Ruth Levine has a depressing blog post on the Center for Global Development blog today. She points out that President Obama’s efforts to improve American global health assistance by shifting to a health systems approach will actually make things look worse in the short run. For example, treatment of HIV is a lot more impressive to look at than prevention, and any comprehensive HIV programming is bound to focus on prevention as well as treatment. A prevention plus treament approach is much better science, and it’s going to save more lives, but that doesn’t make it easy to appreciate.

As she puts it, “Improvements on the prevention side, which very well may result from smart policy and programmatic measures, will be awfully hard to detect.” Levine goes on to discuss the issues involved with expanding the President’s Malaria Initiative beyond its target countries, and in strengthening health systems to improve maternal health. None of that is going to produce easy-to-read success stories, but over the long haul, they’ll do more for global health than the kind of programs that produce good photo ops.

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