Foreign Policy examines GHI, PEPFAR

Jun 29 2010

Foreign Policy examines reactions to the priorities set forth in President Barack Obama's Global Health Initiative (GHI) and what they might mean for PEPFAR. Some argue that the administration is "backtracking on a global health battle the world was starting to win" against HIV/AIDS, while others believe the U.S. "responded to the HIV/AIDS emergency a decade ago … now it's time to take a broader, more sustainable approach that can eventually move patients away from their reliance on the United States."

The piece details the success of PEPFAR launched by former President George W. Bush; the questions that emerged when Obama took office about the sustainability and focus of the program; and the administration's decision to launch the $63 billion GHI. The GHI "took PEPFAR under its umbrella and shifted the focus from HIV/AIDS to including malaria, tuberculosis, maternal health, child health, nutrition, family planning and reproductive health, and neglected tropical diseases, according to the program's initial consultation document," while simultaneously working with countries on health system strengthening, the news service writes.

The article notes the reaction of the HIV/AIDS advocacy community to Obama's FY 2011 budget request that increased PEPFAR funding by 2.3 percent. It also notes the challenges associated with some of the aims of the GHI, such as the social and moral debates that could emerge with increased attention on maternal health and family planning.

The piece includes comments by U.S. Global AIDS Coordinator Eric Goosby, Global Fund Executive Director Michel Kazatchkine, Center for Strategic and International Studies' J. Stephen Morrison, Medecins Sans Frontieres' Emi MacLean and Human Rights Watch's Joseph Amon.

According to Foreign Policy, the test ahead for the Obama administration will be "whether [the GHI] can really build the environment that would be conducive to a shift from emergency to long-term HIV treatment, strengthening health-care systems where many have tried before and failed. In an ideal world, there would be enough money to fund both emergency and long-term solutions. But here's the truth: There isn't. So this was an inevitable juncture: A global recession, constrained budgets across the developed world, and a simple realization that treating HIV/AIDS is expensive have forced the U.S. government and other governments to answer hard questions about how their dollars will be spent. If Obama can make those hard decisions and manage the transition from emergency to long term, the fight against HIV/AIDS will be on a more sustainable footing. A wrong turn, however, could endanger the incredible gains made in recent years" (Dickinson, 6/25).

IRIN/PlusNews Examines GHI Plus Countries

IRIN/PlusNews reports on the recent announcement by the U.S. of the eight nations tapped as GHI Plus countries. "Countries including Ethiopia, Kenya and Malawi will receive additional U.S. government resources as part of the six-year, $63 billion initiative to help strengthen national health systems by improving supply chain management, health worker retention, and information management, said Nicole Schiegg of the U.S. Agency for Development (USAID)," the news service writes.

The article examines the possible effects on Kenya because of its selection as as a GHI Plus country. It also notes the ongoing debate over the GHI strategy. "The U.S. could extend the GHI Plus grant to as many as 20 countries by 2014," according to GHI's new consultation document (.pdf), IRIN/PlusNews writes (6/24).