Global Health Initiative and 2011 U.S. global health funding

Partners In Health (PIH) commends the Obama Administration on the newly introduced Global Health Initiative (GHI), a six-year $63 billion effort that aims to improve health systems and maintain successful prevention and treatment programs in HIV, tuberculosis (TB), and malaria. The GHI also increases funds for treating neglected tropical diseases in developing countries and will have a particular focus on improving newborn, child and women’s health.

During an era of government belt-tightening that has seen a freeze in most discretionary spending, the modest increase in international health programs is a welcome sign from the White House.  Hunger and infectious disease do not ease up during down markets. In fact, economic hardship forces more families into poverty, increasing their vulnerability to disease and malnutrition.

The GHI will be included in the $9.6 billion for global health funding that the Administration recently announced for fiscal year 2011 (which spans July 2010 to June 2011).  The White House’s pledge includes a 9 percent increase in global health spending through the State Department, the U.S. Agency for International Development, the Department of Health and Human Services, and the Department of Defense.  The vast majority of this funding (about $7 billion) will go to the President’s Emergency Plan for AIDS Relief (PEPFAR), a figure that includes a $1.05 billion contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM).

However, while the 2011 funding may seem to be a step forward, in the 2008 reauthorization of PEPFAR, Congress actually included funding levels much higher than what is currently requested. For instance, in HIV/AIDS funding, this 2008 legislation authorized about $2 billion more for 2011 than what is included in the President’s current budget. And the GFATM contribution, while over $1 billion, is still $50 million less than what was appropriated in fiscal year 2010.  Both PEPFAR and GFATM funding are critical to PIH program success in providing TB and HIV treatment and strengthening public health systems.

President Obama’s commitment to the GHI is a step in the right direction, but more needs to be done. For example, the GHI lowers the target for expanding TB treatment while increasing the number of years to achieve it. The target for multi-drug resistant TB treatment—only 57,200 patients over 6 years—is astoundingly low given that 500,000 new cases are detected each year.  The bold targets for reducing neonatal, child, and maternal mortality in the GHI have been long awaited and are welcome in the face of decades of neglect, especially in reducing maternal deaths. However, the methods for achieving these reductions are not clear in the GHI. Fiscal year 2011 funding requests do not match the amounts needed to meet these targets.

With the introduction of the GHI and increased global health funding request, President Obama clearly recognizes that we cannot rest in the global health fight; as does Congress. We applaud the efforts of U.S. leadership and encourage them to continue to do far more to address the global disparities in health.

PIH worked closely with several other organizations to develop a complete response to the Global Health Initiative. Download the PDF file to read the response in its entirety.