Briefing focuses on global health financing

Rep. Tom Lantos (D-CA) urged Congress to support the reauthorization of the President's Emergency Plan for Aids Relief (PEPFAR) program at a July 16 briefing on global health at the National Press Club.

The event, Financing and Improving Global Health Care, was sponsored by Health Affairs, a bimonthly journal of health policy, and was presented in conjunction with the journal's new thematic issue on global health financing. The briefing featured a panel of global health experts that discussed topics on AIDS relief, an AIDS vaccine, health care spending and international health aid.

As the first panelist, Lantos emphasized the importance of a renewal of the PEPFAR program that expires in 2008, for which President Bush plans to double its funding to $30 billion.

Lantos, chair of the House Foreign Affairs Committee and co-author of the initial PEPFAR, celebrated the successes of its first 5 years, which supported life-saving antiretroviral treatment for 1.1 million people living with HIV/AIDS. He noted that there still remain many challenges ahead in the fight against the disease. "The battle against HIV/AIDS is a marathon, not a sprint."

Despite concerns over the program's specific allocations, Lantos said the program renewal is vital to reducing the burden of HIV/AIDS across the globe. He also stressed issues essential to the successes of the future program, including the significance of education and treatment, a potential for a vaccine and medical research. "It is imperative that we invest in research," he said.

Another panelist, John Stover, president of the Futures Institute, discussed a new report concluding that continuing to invest in AIDS vaccine research and development makes economic and scientific sense.

Stating that the earliest an HIV/AIDS vaccine will be available is 2015, the report simulated a vaccine's impact based on its efficiency and its cost effectiveness.

Stover found that even with a modest effectiveness, an AIDS vaccine would still have a significant impact on the epidemic. The report also concluded a vaccine to be economically beneficial as well.

"Given its direct and indirect impacts, it's quite clear that it would be a cost effective program," Stover said.

Philip Musgrove, deputy editor of Health Affairs, spoke on behalf of a new World Health Organization study on health spending. The report provides the first global estimates of catastrophic health spending, defined as health spending that exceeds 40% of a family's non-food budget.

Musgrove said the report concluded that some form of pre-payment for health care spending, as opposed to out-of-pocket spending, is vital to preventing financial catastrophe.

No significant differences were found between pre-payment types, such as social health insurance or taxed-based systems, and that one in 200 families in the United States suffered catastrophic health spending, Musgrove said.

International health aid was the topic of panelist Amanda Glassman. Deputy director of global health initiative at the Brookings Institution, Glassman discussed a new study that found most health aid is still fragmented and unpredictable.

She said aid is disproportionately targeted to countries with smaller populations and to countries with a larger commitment to health. "Improving health outcomes will depend on improving the terms of aid allocation," Glassman said.

The study also noted that although health aid nearly doubled between 2002 and 2005, global health financing is still much lower than the estimated need, which is additionally $30-70 billion a year.

"There is still a considerable scope to improve health aid," Glassman said.

The reports discussed by the panelists are among the lengthy collection of global health studies included in the July/August issue of Health Affairs. The thematic issue was published with the support of a five-year grant from the Bill & Melinda Gates Foundation, and Health Affairs plans to release a global health edition yearly.

Originally published 7/2007

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