New Coalition Urges White House to Think Big, Boldly on Global Health

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 A diverse coalition of more than two dozen organizations outlined a bold, comprehensive approach to global health at a Capitol Hill briefing today. The briefing comes as White House officials work behind closed doors to flesh out the details of a much-anticipated new US strategy on fighting disease and improving health across the globe.

Today’s event brought together, for the first time, experts and advocates who work on HIV/AIDS, malaria, tuberculosis, child and maternal health, and other health issues, with a unified message: President Obama’s proposal for a new Global Health Initiative  (GHI) offers a significant opportunity for the US to take a transformative role in global health, but the new plan will fall far short if the US does not provide the leadership and resources to back up its promises of more comprehensive, integrated care. If given short-shrift, advocates warned, the GHI could force false choices between diseases and threaten key gains made in combating global AIDS and other epidemics.

“We are massively excited about the possibilities, but we are massively worried” that the funding will not match the rhetoric, said Matthew Kavanagh, director of US advocacy for Health GAP, who moderated today’s Congressional briefing.

Kavanagh said the President’s proposed price tag for the GHI—$63 billion over six years—is simply not sufficient to achieve the goals his plan has identified. The GHI, which the White House first sketched out in May and is expected to detail more fully later this year, listed six target health areas: HIV/AIDS; malaria; tuberculosis; reproductive, maternal, newborn and child health; health systems and health workforce; and neglected tropical diseases.

To truly address those global health issues, the White House and Congress will need to spend about $95 billion over that time period, according to a new report, “The Future of Global Health: Ingredients for a Bold & Effective U.S. Initiative,” released in conjunction with today’s briefing.

In addition to robust funding, the report says the White House needs to set bold targets for prevention and treatment in its focus areas. Targets can help “drive success” by creating accountability, building political momentum, and galvanizing the world community, Kavanagh noted. In short, they can help translate promises into action. Click here to read the full report and see the suggested targets and funding levels for each health area. Click here to see the coalition’s website, where you will also find audio of a media conference the group held before today’s Congressional briefing.

“The world desperately needs the President and the Congress to get this right, not just in words but in execution,” said Ann Stars, president of Family Care International, a nonprofit dedicated to making pregnancy and childbirth safer in the developing world.

Stars said everyone has heard stories of “shiny new AIDS clinics” that are well staffed and resourced to deal with the HIV epidemic, while down the road sit “shabby” clinics overwhelmed and unable to cope with other health needs. “But people get the wrong moral from this story,” she said. When one family is well fed and another is hungry, the solution is not to take food from the first family and give it to the second, she said.

Similarly, when it comes to global health, the way to providing better care for more people “is not to cut the pie into smaller and smaller pieces until everyone goes hungry. We need to make a bigger pie.”

Another presenter, Patrick Almazor, a Haitian doctor with Partners in Health, spoke eloquently about how HIV/AIDS funding has helped PIH clinics in his country scale up much more than HIV treatment. Hospitals and clinics where people used to come to die because they offered few or no services, he said, are now offering prenatal care, family planning services, immunizations, and other care.

During a media teleconference, organized by the coalition partners before the event, Dr. Peter Mugyenyi, director of the Uganda’s HIV/AIDS Joint Clinical Research Centre, said that AIDS remains the most urgent health threat in Africa and that “no health initiative can succeed without treating the millions of AIDS patients in frantic need of lifesaving therapy,” because AIDS will “continue to incapacitate” other components of the health system. He noted, for example, that efforts to make gains in maternal, newborn and child health without combating HIV/AIDS would fail because AIDS afflicts so many mothers and children on the continent.

At the Congressional briefing, three lawmakers expressed support for the coalition’s goals and agenda; Reps. Diane Watson (D-Calif.), Jan Schakowsky (D-Ill.), and Betsy McCollum (D-Minn.) all made supportive remarks about the need to provide robust funding and take a more integrated approach to global health. 

Rep. McCollum said a more comprehensive approach was “exactly” the right way forward. But she warned of challenges because of the global economic downturn. “New funding increases are going to be tough,” she said. “It means squeezing every penny out of every dollar” to get the most out of US investments. She also pointed to the continuing vacancy at USAID, which will hobble efforts to coordinate a winning strategy.

Advocates agreed and said the president’s new plan could have a “transformative effect,” as Kavanagh put it. But he and others emphasized that the initiative will fail if it takes funding from one disease to scale up another.

“It’s unacceptable to pit one sick patient against another,” said Dr. Matthew Spitzer, president of Doctors Without Borders/MSF-USA.

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