Posts Tagged ‘aid’

Tina Fey, make up artists and $150,000 on a new wardrobe. Amidst the gags and sketches that are admittedly largely directed at the Sarah ‘the Pitbull’ Palin, it’s easy to forget that next week’s US Presidential election will have a profound impact on the whole world, not just those with the right (if not the will) to vote. Undeniably, the outcome will have a significant influence in shaping the global health agenda for the next four years.

At first glance, both candidates have a tough act to follow. The Bush administration has committed unprecedented sums of money to tackle HIV/AIDS, malaria and even neglected tropical diseases through PEPFAR, the President’s Malaria Initiative and the President’s Initiative to Combat Neglected Tropical Diseases.

Dig a little deeper and the picture is not quite so impressive. Despite committing more than $49 billion to combat these diseases over the next five years, the US contribution to Official Development Assistance (ODA) at 0.16% of GNI still falls woefully short of the 0.7% target agreed with other OECD nations. Moreover, many believe that the $18.8 billion spent by PEPFAR to date has been undermined by an insistence of placing the emphasis on treatment over prevention, circumventing the Global Fund for a large proportion of funding and for putting ideology ahead of evidence-based practices (at least 33% of funds committed to HIV prevention programmes must be allocated to abstinence only programmes).

Despite these criticisms, PEPFAR has expanded (or more accurately, contributed to the expansion of) antiretroviral treatment for HIV infected people to cover almost 2 million people, and the Bush administration would have you believe that George Bush’s contribution to global health and Africa will be his most noteworthy legacy.

So how do John McCain and Barack Obama fare when it comes to global health? Well, their policies are analysed at Health 08 and by the ONE campaign, but to sum up: John McCain = more of the same, Barack Obama = double the commitment and no ideological restrictions. On paper, at least, there is one clear winner when it comes to global health…

Either way, the contributions that both candidates would make to global health, if elected, will dwarf those made by the rest of the world. Such is the size of the US economy, that even when they are not being generous (relatively), the Americans are being very generous indeed (absolutely). The incumbent President will also take the helm at a critical juncture, on the back of renewed optimism in the global health community, but in the middle of a global financial crisis that will not only increase pressure to make domestic issues a priority but also threatens to increase the risk of malnutrition as food prices and oil prices continue to rise.

But one question remains. What would the Pitbull do, if she were President?