On May 5, 2009, President Obama announced the creation of a “Global Health Initiative.” This program is to be supported with $63 billion over six years (2009 to 2014).[i] The majority of the funds are intended to support existing programs.[ii] Under the Initiative, the President’s Emergency Plan for AIDS Relief (PEPFAR) would receive $51 billion over the six-year period, with the other $12 billion going toward a variety of programs, including those focusing on neglected tropical diseases, maternal and child health, and family planning.[iii] Obama’s Fiscal Year 2010 (FY10) budget proposal calls for $7.4 billion to be spent on fighting HIV/AIDS, malaria and tuberculosis, a $366 million increase from 2009.[iv]
It is reported that 26,000 children around the world die every day from extreme poverty and preventable diseases.[v] As such, the Global Health Initiative will focus on bolstering efforts to provide equitable access to the prevention, treatment, and care for these diseases, while relying on programs that are cost-effective. Overall, the program has the ambitious goals of preventing new HIV infections, reducing maternal and under-five child mortality, averting millions of unintended pregnancies, and eliminating some neglected tropical diseases.[vi] Despite the breadth of health areas addressed in the initiative, allocations to support HIV/AIDS-related programs and services will make up the bulk of the funds, with PEPFAR receiving more than 70 percent of U.S. global health funding.[vii]
The Initiative plans to take an integrated approach to global health, or what White House Press Secretary Robert Gibbs called a “comprehensive global health strategy.”[viii] Obama further argued, “We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health.”[ix] This effort would not only include integration among the different focus areas, but also coordinate efforts to strengthen health systems around the world, thus bolstering health outcomes overall.[x] The White House plans to apply some of the approaches already in play in the U.S. response to global HIV/AIDS, malaria, and tuberculosis to other pressing issues in global health.[xi]
In a press release from the White House, the new initiative was framed within the context of transnational security, stating, “We cannot wall ourselves off from the world and hope for the best, nor ignore the public health challenges beyond our borders. An outbreak in Indonesia can reach Indiana within days, and public health crises abroad can cause widespread suffering, conflict, and economic contraction.”[xii]
Moreover, funding global health efforts constitutes what some have called a national security “smart power” strategy. In her statement on the Initiative’s establishment, Secretary of State Hillary Rodham Clinton claimed, “The President’s new global health initiative will be a crucial component of American foreign policy and a signature element of smart power. Bringing better health to people around the globe is an avenue to a more secure, stable, and prosperous world. Our investments…reflect our nation’s leadership as a positive force for progress around the world.”[xiii] Deputy Secretary of State Jack Lew supported this statement, adding that American efforts in global health “advance our core humanitarian values” in addition to enhancing national security.[xiv]
Obama concluded with the following statement: “America can make a significant difference in meeting these challenges, and that is why my administration is committed to act.”[xv]
[i] The White House, “Statement by the President on Global Health Initiative,” Press Release published 5 May 2009, accessed 7 May 2009 <http://www.whitehouse.gov/the_press_office/Statement-by-the-President-on-Global-Health-Initiative/>.
[ii] Caren Bohan, “Obama unveils $63 billion global health initiative,” Reuters, 6 May 2009, accessed 7 May 2009, <http://in.reuters.com/article/marketsNewsUS/idINN0549537020090505>.
[iv] Sheryl Gay Stolberg, “Obama Seeks a Global Health Plan Broader Than Bush’s AIDS Effort,” The New York Times, 5 May 2009, accessed 7 May 2009, <http://www.nytimes.com/2009/05/06/health/policy/06medical.html?_r=3&ref=worldObama>.
[v] The White House, “Press Briefing by Press Secretary Robert Gibbs and Deputy Secretary of State Jack Lew,” Press Release published on 5 May 2009, accessed 7 May 2009, <http://www.whitehouse.gov/the_press_office/Briefing-by-White-House-Press-Secretary-Robert-Gibbs-5/5/09/>.
[vi] “Fiscal Year 2010 Budget Fact Sheets: U.S. Department of State and Other International Programs,” The White House (7 May 2009), accessed 7 May 2009, <http://www.whitehouse.gov/omb/fy2010_department_state/>.
[vii] The White House, “Statement by the President on Global Health Initiative.”
[viii] The White House, “Press Briefing by Press Secretary Robert Gibbs and Deputy Secretary of State Jack Lew.”
[ix] The White House, “Statement by the President on Global Health Initiative.”
[xi] The White House, “Press Briefing by Press Secretary Robert Gibbs and Deputy Secretary of State Jack Lew.”
[xii] The White House, “Statement by the President on Global Health Initiative.”
[xiii] Hillary Rodham Clinton, “President’s Global Health Initiative,” Press Statement 5 May 2009, accessed 3 June 2009, <http://www.america.gov/st/texttrans-english/2009/May/20090505174936eaifas0.7123529.html.>
[xiv] The White House, “Press Briefing by Press Secretary Robert Gibbs and Deputy Secretary of State Jack Lew.”
[xv] The White House, “Statement by the President on Global Health Initiative.”