About the Author: Lois Quam serves as the Executive Director of the U.S. Global Health Initiative (GHI).
Since releasing the GHI Strategy Document last week, we have received a good deal of feedback. And that’s the way it should be! As the new Executive Director of GHI, I am committed to making the GHI process transparent and open to input from the global health community. After all, we wouldn’t be at this stage without bipartisan support from a wide variety of stakeholders. Because of the success the U.S. has already achieved on the global health front we are able to take GHI to the next chapter – a chapter where we save more lives, further promote security and maximize the effectiveness of programs.
Some of the feedback we have received to date concerning the Strategy Document focuses on our continued commitment to the GHI targets. Let me be clear: GHI is committed to these targets. We have had to refine a few of the targets to reflect the changes in the world around us, which I have detailed below. But as President Obama said in announcing GHI, “We have a responsibility to protect the health of our people, while saving lives, reducing suffering, and supporting the health and dignity of people everywhere. America can make a significant difference in meeting these challenges, and that is why my Administration is committed to act.” The President gave us an ambitious task, and I am certain that we are up to it.
Let me touch on a few items to directly respond to some of the concerns we have heard. First, the revised global health needs numbers for malaria, HIV infection, maternal mortality and under-five mortality reported in the new strategy reflect updated international estimates of global burden of diseases. This is good news – this means that from the time when we first cited disease and mortality estimates the global community has identified progress in fighting and assessing the burden of these devastating diseases and health conditions. Future documents will continue to reflect the latest data so we can keep track of progress being achieved.
Second, the Obama Administration is 100% committed to improving the lives of women and girls across the globe. This has been a passion of Secretary Clinton’s for decades, and she will not let us back away from ensuring that women and girls not only survive, but thrive. By changing the word from “implement” to “focus” in the Strategy Document, we recognize that gender must be a part of everything we do. We are stating that our work on gender goes beyond implementation of services, and requires us to work on the structural issues that keep us from implementing a woman- and girl-centered approach. These structural issues include addressing concerns like the lack of women’s participation in health care decision-making and policy changes. In addition to the focus on the overall wellbeing of women and girls, the wording of the principle now reflects a broader focus on gender equality, which involves work with men and boys to address gender norms.
Third, we have removed references to numerical targets where percentage targets existed. These numerical targets were removed when new data became available in 2010 that provided new estimates demonstrating a decline in prevalence or burden from previous estimates. Rather than revising our numerical targets downward, we focused instead on our government’s continued commitment to reduce maternal and child mortality by a percentage rate across assisted countries. This is a change that we can measure with confidence using the best available tools to understand how our efforts are making impact around the world.
Finally, on neglected tropical diseases, GHI’s goals have helped to bring a spotlight to these diseases, which debilitate millions worldwide. Since May 2009, our pledge has been to eliminate onchocerciasis in the Americas, not globally. Regarding lymphatic filariasis, the target date of 2017 was moved to 2020 in the Strategy Document to align with the goal set by the global community.
Many of you have also been anxiously awaiting the GHI plus country strategies. I was pleased to announce the GHI Kenya strategy today during my visit to Africa and other strategies will be released next week.
We are committed to the critical work of GHI on the ground, but obviously, the proposed budget cuts before us provide great uncertainty. As Secretary of State Clinton said in her House Foreign Affairs Committee hearing, “… we have made a lot of progress, but we have a long way to go, and I am worried that the House 2011 budget proposes more than a billion dollars in cuts to global health. What that means is 5 million children and family members will be denied treatment or preventive intervention on malaria; 3,500 mothers and more than 40,000 children under five, of which 16,000 are newborns, will not get access to effective child survival interventions; PEPFAR will have to turn away 400,000 people who require lifesaving treatment against HIV/AIDS; more than 16 million people will be denied treatment for debilitating tropical diseases; more than 40,000 children and family members will be denied treatment for tuberculosis; and we’ll have 18.8 million fewer polio vaccinations and 26.3 million fewer measles vaccinations.”
Yes, we face budget uncertainty. But we are forging ahead on GHI. The GHI Strategy Document is a snapshot of the direction we are heading. It is a living document that will change as needed to meet changing circumstances – but the one thing that will not change is our commitment to GHI’s life-saving goals and principles.
I thank you for your interest in the GHI strategy and encourage you to continue to reach out to my colleagues and me when you have questions, concerns, or suggestions. We are all in this together. Together we can save more lives and build stronger health systems across the globe. At the same time we can ensure a more secure and healthier world, while demonstrating the leadership and compassion of Americans abroad.