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Hillary Clinton Touts Global Health Initiative as Key Foreign Policy Tool

5 years ago
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"What exactly does maternal health or immunizations or the fight against HIV and AIDS have to do with foreign policy?" Secretary of State Hillary Rodham Clinton queried a packed crowd of faculty and students at the Johns Hopkins School of Advance International Studies on Monday. "Well, my answer is 'everything.' "

With a careful nod to the Bush administration's major efforts in global health – the President's Emergency Plan for AIDS Relief (PEPFAR) and the President's Malaria Initiative -- Clinton introduced what she called the "next chapter in America's work in health care worldwide" and laid out the basic outline of the Global Health Initiative (GHI), a "new approach, informed by new thinking and aimed at new goal: to save the greatest possible number of lives, both by increasing our existing health programs and building upon them to help countries develop their own capacity to improve the health of their own people."

Hillary ClintonThe GHI may be new, but it is not exactly news. Rolled out over the last few months, GHI will invest $63 billion over the next six years to help partner countries through integrated health systems with a renewed focus on maternal and infant health. The speech at SAIS was meant as a branding of sorts, a popularizing and contextualizing of the massive project.

To do so, Clinton spent the better part of 90 minutes making the case for an integrated, diplomatic approach to global health care policy and the impact of international health on U.S. interests abroad. "From the very beginning of my time as secretary of state," Clinton said during a Q&A session, "I've talked about elevating diplomacy and development alongside defense -- the three D's of 'smart power,' if you will."

Arguing that health is essential to bolstering fragile or failing states, Clinton grounded the GHI in a larger nonpartisan context and the recent history of U.S. global health policy.

"No nation in history has done more to improve global health. We have led the way on some of the greatest health achievements in our time," she told the audience, listing advancements ranging from eradicating smallpox in the 1960s and 1970s to addressing neglected tropical diseases, to preventing and treating malaria.

Today, the secretary explained, "we provide nearly 60 percent -- 60 percent -- of the world's donor funding for HIV and AIDS. All told, 40 percent of the total global funding for development assistance for health comes from the United States. "

But she also made digs at her predecessors. "The United States was once at the forefront of developing and delivering successful family planning programs. But in recent years we have fallen behind. With the Global Health Initiative, we are making up for lost time."

That was a nudge at the Mexico City Policy -- otherwise known as the global gag rule -- which forbade any U.S. funds from going to a clinic or provider that mentioned abortion, a policy that went above and beyond the Hyde Amendment, which assures no U.S. funds will be used for abortions abroad. (By the summer of 2008, the policy had undermined contraception distribution throughout the developing world.)

Clinton outlined a global-health-supports-security argument, a global-health-as-compassionate-policy argument, and a global-health-as-practical-solution argument.

"We're shifting focus from solving problems, one at a time, to serving people, by considering more fully the circumstances of their lives and ensuring they can get the care they need most over the course of their lifetimes," Clinton explained, and then used an illustrative anecdote about a theoretical rural village woman who can reach a clinic stocked with anti-retroviral medication (to fight HIV) but cannot get antibiotics or contraceptives -- nor can she give birth locally, should her birthing process require intervention. Her children have been protected from malaria, but they may die from dirty water. The moral of the story is one of integrated services and of an assessment of needs on the ground.

"The list of diseases and deficiencies that threaten lives and livelihoods across the world is nearly limitless," she said, "but our resources are not. So therefore we must be strategic and make evidence-based decisions in targeting the most dangerous threats."

Calling for integration, bundling of treatments and coordination, Clinton decried the "vicissitudes of funding cycles and development trends." And, perhaps to quell the concerns of those who fear the Global Health Initiative will negatively affect PEPFAR, she used the latter as an example of why the GHI would be successful. "We are raising our goal for prevention," she said. "We aim to prevent 12 million new HIV infections. To do that we are embracing a more comprehensive approach and expanding on what we know works. We are moving beyond ABC -- abstinence, be faithful, consistent and correct use of condoms," the phrase is from the Bush era, "to an A to Z approach to prevention. . . . We know we need to confront 2.7 million new infections every year. So in order to win this war, we need better results in prevention. . . . So the immediate impact for PEPFAR is clear. Its funding will increase, its impact will increase, and its prevention strategies will be more comprehensive."

The twitter feed #saisevents was buzzing with commentators throughout and after the event. Mostly positive, there were those, however, who feared Clinton lost a chance for greater substance.

"After the secretary's speech, I have more questions than answers about the Global Health Initiative," Jirair Ratevosian, deputy director of public policy at amfAR, the Foundation for AIDS Research, tweeted (privately, not on behalf of amFAR) to Politics Daily after the talk. "What are the tangible changes? Budget? Integration?" Agreed Nandini Oomman, director, HIV/AIDS monitor at the Center for Global Development: "While it was encouraging to hear about the US commitment to global health, the 'HOW' " -- as in how to accomplish these goals -- "isn't being shared and it makes people wonder: why?"
Filed Under: Field Notes

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charity begins at home....put some of that money into helping our elderly with health care..why are we putting 60% when we are only one country and according to the democrats we have a poor health care system and obama care will cure that..what are these 2 faced politicians talking about?

August 17 2010 at 12:26 PM Report abuse +10 rate up rate down Reply

It sure is fun spending someone elses money isnt it you Democrats. No Im not a republican, I prefer to vote for most qualified and the presidential team we have now are outta control. Hillary proved her money spending when she was just trying to get the nomination. At one point she spent over 10 million when she only had 7 or so million to back it, John McCain still had millions left in the bank.

August 17 2010 at 12:09 PM Report abuse +10 rate up rate down Reply

Enough money has been spent. Americans are down and out and without health insurance. China is the next superpower so let China pay as you go for diplomacy or don't they care.

August 17 2010 at 11:23 AM Report abuse +14 rate up rate down Reply

Not too far from the five-star hotel where Hillary and the feminists were meeting in Beijing, baby girls and boys were being starved to death at Chinese orphanages.

Pictures of this brutality were smuggled out of the country by Human Rights Watch. One showed an emaciated 11-year-old girl tied down to a bed, withering away to nothing. A British film about the problem, The Dying Rooms, showed children tied to wooden toilets, sleeping in their own excrement.

August 17 2010 at 11:17 AM Report abuse +9 rate up rate down Reply

Is there no end to this nonsense? The liberals just go full speed ahead on the most inane ideas I've ever heard. Hillary will lose big time if she runs for President with ideas like these. Americans will not go along with this thing, any more than we have our own national health program. I question her reasoning on this scheme, I really do.

August 17 2010 at 10:43 AM Report abuse +16 rate up rate down Reply

Good to hear that America politicians want to open our collective pocketbook to up our 60% involvement in global health. Meanwhile and continuously our working class, and bearers of the burden, are losing their homes and jobs while being preyed upon by illegal aliens, gangster politicians and street thugs. Oh Dear...was I being politically incorrect again!!!

August 17 2010 at 9:34 AM Report abuse +18 rate up rate down Reply

How is Hillary planning to pay for this?

August 17 2010 at 9:03 AM Report abuse +23 rate up rate down Reply

PLEASE aks Mrs. Clinton to invest in America people first before goin GHI. We can't tell other coutries how to do it, if our citizens are still not healthy. Get real and work on America First!

August 17 2010 at 8:47 AM Report abuse +18 rate up rate down Reply

The issue of state vs. religion and freedom of speech has already become rebellious against the commandment given in the Holy Bible, 'Have the faith of Jesus Christ'.
When the Master healer is disregarded by forcing Health Care on a society, the terms used by the Master healer is not about Big Brother vs. Citizen but rather, Christ vs. anti - christ.
Anyone can read the end and the beginning of the Holy Bible and find out who won by true right. It is writtten, 'It IS finished'.

August 17 2010 at 8:12 AM Report abuse +11 rate up rate down Reply
1 reply to realmality's comment

So ... does this mean that you don't use health care but you pray for health instead? Whoa ...

August 17 2010 at 2:09 PM Report abuse -2 rate up rate down Reply

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