Taking root; a GHI progress report

WASHINGTON, D.C, — Here at the annual Global Health Council Conference Lois Quam, Executive Director of the Obama administration’s Global Health Initiative (GHI), spoke of the accomplishments of the ambitious effort to improve delivery of health care for the world’s poorest.

Two years after it was launched, GHI has stumbled to a start and received some criticism by health care experts and officials. But in her presentation Quam defended the program even if her panel was met with some hard questions.

In her presentation, she emphasized that GHI had built on a strong foundation already in place through previous initiatives such as PEPFAR and the President’s Malaria Initiative (PMI), but was founded on the idea that much more could be done. 

“GHI was designed to add tremendous momentum to save more lives,” said Quam.

Last year at this conference, the GHI announced their eight GHI plus countries. These countries are Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda. Today, Quam, along with Lee Brudvig, the Deputy Chief of Mission in Kenya, and Jennifer Klein, Special Advisor, for the Office of Global Health Women’s Issues, would talk about the strategies that GHI had implemented in those countries. Over 200 people crammed into the conference room to hear the results. 

Quam said, “Each country has taken the targets and principles and crafted a country specific strategy,” said Quam, as she explained the progress that the countries had made. According to Quam, these countries can now act as mentors to the 20 “Round 2” countries that have been selected to advance the GHI’s principles. “GHI has taken root.” 

Quam explained that results could be seen in countries such as Mali where GHI’s efforts were being consolidated. In Mali, GHI had invited US agencies such as USAID to work closely with the government to reexamine their strategy.

In Bangladesh, GHI had simplified curriculum for infant care in conjunction with organizations such as the American Academy of Pediatrics and Save the Children. 

In Ethiopia, GHI had worked to train skilled birth attendants, working to raise the amount of births in trained facilities. 

However, what the panel lacked were the concrete specifics that showed GHI's progress in each country.

Toward the end of the panel the floor was opened up for questions. 

“What we’re seeing are outputs, not outcomes” complained Sallie Craig Huber, from Management Sciences for Health. 

She asked to see some specific outcomes in each of the countries, but her question was never completely addressed. Huber wanted to see the health impact of the output results. 

“Stop showing us how much contraception usage has grown considerably,” she argued. “Instead, let us know if we reduced fertility. That’s much more valuable.” 

Earlier today, at the conference’s plenary, Liberia’s Minister of Health had asked if donors would fund a country’s specific plans for global health. At this panel, the same idea was echoed through many of the questions. Is the GHI doing enough to ensure that countries had ownership over their health programs?

“I came to receive an overview of GHI,” said Rick Santos, President and Chief Executive Officer at IMA Health. He agreed that got an adequate overview. “But the local ownership?” he asked. “That issue was sidestepped.” 

Next year, said Quam, she hopes that the GHI panel at the Global Health Council Conference would be more like a virtual town hall meeting. She hopes that instead of a status report from her about what is occurring in each country, each country can present some of the progress they have made themselves. They would close, she hoped, by sharing what each of them had learned. Meanwhile, it looks like it falls upon Quam herself to answer the hard questions.