The Center for Global Health Policy has detailed its concerns with the Obama Administration’s proposed Global Health Initiative (GHI), raising particular questions about how U.S. efforts to combat global HIV and tuberculosis would fare under this new approach to global health.
At issue is a “Consultation Document” the State Department released on Feb. 1, with a call for public comments on the proposal due today. The Consultation Document provided some new details about how the Administration plans to implement President Obama’s call for a $63 billion six-year GHI, which envisions a more comprehensive approach to global health aid and a more intensive focus on child and maternal health.
In an official response submitted to the State Department today, the Global Center’s two co-chairs write that the Consultation Document includes many significant and laudable goals. But they said the GHI blueprint falls short in key respects, from scaled-back targets for TB treatment to murky details about funding to inadequate plans for addressing the health care worker shortage.
Take, for instance, the disconnect between the GHI and Lantos-Hyde (the reauthorized version of PEPFAR). Lantos-Hyde requires the President to formulate a comprehensive 5-year strategy to combat global TB, including the treatment of 4.5 million new TB patients and the diagnosis and treatment of 90,000 new multidrug-resistant (MDR) TB cases, with both targets to be achieved by 2013. The GHI Consultation Document, by contrast, sets a goal of treating 2.6 million new TB cases and 57,200 multi-drug resistant (MDR) cases of TB.
“Despite the enormous death toll resulting from tuberculosis, the burden it places on the health care system, and the growing threat of drug resistant TB, this goal is roughly half of the target set by Congress in Lantos-Hyde, and it extends over a longer time frame, six years under the GHI as compared to five years under Lantos-Hyde,” the Global Center notes in its response to State.
On HIV/AIDS, the Global Center notes that the Consultation Document is short on specifics explaining how the Administration would meet key treatment and prevention goals with the modest funding increases proposed. In addition, there are serious questions about an apparent proposal to direct $100 million of the PEPFAR 2011 budget to the new Global Health Initiative Fund.
“We welcome an approach that supports systemic strengthening and better integration across health interventions,” the Global Center’s response says. “However, we are concerned that removing $100 million from an already essentially flat PEPFAR budget for 2011, in part to finance technical assistance, will make it impossible for PEPFAR to continue to scale up lifesaving prevention and treatment interventions, particularly in marginalized communities.”
Here is the Center’s full submission: commentsGHIconsultationfinal
And tell us what you think of the GHI Consultation Document.