Secretary Clinton on the Global Health Initiative and “Filling the Gaps” on the MDGs

Secretary Clinton gave a big speech at Johns Hopkins University on the Obama administration’s Global Health Initiative yesterday. The GHI, as it is known, is a six year, $63 billion plan to improve public health in the developing world. The program builds on some George W. Bush administration successes, like PEPFAR and the President’s Malaria Initiative,  to support partner country efforts at building capacity in their public health sectors. 

Overall,  I thought the speech was an excellent demonstration of top-level American committment to the kinds of issues that have the potential to save millions of lives around the world, strengthen America’s image abroad, and make the planet a better, safer place for everyone.  What struck me about the speech, though, was the timing. The Global Health Initiative was introduced in detail back in February and Secretary Clinton’s remarks contained no new “news” about GHI. If the speech was not intended to make any new announcements, I at least expected to hear the Secretary discuss the upcoming UN summit on the MDGs. Alas her prepared remarks made no mention of the summit or the MDGs. The only time it came up is when a student asked her about it:

QUESTION: Madam Secretary, I’m Sam Christophe (ph). I’m a student here at SAIS. My question is about the relationship between the health initiative and the MDGs. Obviously, health is an important part of the Millennium Development Goals, sorry MDGs – I think three, four, and five or four, five, and six. A number of the targets under the initiative, while they are ambitious, even if they’re achieved, I think it’s by 2014, will still fall well short of the MDGs. I just wonder – I mean, do you see the MDGs as no longer achievable, and I mean, if you do, what sort of outcomes will you be looking for from the summit next month in New York? Thanks.

SECRETARY CLINTON: Well, I certainly do see the MDGs as achievable, but I also see their achievement as taking longer than any of us would have hoped for when they were first adopted back in 2000. I’m looking forward to the summit during the United Nations General Assembly in September. I’ve agreed to participate because what we’re doing is continuing on the path toward the Millennium Development Goals. But we are also taking stock, and we’ve met with the UN officials responsible for the summit and the work on behalf of the MDGs through the various UN organs, to ask that everybody take stock. We all have to ask ourselves where we’ve made progress and why, where we’ve fallen short and why, what can we do to try to fill the gap as we continue on the path toward achieving the goals that were set for it.

I am sensing a much greater openness to accountability, to measurement. It’s not enough just to care a lot and go out and try to do good; that is a sine qua non of making it happen. But you have to be willing to ask yourself how much good am I really doing and am I doing it in a way that’s likely to maximize progress toward the MDGs or other goals that have been set.

So I think we can say that the picture in 2010, 10 years after, is a mixed one. I think we can take some pleasure and pride in the progress that has been made. Child mortality is down, for example. There are some positive milestones that have been reached on the way to the goals. But we have a long way to go, and we hope to use the UN process in September as a forum for bringing a lot of the multilateral organizations and the country donors together to have this very frank discussion.

Raj Shah has started this extraordinary effort in USAID to really maximize use of science and technology in tackling and solving global development challenges, and we’ve got some great ideas. In the United States, we’ll be working to implement them, but we want to spark this kind of effort worldwide. We think that technology can make a big difference in collecting and disseminating information that will help us better educate people about what they can do for themselves. So I think that we see the glass half full, but it’s got a long way to go till it gets to the top. But we are absolutely committed to the MDG process and to the eventual achievement of them.

The GHI featured prominently in USAID’s MDG strategy document, so it is good to see the USA’s top diplomat asking the right questions about how to achieve the MDGs.  The concept of “filling the gap” in achieving the MDGs is something that you also hear from UN officials and in UN documents. 

It should also be said that among these gaps, the biggest so far has been in maternal health and maternal mortality (Goal 5)  so it was encouraging to hear Secretary Clinton candidly explain how the GHI will promote reproductive health and family planning: 

And we are scaling up our work in family planning and maternal and child health—areas in which the United States can and must lead. Every year, hundreds of thousands of women die from complications related to pregnancy or childbirth, nearly all of them in the developing world, and for every one woman who dies, 20 more suffer debilitating injuries or infections. And every year, millions of children in the developing world die from wholly preventable causes.

Saving the lives of women and children requires a range of care, from improving nutrition to training birth attendants who can help women give birth safely. It also requires increased access to family planning. Family planning represents one of the most cost-effective public health interventions available in the world today. It prevents both maternal and child deaths by helping women space their births and bear children during their healthiest years. And it reduces the deaths of women from unsafe abortions.

The United States was once at the forefront of developing and delivering successful family planning programs. But in recent years, we have fallen behind. With the Global Health Initiative, we are making up for lost time.

Here is here speech: