Secretary of State Hillary Clinton outlines the Obama administration's Global Health Initiative at Johns Hopkins University on Monday, August 16, 2010. (Photo from Johns Hopkins University's School of Advanced International Studies Web site)

– The Obama administration is focused not just on health-care reform in the United States – but also on improving health care systems around the world, Secretary of State Hillary Clinton announced on Monday.The new plan has a “woman- and girl-centered approach,” according to an administration fact sheet Speaking at Johns Hopkins University,Clinton outlined the six-year, $63-billion Obama administration initiative to bring global health care services “to more people in more places.” The administration’s Global Health Initiative has “everything” to do with foreign policy, she said.“This is a signature of American leadership in the world today, Clinton said. “ It’s also an issue very close to my own heart.”Clinton said in her world travels, she’s met “countless people who are proof of what successful global health programs can do.” She mentioned HIV-positive farmers in Kenya who are able to continue farming, thanks to antiretroviral drugs; children in Angola who now sleep under bed nets to ward off malaria; mothers of healthy babies who were delivered by trained midwives; and people who survived into adulthood because of childhood immunizations.Clinton then outlined the “new approach” to global health care, which is aimed at “saving the greatest possible number of lives” by expanding existing health programs “to help countries develop their own capacity to improve the health of their own people.”Clinton said the administration’s Global Health Initiative (GHI) would build on the groundbreaking work of the George W. Bush administration’s PEPFAR program (President’s Emergency Plan For AIDS Relief). The Obama administration, Clinton said, will expand the PEPFAR program to provide anti-AIDS retroviral drugs to more people in developing countries.The new GHI programs will have what the Obama administration describes as a “woman-centered” approach, providing funding for neonatal care, family planning services, and infant health care.The centerpiece of the Obama administration’s Global Health Initiative will be to encourage and help developing countries run their own health care systems instead of relying on foreign aid workers. This part of the plan will have U.S. aid workers and diplomats work with foreign governments to design locally administered health care systems that – while funded through international aid networks – will be run by local governments.Clinton explained that this aspect of global health addresses not just a humanitarian concern but a geopolitical one as well, since poor, weak states often are crippled in part because of poor public health.“We invest in global health to strengthen fragile or failing states,” Clinton said. “We have seen the devastating impact of HIV-AIDS on countries stripped of their farmers, teachers, soldiers, health workers, and other professionals.”Clinton said improving health care in developing countries also fulfills other foreign policy goals – such as promoting social and economic progress in countries that may be able to help the U.S. solve regional and global problems. Investments in global health protect U.S. national security, including the threat posed by disease outbreaks; and those investments also serve as a tool of public diplomacy, boosting the U.S. image in the eyes of people who receive health care they might otherwise go without.The Obama administration’s GHI will develop data-tracking systems to measure the efficacy of U.S. foreign health aid. Part of the $63 billion in new funding will go toward developing ways to test and evaluate existing global health programs to determine which ones are effective and which are not.Clinton said these initiatives would take U.S. aid programs “to the next level” by making them more efficient and effective and less reliant on foreign workers.“We’re shifting our focus from solving problems one at a time to serving people by considering more fully the circumstances of their lives and ensuring they can get the care they need most over the course of their lifetimes,” she said.Clinton highlighted the expansion of family planning services, saying that the administration would pressure other countries to reform child marriage laws and would also work to expand access to contraceptives and family planning education.According to the government’s fact sheet, one of GHI’s goals is to “prevent 54 million unintended pregnancies by meeting unmet need for modern contraception.”Clinton said family planning – including pregnancy prevention – not only will improve women’s health but also will reduce the poverty that often afflicts large families in poorer countries. She said women must be given more control over when they become pregnant.“We are scaling up our work in family planning and maternal and child health, areas in which the United States can and must lead,” Clinton said. She noted “Every year, hundreds of thousands of women die from complications related to pregnancy or childbirth – nearly all of them in the developing world.”“Family planning represents one of the most cost effective public health interventions available in the world today. It prevents both maternal and child deaths by helping women space their births and bear children during their healthiest years and it reduces the deaths of women from unsafe abortions.”Clinton said that GHI will be “making up for lost time” in funding family planning services – boosting existing programs whose funding has diminished in recent years.Clinton also said the administration was “moving beyond” the ABC (Abstinence, Be faithful, Correct contraceptive use) anti-AIDS approach adopted during the Bush years to an “A to Z approach to [HIV] prevention” that includes measures such as “male circumcision [and] the prevention of mother-to-child transmission” as well as better HIV screening and education.The administration’s Global Health Initiative also will address lesser known tropical diseases such as guinea worm as well as increase funding for child nutrition programs and malaria and tuberculosis treatment and prevention.