The U.S. Government’s Global Health Initiative

1. The U.S. Government’s Global Health Initiative “The U.S. has a moral and strategic interest in promoting global health.” -- President Obama’s National Security Strategy, May 27, 2010

2. President Obama’s National Security Strategy______________________________________________________________________________________________ 3 Ds defense, diplomacy and development Development is a strategic, economic and moral imperative. 4 enduring national interests Security, prosperity, values, international order

3. International Order • Our relationship with our European allies remains the cornerstone for U.S. engagement with the world, and a catalyst for international action. • Building on European aspirations for greater integration, we are committed to partnering with a stronger European Union to advance our shared goals…

4. U.S. Government’s Global Health Initiative __________________________________________________________________ • Through the GHI the U.S. will invest $63 billion over 6 years to help partner countries improve health outcomes and strengthen health systems. • GHI will have 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 promotes a new business model – based on core principles to achieve dual objectives of attaining significant health improvements and creating an effective, efficient and country-led platform for sustainable delivery of essential health care and public health programs. Requirements of a New Approach

5. Global Health Initiative Principles • Support country ownership and invest in country-led plans. • Implement a woman and girl-centered approach • Increase impact through strategic coordination and integration. • Strengthen and leverage key multilateral organizations, GH partnerships and private sector engagement. • Build sustainability through health systems strengthening. • Improve metrics, monitoring and evaluation (M&E). • Promote research and innovation to identify what works.

6. Strengthen and leverage key multilateral organizations, GH partnerships and private sector engagement __________________________________________________________________ – because improving health outcomes is a shared responsibility; the needs are too vast and the challenges too great for any one county or organization to address alone. -- The GHI will strengthen the U.S. Government’s collaboration with other development partners.

7. Global Health Initiative Targets by 2015 • The GHI is expected to achieve aggregate goals including: • HIV/AIDS: Support prevention of more than 12 million new infections, provision of care to more than 12 million people, and treatment for more than 4 million people. • Child health: Save approximately 3 million lives by reducing under-five mortality rates by 35 percent in assisted countries. • Maternal health: Save 360,000 women’s lives by reducing maternal mortality by 30 percent in assisted countries. • Tuberculosis: Reduce TB prevalence by 50 percent, saving approximately 1.3 million lives. • Malaria: Reduce the burden of malaria by 50 percent for 450 million people. • NTDs: Reduce the prevalence of 7 NTDs by 50 percent among 70 percent of the population affected by NTDs. • Family Planning: Prevent 54 million unintended pregnancies. • Nutrition: Reduce child undernutrition by 30 percent in food-insecure countries in conjunction with the President’s Global Food Security Initiative.

8. GHI - A New Business Model • Collaborate for impact – with country governments, other development partners, and across USG. • Do more of what works – by scaling up proven interventions that address the health challenges of women, newborns, and children as well as their families and communities. • Expand existing platforms to foster stronger systems and sustainable results – including USG platforms in HIV/AIDS, malaria, MCH and family planning. • Innovate for results - through introduction and evaluation of new interventions and promising new approaches.

9. GHI Plus Country Selection and Funding Selection • Phase I – Up to 10 GHI Plus countries will be selected in 2010. • Phase II – Up to 10 additional GHI Plus countries will be selected in 2010. • Countries will be selected after consultations with relevant stakeholders. Funding • In FY2011, additional funding comes from a GHI Strategic Reserve Fund of $200 million • GHI Strategic Reserve Funding will be used to jumpstart programming, but will not supplant existing USG or partner government financing and programs.

10. GHI Funding ($ in millions) FY 09 FY 10 FY11 Enacted Enacted Request HIV/AIDS 5,609 5,609 5,900 TB 163 173 230 Malaria 385 585 700 MCH 455 450 875 Nutrition 40 75 250 FP/RH 455 475 600 Avian/Pandemic Flu 140 125 75 Neglected Tropical Diseases 25 70 140 Other Public Health Threats 5 18 20 Vulnerable Children 15 15 15 SUBTOTAL: GHCS State/USAID 7,292 7,595 8,805 OTHER AGEN.(NIH, CDC, DOC) 974 1,030 1,030 TOTAL PROGRAM 8,266 8,626 9,835

11. GHI’s woman and girl-centered approach • Examine the role of gender in all U.S. government-funded global health programs; • Identify and implement the best practices for removing the barriers that limit women’s and girls' access to health services; • Increase the number of female health providers and the training of all health care providers on gender issues, in order to improve women’s and girls’ utilization of health services; • Pilot community-based interventions to increase the participation of women in the design and implementation of health programs and to build the capacity of local women's civil society organizations; • Pilot and expand health programs to reach adolescent girls;  • Strategically link GHI programs with programs focused on gender-based violence (GBV), education and other issues that impact health; and • Improve monitoring, evaluation and research on women's and girls' health.

12. U.S. – EU Commonalities in Global Health • A shared commitment to the MDGs. • A shared view that MDGs 4 and 5 lag the most and require accelerated progress to achieve. • An emphasis on sub-Saharan Africa. • The centrality of strengthening comprehensive health systems in partner countries. • The importance of engaging civil society and facilitating increased connections among peoples around the world. • The centrality of gender equality to health and development. • An emphasis on research and innovation and the use of evidence to make decisions.

13. U.S. – EU Coordination in Global Health Next steps: U.S. proposals for consideration by the EU MDG Technical Working Group In-country coordination: Collaboration to identify countries of mutual interest and impact potential for global health investments. Global coordination: Engage in discussions regarding multilateral mechanisms through which possible joint positions and actions might be taken.

14. Conclusion • The starting point for collective action will be our engagement with other countries. The cornerstone of this engagement is the relationship between the United States and our close friends and allies in Europe, Asia, the Americas and the Middle East. • -- President Obama’s National Security Strategy, May 27, 2010 • We look forward to working in partnership with you. • ghi_comments@state.gov