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President Obama's ambitious Global Health Initiative — announced to a receptive international community in 2009 — is faltering as budget constraints and shaky implementation limit the impact of the multibillion-dollar program.

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Lois Quam, director of President Barack Obama's Global Health Initiative. (John Donnelly/GlobalPost)

Special report: healing the world Q&A

Interview with Lois Quam, the new Global Health Initiative director.

WASHINGTON — Lois Quam was recently named the executive director of the Global Health Initiative (GHI), which puts her in control of a sprawling, ambitious and some would say unwieldy effort by President Barack Obama's administration to prevent disease and promote health around the world. This initiative, which was announced two years ago but is just getting underway, will operate with a budget of approximately $50 billion spread out over the next six years. The GHI is integrated in its approach with the U.S. Agency for International Development but falls under the U.S. State Department and Quam is reporting directly to Secretary of State Hillary Clinton.

Quam has a long background in health care and a close working relationship on the issue with Clinton. In 1993, after chairing an initiative in her native Minnesota that greatly expanded health care, Quam worked as a senior advisor to the then-First Lady Clinton’s task force on health care reform.

But most of her experience in health care has been in the private sector, largely with the UnitedHealth Group, where she was president and CEO of the Public and Senior Markets segment of the company. In 2009, she launched and chaired Tysvar, a Minnesota-based health care reform incubator dedicated to universal health care.

John Donnelly, who is heading up a GlobalPost reporting project on the GHI which has been funded in part by the Kaiser Family Foundation, interviewed Quam for GlobalPost in early April, about two months after she took the position as the head of GHI. Here are excerpts from the interview:

Q: Why did you take this job?

“Our country has a significant leadership role to play globally in overcoming these very real and immediate problems of illness”
~Lois Quam, director of the Global Health Initiative

A: It was hard to leave Minnesota winters because I’m a very avid cross-country skier. Throughout my life, I’ve tried to take on important and difficult challenges. I always looked for opportunities to work with talented people and offer my own skills. What I have been best at and enjoyed the most is working with talented people and taking a good idea and bringing it to life, and bringing it to scale.

My career has been principally in industry. I’ve looked at significant challenges, untapped opportunities, and I liked the challenge of improving care to the frailest and the elderly in America, or the people working in rural America, and expanding those services across the country. When the Secretary [of State Hillary Clinton] asked me to work with her on this, it fit so well with what I have done in the past.

I feel very deeply that our country has a significant leadership role to play globally in overcoming these very real and immediate problems of illness and I’m very proud of what our country has done to date around HIV/AIDS treatment, care, and prevention, and the long-standing programs USAID has had in maternal and child health.

I’m also proud of the surveillance work at CDC (the Centers for Disease Control and Prevention), the research capacity and network NIH (National Institutes of Health) has developed, the energetic work the Peace Corps has had in areas, and the logistical work DOD does. But you need to step back and recognize the immense hardship that remains, and the responsibility we have to continue our leadership role in global health.

Q: Two months in, what are the biggest surprises so far?

A: Surprises. Hmm. One challenge that has been very clear to me — a very large one in having come to Washington from Minnesota — is I have really seen the impact of the recession in the country, and I have two points to make about that. One is the strong support in generation after generation, across the country, for global health. It’s been a non-partisan area. Americans have given generally through organizations like CARE or through churches. The depth of that support doesn’t surprise me.

What has surprised me is the impact of the recession of the country is very significant. Some 44 million Americans now qualify for food stamps. As Washington seeks to deal with the budget, it is very important that all of us in leadership positions do all we can to ensure that the funds we are bringing to bear are used most efficiently and effectively. It’s not easy for Washington to realize what the sense is of the rest of the country.

http://www.globalpost.com/dispatch/news/health/110504/special-report-healing-the-world