Economist Jeffrey Sachs on President Obama’s Global Health Initiative
Read the entire ‘Global Health Recommendations for a New Administration and Congress’ report here.
Dr. Jeffrey Sachs, author of The End of Poverty, spoke to media in the morning. Here are his comments:
"Thank you very much. Well, I’m really thrilled with this new report on the future of global health. I think it’s enormously important, very well done and I think it will be very helpful for the administration. This is an administration which we all support and we admire and we believe that the global health initiative that this administration is taking up can be truly a historic contribution of the United States to a major challenge.
"And as Representative McDermott has just said, it is an initiative which is very much inline with the values of the American people with the great capacity of the U.S. to contribute to saving lives and improving health and thereby to unlocking economic growth and also helping to stabilize very unstable parts of the world where high mortality rates and high disease burden contribute directly to instability and impoverishment and therefore, to security challenges, as well.
"Now I would like to put this in the context of the millennium development goals, which are another major objective that the Obama administration has taken on front and center. I hope everybody remembers that the millennium development goals were adopted by all of the countries of the world, of course including the United States, in September 2000 with a 15 year interval to achieve very important goals in fighting poverty, hunger and disease.
"And it’s not a coincidence that about half of the millennium development goals are about health because lack of access to lifesaving health interventions constitutes perhaps the cruelest form of poverty overall and the drafters of the millennium development goals, led by (inaudible) and adopted by the world, understood that the fight against poverty was also a fight for the human right to health and as a very practical matter, poverty could not be eliminated if children are constantly infected with worms or are dying of malaria or their mothers and fathers are dying of AIDS for lack of treatment or their mothers are dying in childbirth, leaving orphaned families behind.
"So the millennium development goals are now in their ninth year. Health is actually one of the most important accomplishments of these first nine years. What we’ve seen in the health area and I think this is really the point that needs to be emphasized in thinking about a report like the future of global health is that every time the world has invested in health in poor settings, the results have come through in a spectacular fashion, even better than was expected and often, again, lots of initial opposition that said, "It can’t be done", it turned out, yes, we can. It can be done.
"So malaria is now falling sharply throughout Africa because in the last two and a half years about 200 million bed nets have been distributed. Measles deaths are down by more 90 percent. Millions of people are now kept alive successfully through anti-retroviral treatment and there’s been a significant spread of testing and awareness of the AIDS infection, which is, of course, a predicate to prevention itself because of the expansion of programs like the global fund to fight AIDS, TB and malaria and the U.S. PEPFAR program. Similarly, there has been a massive expansion of new vaccines that have come along because of the work of the Gates Foundation and the global alliance for vaccines and immunizations, GAVI, which the Gates Foundation helped to launch a decade ago.
"So all in all, the scale up of the fight against disease has been a remarkable success as far as we’ve gotten and the point of the global health initiative of the President and of the future of global health, the report being issued today, is that we’ve gotten perhaps one-third of the way that we need to go. In other words, a big increase from what started out at about a tenth of the effort that was needed. We’ve roughly tripled the effort during this nine years since the millennium development goals were established, but we’re roughly one-third of where we need to be in the global help for the poorest places in the world. And very quickly, let me just run through the numbers.
"Several reports, starting with the one that I helped to chair for the World Health Organization in 2000, followed by the UN millennium project report in 2005, followed by the Institute of Medicine report, a recent report called, "The Task Force on Innovative International Financing for Health" and now, today’s report have all come to the same conclusion, which is that if we invest around one-tenth of one percent of our income, one-tenth of one percent of our annual income, that’s 10 cents out of every $100. If the United States does that, if Western Europe does it, if Japan does it and other high income countries, that would create a total pool of funding of roughly $40 billion and that $40 billion would, if properly invested, save six to eight million lives per year and also enabled the world’s population to stabilize through access to family planning services and to contraceptive services. And so we have a remarkable opportunity for 10 cents on the $100 to get this done.
"Where we are right now is that we started at about one cent on the $100, roughly around $3 billion a year. We’ve climbed up to probably around $14 billion per year now, maybe $12 billion to $14 billion. We need to get to between $35 billion and $40 billion and so we’ve gone from one cent per $100 to three cents per $100 and we’re on our way to just 10 cents per $100 would get the job done. And what the administration’s plan calls for is to step up efforts in areas that have not yet been the focus. So right now, there has been a lot of focus on AIDS, TB and malaria through the global fund, through PEPFAR, through the so called PMI, the President’s malaria initiative. There’s been a lot of focus on immunizations through GAVI. There is beginning a focus on the so called neglected tropical diseases, which are various horrible worm infections and other parasitic diseases in the tropics. But there hasn’t, for example been almost any funding at all to keep mothers safe in childbirth or to help neonates, that is newborns in the first 28 days of life, to stay alive and yet, that’s where almost 40 percent, it’s estimated or roughly 40 percent of children under five face the peril of death during the first 28 days.
"So what the administration has recognized is that we need to invest in reproductive health in family planning, in newborn survival, in neglected tropical diseases, in health systems, including what Representative McDermott said in training community health workers, midwives, nurses and so forth who can be trained quickly and make a huge difference.
"Now the point of this report today is that all of these things can be done and indeed, the world’s experts have said, "Yes, yes, yes. Let’s do them." But the funding is not really in place to accomplish what the global health initiative is setting out to do. For the United States, one-tenth of one percent would be about $14 billion to $15 billion a year because our GNP is from $14 trillion to $15 trillion a year right now. For the world, if you combine the other rich countries, that would be, as I said, between $35 billion and $40 billion per year.
"Whatever the U.S. does has to be matched by other countries. This report has figures for the U.S. that are averaging $16 billion a year and climbing over time. I think what’s important to note is that we need more financing, we need the holistic comprehensive approach because all of these different interventions are synergistic, they all build a basic primary health system. We need in the aggregate the United States and other countries to combine to the total of .1 of one percent of the rich world GNP and very importantly, we need a plan to get this done.
"And here’s where I want to end by reminding everybody of a very important speech that President Obama gave on September 23rd to the United Nations’ general assembly. This was, of course, his first speech ever to the assembled leaders of the world. I was in the chamber. It was stunning. The speech was great and the worldwide reception was absolutely dynamic. People were thrilled because the President said, "We’re going to cooperate to solve great global challenges." And one of the statements that he made is the following, he said, "We will support the millennium development goals and approach next year’s summit", which will take place in September 2010, on the MDGs. He said, "We’ll approach next year’s summit with a global plan to make them a reality and we will set our sights on the eradication of extreme poverty in our time."
"So what I would strongly urge the administration is read this wonderful report, take these numbers seriously that come from this report, the IOM, the task force on innovative international financing. They all come to the same point about the scale of need. Gather the rest of the high income world to make a reality this wonderful pledge that the President made that the United States will come to next year’s summit with a global plan to make the MDGs a reality and since the MDGs include maternal health, child survival, the fight against undernourishment, the fight against the specific killer diseases like malaria, AIDS, tuberculosis, the neglected tropical diseases. Since all of that requires a health system to do, today’s report provides crucial guidelines. The numbers are clear. The United States is not far off what it needs to be; we’re doing a good job on the health area. We have to actually build up in other areas, but we still have to stretch in the health area. That’s the message of this report. Good start, some way to go, but all within an absolutely achievable line.
"We certainly should take as a standard that the bonuses to the bankers on Wall Street should not outpace the U.S. aid for the world and the U.S. aid for international health. And yet, that’s what’s been happening. What we need is an effort that is commensurate with our great wealth, our great stakes in the world, our great leadership right now saying that we will achieve all of the millennium development goals and really for the first time, that we’ll have a plan of action, a global plan to make the MDGs a reality.
"So in conclusion, an important report, a very important message, holistic strategy, proper financing, let’s get the U.S. to do it’s part and surely get the U.S. to mobilize the other countries to do their part so we view this as a package deal and we’ll get this job done and the U.S. will make history just the way the American people would like. Just the way we’ve started out, we’re not quite there yet, but we’re getting there and I think this report takes us another step on this incredibly important journey."
