The Future of Aid for Health: Yesterday, I gave a keynote speech at the World Innovation Summit for Health on “The Future of Aid for Health”. When I agreed to give the speech, which built on the work of a Commission I chaired several years ago on Global Health 2035, I did not imagine the degree of uncertainty that the US election would bring to the global health area and indeed to the global community.
We are in uncharted territory. No one can know what the attitude of the new US administration will be to funding foreign assistance of any kind or to global cooperation in the health area. Certainly an “America first” strategy is not highly propitious. Global health has been an area of bipartisan cooperation with major initiatives launched during both Democratic and Republican administrations and has some Congressional champions in both parties so perhaps things will work out.
Rather than dwelling on political uncertainties I could not dispel, I chose to concentrate on something that should be a priority for those concerned with reducing premature death around the world, for those looking to foreign assistance as forward defense of US interests, and to those primarily interested in reducing budgets—assuring the optimal allocation of aid resources.
My argument was simple. The world needs to move decisively away from the current regime where 80 percent of health assistance is devoted to supporting national health care delivery and only 20 percent is devoted to global service delivery towards a model where half of assistance is devoted to global goods. …
While I have often disagreed with particular judgments or been distressed that political considerations sometime carried the day my experience in policymaking in the United States and at the international level is that reason has always had its day in court and usually carried the day.
I desperately hope this tradition continues. But when the President of the United States is someone who believes that vaccines cause autism, that Barack Obama was born in Kenya, and that global climate change is a hoax, I am far from certain how decisions will be made going forward.