IHSJ Issue: Funding for Global Health

The Institute for Health and Social Justice (IHSJ) plays an active role in advocating for the advancement of policies and programs that foster a preferential health care option for the poor. Central to our mission is the knowledge that we must hold the health of all people as equal, and work to insure that disparities are addressed and eliminated. Health should not rest only in the hands of the wealthy, as it is an essential human right, and we support efforts that assist governments in enacting those rights.

The IHSJ seeks to persuade the US, as well as other G8 leaders, to support funding mechanisms that combat disease and poverty at the roots. The Global Fund to Fight AIDS, TB, and Malaria (GFATM), and the President’s Emergency Plan for AIDS Relief (PEPFAR) are two such institutions.

Global Fund to Fight AIDS, TB and Malaria:
We applaud the Global Fund to Fight AIDS, TB and Malaria (GFATM), which promotes responsible governance and international cooperation in the fight against these three diseases, which are all tied to poverty. Breaking with the traditional model of foreign aid, in which assistance is tied to conditions, the Global Fund does not allow for political or ideological "strings" to be attached to grants. Instead, the aid can be used to account for the many factors that contribute to the spread of these diseases—the money can go to any evidence-based program to fight AIDS, TB and malaria, including: harm reduction strategies for drug users, the "topping off" of government salaries of health workers in developing nations, the purchase of generic medicines that are protected under WTO agreements, and programs that work with sex workers.  

President’s Emergency Plan for AIDS Relief:
Launched in 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) has provided critical funds to 15 countries for scaling up HIV/AIDS programs. PIH and Zanmi Lasante have used PEPFAR funding to provide and scale-up treatment for thousands of patients in Haiti’s Central Plateau. PEPFAR will be reauthorized in 2008 and the IHSJ is collaborating with other NGOs and congressional staffers to recommend increasing the budget of PEPFAR.
We are also working to help improve PEPFAR based on our field experience. For example, PEPFAR funding heavily supports international NGOs, US government agencies and academic institutions that may not work in conjunction with each other or within the existing national structures of the countries they are working in. Developing “parallel structures” and isolated "vertical programs" that operate independent of governments is often not the best approach, as these undertakings are inherently unsustainable and contribute to drawing resources as well as qualified nationals away from understaffed government offices, health care centers and local community support organizations—thus exacerbating the health care worker shortages in these countries (read more about these shortages here).

Removal of User Fees

Another related focus of our work to address and eliminate disparities in accessing health care is the removal of user fees for health services. The imposition of user fees has resulted in empty hospitals and clinics, especially in settings where the burden of poverty and disease are greatest. Because health is a fundamental route to development, it is counterproductive (not to mention immoral) to charge user fees for health care to those who need these services most and can afford them least. PIH works to ensure that cost does not prevent access to primary health care and education for the poor.

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