GlobalPost examines Pres. Obama's Global Health Initiative

May 11 2011

GlobalPost has published two articles on President Barack Obama's Global Health Initiative (GHI). "In a series of reports over the coming months from Washington and in capitals around the world, GlobalPost will examine the behind-the-scenes decisions in the Obama administration as well as what diplomats and health experts are doing now in several countries to try to bring to life this new, but what some say is a stumbling approach in global health," the publication writes.

According to the first article, which is reported from Ethiopia, the GHI aims "to expand U.S. government focus much more aggressively into other critical global health challenges, such as saving mothers when they give birth or protecting communities from river blindness, instead of the United States continuing to attack one disease at a time, such as AIDS, tuberculosis and malaria, without any coordination."

But the implementation so far, has not yet reflected that vision, according to the story. "The administration can point only to a few small programs started under GHI in countries around the world, and those are too new or too small to yield any tangible results. While many health experts argue that it takes time to overhaul assistance to a network of programs, and that ensuring quality is more important than rushing into something, the considerable delays in turning words into action have put the initiative in some fiscal peril. And as a result, supporters fear the GHI's lofty goals may now be threatened," GlobalPost reports.

Ezekiel Emanuel, who helped create the GHI, is among several experts quoted in the article. "I'm an impatient guy. Of course, I'm frustrated. But I'm also realistic," Emanuel said of the program. "Have we made as much progress as we would like? No. Have we made no progress in the field? That's absolutely wrong."

Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies, said, "The goals and principles of GHI are absolutely correct. ... But GHI is off to a very poor start" (Donnelly, 5/9).

A second article, reported from Washington, indicates that "from the start, the GHI was difficult to define. What was it? What wasn't it? The architects of the GHI acknowledged that the process took time and several said that they needed to think through the consequences of redrawing a whole new global health approach. The old way of doing things, they argued, may have led to quick results against a disease, but it was an inefficient and piecemeal approach to health care," GlobalPost writes.

The story reports that there were "three major hurdles from the start in trying to build a new architecture for U.S. global health programs. One was that the money tilts heavily toward the AIDS fight - roughly 70 percent of all global health funding."

Another issue "was that the GHI had three chiefs - as opposed to ... [President George W.] Bush's PEPFAR AIDS plan that had one office, one ambassador, and a president's marching orders to plow through red tape. ... The third issue was that during the long buildup for the GHI, few administration officials reached out to Congress to keep it informed and build support. The result, according to many observers, was that the bipartisan goodwill built toward the AIDS program began to wither and the support for the GHI has yet to take hold," according to the article.

In addition, GlobalPost reports that funding for the GHI "has run into one of the most difficult budgetary climates in Washington in decades," and the initiative has been dogged by "issues that touch the political third rail of 'reproductive rights' for women" (Donnelly, 5/9).

The article series also features an interview with Lois Quam, the executive director of the GHI (Donnelly, 5/9).

There are also snap-shots available of the eight GHI Plus countries.

Funding for the project is provided by the Kaiser Family Foundation as part of its U.S. Global Health Policy program.