GLOBAL HEALTH INITIATIVE: PROMOTING GREATER AWARENESS AND

UNCLAS STATE 125761 FOR CHIEFS OF MISSION, DEPUTY CHIEFS OF MISSION AND HEALTH TEAM LEADS E.O.: 12958 TAGS: EAID KHIV KWMN KOCI SUBJECT: GLOBAL HEALTH INITIATIVE: PROMOTING GREATER AWARENESS AND PARTICIPATION -------------- SUMMARY -------------- ¶1. SUMMARY This is an action request. See Paragraph ¶10. Earlier this year President Obama announced the launch of the Global Health Initiative (GHI),a six-year, $63 billion interagency effort of the U.S. government to support partner countries in improving and expanding access to health services. The Presidents global health agenda is an ambitious one. The GHI builds on past successes in U.S. global health assistance by making significant new investments in health programs and leveraging the full range of U.S. assets in support of a long-term strategic approach to global health. The GHI includes a prominent global leadership role for the U.S., encompassing both a robust bilateral program and a concerted and deliberate effort to work together with the international community to advance common global health objectives. The GHI seeks to improve specific health outcomes through activities that are guided by the following principles: i)adopt a women and girl-centered approach to health and gender equity; ii) increase impact through strategic integration and coordination; iii) strengthen and leverage multilateral institutions; iv) encourage country ownership and invest in country-led plans; v) build sustainability through health systems strengthening; vi) improve metrics, monitoring and evaluation; and vii) promote research, development and innovation. The Department solicits feedback on the goals and principles of the Initiative, further described in paragraphs 7-9. END SUMMARY ¶2. The Presidents launch of the GHI emphasized the commitment of the United States to a comprehensive global health strategy that continues historically strong support for fighting infectious diseases while expanding efforts to strengthen health systems, improve child and maternal health and family planning, and promote better integration and alignment of global health programs. More information on the Global Health Initiative can be found at: http://www.whitehouse.gov/the_press_office/St atement-bythe- President-on-Global-Health-Initiative/. -------------- ENCOURAGING PARTICIPATION IN THE GHI PROCESS -------------- ¶3. Field-based health personnel have already begun to work with colleagues from State, USAID, HHS, DoD and �00A;other agencies in planning the GHI strategy and implementation. We are seeking additional input and suggestions to help shape and inform the Initiatives development. This cable solicits feedback on the Initiatives goals and principles described in Paragraphs 7 - 9. Future cables will solicit feedback on the draft GHI strategy and on plans for implementation. ¶4. The GHI builds on the successes and lessons learned from PEPFAR, PMI, Stop TB, Stop Polio and other global health programs. Inputs based on experiences with these programs are critical to planning the GHI. Posts are requested to draw on the material contained in this cable to inform USG staff about the goals and principles of the GHI. ¶5. The following five working groups, under the guidance of a Steering Committee, have shaped and designed aspects of the GHI: a) Maternal and Child Health, Family Planning and Nutrition; b) Integration and Coordination; c) Health System Strengthening; d) Infectious Diseases; and e) Metrics, Monitoring and Evaluation, Research and Innovation. These working groups have already begun to solicit feedback from the field, and include among their membership field personnel. The purpose of this cable is to establish a broader mechanism for information and engagement with Posts. Post engagement, whether as individuals, officers or interagency teams, is essential to the strategy and implementation planning process. ¶6. Additionally, a series of outreach meetings recently took place in Washington D.C. to solicit feedback from civil society, philanthropic organizations, multilateral institutions and academic and foundation leaders. The working groups and Steering Committee are also pursuing international outreach efforts in tandem with international health events. For example, a GHI team held consultative meetings and engaged in a helpful series of discussions with international attendees at the recent Global Fund Board meeting in Ethiopia. The Department welcomes input regarding other such opportunities, and Posts will be informed when in-country outreach meetings are planned. Posts are also invited to seek opportunities to discuss GHI goals and principles with partners and in-country colleagues. -------------- Approach of the Global Health Initiative -------------- ¶7. The Global Health Initiative strategy is being developed through a consultative process within the U.S. government and with the global community and other stakeholders, including foundations, universities, nongovernmental organizations, and the private sector. It will include both specific targets to be reached by 2015 and a longer term vision for the next ten years and beyond. Broadly stated, the goals of the Initiative are to improve health outcomes and access while increasing sustainability by improving and expanding country capacity to implement and manage health services. These goals will be achieved by better integrating U.S. government health programs, increasing alignment with country-led and defined priorities, systems and procedures, and engaging more deeply with the donor community and multilaterals to address the health needs of the worlds poor. ¶8. In addition to these broad goals, the Presidents announcement last May identified four specific areas on which the Global Health Initiative will focus: --Prevent millions of new HIV infections; --Reduce mortality of mothers and children under five, saving millions of lives; --Avert millions of unintended pregnancies; and --Eliminate some neglected tropical diseases. -------------- Principles of the Global Health Initiative -------------- ¶9. The United States believes that the principles summarized below should guide the GHIs comprehensive approach to global health. It is expected that a focus on these principles will enable U.S. global health programs to contribute to a greater impact on health outcomes by making them more effective, efficient and sustainable. The USG intends to engage the global health community on these principles and to apply them to all USG global health programs, as appropriate, irrespective of funding levels. ¶A. Adopt a Women and Girl-Centered Approach to Health and Gender Equity Evidence has repeatedly shown that women are the gateway to healthy families and key to achieving long-term development goals. Central to the GHI are long-term, systemic changes in the way health programs respond to and incorporate the needs, perspectives and abilities of women and girls, as well as funding increases in programs that are geared towards women and girls, including maternal and child health, family planning, and nutrition. A woman-centered approach takes into account the realities of womens and girls lives as shaped by gender norms, service availability, and larger structural factors. Working with men and boys will be important to achieving these goals. ¶B. Increase Impact through Strategic Integration and Coordination The U.S. government has achieved significant success with disease- and issue-specific initiatives and programs. Under the GHI these efforts will be planned, programmed and implemented in a more holistic manner, taking into account the multiple health and development needs faced by governments and people. The GHI will foster integration where effective and efficient. It will also improve coordination among existing USG health agencies and programs, as well as with other USG development programs outside of health (e.g., food security, basic education, etc.) and with public and private donors and partners. ¶C. Strengthen and Leverage Key Multilateral Institutions The GHI recognizes the critical role multilateral institutions and strategic global partners play in achieving health outcomes. The United States will expand its engagement with key multilateral institutions and global health partnerships to develop a comprehensive approach to defining and achieving health outcomes, maximizing and coordinating investments, and evaluating programs and ensuring accountability. ¶D. Encourage Country Ownership and Invest in Country-led Plans The United States will partner with each countrys government, civil society and private sector to ensure that countries are at the center of development, implementation, management, decision-making and leadership of programs. GHI programs and activities will support country-led health and development plans. In countries without existing plans, the GHI will work with governments and other partners to develop strategies targeting each countrys specific needs. Working with other donors and multilateral organizations, the GHI will encourage country ownership and will develop long-term partner country capacity to provide essential health services, with particular attention to the poor and underserved, and with overall guidance and management of the health system provided by the country government. The GHI will mobilize complementary resources from the private sector to achieve the goals of the GHI. ¶E. Build Sustainability through Health System Strengthening There has been substantial global progress in reducing under-five mortality; addressing the burden of HIV/AIDS, TB and malaria; and reducing the unmet need for family planning. Further progress on health impact requires a focus on sustainability. The United States recognizes that achieving sustainable health impact requires country commitment to health systems that extend access, increase equity and ensure quality health services. To this end, the GHI will help countries make measurable improvements in the six building blocks of health systems: service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance. The GHI will also support improvements in partner government capacity to plan, manage, and finance their health systems, key factors related to sustainability. ¶F. Improve Metrics, Monitoring and Evaluation Programs must be continually and effectively monitored and evaluated to ensure accountability and measurable results. The GHI will identify or, when necessary, develop indicators, data sources and measurement techniques to assess outcomes and progress related to the GHI and its principles and to link that progress to higher-level health goals. The GHI will also work with multilateral partners to harmonize indicators and will review processes to reduce reporting burdens on countries and field teams. ¶G. Promote Research, Development and Innovation Research and innovation under the GHI will directly address important questions that are immediately relevant to both the GHI and partner country goals and objectives. The GHI will strengthen institutional capacity and expertise in research and innovation to support country ownership and sustainability and to promote data use, analysis and evidence-based decision-making. -------------- ACTION REQUEST -------------- ¶10. Posts are requested to draw on the material contained in this cable to inform USG staff about the goals and principles of the Global Health Initiative. Posts should send comments on these goals and principles and, to the extent available, examples of best practices, lessons learned, and opportunities relevant to the GHI. These comments and inputs should be directed to Chris Bonner [BonnerCH@state.gov] by December 15. CLINTON