Global Health Initiative Next Steps - A Joint Message

Administrator Rajiv Shah, Ambassador Eric Goosby, Director Thomas Frieden, and Executive Director Lois Quam

Today we want to update you on the next phase of the President's Global Health Initiative (GHI). First and most importantly, we value your interest and partnership in advancing USG global health goals. Together, we are expanding the impact of our investments, and saving millions of lives each year. We are proud of our collective successes, but know that we can and must achieve more.

Since the launch of GHI, we have made measurable strides toward achieving bold goals. To date, our global health teams in the field and at headquarters are implementing more than 40 GHI strategies, applying the GHI principles and pursuing the GHI targets. In pursuit of GHI objectives, we have identified three key areas of focus as we move from individual program activities to coordinated actions that can save more lives: creating an AIDS-free generation, investing in women and saving mothers, and ending preventable child death. As we move forward, we will continue to build on the GHI efforts and systems in place in-country that are already working well.

The Quadrennial Diplomacy and Development Review (QDDR) provided a forum for review of the structure of GHI. After careful consideration of evolving U.S. global health leadership needs, we have reached several key conclusions that will help guide the next phase of GHI:

• First, we continue to recognize the capabilities of our global health agencies. Each has critical leadership responsibilities that must be maintained in the next phase of GHI as we seek greater impact and efficiency from our collective whole-of-government efforts to implement our health programs.
• Second, we believe that a continued emphasis on country-level leadership of our global health activities will best achieve improved USG coordination of programs in the field, stronger country partnerships and ownership, and innovation for results.
• Third, we recognize the critical role of health diplomacy to increase political will and resource commitments around global health among partner countries and increase external coordination among donors and stakeholders.

As a result of our analysis and conclusions, we have made a collective recommendation to close the QDDR benchmark process and shift our focus from leadership within the U.S. Government to global leadership by the U.S. Government. This recommendation has been accepted.

Our recommendation and the decision to move forward are a reflection of the strength and leadership of each agency. The success of the recent Child Survival Call to Action, spearheaded by USAID, to launch a program to end preventable child death is a sterling example of our GHI principles at work, challenging countries with the greatest child mortality to take greater ownership and coordinating efforts from partners. USAID is also assuming management responsibility for Saving Mothers, Giving Life, a public-private partnership to help reduce maternal mortality during labor, delivery, and the first 24 hours postpartum. The Office of the Global AIDS Coordinator will continue to lead PEPFAR, ensuring that all Country Operational Plans reflect the principles of GHI in activities, thus improving programmatic integration and coordination, supporting country ownership and health systems strengthening, and focusing on gender equality. Through these activities, among others, PEPFAR is helping to create an AIDS free generation. And, CDC is continuing its remarkable work implementing programs and leading the strengthening of public health systems across a diverse range of activities around the world.

What does this approach mean for the future of GHI work in country and at headquarters? The Global Health Initiative will continue as the priority global health initiative of the U.S. Government. GHI will continue to function with a collaborative leadership structure headed by the three core entities - USAID, CDC, OGAC - and with the enduring mandate of ensuring the GHI principles are implemented in the field to achieve our ambitious GHI goals. GHI country teams and GHI planning leads will continue to work to implement GHI strategies under the leadership of the U.S. Ambassador.

At the State Department, the GHI Office (S/GHI) will close and the Office of Global Health Diplomacy (S/GHD) will be stood up. Unlike S/GHI's focus on interagency coordination, the S/GHD office's mandate will be to champion the priorities and policies of GHI in the diplomatic arena. Success in the next phase will be measured by our ability to leverage our collective interagency leadership to influence global stakeholders, align donor investments with country resources and oversight and maintain and build country-focused technical support that expands capacity for global health priorities.

As we move into the next phase of GHI, we are committed to working together to achieve our ambitious GHI goals and to support and enhance our combined efforts to save lives.