Healthcare scheme in the US raises doubts and questions

A senior US State Department official said they are preparing to finalize some of those compacts by early December, and that countries are really excited about what this opportunity presents. Health experts say American health strategy is risky.

Health experts are warning that the Trump administration’s new “America First Global Health Strategy” could further damage public health systems already reeling from billions of dollars in foreign aid cuts following the destruction of the US Agency for International Development (USAID), and while some say the new system could bring benefits, there is agreement it marks a radical change in approach from decades of US policy, reports CNN.

Under the new strategy, touted as an ambitious overhaul of the way the US provides health assistance throughout the world, American aid will be funneled through a new system of one-on-one agreements with individual countries, rather than distributed through international aid partners and organizations.

The stated goal is to have recipient countries further develop their own health systems – and the US decrease its assistance spending.

The strategy calls for bilateral agreements to be completed by December 31 for countries that receive the vast majority of US health foreign assistance. A senior State Department official said they are preparing to finalize some of those compacts by early December, and that countries are “really excited about what this opportunity presents.”

On Tuesday, as part of the strategy, the State Department announced an agreement to provide “up to $150 million” to an American drone company “to expand access to life-saving medical supplies, including blood and medicines,” in five African nations.

The strategy’s core argument is that US global health aid was often duplicative and inefficient, with significant overhead costs, including money spent on technical assistance and program management. It also criticizes high overhead costs, including high CEO pay, for some of the contracting companies called “implementing partners” that carry out US foreign aid projects. However, some experts note that some of those activities are crucial to global health work.

Although remaining projects have been allowed to continue, they have had to do so within tighter guidelines and with fewer resources, and, even recently, service disruptions in some areas continue, including for HIV treatment and malaria commodities. Other services have been discontinued altogether, including many HIV prevention activities and much maternal and child health programming, which not only have direct impacts in those areas but also could carry broader implications for reaching the goals stated in the America First Global Health Strategy. For example, malaria goals could be compromised in the absence of a broader maternal and child health platform.