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The United States has been a generous sponsor of global health
programs for the past 25 years or more. This investment has
contributed to meaningful changes, especially for women and
children, who suffer the brunt of the world's disease and
disability. Development experts have long debated the relative
merits of vertical health programming, targeted to a specific
service or patient group, and horizontal programming, supporting
more comprehensive care. The U.S. government has invested heavily
in vertical programs, most notably through the President's
Emergency Plan for AIDS Relief (PEPFAR), its flagship initiative
for HIV and AIDS. PEPFAR and programs like it have met with good
success. Protecting these successes and continuing progress in the
future depends on the judicious integration of vertical programs
with local health systems. A strong health system is the best
insurance developing countries can have against a disease burden
that is shifting rapidly and in ways that history has not prepared
us for. Reaching the poor with development assistance is an
increasingly complicated task. The majority of the roughly 1
billion people living in dire poverty are in middle-income
countries, where foreign assistance is not necessarily needed or
welcome. Many of the rest live in fragile states, where political
volatility and weak infrastructure make it difficult to use aid
effectively. The poorest people in the world are also the sickest;
they are most exposed to disease vectors and infection.
Nevertheless, they are less likely to access health services.
Improving their lot means removing the systemic barriers that keep
the most vulnerable people from gaining such access. Investing in
Global Health Systems discusses the past and future of global
health. First, the report gives context by laying out broad trends
in global health. Next, it discusses the timeliness of American
investment in health systems abroad and explains how functional
health systems support health, encourage prosperity, and advance
global security. Lastly, it lays out, in broad terms, an effective
donor strategy for health, suggesting directions for both the
manner and substance of foreign aid given. The challenge of the
future of aid programming is to sustain the successes of the past
25 years, while reducing dependence on foreign aid. Investing in
Global Health Systems aims to help government decision makers
assess the rapidly changing social and economic situation in
developing countries and its implications for effective development
assistance. This report explains how health systems improvements
can lead to better health, reduce poverty, and make donor
investment in health sustainable.
Israeli-US relations are an important factor in U.S. policy in the
Middle East, and Congress has placed considerable emphasis on the
maintenance of a close and supportive relationship. The main
vehicle for expressing support for Israel has been foreign aid;
Israel currently receives about $3 billion per year in economic and
military grants, refugee settlement assistance, and other aid.
Israel is not economically self-sufficient, and relies on foreign
assistance and borrowing to maintain its economy. Since 1976,
Israel has been the largest annual recipient of US foreign
assistance, and is the largest cumulative recipient since World War
II. In addition to US assistance, it is estimated that Israel
receives about $1 billion annually through philanthropy, an equal
amount through short- and long-term commercial loans, and around $1
billion in Israel Bonds proceeds. What might appear to be massive
largesse, however, helps economically support a country which has
steadily supported the US in the region and world and also serves a
leader in innovation in many fields such as medicine, military
electronics and other crucial areas of technological development
which may not be able to take place in the US for a variety of
reasons. This book presents the current situation in a relationship
that is mutually useful and at the same time sometimes
cantankerous.
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