Opinion: For better or worse, politics define 2016 top global health moments

By Karl Hofmann 07 December 2016

Canadian Prime Minister Justin Trudeau speaking at the opening of The Global Fund Replenishment Conference in Montreal, Canada. Photo by: Vadim Daniel / The Global Fund

The world had a pretty good idea what foreign aid would look like under a Hillary Clinton administration, but what President-elect Donald Trump’s agenda will be is anyone’s guess. As the U.S. shifted to the right, its northern neighbor Canada shifted to the left and European governments struggled with economic turmoil and an unprecedented refugee crisis taxing aid budgets.

But 2016 had a few bright spots, including a record replenishment for The Global Fund to Fight AIDS, Tuberculosis and Malaria, and two innovative efforts that may very well redefine what it means to be a philanthropist. Here are six top global health moments:

1. America votes, girls and women are set back.

Trump hasn’t spoken much about foreign aid, and his policy agenda is unclear at best. He has said he intends to fight funding for Planned Parenthood and will very likely appoint Supreme Court justices who would overturn Roe v. Wade — the 1973 U.S. Supreme Court decision which recognized that the constitutional right to privacy extends to a woman’s right to make her own personal medical decisions, including the decision to have an abortion.

Internationally, Trump has said very little aside from a few tweets, including his pledge to “stop sending foreign aid to countries that hate us.” Despite Trump’s vice president, Mike Pence, championing The President's Emergency Plan For AIDS Relief, or PEPFAR — a U.S. governmental initiative to address the global HIV/AIDS epidemic — he hasn’t generally been supportive of foreign aid and is extremely conservative when it comes to reproductive health. It’s highly likely the Mexico City Policy — known by insiders as the “global gag rule” — will be reinstated and will force foreign nonprofit organizations to choose between accepting U.S. funding or providing abortion services and advocacy.

Despite Trump’s isolationist rhetoric, Congress has historically shown bipartisan support of foreign aid. Presidents Ronald Reagan and George W. Bush both came into office critical of foreign aid, but came to see it as a vital humanitarian and diplomatic tool for the U.S. Let’s see what Trump’s first 100 days holds for foreign aid and its positive impact on girls and women worldwide.

2. Aid funding in Europe shifts to address an unprecedented refugee crisis.

The 65 million people living today across the globe as refugees is unprecedented. Wealthy nations, particularly in Europe, bear the brunt of the refugee crisis as people from the Middle East, North and East Africa flee to perceived prosperity and safety. Some $13.9 billion in aid that would typically be directed to developing countries is now being spent on refugee costs within the borders of donor nations.

The health, development and human rights challenges facing millions in the “global south” aren’t going away anytime soon and the refugee crisis continues to tax Europe with no end in sight. This is a case where nobody wins.

3. U.S. Congress plays a political ‘chess game’ with Zika funding.

In 2016 much of world was introduced to a little known mosquito-borne virus Zika. Democrats and Republicans argued over a provision in a bill that would give Planned Parenthood funding to provide contraception, stemming the spread of Zika. When $222 million in funding was finally awarded to the Centers for Disease Control and Prevention, it was too little and too late; by August the funding was nearly spent.

Meanwhile, nearly 17,000 Americans had been infected with Zika, including 1,600 pregnant women and 16 babies were born with the birth defects caused by Zika. It’s well past time to put science, evidence and health over politics.

4. The Global Fund looks to the ‘global south,’ secures record $12.9 billion replenishment.

September saw The Global Fund’s fifth replenishment effort stewarded by its Executive Director Mark Dybul, with donor nations pledging a record $12.9 billion over the next three years despite an international economic downturn. Perhaps most notably, countries that are themselves aid recipients and severely affected by HIV/AIDS, tuberculosis and malaria, such as Benin and Togo, contributed to the fund for the first time.

5. Trudeau’s ‘golden touch’ extends to foreign aid.

In 2016, Canada returned to a more progressive foreign aid stance under Prime Minister Justin Trudeau. Trudeau gave clear instructions to his Minister of International Development Marie-Claude Bibeau to restructure Canada’s international assistance. According to the Toronto Sun, “The decision to remove [former Prime Minister] Harper's restriction on funding of overseas abortions is hardly surprising since Trudeau required all candidates who ran under his banner last fall to support a woman's right to choose.”

Canada also hosted The Global Fund’s fifth replenishment conference, and increased its assistance for AIDS, TB and malaria by 23 percent — a silver lining in an otherwise otherwise cloudy global development landscape.

6. Two new models help redefine philanthropy.

A year into the Chan Zuckerberg Initiative, a look at the growing team

In a Facebook Live conversation on Thursday, Priscilla Chan and Mark Zuckerberg provided a look at the team they are assembling to pursue their stated mission of "advancing human potential and promoting equal opportunity."

This year, Mark Zuckerberg and Priscilla Chan pledged $3 billion to fund an ambitious goal: Can we prevent, manage or cure all diseases in our children’s lifetime? What makes this initiative truly groundbreaking isn’t only its goal, but also the structure of their LLC. The Chan Zuckerberg Initiative will be a for-profit organization, allowing it to invest in for-profits and nonprofits to fund research and advocacy. Profits made from these investments will go straight back into the initiative.

The idea of a “for-profit” organization doing charity work has rung some alarm bells across the world of philanthropy; Chan and Zuckerberg have been criticized for trying to evade taxes. And being registered as an LLC, they’ll be able to operate with much less transparency than your typical 501(c)3 nonprofit, potentially giving them a much greater degree of flexibility to solve problems. Despite criticisms, we’re likely to see more philanthropists follow suit.

In 2016, Crown Princess of Norway Mette Marit and Melinda Gates launched Maverick Collective, which trains motivated female philanthropists to become super-advocates who contribute their resources, intellect and business skills to help create innovative pilot projects with health experts that have the potential to change the way health is delivered to girls and women in the “global south”.

To date, the effort has galvanized $60 million in funding and impacted the lives of over 300,000 girls and women.

According to Fast Company, what makes Maverick Collective different is its model of partnership — new champions, fresh perspectives and new voices. Pam Scott, founder of research and branding firm The Curious Company, is using her experience to address unintended pregnancy in Tanzania.

“Because I practice human-centered design, it was important that [Maverick Collective] not come to me with a program that had been all figured out,” Scott said. “My expertise lies in doing the research, figuring out the design opportunities, writing creative briefs, and working with teams to develop amazing ideas that solve the problem.”

This is one to watch.

2017 will be a year for the global health community to redouble its efforts. We must speak with one voice to let taxpayers know the tremendous economic, humanitarian and diplomatic value aid brings and let legislators know that anything less than an increase in aid spending threatens to reverse the historic gains of the past 30 years.

I’m reminded of a quote by Winston Churchill: “It is not enough that we do our best; sometimes we must do what is required.”

What were some of the other big global health moments of the year? Share your thoughts by leaving a comment below.

For more Devex coverage on global health, visit Focus On: Global Health 

About the author

Devbuzz profile
Karl Hofmann

Karl Hofmann is president and CEO of Population Services International, a Washington, D.C.-based global health nonprofit focused on family planning and reproductive health, malaria, child survival, HIV, maternal and child health, and NCDs. Before joining the organization in 2007, he was a career U.S. diplomat for 23 years, serving as ambassador to Togo, executive secretary of the Department of State and deputy chief of mission at the U.S. embassy in Paris.


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