USAID Administrator Rajiv Shah on Tuesday delivered a speech at the National Institutes of Health (NIH) where he reaffirmed President Barack Obama’s commitment to the 6-year $63 billion Global Health Initiative (GHI) and discussed the USAID’s role in bolstering U.S. global health programs, CIDRAP News reports. During his speech, Shah emphasized the administration’s focus on structuring global health programs to be more cost efficient. “Some of the administration’s themes are improving health delivery efficiency at the country level by encouraging local leadership and to build more efficiency into existing programs, such as the President’s Emergency Plan for AIDS Relief (PEPFAR),” the news service writes (Schnirring, 2/15).

“NIH represents one of America’s core competitive advantages: advancing science, technology and innovation aimed directly at improving human welfare,” Shah said, according to a USAID press release. “If we can target the freed resources provided by GHI toward the expansion of new scientific breakthroughs, I believe by 2016, we can: save the lives of over 3 million children; prevent more than 12 million HIV infections; avert 700,000 malaria deaths; ensure nearly 200,000 pregnant women can safely give birth; prevent 54 million unintended pregnancies; cure 2.4 million people infected with TB,” Shah said, according to the release.

However, he stressed, “We cannot simply seek to do more of the same in an effort to provide services using currently available tools and technologies. Instead, we need to focus our efforts on facilitating a continuum of invention and innovation from bench to bush” (2/15). Shah noted the promise of new technologies to improve TB and malaria testing and develop new insecticides, vaccines and gel-based microbicides, according to CIDRAP News. He also spoke of the role of community health workers in bringing such diagnostics and interventions to patients.

To facilitate efforts to developing tools for global health issues, Shah announced “we will unveil a series of scientific and technical challenge grant programs designed to focus the community on inventing the breakthroughs that can truly span the last mile,” according to the USAID release. Additionally, “[t]o keep us all focused on whether we really are changing the field of global health, we will release an annual accountability review of global health technology, detailing product introduction and adoption, and identifying areas where we can accelerate progress,” he said (2/15).

Inter Press Service notes that during the speech, “Shah stressed repeatedly that without the sustained commitment of donors, the implementation of existing and state-of-the-art technology – particularly in rural areas – and a determination on the part of the global health network to deal effectively with epidemics, … the shining platform on which the GHI was erected will remain eroded.” The article describes some concerns expressed by global health advocates over whether the U.S. funding for the GHI is enough to continue the progress in tackling global health issues, including the HIV/AIDS efforts that initiated with PEPFAR.

“Our biggest problem with GHI is the lack of a needs-based analysis of the problems in global health. An effective, needs-based Global Health Initiative would require doubling U.S. aid for global health in 2011, and it would challenge other donors to scale up investments,” said Carol Bergman, deputy director of advocacy for the Global AIDS Alliance, according to IPS (D’Almeida, 2/15).