U.S. Global Health Initiative GHI Forum with GBC Lois Quam, Executive Director May 17, 2011

U.S. Global Health Initiative U.S. is the world’s leading bilateral provider of global health assistance. Proven record of impressive accomplishments in Global Health o Saved millions of lives through immunization o Reduced infant deaths by making oral rehydration therapy available globally and have helped women plan the number, timing, and spacing of their births. o Helped eradicate smallpox o Reduced polio to the point that is endemic in only a few countries Global Health: The Context

U.S. Global Health Initiative HIV/AIDS o The U.S. directly supported in FY2010: o life-saving antiretroviral treatment for more than 3.2 million men, women and children worldwide o antiretroviral prophylaxis to prevent mother-to-child HIV transmission for more than 600,000 HIV-positive pregnant women, allowing more than 114,000 infants to be born HIV-free o 11 million people with care and support, including nearly 3.8 million orphans and vulnerable children o HIV counseling and testing for nearly 33 million people o U.S. made a multi-year $4 billion commitment to the Global Fund, accompanied by a call for major reforms that would maximize the impact of Global Fund resources Malaria o Reductions of 20 – 30 percent in all childhood deaths (to which malaria is a major contributor) are already being reported from six countries: Ghana, Kenya, Rwanda, Senegal, Tanzania, and Zambia Neglected Tropical Diseases o The U.S. investment of $90 million has resulted in donations of more than $1.3 billion in medicines in the past two years, providing treatment to more than 124 million people Global Health: The Context

U.S. Global Health Initiative Health Needs Are Great More than 2.6 million people are infected with HIV each year, and AIDS is the leading cause of death of women of reproductive age around the world. Malaria kills 800,000 people every year, mostly children under age five, with an estimated 250 million more cases annually. More than 9 million people develop TB every year, and 1.7 million die from this disease. More than a billion people suffer from neglected tropical diseases (NTDs), and 500,000 die every year from these diseases. 358,000 women die annually from largely preventable complications related to pregnancy or childbirth; millions more women suffer often debilitating pregnancy-related injury and infections. 215 million women want to avoid pregnancy but are not using a modern method of contraception, and two-fifths of all pregnancies in the developing world are unintended. 8.1 million children under five die every year, many from easily treatable or vaccine-preventable conditions or malnutrition; 40 percent of them die during their first four weeks of life. 200 million children under age five and 1 out of 3 women in the developing world are undernourished.

U.S. Global Health Initiative GHI – Saving Lives, Promoting Security, Maximizing Results Next chapter in the way U.S. agencies conduct global health activities, building on successful bipartisan leadership in global health Supports countries as they work to improve the health of their people Strengthens health systems, coordinates care instead of working in disease silos

U.S. Global Health Initiative GHI Goals and Targets HIV/AIDS: Support prevention of more than 12 million new infections, care for more than 12 million people, and treatment for more than 4 million people. Child health: Reduce under-five mortality rates by 35 percent in assisted countries. Maternal health: Reduce maternal mortality by 30 percent in assisted countries. Tuberculosis: Treat a minimum of 2.6 million new sputum smear positive TB cases and 57,200 multi-drug resistant cases of TB by Malaria: Reduce the burden of malaria by 50 percent for 450 million people. NTDs: Reduce the prevalence of 7 NTDs by 50 percent among 70 percent of the population affected by NTDs. Family Planning: Prevent 54 million unintended pregnancies. Nutrition: Reduce child undernutrition by 30 percent in food-insecure countries in conjunction with Feed the Future.

U.S. Global Health Initiative GHI Principles Focus on women, girls, and gender equality to improve health outcomes for women and recognize that women are central to the health of families and communities. Support country ownership and invest in country-led plans. Place countries in the leadership position of defining priorities, coordinating assistance, and managing health and development efforts in a spirit of mutual respect. Build sustainability by strengthening health systems. Strengthen and leverage key multilateral organizations, GH partnerships and private sector engagement because improving health outcomes is a shared responsibility. Increase impact through strategic coordination and integration to strengthen health delivery platforms and systems. Improve metrics, monitoring and evaluation. Promote research and innovation to identify what works.

U.S. Global Health Initiative GHI In Action - Examples Bangladesh –Helping Babies Breathe in Bangladesh Ethiopia –Supporting Health Services Closer to Communities in Ethiopia –Backing country-owned strategies and delivery systems Guatemala –Strengthening Nutrition in Guatemala's Highlands Kenya –Improving Health for Kenya's Refugees by Building Laboratory Capacity –One Woman, One Community, Many Gains –Strategic coordination and integration lead to improved health Malawi –Improving Health in Rural Malawi

U.S. Global Health Initiative Moving Ahead Reached out to all countries receiving global health support from the U.S. Implementing GHI Principles in each of the more than 80 countries where the U.S. works Released GHI Strategy on Publically released strategies for 7 GHI Plus Countries Bangladesh Ethiopia Guatemala Kenya Malawi Mali Nepal

U.S. Global Health Initiative Vision for the Future We will focus squarely on achieving our targets and diminish our focus on internal supporting processes. Our targets are ambitious, but achievable. We will focus specifically on country- level discussions about achieving targets rather than more abstract discussions about what can or can’t work. We will focus more externally – “whole of America” approach