G8 and G20 Summits: Good News for Global Health, or More of the Same?
This past weekend, Canada hosted the G8 and G20 summits, bringing together major economic powers to talk about global coordination on a number of issues.
At least two things are of interest to those who care about global health.
G8: Muskoka Initiative for maternal and child health
One, at the G8 summit on Friday Canadian Prime Minister Stephen Harper announced the Muskoka Initiative for maternal and child health. This intiative promises $7.3 billion over the next five years to make progress on achieving Millenium Development Goals 4 and 5 (reduce child mortality and improve maternal health, respectively). G8 countries will contribute $5 billion and other countries plus the Bill and Melinda Gates Foundation and UN Foundations will make up the remaining $2.3 billion. Read the full G8 communiqué.
Benefits of the Muskoka Initiative (named after the region in Ontario where the G8 meeting was held) include:
- It focuses attention on maternal and child health.
- It aims to 1) prevent 1.3 million deaths of children under five years of age, 2) prevent 64,000 maternal deaths and 3) enable access to modern methods of family planning by an additional 12 million couples.
- It supports the new UN-led process to develop a Joint Action Plan to Improve the Health of Women and Children.
- It will "focus efforts on training of medical personnel." Further language on establishing stronger "health innovation networks" in Africa and elsewhere is less clear.
- It encourages the "integration of HIV and sexual and reproductive health, rights and services within the broader context of health systems strengthening."
- It supports polio eradication, attention to neglected tropical diseases, food security and overall economic development and investment.
Criticisms of the Initiative include:
- It isn't that much "new" money -- aside from Canada's $1.1 billion not previously allocated, the U.S. share, for instance, is the $1.3 billion it had already earmarked for maternal and child health -- and overall, the amount is criticized by some aid groups as insufficient. The Partnership for Maternal, Newborn and Child Health, which issued a positive response to the Initiative, reminds us that $30 billion will be needed to meet the MDG 4 and 5 goals by 2015.
- Despite the Initiative touting integrated efforts for maternal health, in discussions leading up to the summit Prime Minister Harper indicated that abortion would not be included, and even family planning programs may be in question.
- The G8 nations have not met the 2005 Gleneagles commitments of $25 billion per year in overseas development assistance for African countries, and another $25 billion for other countries. According to Laurie Garrett from the Council on Foreign Relations, they are about $10 billion short; by another account, more like $20 billion. What happened to those 2005 commitments, and is this much smaller pledge going to be honored anyway?
In summary, the intention and attention are good, but the funding falls short. It remains to be seen whether countries will follow through and how the funds will actually be used. For more detail on how the summit was run and more NGO reactions, check out the Global Health Council's blog posts from the summit (6/25-6/27 posts).
G20: Where's the currency transaction levy?
The second item of interest is notable in its absence at the G20 summit -- no discussion of a currency transaction levy.
At a meeting early in June, G20 finance ministers decided not to pursue a global coordinated tax on financial transactions. (Canada, Australia and Brazil, countries that didn't bail out their banking sectors during the economic crisis, led the charge against it.) Because of this lack of agreement, the subject was scrapped from the full G20 summit agenda this past weekend in Toronto.
Nonetheless, the US, UK and other European countries are still in favor of some kind of bank tax and will pursue policies individually.
The idea behind a currency transaction levy is that it would apply to wholesale exchanges of currency by banks. A "decimal dust" rate of .005% has been proposed in the US, which would be small enough not to deter transactions, but could raise as much as $28 billion on the US dollar alone. The tax would serve the dual purposes of ensuring a fair contribution to recovery from the financial sector, which received massive taxpayer bailouts in recent years, and also provide funds to fulfill US commitments to global health and climate change. See this RESULTS UK explanation of the differences between several different kinds of financial sector tax proposals, or this fact sheet on a currency transaction levy (or CTL).
Instead, the G20 summit focused on controversial austerity measures, halving deficits and new regulations to reduce risk in the financial sector (although delegates retreated from establishing a firm deadline for regulations to take effect). Read the full G20 communiqué.
According to Reuters:
Unable to muster the unity of the past three crisis-era G20 summits, the leaders fell back on the "Sinatra doctrine", leaving each country to do it "my way", move at its own pace and adopt "differentiated and tailored" policies.
Prime Minister Harper and President Obama shake hands at the G8 meeting (AP Photo/Lefteris Pitarakis)
What next?
So what did the G8 and G20 do for global health, and where do we go from here?
The summits in Canada highlighted the fall-out of the economic crisis, namely concern with shoring up financial systems, and faltering support for foreign aid in the face of domestic budget problems. Even successful programs like PEPFAR are flat-lined at best.
There are still many unknowns about where US foreign policy and global health programs will end up. Some things we'll be keeping our eyes on are:
- More information about the Global Health Initiative. The first 8 "GHI Plus" countries were announced last week -- Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal and Rwanda, but questions still remain about exactly how funding and technical assistance will be coordinated at the country level, how health systems strengthening will be prioritized, and how the goal of local country ownership will be implemented. A second consultation document on the GHI is expected later in the summer. (Read our past blog post on the GHI.)
- Upcoming Presidential Study Directive on development (PSD-7). A draft of the report was leaked back in May, and included some indication of where the administration was leaning in terms of how the National Security Council, USAID and the State Department would coordinate on development efforts. (Hint: USAID director would still report to the Secretary of State, but would also attend National Security Council meetings "as appropriate." Also, a new Development Policy Committee would be created to coordinate development across the Executive Branch.) The PSD is expected to inform any rewrite of the Foreign Assistance Act.
- Upcoming Quadrennial Diplomacy and Development Review (QDDR). This is the State Department's own review of , modeled after the Defense Department's every-four-year process. There are questions as to whether the QDDR, expected to be released this fall, will clearly articulate priorities and issues such as whether development is a tool for diplomacy and security, or an independent end unto itself. Read more on the Stimson Center blog.
- Global Health Act (HR 4933). Rep. Barbara Lee's bill calls for better coordination on global health, and a new global health workforce initiative to support training, recruitment and retention of health workers in areas of severe shortage. The bill is also expected to inform the rewrite of the Foreign Assistance Act. You can find some of our past blogs on the GHA here and here.
Let us know your thoughts on the G8 and G20 summits, prospects for global health, and how US aid for health can be improved.
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