16 July 2012

PSI's Hofmann on the GHI

As I continue to track the latest developments on the GHI, Karl Hofmann, CEO of PSI, weighs in with a short statement on the future of the GHI.
The announcement Friday before the July 4 weekend that the Administration's signature Global Health Initiative (GHI) was being replaced by a new Office of Global Health Diplomacy at State was greeted with withering criticism from many in the global health community.

Here's why this change matters less than one might first think.

GHI was meant to bring coordination and integration to the USG's vast global health bureaucracy, and particularly to drive more integrated health programming in the GHI focus countries. The aim to achieve greater integration of Washington agencies and their individual health appropriations was never as likely nor frankly important as the aim to achieve more integrated health programming at country level. The former is Washington's favorite contact sport, with endless periods on the field and no permanent winners -- it's sensible for the Administration to stop beating its head against this goal post. The latter probably has much more significance to the intended beneficiaries of US global health assistance, and here there has indeed been some country-level progress.

What matters more than org charts is of course appropriations. In truth, the Administration and Congress have done rather well by global health, given our fiscal realities.

As a former US ambassador, I know the challenges of trying to get interagency coordination in Washington. In fact, it's often easier to get on-the-ground coordination in a particular embassy country team than it ever is to get agencies' Washington headquarters to even talk to each other. Putting more emphasis on making global health integration a programmatic reality at the country level is probably the right way for the Administration to bring GHI principles to life.
Disclosure: I write the PSI Healthy Lives Blog where this originally appears. Though I am connected to the organization, my interest in sharing is based on the future of the GHI.