Invitation to join the Global Health Coalition being formed by Hogan and Hartson.
The President’s Emergency Plan for AIDS Relief (PEPFAR) has been a singular success in producing substantial measurable improvement in the health of millions of people in sub-Sahara Africa. The United States is now poised to extend significantly its global health initiatives, including to prevention and treatment of infectious diseases and diseases and conditions that particularly affect mothers and children, as well as the establishment of effective healthcare delivery systems. PEPFAR provides a successful model for such initiatives. Educational institutions should play a leading role in a government coordinated effort to design and implement the next generation of global health initiatives. On behalf of interested parties, we propose to form a coalition of universities and other interested organizations to seek legislation and funding for this purpose and invite your institution join this coalition.
In the fiscal year ended September 20, 2008, the U.S. committed $7.5 billion for programs promoting global health. In its report released on December 15, 2008, an expert committee convened by the Institute of Medicine of the National Academies recommended that, by fiscal year 2012, the government’s annual commitment to global health initiatives be doubled to $15 billion, of which $13 billion be allocated to reduction of child mortality, improvement of maternal health and combating HIV/AIDS, malaria and other diseases and $2 billion be allocated to addressing noncommunicable diseases and other injuries. Development of in-country healthcare systems, including establishment and maintenance of a cadre of trained local healthcare professionals, will be an important component of these initiatives. The committee also calls for government-wide coordination of these efforts in a manner akin to the organization of PEPFAR, as well as the establishment of metrics to measure outcomes and mechanisms to ensure that outcomes are monitored.
PEPFAR has demonstrated that for a program to be effective (i) there must be clear objectives by which the impact of any initiative can be measured and through which the implementing bureaucracies can be managed; (ii) the program should be designed to deliver quality healthcare opposed to “technical assistance;” and (iii) there must be a competent U.S. healthcare force that can act effectively under the circumstances existing in-country.
Unlike most of the government agencies and private consulting firms, health professional educational institutions can provide the technical expertise necessary for both infrastructure development and service delivery. Moreover, they alone are in the business of education and, thus, uniquely qualified to develop and deliver the educational programs for both the U.S. health care service providers and “health diplomats” and the in-country healthcare service providers and program managers. Many institutions have already established programs targeted at promoting global health. Thus, if structured properly, upcoming global health initiatives will provide attractive opportunities for health professional educational institutions of every type – medical, dental, nursing and pharmacy schools.
We are optimistic that legislation establishing and funding the foregoing expanded health care initiatives can be enacted in 2009 or 2010. Time is of the essence, since both houses of Congress are slated to consider relevant legislation in the coming months. We are also pleased to inform you that Dr. Joseph F. O’Neill, currently on the faculty of the University of Maryland and former Director of the White House Office of National AIDS Policy, former Deputy Director of PEPFAR and former Director of the Ryan White Project of the U. S. Department of Health and Human Services, Health Resources and Services Administration, and Dr. Gregory Pappas, The Noordin M. Thobani Professor and Chairman, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan and an author of the “PEPFAR Five Year Strategy: a Report to Congress,” have agreed to join our team for this project.
Attached is a white paper by Drs. O'Neill and Pappas.
For more information contact Dr. Pappas..