The Cable

Development community upset over future of Global Health Initiative

The Obama administration quietly announced this week that it is scrapping the office of the Global Health Initiative and abandoning plans to move the whole project over to USAID, creating anger and frustration in the non-government organization community.

Following what administration sources described as a knock-down drag-out interagency fight between USAID and CDC over whether the Global Health Initiative, a huge $63 billion project to help the world's poorest announced by President Barack Obama in 2009, would actually be moved to USAID as promised in the State Department's Quadrennial Diplomacy and Development Review (QDDR), the administration has decided to forgo what the QDDR directed and stop trying to consolidate the leadership of the multi-billion dollar program at USAID.

"As a result of our analysis and conclusions, we have made a collective recommendation to close the QDDR benchmark process and shift our focus from leadership within the U.S. Government to global leadership by the U.S. Government. This recommendation has been accepted," read a July 3 blog post by USAID Administrator Rajiv Shah, Ambassador Eric Goosby, Director Thomas Frieden, and Executive Director Lois Quam.

"At the State Department, the GHI Office (S/GHI) will close and the Office of Global Health Diplomacy (S/GHD) will be stood up. Unlike S/GHI's focus on interagency coordination, the S/GHD office's mandate will be to champion the priorities and policies of GHI in the diplomatic arena.... Global Health Initiative will continue as the priority global health initiative of the U.S. Government.... GHI country teams and GHI planning leads will continue to work to implement GHI strategies under the leadership of the U.S. Ambassador."

The Modernizing Foreign Assistance Network (MFAN), an umbrella group representing development organizations co-chaired by David Beckmann, George Ingram and Jim Kolbe, today issued a harsh criticism of the administration's decision. 

"The Obama Administration unfortunately yielded to inertia and interagency turf battles in deciding not to move leadership of the Global Health Initiative (GHI), America's largest development program, to the United States Agency for International Development (USAID), our premier development agency," MFAN wrote. "We are concerned that our partners on the ground will continue to be confused about global health leadership and coordination, which will hamper efforts to effectively transition ownership of development programs to recipient countries.... Viewed through these lenses, the Administration may have undermined its own landmark efforts to increase development effectiveness and accountability."

Development experts Amanda Glassman and Rachel Silverman wrote about the backstory in a blog post on the website of the Center for Global Development. They said the administration has dramatically scaled back its ambitions for GHI by deciding not to consolidate its leadership at USAID.

"The news is deeply disappointing and frustrating on a number of levels. The announcement reflects a breakdown of the inter-agency process. It demonstrates a continued lack of political will to address the hard questions that hamper integration, particularly separate earmarked funding streams and parallel, competing institutions within the U.S. government that had different strategies and relationships with recipient country governments," they wrote. "The bottom line: GHI 1.0 failed on the hard questions, and GHI 2.0 isn't even trying."

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