Global Health Institute

By Maya Gabby

On Tuesday, January 21, 2020, our “Conversations in Global Health” lecture welcomed Keifer Buckingham, Senior Policy Advisor for International Public Health at Open Society Foundations (OSF). Buckingham began with an overview of her path to her current role at OSF. In speaking about critical moments in her educational journey, she cited both her undergraduate and graduate programs as having significant impacts on her career trajectory. 

Buckingham, like many other global health professionals, has worked on a variety of health areas over the course of her career, but has grappled most with the politics of reproductive health rights. When asked about the current state of the Global Gag Rule (GGR), it was obvious that it remains her passion. Under the Trump administration, the GGR – or the Mexico City Policy as it is also known as has been vastly expanded and is now the “Protecting Life in Global Health Assistance. Funding for international health services through USAID and PEPFAR have been drastically impacted. Having lobbied for the Global Health Empowerment and Rights (HER) Act this past summer, which would permanently end the GGR, I was curious if there had been any meaningful improvement. Unfortunately, while global health funding used to be a relatively bipartisan issue, the current administration has caused increasing polarization and the bill has not been moved beyond democratic participation. 

However, hope is not lost -- at least not according to Buckingham. She is a firm believer in “budgets [as] moral documents, even when they don’t pass”. And while the Trump administration has offered very little to improving sexual and reproductive health and rights (SRHR), house democrats have continued to list global health assistance as a top priority in their budgetary considerations. Buckingham is quick to cite the financial return of family planning (for every $1 spent on family planning there is a $7 return on investment) and wealth of positive data as key ways to engage with morally opposed individuals. After all, relationship building has been at the heart of her success in the political world. With the upcoming election in the front of my mind, this brought me great hope for the future of the GGR and my own interest in health policy. As advocates for global health equity, Buckingham’s parting words were meant as inspiration and encouragement to those of us still in the undergraduate portion of our journeys. Facing us, she said “We need more curiosity and empathy in the world.” 

Maya Gabby (NHS ‘21) is a third-year undergraduate at Georgetown studying global health, with specific interests in sexual and reproductive health and rights and health policy.

By Rachel Williamson

On Tuesday, January 21, 2020, the Conversations in Global Health lecture series had the pleasure of talking with Keifer Buckingham, Senior Policy Advisor for International Public Health at Open Society Foundations. Buckingham shared her post-grad trajectory and provided valuable insights and experiences into the fields of global health, reproductive rights and advocacy. Over the course of the evening, Keifer spoke of the roads that lead her to where she is, domestic public health and advocacy work, and the importance of collaboration and trust while working on Capitol Hill for Congresswoman Lee.

Towards the end of the evening, the conversation came to Universal Health Coverage (UHC), a landmark goal of global health and development. As a Global Health Senior here at Georgetown, we have touched upon and discussed this goal of the United Nations in many of our classes. While the question originally concerned how reproductive health can be a comprehensive component of UHC, especially in the Trump-era, Buckingham stepped the question back. The global health professional was up-front about the lofty-nature of this goal, as even the United States is far away from having UHC. Instead, Buckingham focused on what needs to happen in order to put the systems in place that will allow UHC to become a reality in the long term; how the conversations of global health aid and assistance in the US need to shift toward helping countries get to a place where they will eventually be ready for UHC.

Starting with a bit of history, she touched upon the siloed nature of much global health assistance. Key programs that have achieved enormous success, such as PEPFAR and the Global Fund to Fight AIDS, TB and Malaria, focus on select diseases. As a result, systems are weak and services unintegrated. Buckingham explained, “right now, a mother can go into a clinic and get effective HIV medication, but she cannot get basic family planning services.” She was clear that the current appropriations system is not set up to think in the way of breaking down the silos in which global health aid and development has operated for decades. Appropriators are much more inclined to do the quantitative work of providing x number of bed nets or vaccines, as opposed to the less tangible work of health system strengthening - the exact activity that is necessary if the world is going to get close to achieving UHC for all. The path forward now seems a bit more clear, the pressing work is to convince the decision makers to think differently about aid and how strengthening systems for health is most effective path forward if the world is to get closer to actualizing UHC for all. 

Rachel Williamson (NHS ’20) is an undergraduate student studying global health. She is also an intern at the Global Digital Health Network.