The Obama administration made some quiet changes this week that strengthen one of its most significant policy shifts: that global health and foreign assistance are critical components of diplomacy. On Tuesday, administration officials announced the creation of the Office of Global Health Diplomacy. It will implement the principles of the Global Health Initiative that make economic and humanitarian sense, namely a woman-centered approach, country ownership, and health sector integration. The GHI's principles have the potential to make real progress against the world's greatest health challenges, and we have to pay meticulous attention to ensuring they are put into action.
We have already seen the benefits of the GHI principles in some of its target countries.
Last week, the Center for Health and Gender Equity (CHANGE) released two reports examining progress of GHI in Ethiopia and Guatemala, with a third report on Nigeria to be issued by the end of the year. The reports find that GHI's key principles of a focus on women and girls and health sector integration are already making a positive difference.
For example, in Guatemala, the GHI country strategy demonstrates a keen awareness of the discrimination that prevents indigenous women from accessing maternal health and family planning programs. In Ethiopia, where health sector integration predates the GHI, the GHI has opened the door for more emphasis on women's health and rights.
GHI is also exposing program weaknesses that will hinder U.S. development efforts without proper attention, namely if they are not restructured to align with key GHI principles. While USAID in Guatemala has made progress in integration of maternal health and family planning programs, they have not integrated HIV prevention into those programs. The U.S. HIV prevention efforts in Guatemala focus on migrant workers, but not on their partners. Low-cost HIV prevention could be integrated into existing family planning and maternal health programs to reach many of these women.
Guatemala's GHI Country Strategy also does not include a plan to address its rate of adolescent pregnancy, which is the highest in the region. Yet in 2011, 21 infants were born to 10-year-olds. Girls under the age of 15 whose bodies are not prepared for childbirth are more likely to die as a result. GHI targets on maternal mortality won't be reached without an honest, multi-sector approach to this issue.
In Ethiopia, many U.S. partners target adolescents, but many young people reached still do not receive information about and access to female and male condoms to prevent unintended pregnancy and HIV transmission. Ethiopia's GHI country strategy does not detail a plan to combat early marriage -- which U.S. officials acknowledge as a serious threat to adolescent girls' health in Ethiopia.
Full and sustained implementation of GHI's principles is the best way to ensure that U.S. global health programs make a real, measurable difference in the lives of those served by U.S. foreign assistance, and that U.S. dollars are spent effectively. We've seen that its principles have a positive impact that resonates with the efforts of other donors and civil society working in these countries. The Office of Global Health Diplomacy is the first step toward expanding that impact.
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