Ideas to Action:

Independent research for global prosperity

Publications

 

Health Transition Memo cover
October 28, 2016

First Hundred Days for Global Health

Attention presidential transition teams: The first hundred days of the new administration should kick start an ambitious agenda in global health alongside long-needed reforms to enhance the efficiency and effectiveness of US action. Building on our earlier work, we suggest seven priority actions within three broad categories.

The White House and the World
August 8, 2016

Evolving the US Model of Global Health Engagement

The United States Government has the requisite technical know-how, financial and logistical resources, and bipartisan political support to lead the response to enduring global health challenges, and it is critical that the United States is prepared to meet them. This memo’s six recommendations are the result of a roundtable discussion on how the next administration and Congress can update and improve on the US global health engagement model.

July 20, 2015

Strengthening Incentives for a Sustainable Response to AIDS: A PEPFAR for the AIDS Transition

Remarkable progress has been made in the global fight against HIV/AIDS. The number of people receiving treatment in low- and middle-income countries increased from 300,000 in 2003 to 13.7 million in 2015, including 7 million supported by the United States. These gains are primarily attributable to a 2003 US government initiative called PEPFAR (the President’s Emergency Plan for AIDS Relief) that provided major new multiyear funding for global HIV/AIDS and created a new entity, the Office of the Global AIDS Coordinator, headed by an ambassador-rank Global AIDS Coordinator who is authorized to allocate PEPFAR’s resources and coordinate all US bilateral and multilateral activities on HIV/AIDS.

However, without dramatic changes to PEPFAR, the next president risks being held responsible for the failure of a program that until now has been one of the United States’ proudest foreign assistance achievements. And because PEPFAR is a major component of US foreign assistance spending, the next president’s choices about PEPFAR will heavily influence any subsequent assessments of his or her humanitarian foreign assistance policies.

July 20, 2015

Restructuring US Global Health Programs to Respond to New Challenges and Missed Opportunities

In the absence of effective international institutions, the United States has become the world’s de facto first responder for global health crises such as HIV/AIDS and new threats like Ebola. The US government has the technical know-how, financial and logistical resources, and unparalleled political support to act quickly and save lives. Initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative are widely considered among the most effective aid programs in the world.

Yet US global health approaches are based on increasingly outdated engagement models, which fail to reflect emerging challenges, threats, and financial constraints. The next US president, working closely with Congress, should modernize how US global health programs are organized, deployed, and overseen. By taking three specific steps, the United States can reduce the need for costly first responses and generate more health and economic impact for every US taxpayer dollar spent.

December 16, 2013

Clear Direction for a New Decade: Priorities for PEPFAR and the Next US Global AIDS Coordinator

PEPFAR is at a critical turning point in its decade-long existence. The next US Global AIDS Coordinator is uniquely positioned to set the course for the program’s future. A change in leadership at the President’s Emergency Plan for AIDS Relief creates an opportunity to ask questions about the organization and reflect in more general terms on the US response to the global AIDS epidemic.

January 30, 2012

GHI Mid-Term Review and a Way Forward

As the Global Health Initiative moves into its third year of implementation, Nandini Oomman and Rachel Silverman summarize the current status of this major development initiative, highlight the challenges for the GHI, and propose specific recommendations for a way forward.

November 12, 2007

PEPFAR Reauthorization: Improving Transparency in U.S. Funding for HIV/AIDS

The President's Emergency Plan for AIDS Relief (PEPFAR) provides more than $5 billion per year to prevent and treat HIV/AIDS. Exactly how is that money spent? Donors, recipients, and even PEPFAR staff are often left guessing, because much of the extensive data the U.S. government collects on the program isn't released. In this new CGD note, Michael Bernstein and Sarah Jane Staats (Hise) urge the U.S. Congress to require that PEPFAR regularly release this data. They argue that this would improve coordination between PEPFAR and other donors, help PEPFAR staff assess progress and hold recipients accountable, and increase cost-effectiveness. Some of the data will soon be available anyway: CGD's HIV/AIDS Monitor is preparing to release PEPFAR funding data for Fiscal Years 2004-2006 obtained by a partner organization through a Freedom of Information Act request.

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Michael Bernstein and Sarah Jane Staats (Hise)