Secretary Clinton: Countries need to take the lead in their own health care

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Secretary of State Hillary Clinton spoke to students of the Johns Hopkins University School of Advanced International Studies on Monday regarding the Global Health Initiative. Her speech focused on “how the Obama Administration is building upon our country’s long standing commitment to global health,” she said, with an emphasis on integrating and improving existing health programs, but in a new way. One that pursues a sustainable delivery system in which countries develop their own capacity to support the health of their own people.

She started her speech by saying many in the audience might be wondering why the secretary of state is spending her time talking about global health, but she quickly made the connection between global health and foreign policy.

Secretary of State Hillary Clinton speaks on Monday on the Global Health Initiative.

“We invest in global health to strengthen fragile states… and support the rise of capable partners that can help us solve global problems,” Clinton said, adding that orphaned children, depleted work forces, and the destabilizing impact of AIDS led the Clinton Administration to categorize the AIDS pandemic not only as a health threat but as a security threat.

On the funding topic, Clinton noted that, “No nation in history has done more to improve global health,” citing that more than 60 percent of the world’s donor funding for HIV and 40 percent of global funding for global health is from the U.S.  “Building on the foundation for better health tomorrow and for the next generation… informs every aspect of the Global Health Initiative,” Clinton said, and the U.S. is investing $63 billion in this effort first to sustain and support existing health programs, and second to expand upon them.

“Critical gaps in care are left unaddressed,” within the current system, due to too little integration, too little innovation and lack of in-country capacity, Clinton said.  “In many places donor countries and outside NGOs have stepped in to deliver critical services that countries couldn’t provide themselves. But this is a temporary fix, not a long-term solution. Access to care becomes erratic… and future care is uncertain.”

Clinton gave five specific steps to tackling “systemic problems” in order to save the greatest number of lives today and tomorrow, including: working with countries to create and implement strategies for health that they will design and take over based on their strengths; committing to promote health of women and girls; improving how we measure and evaluate U.S. impact by evaluating outcomes not inputs; investing in innovation with a focus on developing tools that will help prevent, diagnose and cure disease in the places that are most affected; and improving coordination and integration of all health programs in-country.

“We cannot afford in a time of limited financial resources to have everybody doing their own thing. If we’re going to have a clinic, that clinic needs to do not just HIV/AIDS, but family planning and polio vaccines,” Clinton said.

She could not emphasize how important in-country leadership is enough, and she often cited South Africa’s tremendous response to the AIDS epidemic under the leadership of President Jacob Zuma. South Africa is home to the highest number of people living with HIV/AIDS in the world.

“We are now asking governments to demonstrate similar commitment in terms of human resources, serious pledges to build capacity, and where feasible, financial support… If we succeed, we will have transformed how health is delivered and received across the world,” Clinton said.

“We expect these countries to step up and their people expect the same.”

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