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HIV/AIDS, population and reproductive health, women's health, social science methods and public health research, India, South and Southeast Asia, Sub-Saharan Africa
Nandini Oomman was director of the HIV/AIDS Monitor at the Center for Global Development from March 2006 until December 2011. As director, Oomman led three research teams in Uganda, Mozambique, and Zambia to track the effectiveness of the three main aid responses to the epidemic: the Global Fund, the HIV/AIDS Africa MAP program of the World Bank, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). This collaborative initiative, the first of its kind at CGD, allowed country-based researchers to examine key issues in the design, delivery and management of these donor programs, and provided timely analyses to improve the efficiency and effectiveness of each initiative.
Oomman, N. & J. Gittelsohn. (2002) Qualitative Methods in Gynecological Morbidity Research, in Research Approaches to the Study of Reproductive tract Infections and Other Gynaecological Disorders (eds. Shireen J Jejeebhoy, Michael A Koenig and Christopher Elias). Cambridge University Press, Cambridge UK
Oomman, N. (2000) Gynecological Morbidity in India: A Decade of Research on Reproductive Tract Infections (RTIs) and other Gynaecological Morbidity in India: What we know and what we don’t know, In Readings in Women’s Reproductive Health in India, (eds. R. Ramasubban, & S. Jejeebhoy). Centre for Social and Technological Change, Rawat Publications, Mumbai, India.
Oomman N, & B. Ganatra. (2002) Sex Selection: The Systematic Elimination of Girls Reproductive Health Matters, 10 (19): 184-188
This is a joint post with Connie Veillette. It is cross-posted on the Global Health Policy blog.
The QDDR pre-release consultation document says the Global Health Initiative will eventually be managed by USAID. For a number of reasons, it makes complete sense for USAID to lead the GHI.
Health is a core development mission. Consider that the FY2010 budget for health programs totals $7.8 billion, or more than 20% of the entire foreign assistance budget. We use development assistance dollars for global health as part of a broader development mission. President Obama’s Global Development Policy identifies the GHI as a key development initiative, so our premier development agency should surely be given the charge to lead the administration’s largest development initiative.
Health is more than just health. Health is about treating and preventing disease and improving health systems but it is also much more. It’s about improved nutrition and equitable access to food, clean water and sanitation, education, and investments in research and technology. These are sectors in which USAID has long worked, and they need to be integrated into a strategy that supports the GHI.
The GHI needs one leader, not three, for better decision-making and results (see related blog posts here and here). The administration points to the GHI as a new way of doing business and as a leading edge of aid reform efforts, but the current inter-agency consensus style leadership doesn’t seem to be working efficiently. While all U.S.G. staff at HQ and in-country are working fast and furiously, the lack of a leader at the top seems to be slowing decision-making at the highest levels. Some visible expressions of this lack of efficiency include the absence, a full year and seven months since the GHI was announced, of a final strategy, country strategies, or even a GHI website. For this new and ambitious approach to take off, the U.S. needs one leader that is able to tap the strengths of different government agencies that make unique contributions to the GHI.
In a recent pitch for the $63 billion Global Health Initiative (see my post on the event), U.S. Secretary of State Hillary Clinton responded to a question about measuring progress in women’s health. “We are focusing on maternal mortality because that is so measurable. We know where we have a better idea of what works and what it will take to have more women deliver babies successfully. There’s all kinds of interventions from the very simplest, like a safe birthing kit, which is a piece of twine and a clean razor blade and a bar of soap and a piece of plastic to put under the women, all the way up to tertiary care for complicated pregnancies…”
The Institute of Medicine (IOM) will soon release its much anticipated report evaluating the implementation of the President’s Emergency Plan for AIDS Relief (PEPFAR). Conducted at the request of Congress, the forthcoming report should follow up on points raised by a previous IOM report (2007), which provided a “short-term evaluation” of implementation after PEPFAR’s first three years, and which was soon followed by PEPFAR’s Congressional reauthorization in 2008. The new report is expected to broadly assess the cumulative performance of US HIV/AIDS programs, with two main tasks:
Since the launch of the Obama administration’s $63 billion Global Health Initiative (GHI) in May 2009, we have followed its ups and downs with great enthusiasm (see for example: here, here, here and here), trying to better understand its structure and role within the U.S. government’s complicated global health architecture. One recurring question we have continually raised has focused on leadership: who, exactly, was to be in charge of this massive undertaking? Who would be accountable for meeting the initiative’s eight high-level targets and adhering to its seven guiding principles?
Last December, the State Department’s Quadrennial Diplomacy and Development Review (QDDR) appeared to put those questions to rest. According to the 200+ page document, USAID would assume leadership of the GHI by September 2012, contingent upon fulfilling a set of 10 benchmarks to demonstrate its capacity. But upon closer inspection of the GHI over the last year, the QDDR provision only seems to have generated a new set of questions that are more difficult to resolve. While there are no easy answers, the administration should consider these issues as it thinks through the tough decision of pulling the GHI together under one leader and demonstrating success by meeting its targets:
Are the billions of dollars spent on HIV/AIDS in developing countries missing out on opportunities to strengthen national health systems? To find out, CGD’s HIV/AIDS Monitor asked researchers in three countries with high levels of donor AIDS spending -- Mozambique, Uganda, and Zambia -- to assess the interaction between health systems and the three big AIDS donor programs: the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the World Bank’s Multi-County AIDS Program (MAP) in Africa, and the Global Fund for AIDS, TB and Malaria. The resulting report, Seizing the Opportunity on AIDS and Health Systems, is being released this week at the international AIDS conference in Mexico City. Nandini Oomman, director of the HIV/AIDS Monitor and the lead author of the report, explains the key findings:
The 16th International AIDS Conference starting in Toronto this Sunday will attract some 24,000 delegates from 132 countries, celebrities and entertainers including The Blue Man Group, Bill Clinton, Bill and Melinda Gates, 3,000 journalists, and an army of researchers scheduled to present more than 4,500 scientific papers. Nandini Oomman, director of the Center for Global Development's HIV/AIDS Monitor, explains what she hopes to learn--and share--at the upcoming conference. Learn more