The big global health news story of the day was Obama’s announcement of his new “Global Health Initiative”. His 6 year plan is budgeted at $63 billion dollars, which is by my calculation a bump over the already large commitments made during the most recent reauthorization of PEPFAR ($48 billion over 5 years).

In the press release, he states:

“…I also recognize that we will not be successful in our efforts to end deaths from AIDS, malaria, and tuberculosis unless we do more to improve health systems around the world, focus our efforts on child and maternal health, and ensure that best practices drive the funding for these programs.”

I admit, I was about as excited to see the term “health systems” as I was when he used the words “data” and “science” during his inauguration speech.

He continues to say that the focus of the program will be on :

“…broader global health challenges, including child and maternal health, family planning, and neglected tropical diseases, with cost effective intervention. It also provides robust funding for HIV/AIDS. The initiative adopts a more integrated approach to fighting diseases, improving health, and strengthening health systems.”

I found a few things interesting about this budget. First, while it represents a much larger amount of total funding for global health, most of the new monies are not for PEPFAR. PEPFAR will get about 70% of the total budget, but if you look at the annual allocations, the levels are probably less than implied during the reauthorization and the levels do not increase much over time.

I also noticed that one of stated benefits of the new “comprehensive strategy” was to prevent new infections with no mentions of putting any more people on treatment. Perhaps a realization of the challenges associated with such pledges over the long run and certainly consistent with the flatlining of allocations for PEPFAR.

Was it just me or did you double take to see family planning and NTDs among the highest priorities? This could be one of the biggest changes in the way in which the administration deals with global health issues and kudos to him for recognizing them.

On the critical side, I see a lot of talk about health systems strengthening and then a lot of discussion about disease specific projects. I am personally skeptical about the feasibility of building health systems around disease specific programs, in particular when such programs are so focus on achieving short term results. I will be very curious to see how he plans to operationalize these aspects of the program.

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2 Responses to “Obama's comprehensive strategy on global health announced”

  1. Dawn says:

    I don’t know where you find the time for these cogent musings, but I thoroughly enjoy your blogs. Your observations and the links you provide they really help to keep me in the loop of other conversations vs. the ones that tend to take up more space my world here in the Bay Area. Thanks Karen!

  2. thdblog.wordpress.com says:

    The different perspectives on this budget are shaping up to be potentially feisty (AIDS funding advocates vs. other diseases). KFF is hosting a live interactive webcast on the global health budget tomorrow (Thursday).

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