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What changes to the Obama administration's Global Health Initiative mean

  1. On the afternoon before the July 4th holiday, the Obama administration announced several changes to its global health strategy, including the close of the Global Health Initiative office. 
  2. John Donnelly reported on the announcement on GlobalPost's Global Pulse blog. 

    Here's an excerpt:

    The reason [for the GHI office close]? The official line – from GHI Executive Director Lois Quam in an interview with GlobalPost – is that the office’s work will be “elevated” into the State Department’s Office of Global Diplomacy and that GHI’s principles of building health systems to treat patients instead of diseases are now firmly embedded in developing countries. Some 42 GHI country teams have been established.


    “By shifting from what was too often an internal focus to a strong external focus, we feel this diplomacy focus is important in order to bring more resources to achieve GHI targets,” Quam said. “Diplomacy allows us to work with partner countries and donor countries in a stronger way. I’m very pleased about this.”


    But global health observers outside the government say that GHI ran into problems from the start and never fully found its place inside the Obama administration, which has put much less high-level attention on global health than its predecessor, the Bush administration.

  3. This morning, Laurie Garrett of the Council on Foreign Relations took to Twitter to offer some analysis on the change document: 

  4. On the eve of holiday mega-announce about #Obama global health #GHI was released. Anybody notice? GHI is dead, long live the new GHI. More..
  5. #GHI changes (1.) Ambassador for Global Health Diplomacy is created. #Obama puts most #GlobalHealth prgms under US Ambassadors in countries
  6. #GHI changes (2.) #QDDR said all #GHI would shift from State to USAID: fudgggedaboudit --- #StateDept tosses out QDDR and stays in charge
  7. #GHI changes (3.) Funding will NOT reach originally announced #GHI goal of $63b over five years (2009-2013). May end up as low as $40B
  8. #GHI changes (4.) PEPFAR stays where it is, inside State, controlled by Goosby/OGAC. No change #HIV/AIDS except maybe amt $$
  9. #GHI changes (5.) though QDDR is abandoned (waste of 1st 2 yrs #Obama admin?) the health targets in it remain the goals.
  10. #GHI changes (6.) Whoever is named newly created Amabassador of Health Diplomacy only has job until new Presidency, regardless who wins Nov.
  11. #GHI changes (7.) Primary take-home message: "we stopped looking at international coordination and now look out at countries"
  12. My bottomline on #Obama #GHI: 4 years rearranging deck chairs, and in the end State Dept remains in control, and "coordination" = good will
  13. Question: If all #GHI is now going to be under a Ambassador for Health Diplomacy, who is that & how fast will Congress approve? Then January
  14. Curious what others would add, I asked for additional thoughts and reactions. Here's what I got:

  15. @J_Schiff I think many public health professionals, including myself and those in my office, are frustrated/ sad by this backtracking
  16. @J_Schiff @Laurie_Garrett ending #QDDR benchmark process essentially means #GHI won't move to USAID; not sure much changes at country lvl
  17. @J_Schiff @Laurie_Garrett Quam still will head new #GHI diplomacy office but not clear if/what authority that will have relative to agencies
  18. In response to a question I tweeted about what role Lois Quam, the executive director of the GHI, has played in all this:
  19. @J_Schiff The issue is that we have wasted 4 years of $$ & time & effort just to have US global health siloed again - no + "whole of govt"
  20. @J_Schiff Off the record - one office colleague said "what is this? the find Quam a job show?"
  21. @J_Schiff fed up with lack of leadership, commitment to the promise of ending siloes
  22. Best news in recent #GHI announcement: USG avoids political seppuku of moving @PEPFAR under @USAIDGH @j_schiff @Laurie_Garrett

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Jaclyn Schiff

Social journalist, write on global health, Africa, foreign policy. Media consultant and social media nut. Working with @UNFoundation. Host of Pangea.

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