This is a joint post with Christina Droggitis.Today in Windhoek, Namibia, the AIDS Implementation Meeting kicked off, notably without the presence of a Global AIDS Coordinator to provide U.S. government leadership to the many attendees regarding the future direction of the PEPFAR program. In Washington yesterday, a
confirmation hearing was held for Dr. Goosby, Obama’s nominee for Global AIDS Coordinator. At around 2:20, the room was almost full, largely with Washington-based advocates on issues related to HIV/AIDS. Many, like us, had submitted questions they hoped would be asked. At around 2:40 Dr. Goosby, Sen. Feingold, Sen. Lugar and a handful of staffers took their seats. The opening remarks ran longer than the questions, which totaled only eight.In
Dr. Goosby’s opening statement he made points concerning four of the
five questions posted by Nandini Oomman:
- PEPFAR needs to move towards a sustainable country-owned response (two-in-one),
- Country health systems need to be strengthened, and
- It’s important to address the particular needs of women and girls.
While I am delighted that Dr. Goosby touched on these points, the remarks and subsequent responses to questions offer little insight into the substance of the leadership we can expect from Dr. Goosby. It seems everyone has accepted he is the man for the job, and so questions and answers were kept simple and safe.Two potential directions that might be divined from the entrails of broad rhetoric:
- In his opening remarks, Goosby stated “I believe we can and must achieve [PEPFAR’s] goals, but will do so only through collective action, strong collaboration and strategic positioning of our efforts with the rest of the global community including the Global Fund”. Is this a call for a truly more harmonized approach? Will it translate into more funding through multilateral channels or in-country pooled funding mechanisms?
- In response to a question from Sen. Feingold about whether he would work to add 140,000 new health workers, Dr. Goosby advocated sticking to the current approach, which includes task-shifting, twinning, and investing in support and some training for nurses and mid-level cadres. Dr. Goosby may have been playing it safe with his answer, but some real innovation and hard work will be necessary to make even a small dent in the human resource crisis affecting health the world over.
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