IMPACT: A new Global Health Initiative (GHI) Executive Director, Lois Quam, has recently been named. What will be the organizational relationship between USAID's Global Health Bureau and the Executive Director?
AMIE BATSON: Lois sits in the State Department and is reporting to the GHI Operations Committee and the Secretary of State. The Operations Committee is comprised of USAID Administrator Dr. Shah, Director Frieden of the Centers for Disease Control and Prevention (CDC) and Ambassador Goosby of the Office of the U.S. Global AIDS Coordinator. She is facilitating the day-to-day management of GHI as well as the transition of GHI to USAID leadership in September of 2012.
IMPACT: You have worked at the WHO, UNICEF and the World Bank. How have these jobs prepared you for your current role, especially as one of several principles that guides GHI is to strengthen and leverage key multilateral organizations and global health partnerships?
AB: I've worked at UNICEF, WHO and the World Bank. This has helped me in two big ways. One is that I know the skills each of these different agencies bring to the table. We are reaching out to see how we can draw on the World Bank's strength in health system strengthening or in economic development. Second, I've seen how different institutions are structured and seen is that I know the skills each of these different
agencies bring to the table. We are reaching out to see how we can draw on the World Bank's strength in health system strengthening or in economic development. Second, I've seen how different institutions are structured and seen some of what works well, and what doesn't and can bring some of that learning into both the U.S. government, and USAID specifically, to see how we might improve the way we do business.
IMPACT: In addition, your work has been focused on improving health systems through the use of results-based financing mechanisms. How will that inform your work with USAID to make developing countries’ health systems sustainable?
AB: Results-based financing is about looking at health in a different way, one based on outputs not inputs. We focus largely on ensuring that all of the pieces that are required are present – the right number of trained staff , adequate vaccine supplies and the right facilities – but we need to make sure all of these pieces work as effectively as possible to produce outcomes. Results-based financing provides a small incentive at the point of care based on outputs. But it's not an either/or; it's a question of having that additional incentive to unleash the creativity and energy of the health workers to ensure that at the end of the day the whole continuum of care is realized.
IMPACT: What are the long-term implications on improving the health of people in developing countries if Congress reduces funds for foreign aid programs?
AB: With the H.R. 1 [House Appropriations Committee Continuing Resolution] cuts, USAID health funding would drop by 13 percent from the FY10 levels and by 29 percent from our FY11 requests, so it's a very significant decline. More than 70,000 children under 5 will perish – 30,000 from malaria, 24,000 from a lack of basic immunizations and another 16,000 at birth – in the absence of the highly effective support that we are providing in these child survival interventions. These cuts will not be measured in dollars; they will be measured in deaths.
IMPACT: The new Quadrennial Development and Diplomacy Review stated that the GHI will be turned over to USAID only if defined benchmarks are met. This seems to imply that USAID is not currently capable of collaborating sufficiently with other U.S. agencies, assuring accountability for performance and achieving the other benchmarks. Do you agree with that implication?
AB: It's complicated ground, but I think the intention is clear: USAID should be leveraging its development platform to become the leader of GHI by leading inclusively. For example, CDC has extremely strong technical expertise, and that's where we should ensure that CDC has the capacity, the freedom, and the resources to be able to provide those services for our countries, our shared objectives. So these benchmarks, we welcome them. It's an opportunity to have a very clear cut process that shows that USAID is indeed the development platform and that it will be to the betterment of the entire U.S. government for us to take on that role and for the U.S. government to work collectively in a new way.
This interview has been edited for length and clarity.
Watch the full interview between Amie Batson and Marshall Stowell below or directly on YouTube.