WASHINGTON, DC –Three years ago, President Obama announced with great fanfare his signature global health plan, calling it the Global Health Initiative (GHI). He said it was needed to change direction from President Bush’s disease-specific approaches in AIDS and malaria to “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.”
Today, in a down-page blog on the GHI website, the administration announced that the Global Health Initiative’s office is closing.
The reason? The official line – from GHI Executive Director Lois Quam in an interview with GlobalPost – is that the office’s work will be “elevated” into the State Department’s Office of Global Diplomacy and that GHI’s principles of building health systems to treat patients instead of diseases are now firmly embedded in developing countries. Some 42 GHI country teams have been established.
“By shifting from what was too often an internal focus to a strong external focus, we feel this diplomacy focus is important in order to bring more resources to achieve GHI targets,” Quam said. “Diplomacy allows us to work with partner countries and donor countries in a stronger way. I’m very pleased about this.”
But global health observers outside the government say that GHI ran into problems from the start and never fully found its place inside the Obama administration, which has put much less high-level attention on global health than its predecessor, the Bush administration.
More from GlobalPost: Taking Root: A GHI Progress Report
In addition, many in the field in the developing world were never really clear about what defined a GHI project. In Washington, stories circulated freely about internal struggles for control of GHI. Among those following global health policies in DC, one recurring discussion was the wrestling over resources among the President’s Emergency Plan for AIDS Relief, the US Agency for International Development, State Department, and Centers for Disease Control and Prevention. One battle was over GHI’s eventual home.
The answer came today: Nowhere.
GHI, in actuality, was a tiny operation: just four fulltime workers, plus another half-dozen temporarily assigned officials, nestled inside the sprawling State Department building. Quam now will aid in the transition.
The move into the State’s global diplomacy office “lifts up the GHI to the highest levels of diplomacy in the US government,” Quam said. “This will support our ambassadors and teams in the field. This is the step that moves this forward.”
Perhaps. But the promise surrounding the May 5, 2009 announcement has long since faded, global health observers agree. The administration has given more attention to maternal and child health, but observers wonder if that is because of GHI, or due to the administration’s global health leanings in the first place? Now all that’s left is the strategy. Washington has one less institution, leaving those existing to battle over funding and policy as they did before.
Learn more from this Storify:"What changes to the Obama administration's Global Health Initiative mean," by Jaclyn Schiff