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At What Cost? U.S. Leadership in Global Health in an Era of Austerity. Dr. J. Stephen Morrison Senior Vice President; Director, Global Health Policy Center Center for Strategic and International Studies. US Bilateral Global Health Financing: 1990-2011. Source: IHME DAH Database 2011
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At What Cost? U.S. Leadership in Global Health in an Era of Austerity Dr. J. Stephen Morrison Senior Vice President; Director, Global Health Policy Center Center for Strategic and International Studies
US Bilateral Global Health Financing: 1990-2011 Source: IHME DAH Database 2011 Note: 2010 and 2011 are preliminary estimates based on information from the above organizations, including budgets, appropriations, and correspondence
Donor Health Investments 2002 vs 2010 2002 2010 Total = $4.4 billion (USD) Total = $18.4 billion (USD) SOURCE: Kaiser Family Foundation Note: Amounts in gross US$ disbursements. Health ODA combines data from three OECD CRS sub-sectors: (1) Health; (2) Population Policies/Programs and Reproductive Health (includes HIV/AIDS & STDs); and (3) Other Social Infrastructure and Services - Social Mitigation of HIV/AIDS Source: Analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS), November 7, 2012.
Changing Global Burden of Disease:Changes in Cause of Death, 1990-2010 SOURCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010, online
Global Estimates of People Living with HIV/AIDS 1990-2011 Millions CHART BY: Kaiser Family Foundation SOURCE: UNAIDS, Report on the Global AIDS Epidemic, 2012.
HIV/AIDS Pandemic Overview (2011) • HIV/AIDS remains a serious global threat: • 2.5 million new HIV infections worldwide • 1.7 million AIDS-related deaths • Progress is being made: • 8 million people (54 percent of eligible people) worldwide received treatment with effective antiretroviral drugs • Between 2001 and 2011, the rate of new HIV infections has been reduced by more than 50 percent among adults (15 to 49 years) in 25 countries • The number of people dying from AIDS-related causes in sub-Saharan Africa declined by 32 percent, from 1.8 million to 1.2 million, between 2005 and 2011 • Major challenges remain: • 6.8 million people remain eligible and waiting for treatment • Only 30% of treatment-eligible pregnant women living with HIV were receiving ART. Source: UNAIDS, “UNAIDS World AIDS Day Report 2012,” December 2012, online
Global Deaths from HIV/AIDS: Regional Distribution (2011) Source: UNAIDS, online
Reported Global Polio Cases: 2001-2012 Source: WHO AFP/Polio Database; communications with WHO
US Priorities During the Second Obama Term • Sustainability: partner country ownership & orderly transitions • Ensure continuous high-level US leadership • Preserve broad American consensus • Consolidate reforms in face of recession • Clarify priorities and who is in charge
Global Health Diplomacy • Preserve centrality of the Secretary of State • Better engage G-8 and emerging powers • Empower U.S. ambassadors
HIV/AIDS • Maintain funding • Link U.S. programs with Global Fund • Implement AIDS-Free Generation • Manage transition challenges
Malaria • Expand use of rapid diagnostics • Explore innovative finance • Focus upon rising resistance • Continue research investment • Control substandard products.
Polio • Concentrate upon achieving eradication • Combine CDC and USAID contributions • Pakistan, Afghanistan, Nigeria: how reconcile global security versus global health?
Women’s Global Health • Translate U.S. policies into action • Monitor progress in addressing inequality • Advance partnerships on cervical cancer, violence, safe motherhood
Multilateral Partners • Possess valuable assets • Of rising significance to U.S. interests • Face funding replenishments and continued pressures to reform
Global Health Security • Diminished perceived threat • International Health Regulations: laboratories, surveillance, reporting, training. • Integration of public health with biosecurity
Thank You! • Please register at www.SmartGlobalHealth.org to receive the CSIS volume Global Health Policy in the Second Obama Term, which will be available in late February.