Panel tackles global health

By Bryan Bender, Globe Staff

WASHINGTON -- A high-level commission will develop a blueprint this year for how to get the most out of record levels of global health aid, enlisting lawmakers, pharmaceutical executives, and a wide array of specialists to recommend ways the US government can better coordinate what organizers say is now a fragmented approach to helping the world's most vulnerable people.

The bipartisan Commission on Smart Global Health Policy, whose members include Senators Jeanne Shaheen of New Hampshire and Olympia Snowe of Maine, was given a mandate today to identify a more comprehensive strategy for spending the estimated $10 billion dedicated each year to assisting the world's most disease-plagued nations.

"How does the US capitalize on current investments? What should we be doing more of? What should we be doing differently?" Helene D. Gayle, president of the humanitarian organization CARE and a former assistant US surgeon general, said in outlining the objectives of the study she will help lead.

Perhaps a more important challenge, she added, is, "How do we better measure our impacts?"

The commission, which plans to issue its recommendations to the Obama administration early next year, has also enlisted an unlikely figure to spearhead the effort: retired Navy Admiral William J. Fallon, who was commander US military forces in the Middle East and Asia and is now a professor at MIT's Center for International Studies.

Fallon told reporters at a kickoff breakfast that he hopes to bring to the effort 40 years of experience witnessing first-hand the haphazard, short-term course the United States often takes in helping meet the basic needs of at-risk populations in what are often already unstable parts of the world.

Fallon, who oversaw the US military response to the Asian tsunami in 2004, said that in relative terms the amount the United States spends on global health each year is significant but could be far better utilized over the long term -- including for what he called "preventative maintenance" in Muslim countries where a deep distrust of American motives breeds extremism.

"If we could ever get our act together and come up with a comprehensive plan to pool resources...we can probably get some stuff done," Fallon said. "When you start slicing and dicing this thing to see where the money is actually going, it's a thousand places. And what's the effect?"

The commission is sponsored by the nonpartisan Center for Strategic and International Studies in Washington. Organizers say it is prepared to take on some controversial subjects, including whether there is too much focus on Africa and whether the major emphasis on treating HIV should be balanced with greater efforts to meet basic needs such as clean drinking water that could prevent diseases such as malaria that affect far larger numbers of people than HIV.

J. Stephen Morrison, who runs CSIS' Global Health Policy Center, and Jen Kates of the Kaiser Family Foundation, wrote in a paper released today that one "delicate task" of the commission will be to "decide on the correct balance between HIV and other areas."

"That will involve complex choices, potentially involving winners and losers or at least the perception of such," they wrote.

The commission's 26 members include several members of Congress; former top diplomats and intelligence officials such as John Negroponte; leaders of nonprofits such as the Bill and Melinda Gates Foundation; former Health and Human Services Secretary Donna Shalala; the president of Barnard College; and executives from major corporations such as Exxon Mobil, Coca Cola, and drug giant Merck and Co.

"We have an unprecedented opportunity," Gale said, "to think about this issue in a way that I think has not been done before."

Shaheen told the Globe in a statement that the commission's work is critically important, not just for the foreign nations most in need.

“Creating a long-term, strategic policy to address global health care challenges will strengthen our national security, our economy, and our standing as a moral leader in the world," she said.