent – from malaria, diarrhea, or measles, for example,” Kenny writes, concluding, “In rich countries with well-functioning regulatory systems, building regulations and land use codes specifically responding to earthquake threats have a place. In poor countries where regulation is capriciously enforced, they may even be harmful. If we want to change that grim calculus, we have to learn to treat earthquake deaths as a symptom of misery – not the cause” (3/14).

Now Is the Time To ‘Start Comprehensively Tackling’ NCDs In Developing Countries

While “[i]nfectious diseases still take a grave toll in poor countries, especially childhood killers such as malaria, pneumonia and diarrheal diseases … cases of non-communicable diseases (NCDs) such as diabetes, cancer and hypertension are increasing worldwide,” Josh Ruxin, founder and director of the Access Project, writes on Forbes’ blog “Science Business.” “It’s time to shape our global health policy accordingly,” he writes, describing several efforts to bring treatment for and promote education about NCDs in developing countries.

Still, Ruxin says “the international response to NCDs has been underwhelming. Despite a relative increase in global health awareness, only 3% of the $22 billion in international health aid spent in low- and middle-income countries has been directed towards NCDs.” He concludes, “It is high time for us to start comprehensively tackling the newest killers in the developing world. Ailments like diabetes and high blood pressure are not merely diseases of the rich nations: they have become global killers and demand a global response” (3/14).

Cash On Delivery Could Provide Useful Alternative To Traditional Aid

In an opinion piece on the New York Times’ “Opinionater” blog, journalist Tina Rosenberg examines the potential for the “Cash on Delivery” model to help “make some forms of foreign aid more effective, less corrupt and more responsive to what people need. And in doing so, … capture more public support for something that improves, and often saves, the lives of millions.” With Cash on Delivery, “instead of rich countries paying for all the little pieces that go into a poor country’s program, they pay only when something good comes out,” Rosenberg writes.  She describes how such a plan would operate, using the the success of “pay-for-results” used by GAVI to boost the number of children receiving vaccines in developing countries as an example. She also notes the issues created by “pay-for-performance” measures.

“No one is suggesting that Cash on Delivery should replace traditional aid,” Rosenberg writes, adding, “But in certain situations Cash on Delivery might turn out to be a useful alternative to traditional aid. And its advantages may go beyond a more effective use of dollars: it might increase political support for foreign aid. … It could also help to create more accountability in poor countries.” (3/14).

U.S. Should ‘Destroy Smallpox Stocks And Wipe Out Scourge Once And For All’

In Forbes’ blog “Science Business,” Steven Salzberg, director of the Center for Bioinformatics and Computational Biology at the University of Maryland, refutes the argument that the U.S. and Russia must maintain stocks of smallpox because “more research is needed to develop better vaccines, to protect us from a bioterrorism attack.” Rather, according to Salzberg, “keeping the smallpox around dramatically increases the risk” the virus could be reintroduced into the world.

Salzberg describes the impact the return of smallpox could mean for the world and the argument by some scientists that “new vaccines [could be developed] without the virus.” He concludes, “President Obama: here is an opportunity to do the right thing. You can order the CDC to destroy their stocks of smallpox, and eliminate this unnecessary risk from the planet. The United States can and should take the moral lead on this public health threat, rather than stonewalling once again at the next World Health Assembly. Destroy the smallpox, and wipe out this scourge once and for all” (3/13).

Proposed Cuts To Global Health Funding Will Hurt HIV/AIDS Prevention, Treatment For Women

“HIV is the leading cause of death globally among women of reproductive age, and rollbacks to programs that prevent mother-to-child transmission could leave 32,560 more infants infected with HIV each year,” journalist Nancy Goldstein writes in an opinion piece in the American Prospect, in which she describes the impact proposed budget cuts to U.S. funding of global health could have on HIV prevention and treatment programs for women worldwide. “Already, too few resources go to preventing women from contracting HIV in the first place, a problem that will only worsen with Congress’ proposed funding cuts,” she writes.

“If the budget deficit were truly at the heart of the current D.C. showdown, and if the U.S. truly wanted to bring down the cost of HIV prevention and treatment abroad, we could reconfigure current U.S. programming mandates to save costs and reflect best practices,” Goldstein writes, before suggesting efforts be directed toward increasing developing countries’ access to generic antiretrovirals (ARVs) and shifting some U.S. funds away from “ABC” programs (3/10).

Republicans’ Proposed Budget Cuts Threaten Family Planning, Health Progress Worldwide

“While the (largely male, white and middle-aged) Congress dithers on spending cuts that amount to a negligible fraction of the country’s overall deficit, women face at least another year of deferred promises and crippled hopes,” journalist Michelle Chen writes in a Huffington Post opinion piece highlighting the possible effects of conservatives’ efforts to reduce funding for global and domestic family planning programs. The proposed spending cuts “would deeply hinder efforts to provide women with social supports and medical resources for negotiating sexuality, pregnancy and related health risks,” and the “ripple effects” would affect the link between maternal health and HIV/AIDS prevention, according to Chen. “Family planning services are often the initial point of contact between impoverished women and any form of regular health care,” Chen writes, adding, “If anti-choice conservatives get their way in the budget process, they’ll also reinstate the global gag rule” (3/11).