CGD Policy Blogs
This month, both Health Affairs and the Journal of Acquired Immune Deficiency Syndrome (JAIDS) released special thematic issues on the US President’s Emergency Plan for AIDS Relief (PEPFAR) in which the articles – mainly commentaries but some analyses – provide an exceptionally positive readout on PEPFAR’s past performance and future direction. In principle, this is great – any insights into PEPFAR are always welcome, and it’s clearly valuable to discuss and disseminate lessons learned from the program. If these articles were posted on the PEPFAR website, or released as official PEPFAR reports, we wouldn’t bat an eye. But within scientific, peer-reviewed journals, the articles read more like PEPFAR PR rather than commentary and analysis from independent, third-party observers and stakeholders. A quick skim of the titles in the table of contents illustrates this point (see word cloud of selected title excerpts), and a closer look at the contributors sheds some light on why this may be the case: most authors of the articles are somehow affiliated with PEPFAR or with organizations that have received money from the program.
Announced in May 2009 by President Obama, the Global Health Initiative (GHI) promised a new way for the United States to do business in global health. Fragmented U.S. programs would be united under a single banner; vertical structures would be dismantled in favor of an integrated approach; and narrow, disease-focused programs would transition toward a focus on broader health challenges, such as maternal health, child survival, and health systems’ strengthening.
Recently, the American Journal of Tropical Medicine & Hygiene published a paper by Shepard et al. evaluating the impact of HIV/AIDS funding on Rwanda’s health system. The headline of the press release was catchy and assertive: “Six-year Study in Rwanda Finds Influx of HIV/AIDS Funding Does Not Undermine Health Care Services for Other Diseases. Study Addresses Long-standing Debate about Funding Imbalances for Global Diseases.”