Sharing Insights and Experience: A Conversation with Senior Policy Advisor Keifer Buckingham
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.