Obama proposes $63 billion global health initiative over six years

President Obama has proposed a $63 billion, six-year global health initiative as part of his fiscal year 2010budget, Reuters reports (Bohan, Reuters, 5/5).

Obama's plan calls for the President's Emergency Plan for AIDS Relief to receive $51 billion over six years to fight HIV, tuberculosis and malaria, while the remaining $12 billion would be directed to other global health issues (Stolberg, New York Times, 5/6). The other issues include pre- and post-natal care and child health initiatives (BBC News, 5/5). Obama's proposal would increase FY 2010 spending on global HIV, TB and malaria to $7.4 billion, $366 million more than this year (New York Times, 5/6).

"We cannot fix every problem," Obama said in a statement, adding, "But we have a responsibility to protect the health of our people, while saving lives, reducing suffering, and supporting the health and dignity of people everywhere" (Elliott, AP/Google.com, 5/6). "We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health," Obama said, citing the H1N1 outbreak as an example (New York Times, 5/6).

The Times reports that the plan represents a "broader global health strategy" than HIV, which was the "centerpiece" of former President George W. Bush's PEPFAR program that is "regarded as one of his most significant achievements" (New York Times, 5/6).

Secretary of State Hillary Clinton said, "Our investments in programs to combat HIV/AIDS, malaria, TB and other preventable diseases save millions of lives, reduce maternal and child mortality, and reflect our nation's leadership as a positive force for progress around the world" (AP/Google.com, 5/6). Clinton added that the new global health initiative will be a "crucial component of American foreign policy and a signature element of smart power" (Telegraph, 5/5). White House Deputy Secretary of State Jack Lew said the Obama administration is expanding efforts to fight "poverty, food insecurity and disease with solutions that will leave behind the tools to sustain long-term progress" (AP/Google.com, 5/6).

Reaction

Critics of the plan said Obama's proposal falls short of a campaign pledge, the AP/Google.com reports (AP/Google.com, 5/6). As a presidential candidate, Obama said that he would expand PEPFAR "by $1 billion a year in new money over the next five years" and that he would provide $50 billion by 2013 to fight HIV/AIDS worldwide. The White House on Tuesday said that Obama would meet the $50 billion goal over six years instead of five, but did not provide specific details. Lew said, "We continue to support PEPFAR. We're saying we want to take what we know works and expand it because we can make a big difference in the world" (New York Times, 5/6). According to the White House, PEPFAR funding constitutes 70% of U.S. global health funding under Obama's proposal (White House statement, 5/5).

"They are expanding the mandate, but not expanding the pie," Paul Zeitz, executive director of the Global AIDS Alliance, said. He added, "To me, [Obama's proposal] is a betrayal of trust" (New York Times, 5/6). Christine Lubinski, director of the Center for Global Health Policy, said the proposal is "worse than we had feared," adding that Obama has "overlooked the growing threat of tuberculosis."

Irish musician Bono released a statement from his advocacy group ONE, praising the increase in funding. "The question is no longer whether we can fight these diseases in the poorest countries, it is how much do we want to do? The president is answering 'a lot'" (AP/Google.com, 5/6).

A transcript of the White House briefing is available online.