Up to 10 priority countries would be selected in the next two fiscal years to benefit from a $200 million fund requested by the Obama administration, representatives from agencies contributing to the president’s Global Health Initiative told congressional staffers Feb. 17.
The White House’s budget proposal for fiscal year 2011 calls for the GHI Strategic Reserve Fund to be established with $100 million from the Global Health and Child Survival account at the U.S. State Department and another $100 million from the GHCS account at the U.S. Agency for International Development.
At a briefing with the House Foreign Affairs Committee, representatives from the State Department, USAID, President’s Emergency Plan for AIDS Relief, Department of Health and Human Services and Office of Management and Budget named a preliminary list of candidates: Bangladesh, Nepal, Kenya, Tanzania, Mali, Senegal, Benin, Malawi, Zambia, Ethiopia, Ghana, Guatemala and Honduras. The entire list of potential GHI Partner Plus countries will be announced by March 1, with the selection process for the first 10 to be completed by April 30. In the interim, administration officials will meet with members of Congress as well as representatives from U.S. government agencies and donor organizations, and other stakeholders.
The administration wants to build a final roster with countries of varying sizes, geographic locations and health needs. The levels of giving from outside donor organizations will also factor into decision making, and no country is to receive more than $50 million annually for its GHI Plus status.
Overall, President Obama has proposed an 8.4 percent increase in funding for GHI in fiscal 2011. Neglected tropical diseases, maternal and child health, family planning and malaria stand to see the sharpest rises.
The PEPFAR budget, meanwhile, would increase 2.2 percent if Congress were to approve the president’s proposal. As the growth in funding for HIV/AIDS and tuberculosis slows and support for the Global Fund to Fight AIDS, Tuberculosis, and Malaria faces a potential decline from the enacted total in fiscal 2010, some health advocates are worried the U.S. commitment fails to address the threat from the two pandemics.
“PEPFAR has been a forceful engine driving down AIDS mortality, heading off new infections, and extending life-saving drugs to millions of HIV patients,” said Dr. Kenneth Mayer, co-chair of the Center for Global Health Policy’s Scientific Advisory Committee, in a statement reacting to the budget. “Unfortunately, this budget proposal could imperil the fragile gains made over the last decade in treating HIV. It could also force a Sophie’s choice between prevention and treatment.”
Jennifer Kates, vice president and director of HIV policy at the Kaiser Family Foundation, sees the dichotomy between HIV prevention and treatment as a false dilemma.
“The treatment money is not actually being decreased. The rate of increases is just not at the same level as it’s been,” she told Devex. “What the administration is saying is that they’re going to do treatment and also step up efforts on prevention.”
Representatives from PEPFAR stressed the balance of treatment versus prevention measures with congressional staff.
GHI and the president’s 2011 budget request for the initiative indicate the White House’s preference for holistic global health strategies, according to the GHI consultation document, released Feb. 1. For instance, a clinic providing family planning and antenatal services could help prevent mother-to-child HIV transmission, the document said.
The shift has the international development community seeking a larger role in programs promoting the health agenda.
“A lot more organizations are trying to find synergies,” Kates said. “There might be different skills and approaches, but development assistance includes health.”