Blog Contributor:
Josh Lozman
Josh joined the ONE team in August 2007, and currently serves as the Chief of Staff to the CEO and Senior Advisor on Global Health Policy. He previously served as ONE’s US Policy Director.
Josh earned his Masters of Business Administration and a Masters of Public Health with a concentration in Humanitarian Assistance from Johns Hopkins University Bloomberg School of Public Health, and is currently a Ph.D. candidate in their Health Policy and Management department. He is also a lecturer at George Washington University.
Prior to that, Josh was a Policy Consultant at the Center for Global Development and the Grassroots Coordinator for Global Health Council amongst other things. Josh has extensive campaign experience working for congressional and presidential candidates.
Aug 24th, 2011 10:12 AM UTC
By Josh Lozman
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Yesterday, I went to the Dadaab refugee camp in Kenya with a delegation including longtime ONE supporters Cindy McCain, NBA legend Dikembe Mutombo and musician K’naan. We were there to learn how aid agencies are responding to the crisis and talk to those living in the camp about the situation.
![Dadaab - women with wood to make fences around their tents[1]](http://farm7.static.flickr.com/6209/6076667492_e66195c616.jpg)
Women gather wood to make fences around their tents.
(more…)
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Sep 10th, 2010 2:22 PM UTC
By Josh Lozman
Vida, just a few weeks ago
On Wednesday, ONE lost a friend and an inspiration.
Many of us on the ONE staff were fortunate to know Vida, a Ghanaian girl living just a short drive from Accra, in Tema.
When I saw Vida three weeks ago, she and her father showed me her straight-A report card from school. She was a smart, talented and spirited person. You didn’t need a report card to know that, but it was a physical affirmation of her delight in learning and her hope for the future. Her dream was to someday be a bank manager at the Bank of Ghana, and of course, to buy her very own car.
We were concerned for her, though, because she wasn’t looking so good. It seemed she was missing some of her usual spunk.
Vida was born with HIV. She had been taking antiretroviral therapy (ART) for several years. Since her mother died of HIV, Vida was raised by her father, who is also HIV-positive. She couldn’t start school until she was 9 years old because of complications from AIDS. But once she started ART, she got into school and quickly found she loved it -– especially science –- and excelled in most all of her classes.
During the past few years, Vida has been a friend to and spokesperson for ONE and our sister organization, (RED).
The clinic Vida went to for medical care, including ART, is at the Tema General Hospital. This clinic is run by Dr. Patricia, who is also a friend of ONE and many of our staff. Last week, Vida was admitted to the Tema General Hospital, and placed on antibiotics for a dental abscess but –- having just recently been through a battle with pneumonia –- she was simply unable to beat another strong infection. Yesterday, Dr. Patricia let us know that Vida died on Wednesday.
With your help, ONE has long been advocating for the resources to support programs like the Global Fund and PEPFAR that provide drugs to prevent to prevent mother-to-child transmission of HIV. We often talk about the 1,000 children per day that are still born with HIV, but those numbers are sterile and can’t reflect the vibrant reality of Vida. We will all miss her.
But, just as Vida was a voice for the efforts of ONE and (RED), it is our pledge to be Vida’s ongoing voice in this absolutely winnable battle against mother-to-child transmission of HIV.
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Jul 12th, 2010 12:02 PM UTC
By Josh Lozman
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This week, President Obama will announce a national AIDS strategy to reduce the number of new infections. Many, including us at ONE, were startled and troubled by the news last year that the District of Columbia had an HIV positive rate that is still higher than many African countries. This pandemic is truly global and needs to be fought everywhere. We’ll keep you posted when the strategy is announced.
Here’s an excerpt from the New York Times report:
President Obama will unveil a new national strategy this week to curb the AIDS epidemic by slashing the number of new infections and increasing the number of people who get care and treatment.
“Annual AIDS deaths have declined, but the number of new infections has been static and the number of people living with H.I.V. is growing,” says a final draft of the report, obtained by The New York Times.
In the report, the administration calls for steps to reduce the annual number of new H.I.V. infections by 25 percent within five years. “Approximately 56,000 people become infected each year, and more than 1.1 million Americans are living with H.I.V.,” the report says.
Mr. Obama plans to announce the strategy, distilled from 15 months of work and discussions with thousands of people around the country, at the White House on Tuesday.
While acknowledging that “increased investments in certain key areas are warranted,” the report does not propose a major increase in federal spending. It says the administration will redirect money to areas with the greatest need and population groups at greatest risk, including gay and bisexual men and African-Americans. The federal government now spends more than $19 billion a year on domestic AIDS programs.
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May 13th, 2010 12:56 PM UTC
By Josh Lozman
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Written with Erin Hohlfelder:
It’s easy, and perhaps justified, to feel frustration after reading the pieces on HIV/AIDS in this week’s New York Times. Despite the huge growth in funding for HIV/AIDS in recent years–driven by a coalition of bipartisan politicos, grassroots advocates, philanthropists, and celebrities—our efforts have not been enough, and the goal of universal access to AIDS treatment, prevention, and care remains unrealized.
Yet if we look at where we are today, major progress has been achieved. In 2002, before PEPFAR was announced and the Global Fund was established, there were only 50,000 people on antiretrovirals, and many doubted that widespread distribution of treatment was even feasible. Today, through leadership from the United States, the G8, and some African countries, that number is more than 4 million globally, including nearly 3 million in Africa. The success of these investments is tangible; anyone who has traveled through the developing world can see what progress looks like in the millions of people who are alive today and who are grateful for our investments.
We’ve anticipated for some time that the spike in political will for AIDS funding would not last forever. Also, experts have been saying for years that leading aggressive treatment efforts without equally rigorous prevention programs to match would become unsustainable. These worries and warnings are now becoming reality. The financial crisis is at least partly to blame. Budget crunches globally—particularly in the US and across Europe—have made it really difficult to find the same big increases for global health programs like PEPFAR and the Global Fund that we’ve grown accustomed to and have needed over the last few years. The Global Fund – the world’s largest provider of tuberculosis and malaria services to the poor and the second largest of HIV/AIDS services – is currently facing a financial crisis as it struggles to attract enough investment from donors to continue funding programs that already exist.
The articles also highlight other factors that have perhaps collectively slowed the momentum around the AIDS fight. The Obama Administration, through its Global Health Initiative, has advocated for a prioritization of new global health funding for cost-effective interventions around maternal and child health, malaria, and neglected tropical diseases. This is not inherently wrong, and in fact many of those areas have long been overlooked and underfunded during the period when AIDS funding grew. However, AIDS is not “done”, and it requires continued scaling up of funding for both prevention and treatment efforts. AIDS is called a crisis for a reason: without continued increases in funding, people will die.
Some African governments also need to look in the mirror (and their back pockets) before blaming donors for a lack of funding. Two of the countries mentioned in McNeil’s articles – Uganda and Kenya – have been plagued by corruption scandals. Our global health programs can only succeed if the governments are accountable for investments and penalized if they misuse those investments. And many of these programs have established and been praised for very strong accountability mechanisms. The problem is, of course, that those who suffer as a result of corruption and the penalties that come with it are not the government officials who try to misuse the money, but poor people who need medicine to stay alive. “Improved governance” is not just about better-functioning bureaucracies; it’s also about creating an environment in which donors can trust that their money will be used (well) to save millions more lives.
In spite of all these obstacles, we believe resolutely that the fight against AIDS is one that we can win. But at the end of the day, we all know that doing so requires bold new investments. That’s what drives our current campaign at ONE to ensure that there aren’t cuts to President Obama’s budget request, particularly to his international affairs account—from which AIDS, maternal child health, and other global health money flows. When we read the articles, it’s easy to wring our hands and think “how could we let this happen?” But proposed cuts to the international affairs budget (see Conrad, Kent) pit global health programs that are equally as vital against each other for funding—a true Sophie’s choice when we think about saving lives across the developing world.
We take these New York Times articles as a rallying cry. Your voices – our voices – have become even more important. We must spread the word that investments in global health work; now is not the time to walk away.
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Mar 26th, 2010 7:31 PM UTC
By Josh Lozman
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When the response to AIDS in Africa accelerated in the early 2000s there was essentially no one on treatment on the continent. Today, more than 3 million Africans are getting lifesaving medicine and more have bed nets to protect from malaria, are immunized against leading killers of children, and have access to tuberculosis testing and treatment. To achieve these rapid gains in health donors have funded a variety of initiatives often operating without strong enough coordination.
This week GAVI and the Global Fund strengthen their efforts to coordinate their work by hosting back to back meetings with their stakeholders. After a day and a half of meetings about the Global Fund’s financial needs and results, the two organizations (along with WHO and others) led their donors and supporters in a discussion about how they will work together to build health systems in developing countries to ensure that there is a long-term local solution for improving and sustaining health in developing countries.
This session outlined how the Global Fund, GAVI, the World Bank, UNICEF, WHO and others will work together to improve health systems. This discussion was quite process oriented as each of these agencies does a lot already, but needs to coordinate better. But, generally, there was strong support from most donors for these organizations working together to ensure that there are efforts to create sustainable systems, but that there are not duplicative efforts that are inefficient. Many donors around the table that have their own significant bilateral problems also encouraged these institutions to coordinate better on systems with their bilateral partners.
Because this topic can seem so intangible, let me share a clear example of how this works that was shared at the meeting. Minister Tedros of Ethiopia presented to the joint session of donors how Ethiopia has used funding from the Global Fund and GAVI to train thousands of health care workers in 25,000 health outposts throughout the country. Dr. Tedros has used funds from these two organizations to fund his own country’s plan to build their health system by integrating services and extending their health infrastructure and services out to rural areas of the country. These health extension workers are providing immunizations, malaria testing and treatment and other health services that are contributing to a broad improvement in health across the country. I’ve been to Ethiopia and met with these extension workers; it is an amazing group of people and a great model.
The key to a successful joint program will be figuring a way to build upon the great model that Ethiopia has built and finding appropriate applications in other poor countries. Health systems is a tough thing to define and a good system is appropriate to the geography, population distribution and health challenges of each country. There is no universal application – like a simple vaccine for a disease – to build a good health system. Despite its complexity, this joint work and its potential outcome of building stronger health systems are the long term exit strategy from a dependency on parallel donor and NGO health provision.
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Mar 25th, 2010 1:54 PM UTC
By Josh Lozman
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Yesterday, the Global Fund reviewed its results to date, challenges and opportunities with its donors and some civil society groups. I had the pleasure of representing (RED) and ONE at this meeting. The Global Fund has delivered impressive results during its 8 year lifespan. We have reported on these before but it’s worth saying again – an estimated 4.9 million lives saved, at least 3600 per day. The results are impressive in fighting AIDS, tuberculosis and malaria, but it is clear that the Global Fund is also having a significant impact across the health spectrum – helping to train health workers and improve health infrastructure that improves health overall.
As my colleague Erin wrote on this blog Tuesday, the Global Fund is in the midst of its replenishment effort – a process to determine the Global Fund’s financing levels for the next three years. Let’s be blunt. If you were to pick a year for a three-year replenishment, this probably would not be it. A financial crisis does not lead to donors being particularly generous. That said, he are a few takeaways:
- The tone here is one of family in many ways. There is a sense of solidarity about the Global Fund among donors including universal praise for its transformational effects on the health of the world’s poorest people. Many in the room were in the room when the Global Fund was created; the results delivered since create a sense of pride among many governments.
- Despite donors positive feelings about the Fund, there are clearly concerns about the competition for scarcer domestic resources during the next three years. Donors pledged $10 billion in Berlin in 2007 at the last replenishment. The Global Fund needs between $17 and $20 billion to continue to expand services for the poor at the rate that it has previously. Some donors expressed a feeling that $13 billion was a more pragmatic target, but acknowledged that this will not allow for scale up of new, technically sound proposals.
- Importantly, the language of this meeting is very different than the UN and G8 meetings when the Fund was created. Those that were there in 2000 and 2001 characterized it by words like “emergency and disarray.” The common themes at this meeting were about “partnership, synergies, optimizing results, sustainability and local ownership.” Yes, a lot of those words are global development jargon, but it demonstrates how far the Global Fund and its partners and recipient countries have come that the discussions have turned to these longer-term plans rather than a crisis response.
I will write more soon about the reactions of donors to the funding scenarios and the future of the Global Fund.
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Dec 15th, 2009 5:30 PM UTC
By Josh Lozman
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Nearly 50,000 of you took action a few weeks back to encourage your Senators to sign on as cosponsors of S.1524. The bill, titled The Foreign Assistance Revitalization and Accountability Act of 2009 (S.1524), was introduced at the end of July with three Democratic (Kerry, Menendez and Cardin) and three Republican (Lugar, Corker and Risch) co-sponsors. That list has grown considerably since then (check out the list below). And, it has now gained three new supporters. Republican Senators, Kit Bond of Missouri, Mike Johanns of Nebraska, and Olympia Snowe of Maine.
Though we can all tell from the news that the Senate has a lot on its plate (i.e. health care reform), hopefully the addition of these key Senators to the list of cosponsors will add some momentum to the bill. Currently we are asking you to push the White House to develop a global development strategy. Please sign on today to continue building momentum to make our foreign aid system even more effective!
Here’s the full list of co-sponsors:
1. Sen. John Kerry (D-MA)
2. Sen. Richard Lugar (R-IN)
3. Sen. Robert Menendez (D-NJ)
4. Sen. Bob Corker (R-TN)
5. Sen. Ben Cardin (D-MD)
6. Sen. Jim Risch (R-ID)
7. Sen. Jeanne Shaheen (D-NH)
8. Sen. Bob Casey (D-PA)
9. Sen. Ted Kaufman (D-DE)
10. Sen. Kirsten Gillibrand (D-NY)
11. Sen. Chris Dodd (D-CT)
12. Sen. Jeff Merkley (D-OR)
13. Sen. Tim Johnson (D-SD)
14. Sen. Claire McCaskill (D-MO)
15. Sen. Frank Lautenberg (D-NJ)
16. Sen. Kay Hagan (D-NC)
17. Sen. Dianne Feinstein (D-CA)
18. Sen. Dick Durbin (D-IL)
19. Sen. Chuck Schumer (D-NY)
20. Sen. Olympia Snowe (R-ME)
21. Sen. Kit Bond (R-MO)
22. Sen. Mike Johanns (R-NE)
12/17/09 UPDATE: Sen. Susan Collins (R-ME) has now signed on as well.
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