by Laura Barnitz
Paul Farmer’s appointment as U.N. deputy special envoy for Haiti is very, very good news for Haiti, but could it also be a bad sign for the Obama Administration’s willingness to strengthen and improve U.S. health programs in the developing world? The news of Farmer’s appointment follows very closely on reports that he was no longer being considered for USAID Administrator. With that post going unfilled for so many months, U.S. global health and development experts have got to ask themselves whether or not this White House is going to lead the world on these fundamental issues or just tread water.
Farmer’s sterling record as a health leader and his willingness to tell it like it is makes him seem far better suited for the UN appointment than being saddled with rebuilding a US agency that is suffering from reduced staff, no control of its own budget, struggling to juggle X number of Presidential initiatives that have no real permanent home, and serving at the mercy of the State Department’s short-term interests. Frankly, improving the health of people in Haiti, as poor as the history of international attempts have been there, sounds more doable. Certainly, it will be incredibly difficult to name a sterling leader if there’s no agency left to lead!
But let us assume that this is not a signal from the Obama Administration per se, and it’s nothing more than a tussle between Bill and Hillary. I’m sure Hillary supporters will be riled at such an assertion, but Bill’s high profile trip to North Korea and Hillary’s own comments in Africa last week clearly underscored her dissatisfaction with people asking her what her husband thinks about international issues. Although subsequent reports indicated that the translation of the question that caused her outburst was incorrect, her irritation was certainly justified. Unfortunately, unless attending PEPFAR events is supposed to indicate intentions to make comprehensive improvements in all critical public health issues, a review of her public remarks in one developing country after another keeps underscoring that Hillary’s primary focus is commerce, crime and punishment, and security issues — not health and development.
Either way, the portents are not good for those who want to see the gains made in global health sustained and further improvements achieved. For so many people who had sky-high hopes for the Obama Administration and raising the profile of development issues so that it was on equal footing with defense and diplomacy — the window is closing, quickly. Congress has both raised the US investment and introduced legislation to undertake the beginnings of reform of USAID, but what good will it do without leadership? It looks as though “leadership” is going to be left in the hands of the advocates of those bedrock programs that save lives, decrease poverty and win hearts and minds. It’s time health and development stakeholders stepped forward to fill the gap.
Laura Barnitz, former director of policy communications with the Global Health Council, is currently a freelance writer and health and development communications consultant based in New Delhi, India. This guest blog reflects the author’s individual opinions only, and should not be construed to represent the opinions or positions of the Global Health Council.