New Antipoverty Drugs, Vaccines, and Diagnostics: A Research Agenda for the US President's Global Health Initiative (GHI)

On May 5, 2009, the Obama Administration announced its intention to launch an ambitious United States governmental strategy for global health [1–3]. The US Global Health Initiative (GHI) proposes US$63 billion over 6 years (FY 2009–FY 2014), US$10.5 billion annually on average, approximately 70% of which would be spent on the US President’s Emergency Plan for AIDS Relief (PEPFAR) [1]. If appropriated each year by Congress, the GHI would represent a significant response to calls by the Institute of Medicine of the National Academies for the US government (USG) to invest US$15 billion annually on development assistance for global health by 2012 [3]. In its current form, most of GHI is devoted to direct implementation of existing treatments and preventive interventions for the ‘‘big three diseases,’’ i.e., HIV/ AIDS, malaria, and tuberculosis, especially the delivery of antiretroviral drugs and other prevention measures, antimalarial drugs and bednets, and direct observed therapy, respectively, as well as other critical interventions to improve maternal and child health and strengthen health systems [1,3]. There is also an unprecedented commitment to provide treatments for the neglected tropical diseases (NTDs), with US$65 million committed in FY2010 for rapid impact packages and related measures targeting the seven most common NTDs, which comprise the most prevalent infections affecting the world’s poor [4–8].