Opinions: Reforming U.S. aid; delivering health care in developing countries

Sep 24 2009

To Reform Foreign Aid Institutions, 'Rewrite' The Rules

To change the U.S. foreign aid system, we must "[d]o what the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) did: break the rules and then rewrite them," Mark Dybul, former U.S. global AIDS coordinator, writes in a Foreign Policy opinion piece examining the development and implementation of the program. "PEPFAR was the start of a fundamental change - a break from the past - in not just the intellectual foundations of development but in the nuts and bolts of how it is done," according to Dybul.

He refers to two "new development institutions" - the Millennium Challenge Corporation (MCC) and the Global Fund to Fight AIDS, Tuberculosis and Malaria - as "rule-breakers" that "have the greatest chance of ensuring the ideals of a new era in development." According to Dybul, "In the long term, expanding the MCC and the Global Fund is the right strategy, so long as institutional issues can be resolved." He writes that the world is "at a unique moment in history in which that opportunity - to finally get development right - is an open door," adding that "it would be a great tragedy to take the easy way out by killing development quickly or starving it slowly with partial and ineffective reforms. Instead, we need to harness our new ideas to change the course of human development. Not really much of a choice when you stop to think about it" (9/22).

Developed Nations Must Deliver Essential Health Care To Developing Countries

"Crucial meetings this week in New York and Pittsburgh will determine by next spring whether a new era of collaboration is possible," British Prime Minister Gordon Brown writes in a New York Times opinion piece. In the article, Brown outlines "five urgent challenges" that require an immediate response. One of the challenges he singles out is the delivery of "essential health care to the most vulnerable."

According to Brown, "We must make good on our pledges to achieve the Millennium Development Goals, which are already well behind schedule." But there is one immediate step that developed nations can take: "to stop charging the world's poorest, particularly pregnant women and children, for medical treatment they cannot afford," he writes. "So today in New York I will chair an event that will see a major step toward that goal, with announcements from a range of countries — including Malawi, Ghana, Sierra Leone and others — some of which will revolutionize their national health care systems," he writes. "In the days and months ahead, our collective resolve must hold … If it can, then something bigger and even more lasting than the great reconstruction of the postwar era is possible: the creation of the first truly global society," he concludes (Brown, 9/22).