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Obama expands health agenda, but not funding

HIV ribbon in the International Women´s Summit: Women´s Leadership in HIV and Aids in Nairobi, Kenya. Allan Gichigi/IRIN
At a time when many Americans are preoccupied with the economic crisis on their doorsteps, President Barack Obama has asked Congress to approve US$63 billion for global health over the next six years.

In a statement released on Tuesday, Obama emphasised his continued support of the President’s Emergency Plan for AIDS Relief (PEPFAR), established by his predecessor, George Bush, and outlined his plans for a broader global health approach that would include funding for child and maternal health, family planning and neglected tropical diseases.

"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 programmes," he said.

In July 2008, before the economic crisis, Congress approved legislation that increased funding to combat AIDS, malaria, and tuberculosis to $48 billion over five years. Under Obama's proposal, $51 billion will be spent on the three diseases over six years instead of five.

''We will not be successful in our efforts to end deaths from AIDS, malaria and tuberculosis unless we do more to improve health systems''
PEPFAR will still receive 70 percent of global health funding, starting with US$7.4 billion in 2010, up slightly from 7 billion in 2009.

Critics of the proposal accused Obama of breaking a campaign pledge to "dramatically increase" HIV/AIDS funding, not only to PEPFAR but also to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

A breakdown of the 2010 budget released on Thursday revealed that the Global Fund will receive $900 million, the same as it received in 2009, and way below the $2.7 billion it requested from the US to help it meet a $5 billion funding gap.

Dr Paul Zeitz, executive director of the Washington-based Global AIDS Alliance, said in a statement that Obama's 2010 budget "essentially flatlines support for global health".

Serra Sippel, executive director of the Centre for Health and Gender Equity, was also disappointed that funding had not increased, but welcomed the comprehensive approach as a "more effective use of our aid".

Read more:
 Economic downturn puts treatment of millions at risk
 A new and improved PEPFAR under Obama?
 Global Fund facing shortfall
"I think it is important that the United States begins to look at health issues that are linked and connected," she told IRIN/PlusNews. "The critical thing is to look at where is the money going, and are those effective programmes on the ground?"

A Kaiser Family Foundation survey released on Thursday found that 71 percent of Americans do not believe their country can afford to spend more on global health when the US is experiencing a severe recession, and that the sense of urgency about the global HIV/AIDS epidemic had declined.

Only 26 percent of respondents supported more government funding for health in developing countries, while 39 percent thought funding should merely be maintained.

The global economic crisis is already taking a toll on the health budgets of a number of developing countries hard hit by the HIV/AIDS epidemic. A World Bank report last week suggested that such countries would need more, not less, assistance from donors to avoid cutting back on treatment and prevention programmes.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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