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October 31, 2012 The Global Need  As of 2010, 61 million primary school and 71 million adolescent students are not in school , 1 with 42% of them living in poor, conflict-affected countries. Each year, millions of students who have attended school drop out before the fifth grade, often because of the inferior quality of their education, overcrowding and under- resourced classrooms.   According to the Global Monitoring Report, c urrent aid levels fall far short of the $16 billion required annually to close the external financing gap in low-income countries needed to fund basic education. 2  Significance of Funding Levels  An estimated 57 million children would be assisted by US Government supported education programs if basic education was funded at $800 million. 3  On average, every additional year of schooling is estimated to increase workers’ income by 8 .3%. Educational opportunities in countries struggling to overcome poverty are especially important for girls. Greater educational attainment, particularly for girls, leads to overall health improvements as well as to reduction in fertility and infant mortality. 4  Importance of Funding Education and skills development is vital in reducing unemployment, inequality, poverty, and promoting growth. It is al so a w ise investment  for every $1 spent on education, as much as $10 to $15 can be generated in economic growth. 5 Basic education programs represent a relatively low-cost way to help alleviate poverty through economic growth, while also building markets for US exports and enh ancing stability and security worldwide. 6  With funding for FY13, USAID will pursue its educational goals of:   Improved reading skills for 100 million children in primary grades by 2015; Improved ability of tertiary and workforce d evelopment programs to produce a workforce with relevant skills to support country development goals by 2015; and Increased equitable access to education in crisis and conflict environments for 15 million learners by 2015. 7  The Impact of Funding  Success is Possible Since committing to the Education for All goals in 2000, the international community and partner governments have seen: The number of children out of school has dropped by 47 million worldwide; The percentage of girls not in school has declined from 58% to 53%, and the gender gap in primary education is also narrowing in many countries; and The adult literacy rate has increased over the past two decades, from 76% in 1985-1994 to 84% in 2005- 2010. 8  1 UNESCO (2012) Global Monitoring Report. Pages 4 and 58. Retrieved from:  http://bit.ly/Pz2VO7 2 UNESCO. (2010). Global Monitoring Report, Table 2.9; "Estimating the costs of achieving Education for All in Low-Income Countries. Page 5. Retrieved from http://unesdoc.unesco.org/images/0018/001885/188561e.pdf . 3 This figure is based on the average number of primary and secondary age learners enrolled in USG supported education programs through FY09- FY11 and the correlating fiscal year appropriations levels to determine average cost per student. 4 USAID. (2011). USAID Education Strategy: Opportunity Through Learning. Pages 2-3. As retrieved from  http://1.usa.gov/TeSIUe . 5 UNESCO (2012) Global Monitoring Report. Pgs 18. Retrieved from:  http://bit.ly/Pz2VO7 6  Basic Education Coalition. (2011). Sta tement on President Obama’s FY12 Budget Request for Basic Education.  7 USAID. (2011). USAID Education Strategy: Opportunity Through Learning. Page 1. As retrieved from  http://1.usa.gov/T7Qc1T. 8 UNESCO. (2012). Global Monitoring Report. Pages 58, 355 and 5. Retrieved from:  http://bit.ly/Pz2VO7 Development Assistance: Basic Education Funding FY13 Committee Approved Funding Senate: $800 million House: $800 million

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The Global Need

 As of 2010, 61 million primary school and 71 million adolescent students are not in school,1 with 42% of them living in poor, conflict-affected countries. Each year, millions of students who have attended school dropout before the fifth grade, often because of the inferior quality of their education, overcrowding and under-resourced classrooms.  According to the Global Monitoring Report, current aid levels fall far short of the $16billion required annually to close the external financing gap in low-income countries needed to fund basiceducation.2 

Significance of Funding Levels 

 An estimated 57 million children would be assisted by US Government supported education programs if 

basic education was funded at $800 million.3 

On average, every additional year of schooling is estimated to increase workers’ income by 8.3%. Educationalopportunities in countries struggling to overcome poverty are especially important for girls. Greater educationa

attainment, particularly for girls, leads to overall health improvements as well as to reduction in fertility andinfant mortality.4 

Importance of Funding

Education and skills development is vital in reducing unemployment, inequality, poverty, and promotinggrowth. It is also a wise investment – for every $1 spent on education, as much as $10 to $15 can begenerated in economic growth.5 Basic education programs represent a relatively low-cost way to help alleviatepoverty through economic growth, while also building markets for US exports and enhancing stability andsecurity worldwide.6 

With funding for FY13, USAID will pursue its educational goals of: 

Improved reading skills for 100 million children in primary grades by 2015; Improved ability of tertiary and workforce development programs to produce a workforce with relevant

skills to support country development goals by 2015; and Increased equitable access to education in crisis and conflict environments for 15 million learners by

2015.7 

The Impact of Funding  – Success is Possible 

Since committing to the Education for All goals in 2000, the international community and partner governmentshave seen:

The number of children out of school has dropped by 47 million worldwide; The percentage of girls not in school has declined from 58% to 53%, and the gender gap in primary

education is also narrowing in many countries; and The adult literacy rate has increased over the past two decades, from 76% in 1985-1994 to 84% in 2005-

2010.8 

1 UNESCO (2012) Global Monitoring Report. Pages 4 and 58. Retrieved from: http://bit.ly/Pz2VO7 2 UNESCO. (2010). Global Monitoring Report, Table 2.9; "Estimating the costs of achieving Education for All in Low-Income Countries. Page 5.Retrieved from http://unesdoc.unesco.org/images/0018/001885/188561e.pdf . 3 This figure is based on the average number of primary and secondary age learners enrolled in USG supported education programs through FY09-FY11 and the correlating fiscal year appropriations levels to determine average cost per student.4 USAID. (2011). USAID Education Strategy: Opportunity Through Learning. Pages 2-3. As retrieved from http://1.usa.gov/TeSIUe .5 UNESCO (2012) Global Monitoring Report. Pgs 18. Retrieved from: http://bit.ly/Pz2VO7 6 Basic Education Coalition. (2011). Statement on President Obama’s FY12 Budget Request for Basic Education. 7 USAID. (2011). USAID Education Strategy: Opportunity Through Learning. Page 1. As retrieved from http://1.usa.gov/T7Qc1T. 8 UNESCO. (2012). Global Monitoring Report. Pages 58, 355 and 5. Retrieved from: http://bit.ly/Pz2VO7 

Development Assistance:

Basic Education Funding 

FY13 Committee Approved Funding 

Senate: $800 millionHouse: $800 million

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The Global Need

Healthy ecosystems are the foundation of prosperity, security, and health and provide the raw materials for much of theworld’s economic activity. People living in poverty, especially in rural areas, feel the most immediate impacts when thesesystems are at risk, as they often draw their livelihoods directly from forests, fields, rivers, and oceans. Today the world isexperiencing more frequent and severe storms, floods, droughts, and temperature changes, presenting serious risks tothe livelihoods of millions of poor people and to the natural resources on which they depend. The resulting resourcescarcity can lead to conflict, causing instability and disrupting trade and economic growth. Developing countries areestimated to bear 75 to 80 percent of the costs of climate-related damages, and even minimal temperature changes couldresult in reductions in GDP of 4 to 5 percent for Africa and South Asia. Most developing countries lack sufficientfinancial and technical capacities to manage increasing climate risk even as development increases their reliance onnatural resources.

Significance of Funding Levels 

Funding levels approved by the Senate Appropriations Committee would significantly enhance a variety ofenergy and environment projects that generate vast economic and livelihood benefits.

The Senate-passed allocation of $190 million for adaptation could generate returns between $275million and $575 million for communities. Every $1 invested in adaptation programs generatesbetween $1.45 to $3.03 for poor communities. Investing in community-based adaptation can result inan average increase in per capita incomes to $2.10 a day, while failure to invest can decrease incomesto below $1 a day. 2 

• The Senate-passed allocation of $200 million for biodiversity could improve natural resourcemanagement of about 70 million hectares of biologically significant areas.3 Conserving just 25percent of the world’s highest biodiversity areas would secure 56 percent of the value of ecosystemservices on which 1.1 billion of the world’s poorest people rely.4 

• The Senate-passed allocation of $113 million for sustainable landscapes could prevent over 11million tons of carbon emissions, the equivalent of taking more than 2 million cars off U.S. roads.5 

Importance of FundingGlobal demand for food, water, and energy is expected to double by 2050 as the global population grows from sevenbillion people to an estimated nine billion. This increase in demand makes the need for conservation and sustainablemanagement of natural resources—as well as increasing the capacity of the poor to adapt to climatic changes—morethan good stewardship. In developing countries, where natural resources are often the very foundation of poorhouseholds’ livelihoods, conservation and adaptation are basic investments in growth.

Impact of Funding – Success is Possible 

For three decades, USAID has helped boost ecological, economic, and environmental sustainability, withsuccessful results, including: 

•  In 2010, helping at least 930,000 people increase their incomes through sustainable natural resourcemanagement and conservation activities;

• In 2011 and 2012, USAID worked with governments in Kenya, Liberia, South Sudan, Tanzania,Kosovo, Ethiopia and Timor-Leste to evaluate and recommend policy reforms in support of strongerland rights and management to give people more secure access to land.

•  By 2016, USAID will have helped 20 partner countries develop and implement strategies for increasingtheir economic growth with lower emissions.7 

1 The World Bank. (2010). World Bank Development Report 2010: Development and Climate Change. Page 15. As retrieved from http://bit.ly/iYyNnD. 2 CARE. (2012). Policy Brief: Climate Change – Why Community Based Adaptation Makes Economic Sense. Page 2. As retrieved fromhttp://www.careclimatechange.org/files/adaptation/PolicyBrief_Why_CBA_Makes_Economic_Sense_July12.pdf. 3 U.S. Agency for International Development (2012). Biodiversity Conservation and Forestry Programs 2011 Report. http://1.usa.gov/UiaHbl 4

Turner, W. et al. 2012. Global Biodiversity Conservation and the Alleviation of Poverty. BioScience 62:1( 85–92). 5

Assuming a conservative return on investment of 1 ton avoided emissions per $10 dollars. 6 World Wildlife Federation. (2012). International Conservation Budget. As retrieved from http://bit.ly/Smm56Q 7 USAID. (2012). Environment and Global Climate Change. As retrieved from http://www.usaid.gov/what-we-do/environment-and-global-climate-change.

Energy and EnvironmentFY13 Committee Approved 

Funding 

Senate: $1.15 billionFY12 Enacted: $1.25 billion

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The Global Need

The need for voluntary family planning is growing, and an estimated 222 million women in the developing worldwish to delay, space, or complete childbearing, but do not have access to modern contraceptives.1 Of the 185million pregnancies which occur yearly in the developing world, 40 percent are unplanned and roughly half of those unplanned pregnancies end in abortion.2 Many of these abortions are clandestine and performed under unsafe conditions.3 

Significance of Funding Levels 

The additional $239 million approved by the Senate Appropriations Committee for FY13, including $44.5million for UNFPA would mean approximately:

12,428,000 additional women and couples would receive contraceptive services and supplies;

3,585,000 fewer unintended pregnancies ;1,673,000 fewer abortions would take place; and 

9,560 fewer maternal deaths would occur as a result of increased access to contraceptive service andsupplies, and 47,800 children would not lose their mothers.4 

Importance of Funding

USAID is committed to ensuring that women and couples in developing countries have access to familyplanning services and are able to make informed, voluntary decisions about their reproductive lives. Fundingfor international family planning and reproductive health is a proven, cost-effective way to meet a broad rangeof international development goals. Family planning could prevent up to 40 percent of the more than287,000 maternal deaths that occur every year, by enabling women to delay their first pregnancy and space

later pregnancies at the safest intervals. In addition, with the ability to control birth spacing, the lives of 1.6million children under the age of five could be saved each year.5 

Benefits of Family Planning Assistance  – Success is Possible 

USAID advances and supports voluntary family planning and reproductive health programs in more than 45countries across the globe. Since the launch of USAID’s family planning program in 1965, parents are better equipped to feed, clothe, educate and provide health care for their children. Successes include:

Since USAID started its program, modern contraceptive use in the 27 countries with the largest USAID-supported programs has increased from under 10 to 37 percent, and the number of children per family has dropped from more than 6 to 4.5;Former recipients of USAID family planning assistance, such as Korea, Thailand, Brazil, and Mexico

have graduated from the programs and are now donors; and According to the USAID Office of Population and Reproductive Health, 22 countries have graduated

from USAID Family Planning and Reproductive Health assistance and no longer require US

government support for family planning programs.

1Guttmacher Institute. (2012). Adding It Up: Costs and Benefits of Contraceptive Services —Estimates for 2012 . Retrieved from

http://www.guttmacher.org/pubs/AIU-2012-estimates.pdf  2

Guttmacher Institute. (2012). Are You In The Know? As Retrieved from http://www.guttmacher.org/in-the-know/pregnancy.html.3

UNFPA. (2012). Reproductive Health: Ensuring that Every Pregnancy is Wanted. Retrieved fromhttp://www.unfpa.org/rh/planning.htm 4

Guttmacher Institute. (May 2012). Just the Numbers: The Impact of U.S. International Family Planning Assistance. Retrieved fromhttp://www.guttmacher.org/media/resources/FB-Family-Planning-Assistance.pdf .5USAID.(2012). Family Planning. As retrieved from http://www.usaid.gov/what-we-do/global-health/family-planning.

Global Health:Family Planning and 

Reproductive Health Funding 

FY13 Committee Approved Funding 

Senate: $700 millionHouse: $461 million

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The Global Need

The Food and Agricultural Organization of the United Nations found that food production will have to rise by

60 percent by 2050 to meet rising demand from growing populations, increased incomes, and the diversionof food crops for energy. However, funding levels for donor investment in agriculture development are wellbelow where they need to be if the world is to avert a major crisis.1 

Importance of Funding

 Almost 900 million people — 1 out of 8 men, women and children in the world — are suffering from chronichunger, while more than 3 million children die each year from malnutrition. Hunger robs the poor of healthy and productive lives and stunts the mental and physical development of young children – but there is asolution. Smallholder farmers already provide up to 80 percent of the food supply in Asian and sub-Saharan

 Africa, but many lack the resources necessary to boost productivity, quality and sustainability of their harvests.2

Feed the Future focuses on the root causes of chronic hunger by improving farmers’ ability to produce andbring their crops to market in a sustainable way, to grow economies, increase food security and promote long-

term stability and resilience. Investments in a gender-sensitive, inclusive, agriculture-led growth includeimproving agricultural productivity, expanding markets and trade, and increasing the economic resilience of vulnerable rural communities.3 

The Impact of Funding  – Success is Possible 4 

Through increased focus on training smallholders to run successful farms, establishing partnerships withagribusinesses, improving financial and agricultural services, and reducing trade barriers, farmers in the 20Feed the Future target countries are increasing their competitiveness in national and international markets. InFY 2011, US Government agricultural assistance benefited over 4.3 million farmers and succeeded inhelping 5.2 million farmers adopt new technologies or management practices. Some of the accomplishments oFeed the Future funding through the Development Assistance account include:

  Increasing the value of incremental sales at the farm level from $900,000 in FY2010 to $87 million inFeed the Future countries such as Guatemala, Liberia, Haiti, and Nepal in FY2011;  Increasing the value of coffee exports in Rwanda by 77% in FY 2011; and   Increasing farmer incomes in Haiti in targeted households by 76% through agriculture production and

processing activities.

*The House SFOPS passed bill for FY 2012 does not include a specific funding amount for Feed the Future programming.**“$1 billion from the Development Assistance Account, and $200 million from multilateral accounts.1Food and Agricultural Organization.(2012). How to Feed the World in 2050. As retrieved from http://bit.ly/Wcg4v 2Food and Agriculture Organization. (2012) Factsheet, Smallholders and Family Farmers. As retrieved from: http://bit.ly/Wcg4v 3USAID. (2012). Feed the Future. As retrieved from http://www.feedthefuture.gov/about. 4Statistics and information in this section are from the FY13 Congressional Budget Justification, Foreign Operations, Volume 2, page 446-448. Asretrieved from http://www.state.gov/documents/organization/185014.pdf . 

Development Assistance:

Feed the Future 

FY13 Committee Approved Funding* 

Senate: $1.2 billion**FY12 Estimate: 1.17 billion

Significance of Funding Levels 

Supporting the Senate Committee level of $1.2 billion for Feed the Futurewould increase impact on food and nutrition security by:

Expanding public-private partnerships, such as existing partnerships with WalMart, PepsiCo, and SwissRe; Improving markets and trade, and increasing economic resilience in vulnerable rural communities; Reducing long-term vulnerability to food insecurity, helping to prevent costly crises such as the 2011

famine in the Horn of Africa and the 2012 food crisis in the Sahel; and Accelerating agricultural production, increasing adoption of technology, improving quality and access to

market information and infrastructure.

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The Global Need

As of September 2012, 870 million people are estimated to be suffering from malnutrition and hunger.1 

Crop failures, conflicts, natural disasters, and high domestic food prices all contribute to this food crisis. InOctober 2012, 35 countries were identified to be in crisis, many of which experience recurrent shocks, keepinghouseholds in a cycle of hunger and poverty.2 Hunger remains one of the world’s most pressing challenges,with almost one in seven people worldwide suffering from chronic hunger. Surviving and recovering from these shocks requires resilience, however many families have lost their ability torespond to natural disasters or increased food prices, and resort to damaging practices like selling off theirassets for survival, leaving them even more vulnerable to future hardship. A combination of immediateemergency assistance and resilience building activities are needed to enable households that can survive andbounce back quickly from crisis.

Significance of Funding Levels 

The additional $316 million dollars approved by the Senate Appropriations Committee for FY13 for Title IIFood for Peace could:

•  Provide food assistance to approximately 9 million more people;3 and•  Increase resilience and decrease the need for future emergency assistance by helping families

acquire the tools they need to improve farming techniques and build self-reliance through Title II Non-Emergency/development funding included in this appropriation.

Importance of Funding

Food for Peace remains the flagship U.S. food assistance program. During emergencies, Food for Peaceprovides immediate and lifesaving food to the most vulnerable through food distributions, food-for-workprograms, and food vouchers. With multi-year programs, Food for Peace development programs also boost

smallholder agricultural output and linkages to markets, improve mother and child nutrition, better managenatural resources, and ultimately help communities reduce future reliance on emergency aid and a host ofother interventions. These steps to reduce hunger and increase the economic well-being of people in thedeveloping world create more prosperous and stable markets for US goods and services. In addition, volatilefood prices and limited access to affordable food can lead to social unrest, making it critical to both our nationaand global security that the US and its partners help developing countries better manage destabilizing eventslike soaring food pricings and natural disasters.4 

Impact of Funding –Success is Possible 

Since Food for Peace began in 1954, more than three billion people in 150 countries have benefiteddirectly from US food aid. At present, it provides food and assistance for millions of individuals in 44countries who are suffering from hunger and malnutrition.5 Examples of success include:

• Reducing stunting prevalence among children under five years by 2.4% per year; and

•  Helping several thousand farmers in Nicaragua move out of low-profit local markets into formal high-profitsupply chains – resulting in a 44% increase in income and sales of $39.8 million in agricultural products tomajor companies in four years. 6 

1 FAO. (2012). The State of Food Security. Page 8. As retrieved from http://www.fao.org/docrep/016/i3027e/i3027e.pdf. 2 FAO. (2012). Countries Requiring External Assistance for Food. As retrieved from http://www.fao.org/giews/english/hotspots/index.htm. 3 This number is based upon a cost per beneficiary amount of approximately $35, drawn from an analysis of funding from the previous three USAID’sInternational Food Assistance Annual Reports, dividing total title II costs by total number of beneficiaries served.4

Roadmap to End Global Hunger. July 2012. As retrieved from http://bit.ly/Wb38d6 5 US Food Aid and Security. (2012). Food for Peace. As retrieved from http://foodaid.org/food-aid-programs/food-for-peace/ . 6 Roadmap to End Global Hunger. July 2012. As retrieved from http://bit.ly/Wb38d6 

Agricultural Appropriations:

Food for Peace (P.L. 480) 

FY13 Committee Approved Funding 

Senate: $1.466 billionHouse: $1.15 billion

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The Global Need

The International Disaster Assistance (IDA) account is the US Government’s frontline fund for responding to major

humanitarian emergencies, natural disasters, and the needs of internally displaced persons (IDPs). Global needs aremounting, with crises in Darfur, Congo, Burma, and Syria, among others, driving global IDP numbers to more than 27million. This is nearly double the size of the world refugee population, yet despite facing similar challenges IDPs receivefar less international support per capita.

1The IDA account also addresses humanitarian needs arising from political

instability and food crises, as in Yemen, ongoing droughts in the Sahel and the Horn of Africa, and natural disasters suchas earthquakes, hurricanes, and tsunamis. According to UNOCHA, the global cost to adequately support humanitarianneeds in 2012 is over $8.8 billion.

2By robustly funding IDA, US leadership can have a ripple effect as this funding can

help leverage increased international resources and pressure other countries to contribute more.

IDA also funds disaster risk reduction (DRR) activities, which builds the ability of communities to prepare for, and mitigate,the effects of disasters. While DRR is chronically underfunded, it is invaluable in building resiliency, preventing loss of lifeand reducing reliance on aid in future emergencies. World Bank research has found that DRR investments can yielda 7 to 1 ratio of savings to investment.

Significance of Funding Levels  

The IDA account is severely stretched, responding to multiple major humanitarian crises in the Horn of Africa, the Sahel,Sudan, Syria, and Yemen. The additional $327 million approved by the Senate Appropriations Committee for FY13 couldprovide further support for:

• Victims of conflict displaced in places like Syria, Darfur, and South Sudan;• Women and children facing starvation in Somalia and the Sahel;• Resources for preventing and mitigating new emergencies; and  • Bolstering the US’s ability to respond to future natural disasters and humanitarian crises.

Importance of Funding

The disparity between US support for refugees and IDPs reflects the reality that even as refugees struggle to adequatelymeet basic needs, IDPs receive far less than the global minimum standards for humanitarian support. The fundingprovided by the Senate could vastly improve basic assistance to approximately 7.8 million IDPs,

4vastly improving

their access to basic services such as water, health care, and shelter. It would also protect other vital humanitarianprograms against future funding squeezes as witnessed in the aftermath of the Haiti earthquake when the Office ofForeign Disaster Assistance (OFDA) cut 40% of funding for programs in other disaster around the world in order toredirect resources to Haiti.

The Impact - Success is Possible 

America’s strong role in supporting the most vulnerable populations in the world demonstrates US leadership inhumanitarian assistance. In 2011, OFDA, which implements IDA funding, has successfully:

•  Provided emergency assistance to tens of millions of people in 54 countries in response to 67 disasters;

•  Addressed conflict and displacement related needs in the Middle East; and

•  Supported the reintegration of returnees to South Sudan and provided livelihood support to help families learnthe skills needed to rebuild their community and country.

1 Internal Displacement Monitoring Center. (2011). IDPs in Protracted Displacement. As retrieved from http://bit.ly/TUgKCb .2 UN OCHA. (2012). Humanitarian Funding: 62 Million Need Humanitarian Help Worldwide. As retrieved from http://bit.ly/PnzX0W . 3 US Geological Survey and the World Bank estimated that an investment of $40 billion would have prevented losses of $280 billion in the 1990s. Asretrieved from Executive Summary, http://www.unisdr.org/files/1071_disasterriskreductionstudy.pdf 4

The average 5-year per capita disparity between refugee and IDP funding was $42 from 2007-2011. $328 million would erase this disparity for5 The Cable. (2012). “Haiti Causing Steep Funding Cuts, Aid Groups Warn.” As retrieved from http://bit.ly/9Sdwft. 6 USAID, Office of US Foreign Disaster Assistance; Annual Report for FY 2011. Pages 9-10 and 111.

International Disaster 

Assistance

FY13 Committee Approved Funding 

Senate: $1.25 billionHouse: 923 million

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The Global Need

Every year, 3.3 billion people are at risk of contracting malaria, leading to approximately 216 million malariacases and an estimated 655,000 deaths. Thanks in part to President George W. Bush’s leadership and thecreation of the Presidential Malaria Initiative in 2005, which currently operates in 19 focus countries,international funding to combat malaria has continued to rise. However, funding still falls short of the $5 billionper year needed from 2010 to 2015 to reach malaria control targets.1 Additionally, robust funding for malariaresearch and development is necessary to sustain the remarkable gains made against the disease in the lastdecade.

Significance of Funding Levels  

The extra $20 million dollars approved by the Senate Appropriations Committee for FY13 could provide:  Bed nets for over 5 million people; 

  Artemisnin-based Combination Therapy (ACT) treatment for more than 14 million people; or 

  Rapid diagnostic testing (RDT) for 33 million people.

Cost of Care 

$4.00 = Long-lasting insecticidal bed net that lasts three years $1.40 = ACT course for an adult  $0.60 = Rapid diagnostic testing for children and adults2 

Importance of Funding

The World Health Organization (WHO) estimates that half of the world’s population is at risk of malaria

infection. Malaria is prevalent in 106 countries, referred to as malaria-endemic countries. Malaria imposessignificant costs to both individuals and governments. Direct costs such as illness, treatment, or prematuredeath have been estimated to be at least $12 billion per year. Indirect costs, like loss of economic growth, aremany times more than that.3 

The Impact of Funding - Success is Possible 

USAID works closely with national governments to build their capacity to prevent and treat malaria. With thehelp of US and global funding efforts, significant gains in combating malaria have been made, including:

43 countries have reported a reduction in malaria cases of more than 50 percent; Estimated new cases of malaria have decreased by 17 percent globally; Mortality in children under five has fallen dramatically across Sub-Saharan Africa due to a scale-up of 

malaria control efforts;4

and The overall annual malaria death toll has declined from 985,000 to 655,000 people, a 26 percent

reduction in global malaria mortality.5 

By continuing these smart investments, the U.S. can continue to lead the international community inending malaria deaths globally. 

1 Kendall, Alexandra. (June 2012). Congressional Research Services: U.S Response to the Global Threat of Malaria. Retrieved from

http://www.fas.org/sgp/crs/misc/R41644.pdf .2 World Health Organization. (2011). World Malaria Report 2011: Financing Malaria Control. Retrieved from http://bit.ly/Rrtlg1 3 Center for Disease and Control Prevention. (2010). Impact of Malaria. Retrieved from http://www.cdc.gov/malaria/malaria_worldwide/impact.html.4 The President’s Malaria Initiative: Sixth Annual Report to Congress (April 2012). Page 3. As retrieved from: http://1.usa.gov/RvHY3Q 5 The Global Fund. (2012). Fighting Malaria: The Global Malaria Epidemic. Retrieved from http://www.theglobalfund.org/en/about/diseases/malaria/. 

Global Health:

Malaria Funding 

FY13 Committee Approved Funding 

Senate: $670 millionHouse: $650 million

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The Global Need

In June 2012, the U.S., along with 162 other governments, made a bold promise to the world to end

preventable child deaths.1 In fact, U.S. investments have made a major contribution to the 10 percentreduction in infant mortality rates worldwide over the last eight years, and USAID interventions helpsave the lives of more than 6 million children under 5 every year. 2 

Still, there are 6.9 million deaths among children under five each year, largely due to avoidableand treatable causes, including pneumonia, diarrhea, and malaria. Malnutrition is the underlyingcause of about one-third of deaths in these young children.3  Every year in 358,000 women aredying from largely preventable complications related to pregnancy or childbirth.

Significance of Funding Levels

The extra $73.418 million dollars approved by the Senate Appropriations Committee for FY13 couldprovide: 

•  Over 6.9 million children immunizations against tetanus, pertussis, and hepatitis, or•  Over 6.3 million children low-cost antibiotics to treat pneumonia-the leading killer of

children under five, or•  Over 11.5 million children oral rehydration salts that could help save many of the 1.1 million

who die needlessly from diarrhea.4 

Importance of Funding

Funding for preventing illness and promoting good health in mothers and children reduces the cost of

curing people when they get sick – by up to $700 million globally per year for child survival alone. 5 U.S. investments and the bold child survival call to action have led to country ownership of theseimportant health initiatives, including in India, Nigeria, Malawi and Nepal- which have prioritized andinvested their own resources in maternal and child health.

Significance of Funding – Success is Possible 

Since the inception of its child survival and maternal health program, the United States, incollaboration with many international partners, has delivered unprecedented successes:

• Almost a billion episodes of child diarrhea treated each year, reducing child deaths fromdiarrheal disease by more than 50 percent since 1990;

• More than 100 million children received basic immunizations each year;• More than 75 million infants and children with pneumonia received treatment annually;• Malnutrition among children under age 5 has been reduced from one in three to one in

four, a 25 percent reduction; and,• More than 70 percent of women receive at least some care during pregnancy.6 

1 A Promise Renewed. (2012). A Call to Action. As retrieved from http://www.apromiserenewed.org/A_Call_to_Action.html. 2 USAID. (2012). USAID Maternal and Child Health. As retrieved from http://www.usaid.gov/what-we-do/global-health/maternal-and-child-health .3 UNICEF. (2012). Committing to Child Survival: A Promise Renewed, Progress Report 2012. Forward, As retrieved from http://uni.cf/QQB5wA 4 Costs determined by average treatment costs of interventions and include vaccines, cold chain, syringes & needles, training and salaries.5

World Health Organization. (2012). Investing in Maternal, Newborn, and Child Health. Page 3. As retrieved from http://bit.ly/VEesIW 6 USAID. (2009). USAID’s Child Survival and Maternal Health Program. Page 2. As retrieved from http://pdf.usaid.gov/pdf_docs/PDACN044.pdf. 

Global Health:

Maternal and Child Health 

FY13 Committee Approved Funding 

Senate: $679 millionHouse: $605 million

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The Global Need

Every year 2.5 million children die from an entirely preventable condition; malnutrition.

1

According to UNICEF, there arean estimated 130 million school-age children in the world’s poorest countries who are undernourished and would beeligible for school feeding programs.

2Currently, USDA funds 36 active agreements with 17 cooperating sponsors in 28

countries,3 assisting more than 4.3 million women and children using programs such as McGovern-Dole.4 

Significance of Funding Levels  

The additional $3.68 million dollars for FY13 approved by the Senate Appropriations Committeecould provide meals for over 92,000 children throughout the school year.

Since FY08, McGovern-Dole has provided school-aged children in poverty-stricken countries what is often their only fullmeal of the day at an average cost of $40 per student, per year. 5 McGovern-Dole not only provides beneficial nutritionalmeals, helping to combat hunger, but also increases literacy and future opportunities that education provides- buildingthe groundwork for long-term sustainable development. 

Importance of Funding

The McGovern-Dole program provides technical and financial assistance to carry out pre- and primary-school programs indeveloping countries in order to improve food security, reduce the incidence of hunger and malnutrition, and improveliteracy and primary education. According to WFP, there are 66 million children who go to school hungry every day. 6 Byproviding school meals, teacher training, and related support, McGovern-Dole projects help boost school enrollment andacademic performance.7 The program also works to help move national governments closer to their goal of fully fundingand operating school meals as an important social safety net.

The Impact of Funding- Success is Possible 

Since 2000, when USDA established the predecessor to the McGovern-Dole program, it has provided meals to feed

more than 22 million children in 41 countries and boosted school attendance by an estimated 14 percent overall and by 17 percent for girls.8 

 Additionally, over the last 45 years, more than 37 national governments have successfully taken over school mealprograms launched by donor countries, NGOs, and international organizations including Brazil and India, which currentlyoperate two of the largest school meal programs in the world. 9 

Country Success Story  – Republic of Congo 

Since 2001, four McGovern-Dole Programs have been implemented in the Republic of Congo. During this time, about30,000 metric tons of US-donated foods (rice, beans, potato flakes and vegetable oil) have been distributed to nearly150,000 pre-school and primary school-age Congolese children. The efforts helped increase Congolese schoolenrollment by nearly 24 percent. The drop-out rate has decreased by more than 50 percent. In 2010, the Congolesegovernment approved a plan that gradually decreases the amount of U.S.-donated food and increases the Congolesegovernment’s logistical and administrative support. The Congolese government is expected to take completeresponsibility for the school lunch program by the end of 2015. 10 

1 State of Food Insecurity in the World, 2012, page 4. As retrieved from http://www.fao.org/docrep/016/i3027e/i3027e.pdf  2 UNICEF. (2009). Tracking Progress on Child and Maternal Nutrition. Page 5. As retrieved from http://uni.cf/darWEi. 3 USDA Blog. (2012). U.S. Wheat Helps Feed Children in Bangladesh. Retrieved from http://1.usa.gov/RyrhDJ .4 U.S. International Food Assistance Report 2010, Page 24. As retrieved from http://1.usa.gov/Pq77Pc 5 Determined by dividing beneficiaries and funding levels from FY 2008-2011. Figures taken from annual US International Food Assistance Reports.6 Two minutes to learn about school meals, page 1. As retrieved from http://bit.ly/OvzqMU 7 U.S. Department of State. (2011). Foreign Operations Congressional Budget Justification Fiscal Year 2011: Volume 2. Retrieved from http://1.usa.gov/Q79zv7 3 U.S. Department of Agriculture. (2012). McGovern –Dole International Food for Education and Child Nutrition Program Fact Sheet. Retrieved from http://1.usa.gov/YrPdwW . 8 UNICEF. (2009). Tracking Progress on Child and Maternal Nutrition. Page 5. As retrieved from http://uni.cf/darWEi. 9 Roadmap to End Global Hunger. Page 15. (July 2012). As retrieved from http://www.thp.org/files/FINAL_roadmap_layout_web.pdf .10 USDA Blog. (Sept 2012). FAS Food for Education Program Fuels Food for Thought. As retrieved from http://1.usa.gov/QICEuv. 

Agricultural Appropriations:

McGovern-Dole International Food for 

Education and Child Nutrition Program 

FY13 Committee Approved Funding 

Senate: $184 millionHouse: $180.32 million

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The Global Need

 An estimated 2.7 billion people around the world have no access to formal financial services, limiting

their ability to save, invest, or grow a business. Microfinance brings essential financial services to many poor women and men around the world, but much more needs to be done to reach those who are very poor, livingon less than $1.25 a day. While commercial investment has entered the marketplace in some countries, ittends to not reach the very poor. In order to promote greater entrepreneurship and private sector growth,microfinance institutions must be able to access capital to grow and continue to meet demand.1 

Significance of Funding Levels 

 Approved FY 13 funding levels could provide approximately 3 million people with the financial means tostart or grow a business and lift themselves out of poverty. Microfinance can often be combined with

health services and other non-financial support to further help families escape poverty.2 

Importance of Funding

In many developing countries, the self-employed comprise more than 50 percent of the labor force. Access to small amounts of credit at reasonable interest rates allows poor people to improve their lives, sendtheir children to school, pay for health care, and improve their nutrition. Microfinance also improves socialcapital as clients become more empowered and integrated into markets and their communities. Evidenceshows that when poor people have access to financial services, they choose to invest their loans, additionalearnings, or savings in activities and assets that benefit their businesses and their families. Thus, access tofinancial services provides the poor with the means to achieve most of the Millennium Development Goals—ontheir own terms, in a sustainable way.3 

Impact of Funding  – Success is Possible 

 As of FY11, USAID was providing microenterprise development assistance in 50 countries, with 93 percent ofall USAID-assisted microfinance institutions operationally self-sustaining. Of the estimated 4.6 millionbeneficiaries of USAID microenterprise funding in FY11, nearly 2 million were very poor, living on less than$1.25 a day.4 

Examples of the work that USAID has supported by partnering with international NGOs and foundations suchas the Bill and Melinda Gates Foundation include:

Connecting 370,000 smallholder farmers in Kenya with technology and markets, nearly quadrupling

maize production and significantly increasing incomes. Extending mobile financial services to 500,000 people living in remote areas in Haiti via their mobile

phone.5 

Microfinance promotes fiscal responsibility, entrepreneurship, and sustainable economic growth.

1 Grameen Foundation. (2012). Microfinance Basis. As retrieved from http://www.grameenfoundation.org/what-we-do/microfinance/microfinance-basics. 2 Based on a cost per beneficiary of $85 as determined from 107 projects which provided information on borrowers, savers, microenterprises or totalnumber of employees from USAID’s Results Reporting in 2011. Page 4. As retrieved from http://pdf.usaid.gov/pdf_docs/PDACT959.pdf  .3 Consultative Group to Assist the Poor. (2002). Microfinance and the Millennium Development Goals. As retrieved from http://bit.ly/VeaECB .4 USAID. (2012). Microenterprise Results Reporting: Annual Report to Congress. Page 6. As retrieved from http://1.usa.gov/VeaoUo. 5 USAID. (2012). Microenterprise Development. As retrieved from http://1.usa.gov/X3fJ1t 

Development Assistance:

Microfinance 

FY13 Committee Approved Funding 

Senate: $265 millionHouse: $265 million

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The Global Need

Armed conflicts are forcing people to flee across borders at a faster rate in 2012 than any other year this

century.1 Since 2000, the number of refugees and internally displaced persons (IDPs) has increased by nearlytwo-thirds, from 25.6 million to 43.7 million. Yet, according to the UN High Commissioner for Refugees, as ofOctober 30th, the agency has less than half the money it needs for Africans displaced by conflict and may needto start cutting support to refugees.2 

On top of record-high displacement in 2011, as of October 2012, the crisis in Syria has forced500,000,refugees into neighboring countries.3 By the end of the year, it is estimated there will be 710,000Syrian refugees. Robust funding is needed to respond to the highest displacement levels in 15 years,including complex emergencies such as in Syria, South Sudan, the Horn of Africa and the Sahel as well asprotracted crisis situations and efforts to support innovative, long-term, sustainable policies that can mitigatefuture costs of responding to emergencies. 

Significance of Funding Levels The MRA account is badly stretched, responding to huge population movements and conflict. The additional$617 million approved by the Senate Appropriations Committee for FY13 would provide further support for:

• Syrian refugees who are placing strain on surrounding countries which are already unable to meet theincreasing demand for water, housing, schools, and hospitals;

• Somalis who are taking refuge in Kenya’s Dadaab camp and are without adequate housing, water,sanitation, and education; and

• Schooling for the 25% of refugee children who have no access to primary education and the more than60% who have no access to secondary school.

Importance of Funding

Refugees supported by the MRA account are heavily dependent on the international assistance for their basicneeds. Refugees often cannot safely return home, and 80% of the world’s refugees are hosted in poor,developing countries that have little capacity to support them. As a major new refugee crisis emerges fromSyria, robust funding for the MRA account is vital. The Senate level will also allow funding for importantgender-based violence prevention and related services, refugee education, livelihoods programs (which reducelong-term dependence on aid), and programs to find permanent solutions for the displaced. Investing in theseimportant activities will lay the groundwork for refugees to become more self-sufficient and less aid dependentin the long run.

Impact of Funding – Success is Possible 

America’s strong role in supporting the most vulnerable populations in the world demonstrates US leadershipin humanitarian assistance, but also plays an invaluable role in creating a more secure, stable world. Fundingto UNHCR and NGOs through the MRA account has achieved important progress, such as:

• Supporting Syrian refugees in Jordan to address basic needs and reduce destabilizing pressure on theJordanian government; and

• Providing the largest bloc of funding for the repatriation of approximately two million Sudanese refugees toSouth Sudan after the end of the civil war. 4 

1 United Nations High Commissioner for Refugees. (2012). UNHCR Global Trends 2011. Page 3. As retrieved from http://www.unhcr.org/4fd6f87f9.html2

Borger, Julian. (October 30, 2012) “UNHCR chief says his agency lacks cash to look after victims of conflict.” The Guardian. As retrieved from:http://bit.ly/St2nZK 3

UNHCR’s Syria Regional Response, Information Sharing Portal. As retrieved on October 24th, 2012 at: http://bit.ly/HqwSM3 

4United Nations High Commissioner for Refugees. (2012). UNHCR Global Trends 2011. Page 7. As retrieved from http://www.unhcr.org/4fd6f87f9.html

Migration andRefugee Assistance

FY13 Committee Approved Funding 

Senate: $2.3 billionHouse: 1.683 billion

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The Global Need

Neglected Tropical Diseases (NTDs) impact nearly 1 in 6 people worldwide, including nearly half abillion children. These diseases include schistosomiasis, river blindness, lymphatic filariasis,trachoma, roundworm, whipworm, and hookworm. Every year up to 400,000 people die fromNTDs; one billion suffer from one or more tropical diseases, causing severe disability and hinderingcognitive development.1 

The general consensus within the development community is it can cost as little as 50 cents per year to treat a person against the most common NTDs.  

Significance of Funding Levels 

The additional $36 million dollars approved by the Senate Appropriations Committeefor FY13 could provide treatment to 72,000,000 people.2 

Importance of Funding 

Eliminating NTDs offers one of the clearest links to cutting the cycle of poverty for millions of people.NTDs coexist with poverty because they thrive where access to clean water and sanitation are limitedand people live without protection from disease vectors. NTDs are also recognized as a contributor topoverty since they can: 

•  Impair intellectual development in children;•  Reduce school enrollment; and,•  Hinder economic productivity by limiting the ability of infected individuals to work.3 

USAID support for NTDs focuses on the scale-up of efficient and sustained preventive chemotherapyin an integrated manner so that control of all and elimination of some of these diseases can beachieved.

Impact of Funding – Success is Possible 

Over the past 5 years, the US Government has leveraged $3.1 billion in donated medicines, resulting

in the delivery of more than:

584.6 million safe and effective treatment strategi e s for NTDs to approximately 257.9 million people .4  

*House level of funding for NTDs was not specified in the FY 2013 State and Foreign Operations Appropriations Amount 1 U.S. Department of State. (2011). Foreign Operations Congressional Budget Justification Fiscal Year 2011: Volume 2. Retrieved fromhttp://1.usa.gov/Q79zv7. 2

Based on cost per beneficiary amount of $0.50, analysis taking the number of beneficiaries over the total funding allotted over the course of severalfiscal years. 3 USAID. (2012). USAID Neglected Tropical Diseases. As retrieved from http://www.usaid.gov/what-we-do/global-health/neglected-tropical-diseases. 4 USAID. (2012). USAID’s Neglected Tropical Diseases Program. As retrieved from http://www.neglecteddiseases.gov/about/index.html. 

Global Health:

Neglected Tropical Diseases  

FY13 Committee Approved Funding 

Senate: $125 millionFY12 Enacted: $89 million*

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The Global Need

Malnutrition is responsible for the deaths of over one out of every three children under age five each year — or more than 2 million children. Virtually all of these deaths are preventable. For the 170 millionchildren1 who are living with chronic malnutrition throughout their young lives, it can cause serious, oftenirreversible, damage to their bodies and brains. Malnutrition among young children can severely limit or impairtheir ability to grow, learn, earn a living, take care of themselves and ultimately help their families rise out ofpoverty.2 

Significance of Funding 

For about $8, a child can be provided with a package of interventions designed to save their lives andhelp prevent the irreversible damage to their brains and bodies caused by malnutrition. Theseinterventions include Vitamin A supplementation, therapeutic zinc for the management of diarrhea,micronutrient powders, de-worming medication, as well as adequate iron and folic acid for expectant mothers.

The extra $27 million dollars approved by the Senate Appropriations Committee for FY13 wouldsupport an additional 3,370,000 children and their moms in their fight against malnutrition.3 

Importance of Funding

The quality of nutrition during pregnancy and until a child’s second birthday – the critical 1,000 day window – also has enormous, long-term macroeconomic implications. Child malnutrition is also a serious drain oneconomic productivity—in some cases, it costs as much as 11% of a country’s GDP—and imposes staggeringhealth costs on countries that are already struggling to meet basic needs. 4 Additionally, it often undermines theinvestments made in other sectors like health care, agriculture and economic development.

The Impact of Funding - Success is Possible 

Evidence has shown that preventing and treating malnutrition during the first years of a child’s life offerstremendous return on investment. By investing in improved nutrition during the critical 1,000 day window, theinternational community can:

•  Save more than 1 million lives each year;5 

• Boost a country’s GDP by at least 2-3 percent annually;6 

• Build self-sufficiency: well-nourished children are more likely to continue their education, have higherIQs, and earn up to 46% more over their lifetimes;7 

• Significantly reduce the human and economic burden of infectious diseases such as malaria andHIV/AIDS, and chronic diseases such as diabetes; and

• Help end hunger and break the cycle of poverty. 

1Onis M, Blossne M, and Borghi E, ‘Prevelance of stunting among pre-school children 1999-2020,’ Growth Assessment and Surveillance Unit, Public 

Health Nutrition , 2011, Jul 14:1-7.2 Global Monitoring Report. (2012) World Bank and International Monetary Fund.3Based on the costing of five interventions--Vitamin A supplementation, therapeutic zinc for the management of diarrhea, micronutrient powders, de-

worming, and adequate iron and folic acid for pregnant women--using data provided by the World Bank and accessed at: http://bit.ly/VGOvIJ. 4

The Cost of Hunger: Social and economic impact of child undernutrition in Central America and the Dominican Republic,The United Nations Economic Commission for Latin America and the Caribbean and World Food Programme, 2008.5

Horton, Susan, et al. Scaling Up Nutrition: What will it cost? The World Bank.6

The World Bank, Repositioning Nutrition as Central to Development, 2006.7 Hoddinott, J., J. Maluccio, et al., 2008: Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults, The 

Lancet , 371.

Global Health:

Nutrition Funding 

FY13 Committee Approved Funding 

Senate: $122 millionHouse: $95 million

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The Global Need

“Polio eradication is at a tipping point between success and failure,” according to the Director Generalof the World Health Organization.1 Less than a quarter century ago, polio was permanently disabling350,000 children every year in 125 countries. By 2011, polio cases had declined to only 650 cases,primarily in Pakistan, Afghanistan, Nigeria, the Democratic Republic of the Congo and Chad. In 2012(through October) only 170 people in the world had been diagnosed with polio. Complete eradicationof polio is achievable in the near future. However, as long as polio remains in one country allcountries are at risk.2 

Significance of Funding Levels 

The approved FY 2013 funding level by the Senate Appropriations Committee enables USAID tocontinue to support rapid response to outbreaks, surveillance in endemic and polio-free countries atrisk of importations of the virus, community mobilization and other critical activities on behalf of theglobal eradication effort. USAID’s polio activities are particularly concerned with protecting children inunder-served communities and countries in conflict.3 

Importance of Funding

As long as a single child remains infected, children everywhere are at risk of contractingpolio. Due to cross-border transmission, polio cases broke out in 23 previously polio-free countriesbetween 2000 and 2010. Success hinges on continued financing of the global eradication initiative—including support for vaccinations, rapid response to outbreaks, and surveillance for cases, as well asfurther analysis provided by the Global Laboratory Network of 145 laboratories.4 Polio eradicationbenefits every society, regardless of where families live. If polio were eradicated in the next fiveyears, it would save developing countries at least $40-$50 billion, mostly in low-income countries.5 

Impact of Funding  – Success is Possible 

Since 1988, when the Global Polio Eradication Initiative began and polio was paralyzing a thousandchildren worldwide every day, 8 million people are walking paralysis-free as a result of the effort

to eradicate polio . More than 2.5 billion children have been immunized against polio since 1988,thanks to the cooperation of more than 200 countries and 20 million volunteers.

The United States took the lead in this historic Initiative, providing $2 billion of the $9 billion spent onpolio eradication between 1988 and 2012. The Rotary Foundation and the Gates Foundation haveeach provided over $1 billion.6 

*This appropriation for polio is part of the FY13 Maternal Child Health account. In addition, Congress supports global polio eradication efforts through theDepartment of Health and Human Services appropriations for the Centers for Disease Control. In 2011 CDC received $107 million for its work with polio.1Polio Global Eradication Initiative. (May 24, 2012.) “Polio eradication shifts into emergency mode.” As retrieved at: http://bit.ly/MLbEK8 

2Global Polio Eradication Initiative.(2012). Data and Monitoring – Polio This Week. As retrieved from http://bit.ly/9BJAP4. 3Based on a cost per dose of $0.14 and three doses per person. Global Polio Eradication Initiative.(2012). Oral Polio Vaccination. As retrieved fromhttp://www.polioeradication.org/Polioandprevention/Thevaccines/OralpoliovaccineOPV.aspx. 4World Health Organization.(2012). Poliomyelitis. As retrieved from http://www.who.int/mediacentre/factsheets/fs114/en/. 5World Health Organization.(2012). Poliomyelitis. As retrieved from http://www.who.int/mediacentre/factsheets/fs114/en/. 6Global Polio Eradication Initiative.(2012). History of Polio. As retrieved from http://www.polioeradication.org/Polioandprevention/Historyofpolio.aspx. 

Global Health:Polio Funding 

FY13 Committee Approved Funding 

Senate: $40 million*House: N/A

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The Global Need

Globally, Tuberculosis (TB) is the second leading cause of death from an infectious disease. It is one of the topthree killers of women globally: in 2010 it killed an estimated 580,000 women, leaving many children andfamilies vulnerable. The World Health Organization also estimates 9.7 million children have been orphaned asa result of losing at least one of their parents to TB.1 In 2010 there were 8.8 million new cases of TB and 1.1million deaths, including 350,000 deaths from TB among people with HIV. The vast majority of deaths from TBare in the developing world.2 

3  \ 

Importance of Funding

As TB knows no borders, strong global TB control is in the national interest of the United States. Drug resistantTB poses a particular challenge to domestic TB control due to high treatment costs, estimated at $100,000 to$300,000 per case.4 TB has a significant economic impact on both families and societies. It is estimated that insome countries the loss of productivity attributable to TB is 4 to 7 percent of countries’ GDP. TB is amajor economic stressor for poor families worldwide, as individuals may need to stop working in order to gettreatment or to care for relatives. The economic costs of seeking treatment are also high — research showsthat mean household spending on TB care for items such as transport to the health facilities as well as fees formedications for private sector care can be as much as 20 percent of total annual household income.5 6 7 

1 USAID. (2012). U.S. Government Report on International Foreign Assistance in TB FY 2010: Leading and Leveraging. As retrieved fromhttp://pdf.usaid.gov/pdf_docs/PDACT268.pdf. 2 The Global Fund. (2012). Fighting Tuberculosis: The Global Tuberculosis Epidemic. As retrieved from http://bit.ly/uTkCG7.3 Based on cost per beneficiary amount of $194, as provided by analysis run by The Global Fund of median costs for Directly Observed Treatment Short(DOTS) from 2007-2009.4 US House of Representatives TB Elimination Caucus letter. (2012). Led by Representatives Eliot Engel, Gene Green, and Don Young.5

USAID. (2012). U.S. Government Report on International Foreign Assistance in TB FY 2010: Leading and Leveraging. As retrieved fromhttp://pdf.usaid.gov/pdf_docs/PDACT268.pdf. 6 USAID. (2012). Stopping Tuberculosis. As retrieved from http://www.usaid.gov/what-we-do/global-health/tuberculosis. 7 The Global Fund. (2012). Fighting Tuberculosis: The Global Tuberculosis Epidemic. As retrieved from http://bit.ly/uTkCG7 

Global Health:

Tuberculosis Funding 

Impact of Funding – Success is Possible 6 

Between 1995 and 2010, 41 million TB patients were treated successfully through TB control programs,saving up to 6 million lives. Globally, deaths due to TB have fallen by more than one-third since 1990.7 

Currently, USAID is working with 28 countries to improve TB services. These efforts save lives and preventthe spread of TB. Additionally, with continued funding, the international community can reduce the potential ofdrug resistant TB in the future. With continued and consistent funding, by 2014 USAID will:

•  Contribute to a 50 percent reduction in TB deaths and disease burden from the 1990 baseline;•  Sustain or exceed the detection of at least 70 percent of sputum smear-positive cases of TB and

successfully treating at least 85 percent of cases detected in countries with established U.S.Government tuberculosis programs;

•  Successfully treat 2.6 million new sputum smear-positive TB patients under DOTS programs by 2014– 

primarily through support for needed services, commodities, health workers, and training, andadditional treatment through coordinated multilateral efforts; and•  Diagnose and initiate treatment of at least 57,200 new multidrug-resistant (MDR) TB cases by 2014,

and provide additional treatment through coordinated multilateral efforts.

Significance of Funding Levels 

The additional $49 million dollars approved by the Senate Appropriations Committee for FY13could provide comprehensive treatment regimens to 252,577 people. 3 

FY13 Committee Approved Funding 

Senate: $285 millionHouse: $236 million

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Importance of Funding

The last two Presidents have elevated development as a pillar of US National Security policy, critical to promoting andprotecting US interests. Reforms to the US’s development infrastructure, initiated during the Bush Administration, have

been reinforced and expanded under President Obama. In recent years, Congress has pushed USAID to be moreresponsive, transparent, and accountable. In response, USAID launched an aggressive reform agenda – USAID Forward

 – which focuses on significantly strengthening monitoring and evaluation (M&E) of development outcomes; maintaining amore transparent platform for showing where foreign aid resources are spent; improving sustainability and strengtheninglocal partners; fostering innovation through science, technology, and the private sector, minimizing non-competitivefunding; and reducing reliance on mega-grants and mega-contracts. The military has strongly supported bolstering UScivilian capacity, as exemplified by former Secretary Gates, who noted:

“…T here is a need for a dramatic increase in spending on the civilian instruments of national security  – diplomacy,strategic communications, foreign assistance, civic action, and economic reconstruction and development… We must 

focus our energies beyond the guns and steel of the military… having robust civilian capabilities available could make it less likely that military force will have to be used in the first place...” 

Development assistance that can reform and modernize while meeting these national security demands requires strong

management, staffing, and accountability. The Operating Expenses (OE) Account is the backbone of USAID, providingfunding for these very functions: paying the salaries of core USAID staff  – both foreign and civil service; providingequipment, technology, and training to enable them to perform their jobs effectively; and financing the tools to monitor progress and ensure accountability through USAID Forward.

Yet for at least the past decade, growth in the program budget has outpaced growth in OE.2

This imbalance betweenprogram increases and operations funding hampers USAID’s ability to execute its mission effectively. Instead of internalexperts extending its reach and making important programming and policy decisions, USAID has been forced to rely onoutside contractors for a significant portion of its core mission. This reliance weakens strategic planning andaccountability.

The Impact - Success is Possible

Investments in OE in recent years have made tangible progress in increasing USAID’s organizational effectiveness: 

After more than two decades of declining capacity within USAID, the DLI has made headway in filling gaps incritical technical skills lost, such as on engineering and agriculture, as well as rebuilding USAID core of contracting staff. Cuts to OE would threaten to roll back the gains of the last five years.

USAID has re-established its policy and budget office; this office has improved budget management andrapidly increased USAID’s focus on core strategic challenges, producing new policies on Countering ViolentExtremism, Youth Issues, and Resiliency.

USAID will have posted 250 performance and impact evaluations by the end of the year providing staff tounderstand better what works and what doesn’t and to adjust program planning accordingly. 

All 73 USAID missions will have established five-year country strategies by 2013 that will guide focused andcoherent investments that are better aligned with host partner countries needs and development priorities.

1Secretary of Defense, Robert Gates, Landon Lecture (Kansas State University) Remarks as Delivered by Secretary of Defense Robert M. Gates,

Manhattan, Kansas, Monday, November 26, 2007. Retrieved at: http://www.defense.gov/speeches/speech.aspx?speechid=11992 Bensahel, Dr Nora and Cronin, Dr. Patrick. America’s Civilian Operations Abroad: Understanding Past and Future Requirements. Center for New

 American Security. January 2011. Retrieved at

http://www.cnas.org/files/documents/publications/CNAS_AmericasCivilianOperationsAbroad_BensahelCronin_0.pdf , pages 9-10.

USAID

Operating Expenses (OE)

Significance of Funding Levels

Funding USAID’s operating budget will make U.S. foreign assistance more effective, accountable, and transparent.

Providing the Senate committee level of $1.39 billion for USAID Operating Expenses would allow:  USAID to more effectively oversee program implementation and monitor accountability and results;

Important reform under USAID Forward to continue, including aggressive efforts to cut waste and streamlinebureaucracy, reform procurement, bolster accountability, and drive innovation.

Continued growth in staff and training opportunities under the Development Leadership Initiative (DLI) started bythe Bush Administration.

FY13 Committee Approved Funding 

Senate: $1.39 billionHouse: $1.274 billion

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The Global Need

Despite the ongoing successes of water and sanitation programs, about 900 million people – mostly in Africa,Asia and Latin America – still lack access to safe drinking water and 2.6 billion people lack access to basicsanitation services.1 Diseases caused by lack of safe drinking water and sanitation remain the world’s singlelargest cause of illness and kill 3,000 children a day, according to UNICEF.2 

Significance of Funding Levels 

The additional $85 million for water and sanitation programs approved by theSenate Appropriations Committee for FY13 could provide sustainable water and sanitation services to an

additional 850,000 people.3 

These funds would enhance the US’ ability to strengthen local capacity, provide support to schools, HIV clinics

and hospitals in communities with the greatest need for water and sanitation and multiply US taxpayer dollarsthrough partnerships between USAID and civic organizations, religious communities, universities, corporationsand philanthropic foundations.

Importance of Funding

Recognizing the lifesaving impact of the Senator Paul Simon Water for the Poor Act of 2005, Congress hasincreased funding since 2008 to its current level of $315 million to support water supply and sanitation, waterproductivity, and water resources management. This funding has improved health, economic development andsecurity concerns in communities throughout the developing world.

Water and sanitation programs implemented by USAID and its partners provide safe drinking water, sanitation,and hygiene (WASH), as well as strengthen the capacity of indigenous non-governmental organizations anddeveloping country governments to solve their own water and sanitation challenges. This will create lasting,sustainable change and lead toward aid independence.4 The World Health Organization estimates that everydollar of funding for water and sanitation programs brings a return of $4 in increased productivity anddecreased health care costs.5 

Impact of Funding – Success is Possible 

In Fiscal Year 2011 alone USAID provided:• More than 3.8 million people with improved access to drinking water supply;• Over 1.9 million people with improved access to sanitation facilities;6 and• In 2010 nearly 12 billion liters of drinking water were disinfected through point-of-use treatment activitiesin 15 country programs and USAID’s central global health program.7 

1USAID. (2012). Safeguarding the World’s Water: 2011 Report on USAID Fiscal Year 2010 Water Sector Activities. Page 1. As retrieved fromhttp://transition.usaid.gov/our_work/cross-cutting_programs/water/WaterReport_2011.pdf .2 UNICEF. (2012) Clean Water Campaign. As retrieved from: http://www.unicefusa.org/work/water/  2

Estimate of $100 average per capita cost for water and sanitation based on field data collected from WASHCost-IRC International Water and SanitationCentre, WASH Advocates, Millennium Water Alliance, CARE, WaterAid America, Water.org, Wine to Water, Water For People, World Vision, Plan USA,Catholic Relief Services, USAID, The World Bank, The Bill and Melinda Gates Foundation, and other organizations, reflecting major variations ingeography, hydrology, climate, and accessibility that affect program design and delivery in target populations.4 Commitments in 2012 for new sanitation facilities and water services, made by 35 countries through the Sanitation and Water for All Partnership—ofwhich the U.S. government is a key member and funder—will be funded primarily by developing countries’ own treasuries. http://bit.ly/Q6rvGo 5World Health Organization. WHO/HSE/WSH/12.01. Available at: http://bit.ly/SBIPCw. 6Department of State. (2012). Annual Report to Congress: Senator Paul Simon Water for the Poor Act. Page 2. As retrieved from

http://www.state.gov/documents/organization/197708.pdf 7USAID. (2012). Safeguarding the World’s Water: 2011 Report on USAID Fiscal Year 2010 Water Sector Activities. Page 5. As retrieved fromhttp://transition usaid gov/our work/cross-cutting programs/water/WaterReport 2011 pdf

Development Assistance:

Water and Sanitation Funding 

FY13 Committee Approved Funding 

Senate: $400 millionHouse: $315 million