This week, the Obama Administration released a new strategic document on its Global Health Initiative (GHI), a 6-year, comprehensive approach to the US’ investments in health. As a quick bit of context, the GHI was announced back in 2009, and in February 2010 the administration provided a consultation document that signaled an improved integration of US programs, listed core policy principles, and perhaps most importantly outlined specific targets that would be achieved by the GHI. For a group like ONE, which is known for holding governments accountable for their measurable pledges for the world’s poor, the GHI looked to be great policy. We looked forward to monitoring progress on the GHI and to cheering the achievement of specific goals outlined, such as 360,000 women’s lives being saved and 3 million children’s lives being saved by 2014.
Since the 2010 document’s release, ONE and other groups had been waiting to see updates from GHI officials on internal leadership, country strategies, implementation guidelines, and indications of progress toward goals — much of which was promised by the end of 2010. A new executive director (Lois Quam) was recently named, and we’re hopeful that her appointment will provide more efficient, streamlined leadership. Yet disappointingly, the new strategic document released on Tuesday removed specific targets around the number of lives to be saved for tuberculosis, maternal, and child health, as well as target deadlines for the elimination of two neglected tropical diseases (NTDs), elephantiasis and river blindness. Additionally, though leaders including USAID Administrator Shah and Secretary Clinton have delivered remarks about how the GHI will improve our global health investments and make our world a more secure place, there have not been any formal releases of country strategies or of detailed updates on implementation in the field. Adding to confusion around what the GHI aims to achieve, a February speech given by Administrator Shah at the NIH reiterated a number of the goals outlined in the GHI and added bolder targets, but noted they could be achieved “by 2016” (two years after the stated completion date of the GHI).
Collectively, these are signals that seem to weaken, instead of strengthen, the GHI. We know that smart US investments in global health will improve and save lives, as they already have through programs like the Global Fund, GAVI, and PEPFAR. We know that developing a more integrated approach to our previously disparate global health programming abroad makes sense and will build sustainable capacity on the ground. And frankly, we understand that in a time when proposals to cut budgets for global health programs are emerging and the stated $63 billion funding target may not be realized, adjustments to outcome targets made in 2009 might make sense. But now more than ever is the time for delivering concrete, specific updates on how GHI is progressing toward its targets, so that we can continue to be effective advocates for our critical global health programs.