With an impending $300 billion dollars in tax cuts and other spending cutbacks in President Obama’s jobs plan it is logical to wonder if global health projects will be eclipsed by more important domestic initiatives in the US. The same thought could be applied internationally since it can be shown that globally, economies are suffering. Dr. J Steven Morrison, Senior Vice President at the Center for Strategic and International Studies mentioned in a blog post about the impending budget cuts that the US will cut funding directed to global health by 9% and foreign aid by 18% overall. One reason for this is that unemployment is still very high, and not only in the US. Unemployment is at 9.7%, 9.1%, 8% in France, the US, and Brittain respectively. Despite any amount of global health advocacy by any group or individual, each nation is expected to ameliorate domestic issues first before attempting to save the world.
So this begs the question: What is the extent of the responsibility of developed nations to the 3rd world when it comes to healthcare? The simple answer to this in my opinion is that there are no responsibilities especially in times of economic hardship. At this point, everyone has been affected in some way. It is inconceivable that a sovereign nation will be bound by obligation to another without the colonization or absorption of the sovereignty of said nation. The role that the US and other developed countries have played in the development of healthcare in third world countries is driven strictly by the advocacy of individual groups and private companies with an interest in those nations, and also politicians with an interest in re-election. For example, USAID has a Global Health Initiatives program which distributes funding to individual interests groups that specifically request funding for specific projects. It appears that that global health interests are less vital for re-election than domestic ones. In an effort to evade annual budget cuts , Rajiv Shah, an administrator for USAID, appealed to republican House Rep. Charlie Dent that the proposed $120 million dollar cuts to USAID could result in the death of 70,000 children across the globe. What was the response? “Can I just quickly change subjects?” Video of the appeal and response below.
Third world nations will need to find a way to exercise a lot more self-sufficiency in terms of funding and implementing their health initiatives, especially under economic times such as what we are currently experiencing. Global health funding from developed nations is no longer guaranteed in duration or amount. However, it seems that for many 3rd world countries, self-sufficiency is the direction many are headed towards. For example, the Philipines is exploring public health practices in reproductive health with the introduction of a Reproductive Health bill currently in debate while in Nigeria there is heated discourse about the direction of the countries public health programs and emergency response protocol in light of the recent attack on the UN building in Abuja. Hopefully, by the time full economic recovery has been established globally, third world nations will no longer require first-world assistance.
Uchenna Onyekwere is a medical student of Nigeria, currently studying medicine in B.S. Biological Sciences, University of Maryland Baltimore County.