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

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SUMMARY
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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/.


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ENCOURAGING PARTICIPATION IN THE GHI PROCESS
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3. Field-based health personnel have already begun to
work with colleagues from State, USAID, HHS, DoD and
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.

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Approach of the Global Health Initiative
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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.

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Principles of the Global Health Initiative
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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.

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ACTION REQUEST
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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