Fact Sheet: The U.S. Government 's Global Health Initiative
"We will not be successful in our efforts to end deaths from AIDS, malaria, and tuberculosis unless we do more to improve health
systems around the world, focus our efforts on child and maternal health, and ensure that best practices drive the funding for
these programs."
– President Barack Obama, May 5, 2009
Through the Global Health Initiative (GHI), the United States is investing $63 billion over six years to help partner countries improve health
outcomes through strengthened health systems - with a particular focus on bolstering the health of women, newborns and children by combating
infectious diseases and providing quality health services. GHI aims to maximize the sustainable health impact the United States achieves for
every dollar invested.
GHI is a business model that builds on the Bush Administration's successful record in global health, and takes those remarkable achievements to
the next level by further accelerating progress and investing in sustainable health delivery systems for the future.
The principles underlying the foundation of GHI are the following:
- Implement a woman- and girl-centered approach
- Increase impact through strategic coordination and integration
- Strengthen and leverage key multilateral organizations, global health partnerships and private sector engagement
- Encourage country ownership and invest in country-led plans
- Build sustainability through health systems strengthening
- Improve metrics, monitoring and evaluation
- Promote research and innovation
The Goals:
Achieving major improvements in health outcomes is the paramount objective of the Initiative. To that end, GHI supports the following goals
and targets:
- HIV/AIDS: The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) will: (1) support the prevention of more than 12 million
new HIV infections; (2) provide direct support for more than 4 million people on treatment; and (3) support care for more than 12 million
people, including 5 million orphans and vulnerable children.
- Malaria: The President's Malaria Initiative (PMI) will reduce the burden of malaria by 50 percent for 450 million people, representing 70
percent of the at-risk population in Africa, and expand malaria efforts into Nigeria and the Democratic Republic of the Congo.
- Tuberculosis (TB): Save approximately 1.3 million lives by reducing TB prevalence by 50 percent. This will involve treating 2.6 million
new TB cases and 57,200 multi-drug resistant cases of TB.
Maternal Health: Save approximately 360,000 women's lives by reducing maternal mortality by 30 percent across assisted countries.
- Child Health: Save approximately 3 million children's lives, including 1.5 million newborns, by reducing under-5 mortality rates by 35
percent across assisted countries.
- Nutrition: Reduce child undernutrition by 30 percent across assisted food-insecure countries, in conjunction with the President's Feed
the Future Initiative.
- Family Planning and Reproductive Health: Prevent 54 million unintended pregnancies by meeting unmet need for modern contraception.
Contraceptive prevalence is expected to rise to 35 percent across assisted countries, reflecting an average 2 percentage point
increase annually. First births by women under 18 should decline to 20 percent.
- Neglected Tropical Diseases: Reduce the prevalence of 7 neglected tropical diseases by 50 percent among 70 percent of the affected
population, and eliminate onchocerciasis in Latin America by 2016, lymphatic filariasis globally by 2017, and leprosy.
How GHI Works:
- Serves as a whole-of-government umbrella to coordinate U.S. government global health efforts
- Seeks to create greater country-level capacity to manage and operate programs
- Builds upon existing plans and programs, rather than duplicating existing efforts
- Enables greater coordination among U.S. government programs and country, donor, and civil society efforts at the country level
- Uses existing negotiated agreements as a basis for future collaboration
- Emphasizes health systems strengthening as a component of disease- and issue-specific programs
A New Business Model:
- Collaborate for impact - with country governments and other development partners, and across the U.S. government.
- Do more of what works - Scale up proven interventions that address the health challenges of women, newborns and children and their
families and communities.
- Build on/expand existing platforms to foster stronger systems and sustainable results - including U.S. government platforms in
HIV/AIDS, malaria, maternal and child health and family planning.
- Innovate for results - introduce and evaluate new interventions and promising new approaches.
Accelerating Impact - GHI Plus:
While the GHI program will apply everywhere U.S. government global health dollars are at work, GHI is launching an intensified effort in a subset
of up to 20 "GHI Plus" countries over the course of the initiative that provide significant opportunities for impact, evaluation, and partnership
with governments. These countries will receive additional technical, management, and financial resources to accelerate the implementation of
GHI's innovative approach, including integrated programmatic interventions and investments across infectious disease, maternal and child health,
family planning, and health systems activities. GHI Plus countries will provide opportunities to learn how to build upon existing platforms, best
use programmatic inputs to deliver results, and work in close collaboration with partner governments, across U.S. government agencies, and with
global partners. Robust monitoring and evaluation will be central to the generation of this knowledge. The lessons learned will be shared with
other GHI countries to inform future decision-making and ensure programmatic accountability. These activities will be carried out in close collaboration
and coordination with country governments, local civil society, international organizations, and other donors.
Comments on GHI:
Bill Gates, Co-Chair, Bill & Melinda Gates Foundation: "…the GHI aims for greater resources and a fresh approach to deploying
resources in order to maximize health outcomes in as short a time as possible. It seeks to concentrate resources in order to better achieve
scale in selected countries. And it utilizes targeted funding increases on diseases and conditions that have a devastating health and economic
impact on countries yet are entirely preventable or treatable. These are laudable goals." (Testimony before Senate Foreign Relations
Committee, 3/10/2010)
Former President Bill Clinton: "The thing I love best about the Global Health Initiative proposal that the administration has made is
that it is designed to work us all out of jobs. It is designed to break the cycle of AIDS. It is designed [to] increase the capacity of local
government." (Testimony before Senate Foreign Relations Committee, 3/10/2010)
Serra Sippel, President of the Center for Health and Gender Equity: "President Obama's Global Health Initiative (GHI) has the
potential to save lives and improve the health and rights of women globally. It is the first comprehensive U.S. policy approach to global
health that recognizes that our greatest plagues -- HIV/AIDS, maternal and infant mortality, and poor sexual and reproductive health
-- are all interconnected, and they are all preventable." (2/1/2010)
Save the Children: "[The President's Global Hunger and Food Security Initiative and the Global Health Initiative] reflect strong investment
and sound principles emphasizing developing country-ownership, strategic coordination among donors and U.S. agencies and
mechanisms for ensuring improved accountability." (2/2/2010)
Through the Global Health Initiative, the U.S. government is pursuing a comprehensive whole-of-government
approach to global health. The Initiative promotes a business model that delivers dual objectives of
achieving significant health improvements and supporting effective, efficient and country-led platforms for the
sustainable delivery of essential health care and public health programs.
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