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Views from the Center

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More Health Workers, Yes. But Only Within Better Systems

*This post is co-authored by Ruth Levine
In the Washington Post today, three doctors with sterling reputations in the AIDS world (Lola Daré, executive secretary of the African Council for Sustainable Health Development International and a member of CGD's working group on IMF programs and health spending; Paul Farmer, pioneer of new AIDS treatment programs in Haiti and Rwanda; and chief of Harvard Medical School's Department of Social Medicine Jim Kim, a member of CGD's working group on the Global Fund), call on the Bush Administration to spend $8 billion on training of community workers, nurses and doctors in Africa to deal with AIDS treatment.
Their proposition that many more community-level health workers be deployed to provide essential services, breaking the implicit and costly monopoly of health "professionals" on health delivery, makes eminent sense. But more money for training, without complementary institutional changes that fundamentally alter the incentives for workers at all levels, won't get the outcomes sought by those who are working on AIDS, or any other health challenges.

Airline Tax Proposal Falls Short

President Chirac's proposal for a global air travel ticket tax to fund development appeared to be gaining momentum last week, with an announcement at the Clinton Global Initiative meeting in New York that four countries had joined the French-led initiative. One important question--how the money will be used--has been answered. Ninety percent will go to buy AIDS drugs. But plans for administering the funds are unlikely to persuade American taxpayers--or the U.S. government--to support the plan.

Transformational Diplomacy or Tweaking?

Steve Krasner, Director of Policy Planning Staff at the Department of State, spoke on Transformational Diplomacy on Friday before a standing-room-only crowd at a CGD event (transcript) He argued that the creation of a new Deputy for Development in the State Department reporting directly to the Secretary of State Condoleezza Rice, announced the day before, would strengthen not weaken USAID and thus the effectiveness of U.S. foreign aid programs.