Given the political uncertainties in London, including when and under what conditions new Prime Minister May will invoke Article 50, formally withdrawing from the EU, none of the organizations dedicated to global health and humanitarian responses are willing to discuss pending details in their budgets and the likely impact EU withdrawal, coupled with the falling British pound value, will have. But they are extremely worried — every single one of them. Privately, key global health leaders tell me they expect losses to exceed anything they experienced as a result of the 2008 financial crisis.
2. On health systems strengthening, the Obama administration for seven years pursued a dual track approach. As you note, some aspects have been incorporated into specific disease programs such as malaria and tuberculosis. For example, the President’s Malaria Initiative (PMI), led by USAID and implemented together with CDC, is focused on further reducing malaria deaths and substantially decreasing malaria morbidity toward the long-term goal of elimination. In addition to scaling up lifesaving prevention and treatment, PMI has placed a great emphasis on support for strengthening key components of country health systems, including commodity supply chains, health information systems, and clinical and laboratory services. Many of the PMI-supported countries that have made the most progress in malaria control also have made the most progress in strengthening these key aspects of their health systems. At the same time, USAID works with priority countries to strengthen specific health functions in country-specific contexts — from bolstering governance structures, to helping countries collect, analyze, disseminate, and use timely and high quality health information. The dual track approach has similar objectives, but are not identical in all respects. (Full disclosure — I work for PMI at USAID).