Built on the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Global Health Initiative was President Obama's promise to fundamentally “restructure US global health enterprise.” In 2009, the Global Health Initiative pledged to invest $63 billion over 6 years (fiscal years 2009-2014): $51 billion for PEPFAR (HIV/AIDS, tuberculosis, and malaria) and $12 billion for broader global health issues (eg, maternal and child health, nutrition, and neglected tropical diseases).1