U.S. Department of State
Bureau of Public Affairs
August 16, 2010
The U.S. Global Health Initiative
Through the Global Health Initiative (GHI), the United States will invest $63 billion over six years to help partner countries improve health outcomes through strengthened health systems – with a particular focus on improving the health of women, newborns and children through programs including infectious disease, nutrition, maternal and child health, and safe water. GHI aims to maximize the sustainable health impact the United States achieves for every dollar invested.
GHI will deliver on that commitment through a comprehensive, whole-of-government approach that specifically targets reductions in death and disease with a fundamental emphasis on these principles: a focus on women, girls, and gender equality; increasing impact and efficiency through strategic coordination and integration; strengthening and leveraging key partnerships, multilateral organizations, and private contributions; encouraging country ownership and investing in country-led plans; improving metrics, monitoring and evaluation; and promoting research and innovation. Through this model, GHI will build on the Bush Administration's successful record in global health, and take these remarkable achievements to the next level by further accelerating progress and investing in sustainable health delivery systems for the future.
The U.S. government has global health investments and programs in approximately 80 countries worldwide, and all of these countries are included in GHI. Eight countries have been selected as the first set of “GHI Plus” countries. They are: Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda. These countries will receive additional technical and management resources to quickly implement GHI’s approach.
The principles underlying the foundation of GHI are the following:
• Focus on women, girls, and gender equality
• Increase impact through strategic coordination and integration
• Strengthen and leverage key multilateral organizations, global health partnerships and private sector engagement
• Encourage country ownership and invest in country-led plans
• Build sustainability through health systems strengthening
• Improve metrics, monitoring and evaluation
• Promote research and innovation
The targets for GHI are the following:
• HIV/AIDS: Through the President’s Emergency Plan for AIDS Relief (PEPFAR), support the prevention of more than 12 million new HIV infections; provide direct support for more than 4 million people on treatment; and support care for more than 12 million people, including 5 million orphans and vulnerable children.
• Malaria: Through the President’s Malaria Initiative (PMI), halve the burden of malaria for 450 million people, representing 70 percent of the at-risk population in Africa. Malaria efforts will expand into Nigeria and the Democratic Republic of Congo.
• Tuberculosis (TB): Save approximately 1.3 million lives by treating a minimum of 2.6 million new TB cases and 57,200 multi-drug resistant (MDR) cases of TB, contributing to a 50 percent reduction in TB deaths and disease burden.
• Maternal Health: Reduce maternal mortality by 30 percent across assisted countries./1
• Child Health: Reduce under 5 mortality rates by 35 percent across assisted countries./2
• Nutrition: Reduce child undernutrition by 30 percent across assisted food insecure countries, in conjunction with the President’s Feed the Future Initiative
• Family Planning and Reproductive Health: Prevent 54 million unintended pregnancies. This will be accomplished by reaching a modern contraceptive prevalence rate of 35 percent across assisted countries, reflecting an average 2 percentage point annual increase by 2014; and reducing from 24 to 20 percent the proportion of women aged 18-24 who have their first birth before age 18.
• Neglected Tropical Diseases (NTDs): Reduce the prevalence of 7 NTDs by 50 percent among 70 percent of the affected population, contributing to: the elimination of onchocerciasis in Latin America by 2016; the elimination of lymphatic filariasis globally by 2020;3 and the elimination of leprosy.
Praise for GHI
Bill Gates, Co-Chair, Bill & Melinda Gates Foundation: “…the GHI aims for greater resources and a fresh approach to deploying resources in order to maximize health outcomes in as short a time as possible. It seeks to concentrate resources in order to better achieve scale in selected countries. And it utilizes targeted funding increases on diseases and conditions that have a devastating health and economic impact on countries yet are entirely preventable or treatable. These are laudable goals.” (Testimony before Senate Foreign Relations Committee, 3/10/2010)
Former President Bill Clinton: “The thing I love best about the Global Health Initiative proposal that the administration has made is that it is designed to work us all out of jobs. It is designed to break the cycle of AIDS. It is designed [to] increase the capacity of local government.” (Testimony before Senate Foreign Relations Committee, 3/10/2010)
Serra Sippel, President of the Center for Health and Gender Equity: “President Obama's Global Health Initiative (GHI) has the potential to save lives and improve the health and rights of women globally. It is the first comprehensive U.S. policy approach to global health that recognizes that our greatest plagues -- HIV/AIDS, maternal and infant mortality, and poor sexual and reproductive health -- are all interconnected, and they are all preventable.” (2/1/2010)
Gregory Adams, Director of Aid Effectiveness for Oxfam America: “The Global Health Initiative represents an opportunity to change the way we do global health overseas: from a top-down, uncoordinated approach to country owned, demand-driven health aid that saves lives both now and in the future.” (6/18/2010)
1/A 2010 study published in The Lancet estimates annual maternal deaths worldwide have declined. This study is under review and additional estimates from the United Nations are forthcoming. Given that no global consensus on the best estimate of worldwide maternal deaths exists at this time, this document will not include a figure of projected lives saved. The U.S. government is committed to reducing the overall maternal mortality burden by 30 percent across assisted countries.
2/In 2010, a recent estimate of worldwide mortality in children younger than 5 years of age was published in The Lancet. These and other estimates are currently under review and additional estimates from the United Nations are forthcoming. Given that no global consensus on the best estimate of worldwide child deaths exists at this time, this document will not include a figure of projected lives saved. The U.S. government is committed to reducing the under age 5 mortality rate by 35 percent across assisted countries.
3/The target date was changed from 2017 to 2020 to align GHI’s goal with the goal of the global community.