This post is by Center Director Christine Lubinski, who attended today’s meeting at the NIH of the Consortium of Universities for Global Health.
When Dr. Eric Goosby, Ambassador at large and the US global AIDS coordinator, addressed academic leaders of global health programs at a gathering outside Washington today, he spent most of his short talk underscoring two concepts that dominate this Administration’s discussions of global health: sustainability and integration.
He also spoke about the Obama Administration’s Global Health Initiative (GHI) as a “seed for a broad discussion moving from bilateral to multilateral actions.” Dr. Goosby, in addressing the Consortium of Universities for Global Health, stated that a bilateral effort is not sustainable—by which he presumably meant PEPFAR. He went on to say: “There is not a will for that on the Hill and there is an interest in partnerships and a shared burden with the global community—for both caring for HIV-infected individuals as well as other conditions.”
Dr. Goosby spoke about the challenge of working to transfer the leadership for development and implementing systems of care to PEPFAR countries’ public health systems. PEPFAR has shown that there is the ability to respond, and now the technical expertise can be moved to the local government, he said. Dr. Goosby noted that PEPFAR staff are working with governments to develop national, provincial and local systems of care to assess unmet needs and to find resources to make allocation decisions based on the prioritization of unmet needs.
Integration became his theme as he spoke about expanding treatment capacity in terms of developing a continuum of treatment and prevention services that would include identifying and treating a variety of primary care conditions, such as hypertension, immunizations, referral to family planning and reproductive health services. Integration would begin with patients already engaged in PEPFAR-financed systems of care, but he also mentioned special outreach to women. If governments are not willing to engage, Dr. Goosby said, he and his team will look to work with NGOs and faith-based organizations to develop care systems.
Dr. Goosby finished his talk with a brief discussion of PEPFAR’s charge to address the health care workforce challenges in developing nations, and he talked about building a capable multi-tiered medical workforce—from community health care workers to doctors. Working on the health care worker pipeline will be a priority by partnering with medical schools to increase their numbers, training capacity and the clinical capability of medical students from Africa and other developing countries. Dr. Goosby spoke of enhancing the curricula in medical schools in the south, with one or two years post-graduate clinical education