The global health legacy of 2012 will be twofold, a year of both increased commitments to health and flat lining budgets. Just look at this past summer: world leaders made a call to end preventable child deaths, the London Summit on Family Planning has resulted in $2.6 billion of commitments, and the International AIDS Conference saw a commitment to the “beginning of the end of AIDS.” While these are all great news, it is still uncertain as to who will pay for these ambitious goals: biggest donors are already scaling down their health aid budgets, and there remains a tremendous resource gap to reach the end of AIDS.
CGD Policy Blogs
This week, eight polio vaccination workers in Sindh and Peshawar have been killed in Pakistan during a three day anti-polio drive (see here). Last week in Afghanistan, two polio vaccinators were also killed. Suspicions of CIA involvement in the campaign have been identified as causes of the attacks. “Our teams are getting attacked, and we are having a hard time hiring health workers because they are worried about being called a spy,” said the Head of Medicine in Khyber Pakhtunkhwa province earlier this summer.
It’s that magical time of the year when we bring you the top 10 most read entries on the CGD Global Health Policy Blog. Together, these top posts had a total almost 20,000 unique page views. This year the blog asked for your feedback on evaluating the quality of health aid, addressed the debate over entities like the GHI and AMFm, and discussed everything from cash transfers to priority-setting.
Ambassador Eric Goosby has been selected to head the US Department of State’s new Office of Global Health Diplomacy, officially turning the page in the ongoing saga of the program formally known as the Global Health Initiative (GHI). Goosby’s appointment will be on top of his role as US global AIDS coordinator, through which he oversees the President’s Emergency Plan for AIDS Relief (PEPFAR), and former Ambassador Leslie Rowe will be in charge of the office’s daily operations. But while the long-awaited announcement said the new office will provide “diplomatic support in implementing the Global Health Initiative’s principles and goals,” it stirred many of the same questions and concerns that arose from the GHI death notice and left me wondering: is this news a Christmas miracle or a lump of coal for US global health programs?
This is a joint post with Rachel Silverman.
Last week, I attended a conference on South Africa’s national health insurance (NHI), which was hosted in Pretoria by the Human Sciences Research Council (HSRC). A key recurring theme and consensus emerged: South Africa must develop a clearer plan and strategy for the “piloting” phase of its national health insurance.
Some background: In 2011, the government of South Africa committed itself to providing all of its citizens with “a defined package of comprehensive (health) services” through national health insurance. While the details are still up in the air, the government issued a preliminary policy paper which estimated NHI to cost R255 billion (~US$30 billion) per year by 2025, if implemented as planned over a 14-year period.
Today in Health Affairs, Jishnu Das, Alaka Holla, Veena Das, Manoj Mohanan, Diana Tabak, and Brian Chan publish a unique and important study on the messy realities of health care in rural areas of the extremely poor state of Madhya Pradesh in India.
This podcast was originally recorded in November 2011.
My guest this week is Mead Over, one of the world’s leading experts on the global response to the HIV/AIDS pandemic. We discuss his new book, Achieving an Aids Transition: Preventing Infections to Sustain Treatment. The key idea is simple but powerful. Mead argues that, instead of reaching vainly for the unsustainable goal of offering treatment to everyone in the developing world who needs it, donor policy should aim to sustain current treatment levels while reducing the number of new infections below the number of AIDS deaths, so that the total number of people with HIV/AIDS declines.
Many currently believe that US domestic entitlements are too large, but disregard the fact that the PEPFAR program has created a new class of moral entitlements overseas – in the form of 4 million and counting people receiving US-supported life-sustaining AIDS treatment in low and middle income countries around the world. Of course, the approximately $2.7 billion that the US spent in 2011 (53% of the $5.3B 2011 budget) on supporting the treatment of these people is only about two-tenths of a per cent of the US’s annual expenditure on Socia
Around this time last year, world leaders called for “the beginning of the end of AIDS” and an “AIDS-free generation”, and committed to reaching the ambitious disease-specific targets for HIV/AIDS: the virtual elimination of mother-to-child transmission; 15 million people on treatment and a reduction in new adult and adolescent HIV infections — all by a rapidly approaching 2015. And this year, US Secretary of State Hillary Clinton recommitted to these ambitious goals in the release of the PEPFAR Blueprint, saying “An AIDS-free generation is not just a rallying cry — it is a goal that is within our reach”. While the overarching World AIDS Day message remains clear – we have made tremendous progress thus far, and there is still a long way to go in the fight against AIDS – one question remains: is this really the beginning of the end of AIDS?
Over the last half-century, global health gains have increased at historic levels (you can see for yourself by using Hans Rosling’s entertaining and informative Gapminder tool). While parts of the gain can be attributed to economic growth, specific health efforts continue to generate significant health benefits.