Health promotors in Lusaka, Zambia, demonstrate how to use a bednet.
Developing countries struggle because of weak health systems and poor infrastructure, and it’s extremely difficult to reach the most vulnerable segments of their population—women and children. Most global health funding in recent years has been disease-focused, with the bulk of the resources going to fight HIV/AIDS. These have helped prevent and treat diseases but have not addressed some of the cross cutting issues that result in poor health and nutrition outcomes, or worse, insufficient progress in reducing maternal and child mortality.
The Obama Administration’s Global Health Initiative (GHI) is a response to these critical challenges and represents a new way of doing business for U.S. investments in global health. With $63 billion pledged over six years, the GHI intends to focus on the following:
- Implementing a women- and girl-centered approach
- Strengthening health systems
- Investing in country-led plans
- Improving use of metrics, monitoring and evaluation
- Promoting research and innovation
- Improving partnerships with multilateral organizations and the private sector
- Improving interagency strategic coordination and integration
In the initial phase, the GHI will choose up to 10 countries to take part in an accelerated implementation program. By 2014, participation will increase to 20 countries, all of which are expected to develop and implement their own country-led investment plans. The GHI can be an important platform to integrate and scale up nutrition interventions.
But several issues await clarification. For example, USAID, the Office of the Global AIDS Coordinator (PEPFAR) at the State Department, and the Centers for Disease Control all have a stake in GHI’s implementation. Which one will be in charge and what will be used to create accountability? How does this interagency approach work on the ground?
With the focus on country-led strategies, it’s not clear how the GHI will engage all stakeholders, not just government, in planning, implementing and monitoring programs. And little has been said about how the GHI will coordinate with Feed the Future, the administration’s other signature aid initiative, for example, particularly around approaches to fighting malnutrition. But for all these uncertainties, the GHI is still a major step forward in thinking about how to make U.S. aid more effective in tackling global health and nutrition challenges.
Diana Aubourg Millner is senior foreign assistance policy analyst for Bread for the World Institute.
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