Right now, the United States has a rare opportunity to stem or eradicate some of the world's most common and fatal health threats. However, as with most opportunities, we have a small amount of time to leverage it effectively.
President Obama's Global Health Initiative (GHI) has the potential to save lives and improve the health and rights of women globally. It is the first comprehensive U.S. policy approach to global health that recognizes that our greatest plagues -- HIV/AIDS, maternal and infant mortality, and poor sexual and reproductive health -- are all interconnected, and they are all preventable. Now the Administration and Congress need to develop the policies and provide the funding that will make it work.
The GHI has a number of strengths right out of the gate. It is the first government-sponsored initiative that promotes a woman-centered approach to policy and programming. With half a million women dying each year from pregnancy-related causes, and HIV/AIDS the leading cause of death for women of reproductive age (15-44), a woman-centered approach is relevant and necessary. It does not ignore or diminish the health needs of men and boys, but rather recognizes and addresses the disparate needs and conditions of women. It's a stellar, surprising and refreshing start.
There are, however, some things the GHI needs if we are truly going to get ahead of something as devastating as HIV/AIDS. In the midst of a domestic budget freeze, the GHI absolutely needs additional funding. By 2011, annual funding needs to double from $8 billion to $16 billion. It would mean an additional 35 million women would have a skilled attendant present during birth, 10 million more couples would have access to family planning, and 370 million adolescents would get comprehensive sexuality education.
Realistically, a budget increase will be difficult. However, with or without additional funding, the GHI still needs to be leveraged to achieve all of its possible potential. To do that, all GHI policy and programming needs to be human rights-based and integrated. "Integrated" means recognizing that HIV/AIDS and reproductive health care are intrinsically linked, and they need to be addressed accordingly. Anyone, woman or man, accessing HIV treatment must also have access to voluntary family planning and other reproductive health services, such as cancer screening and treatment and safe abortion services. For any HIV/AIDS or reproductive health program to be effective, integration has to be a guiding principle.
"Human rights-based" means that absolutely everyone can access high-quality health services and programs at any time, and do so free from discrimination, coercion, and violence. This includes marginalized groups -- sex workers, men who have sex with men, intravenous drug users, and LGBT individuals. In turn, that means that policies that incidentally block a person's access to health care -- such as the antiprostitution loyalty oath -- need to be repealed. And that a woman living with HIV has the right to decide when and whether or not to have a child, and access to the information and services needed to make a voluntary and informed decision.
The GHI could catalyze the tipping point of multiple pandemics. A woman-centered, human-rights based approach, integrated services and programming, and adequate funding comprise the fulcrum. The GHI presents an opportunity that is significant, brief and delicate. We need to make sure that the Administration and Congress recognize its gravitasse and respond accordingly.