The early days of the US International Development Finance Corporation (DFC) have been defined by a mixed record, and its health-focused investments are no exception. In the face of competing foreign (and even domestic) policy priorities under the Trump Administration and pandemic-related shifts in the broader development landscape, the agency has struggled to build a solid pipeline of projects in lower-income markets and systematically articulate a strong development rationale for its financing.
CGD Policy Blogs
The US has backed a request—originally proposed by South Africa and India and now supported by over 100 countries—to temporarily waive international intellectual property protections on COVID vaccines & other health technologies.
Biden Wants to Eliminate Lead Poisoning in American Children. We Propose an Even More Ambitious Goal: Global Eradication.
We applaud the Biden Administration's effort to address lead poisoning in the US. But we suggest Biden adopt an even more ambitious goal: not just national elimination, but global eradication of lead poisoning, especially in children. A global eradication campaign—modelled loosely on prior and ongoing global efforts to eradicate smallpox, polio, and guinea worm, mixed with inspiration from the WHO’s Framework Convention on Tobacco Control—would offer a tremendous contribution to global welfare, economic growth, and even world peace. An American-led effort to eliminate lead poisoning globally could be an international moonshot elevating the Biden administration’s international statue and legacy.
In July, United States Global AIDS Coordinator Deborah Birx made a striking commitment: under her leadership, the President’s Emergency Plan for AIDS Relief (PEPFAR) would direct at least 40 percent of its funding to host country governments or organizations by the end of 2019—rising to 70 percent by the end of 2020. The bottom line: PEPFAR’s local targets are commendable in theory, but we suspect their application in practice will prove complicated. Below is our take on the related issues—and some recommendations for PEPFAR to forge the most effective path forward.
We finally have some clarity on PEPFAR’s new “acceleration” strategy toward epidemic control: a lot more allocated to a few countries, and a lot less for others.
We would argue that investing in global health, at least along certain dimensions, is entirely consistent with President Trump’s philosophy of America First—a real opportunity for his administration to improve the security of the American people by pushing through some much-needed reform. In that spirit, we’ve put together a proposal for a new executive initiative under the Trump Administration. We call it PAHAA: Protecting America’s Health at Home and Abroad.
This is a joint post with Victoria Fan.
While PEPFAR and the Global Health Initiative (GHI) have dominated the global health community’s attention over the past few years, the President’s Malaria Initiative (PMI) has largely flown under the radar. Surprisingly little had been written about the PMI; still the few available materials painted a reasonably positive picture. But just this month, the PMI released the results of an external evaluation which confirms what we’ve long suspected: PMI is doing a remarkably good job and generating “value for money” in U.S. global health efforts. Such results are all the more impressive in light of the common criticisms of USAID past and present – that it is ineffective, incompetent, and hampered by a complex and arcane bureaucracy. The PMI is a USAID success story that helps validate its ongoing efforts to reform and rebuild into the U.S.’s premier development agency.
Originally conceived in 2005 as a five-year, $1.2 billion scale-up of America’s malaria control efforts, the PMI was extended and expanded by the 2008 Lantos-Hyde Act, receiving $625 million in funding for FY2011. While its funding pales in comparison to PEPFAR, which received almost $7 billion for the same period, the PMI is among the largest global donors for malaria, aiming to halve the burden of malaria for 70 percent of at-risk populations in sub-Saharan Africa. Led by USAID under a U.S. Global Malaria Coordinator, the PMI is jointly implemented with the Centers for Disease Control (CDC).