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Development &HumanitarianRelief

Chooseto Invest in

FY2014

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Choose toInvest inDevelopment &HumanitarianRelie

FY2014

Contents

4 List o InterAction Member Organizations

Introduction

5 What is Poverty-Focused Development and Humanitarian Assistance?

6 Compassionate and Moral Leadership8 Invest in Future Trading Partners

9 Alleviating Poverty is Key to Americas Security10 Results Start With Transparency and Accountability

11 InterAction FY2014 Funding Recommendations Summary Table

Investing in Long-Term Development

13 Global Health Programs

15 Maternal and Child Health17 Family Planning and Reproductive Health

19 Nutrition21 Malaria23 Tuberculosis

25 Neglected Tropical Diseases27 HIV/AIDS, PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria

29 NIH Global Health31 CDC Global Health

33 Development Assistance35 Food Security and Agriculture37 Micronance

39 Basic Education41 Climate Change Response (Bilateral)

43 Climate Change Response (Multilateral)45 Biodiversity

47 Water49 Millennium Challenge Account51 International Organizations and Programs

53 International Development Association55 Global Agriculture and Food Security Program

57 International Fund or Agricultural Development59 McGovern-Dole International Food or Education and Child Nutrition

Humanitarian Relie to Cope with Disasters and Crises

61 International Disaster Assistance63 Migration and Reugee Assistance

65 Emergency Reugee and Migration Assistance67 Food or Peace Title II

Creating the Conditions or Development and Peace

69 Contributions to International Peacekeeping Activities71 Peacekeeping Operations

Strengthening U.S. Development Capacity

73 USAID Operating Expenses

75 Other Key Development and Humanitarian Accounts

77 InterAction FY2014 Budget Table

3

Cover photo:Esther Havens,Concern WorldWide

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GOOD360

Habitat or Humanity International

Handicap International USA

Heart to Heart International

Heartland Alliance

Heier International

Helen Keller International

HelpAge USA

Helping Hand or Relie and Development

HIAS

Himalayan Cataract Project

Humane Society International (HSI)

The Hunger Project

Inormation Management and Mine Action Programs (IMMAP)

INMED Partnerships or Children

InsideNGO

Institute or Sustainable Communities

Interchurch Medical Assistance, Inc. (IMA World Health)

International Catholic Migration Commission (ICMC)

International Center or Not-or-Prot Law

International Center or Research on Women (ICRW)

International Emergency and Development Aid (IEDA Relie)International Foundation or Electoral Systems (IFES)

International Housing Coalition (IHC)

International Medical Corps

International Medical Health Organization (IMHO)

International Orthodox Christian Charities (IOCC)

International Relie & Development

International Relie Teams

International Rescue Committee (IRC)

International Social ServiceUnited States o America

Branch, Inc

International Youth Foundation

IntraHealth International, Inc.

Islamic Relie USA

Jesuit Reugee Service/USA

Jhpiego an aliate o The Johns Hopkins UniversityJoint Council on International Childrens Services

Keystone Humane Services International

Latter-day Saint Charities

Lie or Relie and Development

LINGOs

Lutheran Immigration and Reugee Service

Lutheran World Relie

MAG America

Management Sciences or Health (MSH)

MAP International

Medical Care Development

Medical Emergency Relie International (Merlin)

MedShare International

Mennonite Central Committee U.S.

Mercy Corps

Mercy-USA or Aid and Development

Millennium Water Alliance

Mobility International USA

National Association o Social Workers

National Cooperative Business Association

ONE Campaign

One Economy Corporation

Operation USA

Oxam America

Pact

Pan American Development Foundation

Pan American Health and Education Foundation (PAHEF)

PATH

Pathnder International

InterAction Member Organizations

ACDI/VOCA

Action Against Hunger USA

ActionAid International USA

Adeso

Adventist Development and Relie Agency International

(ADRA)

Arican Medical & Research Foundation

Arican Methodist Episcopal Service and Development

Agency (AME-SADA)

Aga Khan Foundation USA

All Hands Volunteers

Alliance or Peacebuilding

Alliance to End Hunger

American Friends Service Committee

American Jewish Joint Distribution Committee

American Jewish World Service

American Red Cross International Services

American Reugee Committee

AmeriCares

Americas Development Foundation (ADF)

AmericasRelie Team

Amigos de las AmricasAnanda Marga Universal Relie Team (AMURT & AMURTEL)

Baptist World Alliance

Basic Education Coalition (BEC)

Bethany Christian Services Global, LLC

Bethesda Lutheran Communities

BRAC USA

Bread or the World

Bread or the World Institute

Brothers Brother Foundation

Buddhist Tzu Chi Foundation

Build Change

CARE

Catholic Relie Services

CBM

CDA Collaborative Learning ProjectsCenter or Civilians in Confict

Center or Health and Gender Equity (CHANGE)

ChildFund International

Church World Service

Concern America

CONCERN Worldwide U.S., Inc.

Congressional Hunger Center

Convoy o Hope

Counterpart International

Creative Learning

Development Gateway

Direct Relie International

Disability Rights Education and Deense Fund (DREDF)

The Eagles Wings Foundation

Education Development Center (EDC)

Episcopal Relie & Development

Ethiopian Community Development Council

Family Care International

Feed the Children

Food For The Poor, Inc. (FFP)

Freedom rom Hunger

Friends o ACTED

Friends o the Global Fight

Giving Children Hope

Global Communities

GlobalGiving

Global Health Council

Global Links

Global Washington

PCI

Perkins International

Physicians or Peace

Plan International USA

Planet Aid

Plant with Purpose

Population Action International

Population Communication

Presbyterian Disaster Assistance and Hunger Program

Project C.U.R.E.

Reugees International

Relie International

Religions or Peace

RESULTS

ReSurge International

Salvation Army World Service Oce

Save the Children

Seva Foundation

ShelterBox USA

Society or International Development (SID)

Solar Cookers International

Solidarity CenterStop Hunger Now

Transparency International USA

Trickle Up Program

Unitarian Universalist Service Committee

United Cerebral Palsy

United Methodist Committee on Relie

United Nations Foundation

United States International Council on Disabilities (USICD)

U.S. Climate Action Network (USCAN)

U.S. Committee or Reugees and Immigrants

U.S. Fund or UNICEF

VAB (Volunteers Association o Bangladesh)

WaterAid America

Water or South Sudan

WellShare InternationalWinrock International

Women or Women International

Women Thrive Worldwide

World Concern

World Connect

World Food Program USA

World Learning

World Neighbors

World Rehabilitation Fund

World Renew

World Society or the Protection o Animals

World Wildlie Fund

World Vision

Zakat Foundation o America

ASSOCIATE MEMBERS

Center or Justice and Peacebuilding, Eastern Mennonite

University

Disaster Resilience Leadership Academy (DRLA) at Tulane

University

Enough Project: a project o the Center or American

Progress (CAP)

Global Masters in Development Practice Secretariat o the

Earth Institute at Columbia University

Transnational NGO Initiative o the Moynihan Institute o

Global Aairs at Maxwell School o Syracuse University

(as o 3/27/13)

4

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InterAction is the nations leading policy advocate

or international humanitarian relie and development

programs and represents millions o Americans who

provide nancial support to over 180 U.S.-based

nongovernmental organizations (NGOs). InterAction

member organizations are aith-based and secular,

large and small, and deliver the kinds o services that

save and improve lives, while promoting sel-suciency

around the world.

The ollowing pages outline InterActions FY2014

unding recommendations or the U.S. governments

poverty-ocused international development and

humanitarian relie programs. Our recommendations

are built on decades o eld experience partnering with

local communities to deliver assistance.

We hope these one-pagers will help members o

Congress, their sta and other U.S. policymakers

improve the lives o those most in need: the poorest

and the most vulnerable. We look orward to working

with you in the coming year to promote U.S. leadershipin ending global poverty and addressing humanitarian

crises.

What is poverty-ocused developmentand humanitarian assistance?

Poverty-ocused development assistance reers to

oreign aid that helps the worlds poorest and most

vulnerable citizens.

Development programs help people and countries

lit themselves out o poverty, building better lives or

themselves and their children. These programs build

sustainability by helping amily armers increase their

productivity, improving health care, getting children to

attend and stay in school, or providing access to sae

water and sanitation.

Humanitarian relie programs help save lives and

alleviate the suering o those who have been aected

by natural and man-made disasters such as confict,

drought and foods by providing emergency access to

ood, medical assistance, water and shelter.

The United States has a unique role

InterAction member NGOs are mostly unded by private

donations: about 70% o unds are raised privately.1 While

NGOs are not as reliant on congressional appropriations

as in the past, we still believe in robust U.S. investments

in development because the U.S. government has a

unique role to play in reducing global poverty.

The United States has the unparalleled ability to

convene a broad range o stakeholders rom the

public, private, corporate and nonprot sectors who

together have the resources and expertise to develop

more integrated country strategies to address extreme

poverty. NGO partners are a key pillar o this collective

orce, leveraging the generosity o millions o individual

Americans who trust and nancially support NGOs.

1 InterAction analysis o members 2009 IRS Form 990s.

InterActionsFY2014 FundingRecommendations or

Foreign Assistance

InterAction member NGOs

are supported by millions

o private contributions,

180+

volunteers and more than1.5 million

Christian, Jewish, Muslim and Buddhist

congregations and aith communities

60,000

5

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Our compassion, and or some our aith,calls us to do the right thing

InterActions more than 180 member organizations

support poverty-ocused development and

humanitarian relie because we believe America can

be a orce or good in the world. Helping those most inneed is a moral imperative. Whether driven by religious

convictions or a sense o common humanity, we share

the view that the United States should be a moral

leader in helping people around the world who live in

extreme poverty.

We believe our actions should t our values. We

believe every person has dignity and rights that

cannot be denied, including lie, liberty and the pursuit

o happiness. People around the world share our

aspirations: a desire to create better lives or their

children with access to basic necessities such as cleanwater, nutritious ood, sae shelter, education and

health care.

Children are precious wherever they are born. With the

right investments, America can be a orce or change

to make sure every person has the opportunity to

help themselves. It is a undamental part o who we

are as Americans; whatever our political background,

we rmly believe the United States has a role to play

in advancing prosperity or the worlds poor andvulnerable people.

Increased needs around the world

Robust levels o assistance are needed now more than

ever to meet the needs created by a dramatic increase

in natural disasters, armed confict, drought and amine

worldwide. From the Haiti earthquake, the Indian

Ocean tsunami and the amine in the Horn o Arica, to

the millions o people in Syria who have been orced to

fee their homes, needs are increasing at an alarming

rate. The United States should be there to help them

get back on their eet.

By investing a tiny raction o our national budget lessthan 1% we can provide people emergency access

to ood, medical assistance, water and shelter. And we

can help them begin the process o healing and moving

one step closer to resuming normal lie.

Success is achievable

A great example o success

is PEPFAR the Presidents

Emergency Plan or AIDS

Relie. Initiated with bipartisan

support by President GeorgeW. Bush, PEPFAR has

directly supported liesaving

antiretroviral treatment or

over 5 million men, women

and children in 2012. Since

its inception, millions o

people have been able to once again become healthy,

productive members o their communities.

around the world live on

2.47 billionpeople

less than$2 per day

Victims othe 2004Indian Oceantsunami receivesupplies sentby the U.S.

PhotographersMate3

rdClassRebeccaJ.Moat/U.S.Navy

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When the United States makes an investment, others

ollow suit. Nations in Europe, Asia or the Americas,

and other private donors, leverage and ampliy the

investments made by the United States. The Global

Fund to Fight AIDS, Tuberculosis and Malaria is a great

example o this leveraging. While the United States

is the Global Funds largest donor, the U.S. portion is

capped at one-third o total contributions. This means

that or every $1 contributed by the United States, at

least $2 must come rom the international community.

Creating sel-suciency

We believe oreign assistance plays a critical role in

creating sel-suciency in developing nations. Eective

aid helps people help themselves. Ater all, the greatest

human dignity is being able to provide or onesel and

ones amily. This is why we invest heavily in programs

that teach people how to sh.

It is also why we strongly support programs that grant

people access to the resources they need to start their

own businesses and invest in their utures.

We know this is not easy. But we see the ruits o our

labor every day, such as when a microloan helps a

woman in Kenya start a business, or when a child in

India graduates rom college even though her parents

did not nish grade school.

When we choose to invest in humanity, we help all

people to live with dignity.

In September 2012,

InterAction members pledged

$1 billionin private, nongovernmental

resources to help small-holder

armers improve their yields and

better provide or their amilies.

UnitedStatesAirForce

7

Destroyed buildings inJacmel, Haiti ollowingthe 2010 earthquake.

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Invest in uture trading partners

While InterActions support or poverty-ocused

development assistance stems primarily rom our belie

that it is the right thing to do, there are also strong

economic reasons why investing in oreign assistance

can help Americans at home.

Now, more than ever beore, U.S. economic growth

is linked with global trade: about 95% o the worlds

consumers are overseas, representing 80% o the

worlds purchasing power.1 For American businesses

to prosper, they will most likely need to nd people

beyond our borders to buy their goods. By helping

people around the globe to increase their economic

buying power, we help them buy American products

and grow our economy here at home.

In numerous instances when the U.S. has

invested in building markets overseas,

the investment has more than paid

or itsel. South Korea, Taiwan and

Colombia once recipients o our

aid are all now major U.S. trading

partners. In act, two-thirds o

Americas top 15 trading partners

were once recipients o U.S. oreign

assistance. This should not come as

a surprise, since developing countries

represent some o the astest growing

markets in the world. Today, they alreadypurchase over hal o all U.S. exports, a number

that is only growing with time.2

One o the best ways o creating jobs at home is

through international trade, which already supports

one in three U.S. manuacturing jobs. As o 2010,

over 38 million U.S. jobs depended on global trade,

representing over one-th o all jobs in our country. In

Texas and Caliornia alone, over 7 million jobs depend

on global trade.3 That trend is only likely to grow in the

uture as our economy becomes urther intertwined

with those overseas.

These economic benets are

also surprisingly inexpensive.

At less than 1% o the ederal

budget, oreign assistance

programs bring remarkable

dividends or a relatively small

investment. Whether your interest

is in preserving Americas global

economic edge or in growing jobs here

at home, supporting poverty-ocuseddevelopment assistance is a smart, cost-

eective investment and one that is likely to bring great

benet to the U.S. or years to come.

1 Over 50 Top Business Leaders Urge Congress to SupportInternational Aairs Budget, USGLC. http://www.usglc.org/downloads/2012/07/FY13-Business-Leaders-Letter-to-Congress.pd.

2 Ibid.

3 Trade and American Jobs, Business Roundtable. http://businessroundtable.org/uploads/studies-reports/downloads/Trade_

and_American_Jobs.pd.

U.S. businesses understand that

diplomacy and development assistance

play vital roles in building economic

prosperity, protecting our national

security, and promoting Americas

humanitarian values. The International

Aairs Budget is critical to U.S.

economic engagement with the world,

especially at a time when there is a

wide recognition o the need to boost

U.S. exports to createAmerican jobs.

U.S. Chamber o Commerce

Letter to Congress, March 29, 2011

8
http://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdf

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Alleviating poverty is keyto Americas security

We live in an interconnected world and work in

partnerships to address global problems like hunger,

disease and human rights abuses. When we do so, we

demonstrate our core values and the kind o leadershipthat builds goodwill toward the United States.

Most global problems do not require military solutions.

To alleviate poverty, halt the spread o disease and

prevent confict, we need strong diplomatic and

assistance programs. By ailing to make adequate

investments in nonmilitary policy tools, we miss

important opportunities to create shared prosperity

and enhance our own security.

Helping responsible governments gain strength

and create the environment or their own citizens

to succeed is a smart investment in global stability.

People who have a stake in their society, and the

opportunity to create their own uture and express their

concerns are less likely to be angry, rustrated and

resentul towards the United States.

A wise investment

Why is it that, year ater year, Americas military and

diplomatic leaders ask Congress to support our

international development budget? It is because they

believe that robust U.S. investment overseas can help

prevent confict, spread peace and security, and give

people hope in their utures.

Recent U.S. National Security Strategies see our

national security apparatus as three-pronged, with

deense, diplomacy and development each having

important roles. As a group o retired fag and generalocers rom all branches o the U.S. Armed Services

wrote in a March 2012 letter to Congress: We rmly

believe the development and diplomacy programs in

the International Aairs Budget are critical to Americas

national security Development and diplomacy keep

us saer by addressing threats in the most dangerous

corners o the world and by preventing conficts beore

they occur.1 The 2010 National Security Strategy

similarly calls international development a strategic,

economic, and moral imperative or the United States.

U.S. oreign policy has long been guided by the beliethat people are more peaceul and less likely to become

entangled in confict when they have hope, dignity and

the power to shape their own destinies: when they have

a sense o human security. One o the best ways to

create an environment o peace around the world is to

support poverty-ocused development assistance.

1 U.S. Global Leadership Coalition, Military Leaders Letter to Congress,March 27, 2012. http://www.usglc.org/wp-content/uploads/2012/03/NSAC-Letter-2012.pd.

9

We frmly believe the development and

diplomacy programs in the International

Aairs Budget are critical to Americas

national security. Military Leaders Letter to Congress

AlissaEverett

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Results start with transparencyand accountability

NGOs dont just advocate or resources. We support

ongoing, comprehensive eorts to modernize and

reorm the way aid is delivered. Transparency and

accountability are key components o successul andeective aid delivery.

Todays scal climate requires us to take a resh look at

the best way to maximize impact rom limited taxpayer

resources while responding to humanitarian crises

and tackling global poverty. America provides aid to

countries worldwide and taxpayers deserve to know

that their money is being invested wisely and that itimproves peoples lives.

Our vision o eective assistance

Our vision o eective aid delivery ocuses on people,

not governments. Where governments are legitimate,

have measures in place to prevent corruption, have the

capacity to do what is needed and are accountable to

their own citizens, the United States should supporttheir development agendas. But where governments

are weak, corrupt and unaccountable, the United

States should support communities directly to meet

their own needs and strengthen their ability to demand

better perormance rom their governments.

More eective aid

Recent international conerences on strengthening

the eectiveness o oreign assistance have ocused

on enhancing transparency and accountability. At

the November 2011 conerence in Busan, SouthKorea, donors promised to publish comprehensive

and timely inormation on the resources devoted

to development using a common standard

that allows inormation to be compared. Timely,

comprehensive, accessible and easily comparable

inormation on how aid dollars are spent, and the

results o that aid, allows Americans to hold our

government accountable and lets local development

actors give their own eedback on the quality o that

assistance.

We applaud the U.S. decision to publish aid inormation

under the International Aid Transparency Initiative

(IATI). The purpose behind IATI is to make inormation

about aid spending easier to nd, use and compare.

InterAction has encouraged the administration

to publish inormation rom all U.S. agencies that

distribute oreign aid to the Foreign Assistance

Dashboard (www.oreignassistance.gov), a website

devoted to showing where our oreign aid money goes

and the impact o that assistance. We have also called

or the establishment o an advisory panel on U.S.oreign aid transparency to provide guidance on how

the United States can become more transparent.

We rmly believe these actions will improve

transparency and accountability in oreign assistance

and signicantly improve the return on investment o

American taxpayer dollars.

10

Where governments are weak, corrupt

and unaccountable, the U.S. should

support communities directlyto

meet their own needs.

AugustoCamba
http://www.foreignassistance.gov/http://www.foreignassistance.gov/

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11

Accounts and Subaccounts

FY2014 FundingRecommendations

(in $ thousands)

Global Health Programs USAID 3,268,000

Maternal and Child Health 750,000

Family Planning in All Accounts 750,000

Nutrition 200,000

Vulnerable Children 23,000

HIV/AIDS 350,000

Malaria 670,000

Tuberculosis 400,000

Neglected Tropical Diseases 125,000

Global Health Programs State (PEPFAR Only)4,492,860

Global Fund to Fight AIDS, Tuberculosis & Malaria 1,650,000

NIH Global Health 605,700

CDC Global Health 362,900

Development Assistance 3,175,000

Food Security and Agriculture in All Bilateral Accounts 1,445,000

Micronance 265,000

Basic Education in All Accounts 925,000

Climate Change in Bilateral Accounts 468,000

Biodiversity in All Accounts 200,000

Water in All Accounts 400,000

Millennium Challenge Account 900,000

International Organizations and Programs 385,000

International Development Association 1,408,500

Global Agriculture and Food Security Program 158,330

International Fund or Agricultural Development 32,243

McGovern-Dole International Food or Education & Child Nutrition 209,500

Least Developed Countries Fund & Special Climate Change Fund 50,000

Green Climate Fund 5,000

Strategic Climate Fund 100,000

Clean Technology Fund 300,000

International Disaster Assistance 1,600,000

Migration and Reugee Assistance 2,800,000

Emergency Reugee & Migration Assistance 100,000

Food or Peace Title II 1,840,000

Contributions to International Peacekeeping Activities 2,179,000

Peacekeeping Operations 257,000

USAID Operating Expenses 1,400,000

InterAction FY2014 Funding Recommendations

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GlobalHealth

Programs

State and USAID global health

unding helps to reduce childmortality, slow the spread o

diseases such as HIV/AIDS, respond

to health emergencies, prevent

malnutrition and support initiatives

such as the Presidents Malaria

Initiative and Presidents Emergency

Plan or AIDS Relie (PEPFAR).

Relatively modest investments by

the United States have not only

saved lives, but also improved the

economic growth and stability odeveloping nations.

Investments in global health save lives and ensure the progress

made thus ar is not lost. Since national borders do not stop thespread o disease, addressing global health issues is also important

to protect the health o Americans.

U.S. global health programs have treated approximately 5.1 million

people living with HIV and prevented HIV transmission to millions

more.1 Immunization programs save more than 3 million lives each

year2 and in FY 2011 alone, the Presidents Malaria Initiative and its

partners distributed more than 42 million long-lasting insecticide-

treated mosquito nets and provided treatment to 45 million

individuals.3 Programming also addresses diseases such as polio,

tuberculosis and neglected tropical diseases as well as preventing

malnutrition, decreasing maternal mortality, improving inant health,

developing new health technologies and vaccines, and assisting

women with the proper timing and spacing o pregnancies.

Global health eorts also ocus on training capable health workers

throughout developing nations in order to strengthen health

systems abroad. Building the capacity o country health systems

ensures healthier and saer populations, creates more prosperous

economies and reduces dependency on oreign aid.

Additionally, global health programs develop and implement new

technologies and tools to help countries get ahead o healthchallenges. Sustaining U.S. investments in global health is crucial;

health problems will only be more expensive and dicult to resolve

in the uture.

Funding History

Purpose Justication

FY2014 Recommendation:

$9.41 billion

For more inormation, contact:

Erin Jeery

Advocacy and International Development

Coordinator

InterAction

[email protected]

13

Enacted

FY13 CR Post-Sequestration (estimated)

FY14 InterAction Recommendation

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Reerences

1 World AIDS Day 2012 Update, PEPFAR. http://www.pepar.gov/unding/results/index.htm.

2 Combination Prevention in PEPFAR: Treatment, PEPFAR. http://www.pepar.gov/documents/organization/183299.pd.

3 Sixth Annual Report to Congress, Presidents Malaria Initiative. http://pmi.gov/resources/reports/pmi_annual_execsum12.pd.

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Maternaland Child

Health

Investing in MCH is critical to making good on U.S. commitments

as a global leader in maternal and child health and to buildhealth and prosperity or the worlds children. Each year, USAID

interventions help save the lives o more than 6 million children

under the age o 5 and help signicantly reduce maternal deaths

rom pregnancy-related causes.1 These interventions range rom

prenatal care and preventing maternal deaths during childbirth to

pediatric immunizations and child nutrition.

However, each year, 6.9 million children under the age o 5 die rom

preventable causes such as pneumonia, malnutrition, diarrhea

and malaria;2 and each day, approximately 800 women die rom

preventable causes during pregnancy and childbirth.3

MCH unding supports cost-eective interventions like vaccines

and nutritional supplements, and trains community health workers

on basic prevention, treatment and management o maternal and

child illness, such as malaria, diarrhea, pneumonia and malnutrition.

Scaling up these programs will help put a stop to child and

maternal mortality. MCH unding also ullls U.S. commitments

to polio eradication and the Global Alliance or Vaccinations and

Immunizations (GAVI).

Additionally, unding or child and maternal health is directly

connected to unding or global nutrition, water and sanitation,UNICEF, PEPFAR and global health research supported by NIH

and CDC.

Justication

Funding History


$750 million


Erin Jeery


Coordinator

InterAction

[email protected]

Funding or maternal and child

health (MCH) programs supportsproven, cost-eective interventions

that protect the lives o children

and mothers. In 2012, the United

States led the world in pledging

to end preventable child deaths

in a generation. To make a

down payment on this and other

commitments, the United States

should provide a least $750 million

or MCH.

Purpose

15

Enacted



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In 2007, Sadios rst child, Matar, died at just 9 months old, rom diarrhea

and respiratory inection. The nearest health post was a 7.5-mile round trip

too ar to travel or a poor amily with a sick baby. Now she has 2-year-old

twins, Adama and Awa, who also suer rom recurrent respiratory troubles.

But things are dierent this time around.

ChildFund International is in its second year as lead on a $40 million

community health grant rom USAID to establish health care services

or children and amilies throughout Senegal, whose 800 doctors are

concentrated in the capital, Dakar. The project provides community-level

health huts staed by trained health workers, traditional birth attendants

and outreach workers all volunteers to provide basic health care and

teach about hygiene, nutrition and more. These volunteers spread their

knowledge throughout their communities.

By the grants end in 2015, ChildFund and its partners Aricare, Catholic Relie Services, Plan International,

World Vision, and Senegals Enda Gra Sahel and Enda Santa will have established 2,151 health huts and 1,717

outreach sites nationwide, in both rural and underserved urban areas. The project also ocuses on neglected

tropical diseases and education about the health dangers o emale genital cutting. By 2015, 9 million people

across Senegal will have access to health care, which will be networked rom the national to the community level.

A health hut was built in Sadios village in 2010. My twins have never suered rom diarrhea or malaria because I

wash my hands with soap and water beore giving them ood, she explained. And we sleep under bed nets. She

added that one o the twins, Adama, oten struggles with respiratory inection, and that the health volunteers reer

her or proessional care when she needs it. Sadio watches, but she no longer worries.

Reerences

1 USAID Maternal and Child Health, USAID. http://www.usaid.gov/what-we-do/global-health/maternal-and-child-health.

2 Committing to Child Survival: A Promise Renewed, Progress Report 2012, UNICEF. http://uni.c/QQB5wA.

3 Maternal Mortality World Health Organization. http://www.who.int/mediacentre/actsheets/s348/en/index.html.

ChildFundInternational

Success Story:Community Health Huts Save Lives in Senegal
http://www.usaid.gov/what-we-do/global-health/maternal-and-child-healthhttp://uni.cf/QQB5wAhttp://www.who.int/mediacentre/factsheets/fs348/en/index.htmlhttp://www.who.int/mediacentre/factsheets/fs348/en/index.htmlhttp://uni.cf/QQB5wAhttp://www.usaid.gov/what-we-do/global-health/maternal-and-child-health

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FamilyPlanning andReproductive

Health

Funding in this account expands

access to voluntary contraceptiveand amily planning methods,

reduces maternal mortality and

improves inant health. Since

1965, the 27 countries with the

largest USAID investments in

amily planning have increased

contraceptive use rom under 10%

to 37%, and reduced the number o

children per amily rom more than

6 to 4.5.1

According to the Guttmacher Institute, in 2012 the use o modern

contraceptives in the developing world prevented an estimated 218million unintended pregnancies, 55 million unplanned births, 138

million abortions, 118,000 maternal deaths and 1.1 million inant

deaths.2 Family planning provides women with the ability to time

and space pregnancies.

These programs are cost-eective and deliver real and sustainable

results. Data rom seven countries across three continents shows

that or every dollar invested in amily planning, there are signicant

savings to governments in the health and education sectors,

ranging rom $2 in Ethiopia to more than $6 in Bangladesh and

Guatemala, and up to $9 in Bolivia.3 Additionally, several countries,

including Brazil, Mexico, Korea and Thailand, no longer require U.S.

government support or amily planning programs.4

One hundred members o Congress signed a letter on December

19, 2012, requesting $1 billion or amily planning or FY2014; and

while InterAction supports that amount, we believe $750 million is

the absolute minimum to continue these essential programs.

Purpose Justication


$750 million

Funding History


Erin Jeery


Coordinator

InterAction

[email protected]

17

Enacted



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In the Amhara region o Ethiopia, Masreshah Abebe

works to improve the health o women. A health

extension worker, she routinely walks rom one end o

her village to another to reach her neighbors a trip

that can take more than an hour.

When I rst started, she remembered, women were

a voiceless group. Few used amily planning. But that

is changing.

With support rom USAID, Abebe delivers amily

planning and reproductive health services to 1,700

households. I track the number o women who use

amily planning, and there has been real change.

Across Ethiopia, more women are able to make choices about their bodies and their utures. Preliminary data

rom the 2011 Ethiopian Demographic and Health Survey show that Ethiopias contraceptive prevalence rate has

increased rom 29% to 96% in just six years.

Abebe will do whatever she can to sustain this remarkable achievement. But she cannot do it alone. So today, she

stands, surrounded by more than 60 community members. They le in rom every side to sit in olding chairs and

lean against ences, to take part in a Community Conversation.

Guided by Abebe and other project sta, villagers discuss problems they ace, such as todays topic: early

marriage. To change villagers minds about this long-held practice, which can have devastating eects on girls,

Abebe has enlisted the help o infuential religious leaders.

Abebe steps to the side, granting Alam Ababa the foor.

This tradition o early marriage has done more harm than good or our girls, he says. Parents must no longer

arrange marriages or orce them to have too many children. We must send our gir ls to school.

Ababa turns to Abebe, who is beaming. There are many good messages rom our health extension workers, and

we must listen.

Reerences

1 Family Planning, USAID. http://www.usaid.gov/what-we-do/global-health/amily-planning.

2 Costs and Benets o Investing in Contraceptive Services in the Developing World, Guttmacher Institute (2012).

3 Family Planning Saves Lives, Population Reerence Bureau. http://www.prb.org/pd09/amilyplanningsaveslives.pd.

4 Fast Facts: Family Planning, USAID. http://transition.usaid.gov/our_work/global_health/pop/news/issue_bries/p_astacts.pd.

SalaLewis/Pathfnder

Success Story:Giving Women Control o Their Futures
http://www.usaid.gov/what-we-do/global-health/family-planninghttp://www.prb.org/pdf09/familyplanningsaveslives.pdfhttp://transition.usaid.gov/our_work/global_health/pop/news/issue_briefs/fp_fastfacts.pdfhttp://transition.usaid.gov/our_work/global_health/pop/news/issue_briefs/fp_fastfacts.pdfhttp://www.prb.org/pdf09/familyplanningsaveslives.pdfhttp://www.usaid.gov/what-we-do/global-health/family-planning

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Nutrition

Despite the ar-reaching

consequences o malnutritionand its impact on child mortality,

nutrition has been a low priority

on global health and development

agendas. InterAction recommends

$200 million in the Global Health

Programs account to adequately

und integrated nutrition programs

and recommends additional ocus

on the integration o nutrition within

Feed the Future.

Malnutrition, one o the worlds most serious yet least addressed

development challenges, contributes to the death o some 2.5million children under 5 each year.1 For the 165 million children

characterized as stunted,2 malnutrition is a lie sentence, resulting in

irreversible physical and cognitive damage.

Research has shown that early nutrition, particularly during the

1,000 days between a womans pregnancy and her childs second

birthday, can determine the uture o a persons health, educational

attainment and lietime earning potential. Thus, poor nutrition

becomes a signicant drain on economic productivity and a burden

on health care systems, making progress on poverty alleviation

harder and costlier to achieve. In some cases, child malnutrition

costs as much as 11% o a countrys GDP.3

Yet globally, nutrition unding represents only 0.3% o total ocial

development assistance4 and 1.2% o the FY2012 Global Health

Programs account within the U.S. oreign assistance budget.

Research has ound that every $1 invested in nutrition generates

as much as $138 in better health and increased productivity.5 U.S.

government investments and continued leadership are critical

to achieving a signicant and lasting progress in preventing

malnutrition.

Purpose Justication


$200 million


Katie Lee

Advocacy and Policy Coordinator or

International Development

InterAction

[email protected]

Erin Jeery


Coordinator

InterAction

[email protected]

19

Enacted



Funding History

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Chisomo Boxer is a community health worker in Malawi. He is

proud that no children under 5 have died in his village since it

opened its health clinic two years ago. But he was araid that

3-year-old Vekelani might be the rst.

He had swelling o his ace, legs and both eet, said Boxer. He

lost his appetite and his skin was very shiny. These are signs o

edema, and his case was very serious. There are our grades o

edema; his was grade three, which meant his lie was in danger.

Boxer told the boys parents they must take Vekelani to the

hospital right away. Boxer was very concerned about Vekelani because a childs development in the rst ew years

will inorm the rest o his lie. But when Boxer checked back two days later he was surprised they had not gone.

They are superstitious. They thought someone was using witchcrat and black magic against their children. Theysaid that was the only possible explanation or why their children were sick so much.

Boxer went back to the amilys house many times to try to convince them to take Vekelani to the hospital. Finally,

ater three weeks, he succeeded.

The district hospital admitted Vekelani to its outpatient therapeutic program and gave him a ready-to-use-ood:

a special mixture o powdered milk, peanut paste, vitamins and minerals. Vekelani likes it, and his health is

improving gradually.

Boxer, who was trained in Save the Childrens community-based maternal and newborn care (CBMNC) program

unded by USAID/Child Survival 22, still visits the amily oten to check on Vekelanis progress and to counsel the

parents about nutrition and hygiene. I go with them to their garden and give advice about how to make balancedmeals, he said. They are beginning to take my recommendations.

The last time I was there, or the rst time, Vekelani looked happy and he smiled at me!

Reerences

1 Committing to Child Survival: A Promise Renewed Progress Report 2012, UNICEF. http://www.unice.org/publications/les/APR_Progress_Report_2012_11Sept2012.pd.

2 Ibid.

3 Black, R.E., L.H. Allen et al. Maternal and child undernutrition global and regional exposures and health consequences, The Lancet, 2008, Vol.371.

4 World Bank Global Monitoring Report: 2012: Food Prices, Nutrition and the Millennium Development Goals, World Bank. http://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pd.

5 Copenhagen Consensus Challenge Paper, Copenhagen Consensus, 2012.

ElvisSukali/SavetheChildren

Success Story:Community Health Workers Teach Parents about Nutrition
http://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdf

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Malaria unding prevents and

treats illness and death associatedwith malaria. Annually, 216 million

people contract malaria and 655,000

individuals die as a result. Eighty-six

percent o malaria deaths occur in

children under the age o 5. Thanks

to the leadership o the Presidents

Malaria Initiative, the U.S. operates

in 19 countries to combat this

disease.

Malaria is prevalent in 106 countries and imposes signicant costs

to both individuals and governments. Direct costs such as illness,treatment or premature death have an estimated price tag o at

least $12 billion per year.1

U.S. investments through the bilateral Presidents Malaria Initiative

and the Global Fund to Fight AIDS, Tuberculosis and Malaria have

had a signicant impact on containing the disease and creating

innovative tools and technologies poised to deliver urther successes:

50 countries are on track to reduce malaria incidence

by 75% by 2015;2

Estimated new cases o malaria have decreased by17% globally since 2000;

The overall annual malaria death toll has declined rom 985,000 to

655,000 people a 26% reduction in global malaria mortality;3 and

U.S. unding has advanced several vaccine candidates into the

human testing stage.

Malaria prevention and treatment programming is a model o cost-

eective success: by sharing responsibility, we are saving millions o

lives while strengthening emerging economies and health systems.

In 2012, the United Nations released a study showing that or every$1 invested in malaria control in Arica, on average, $40 is returned

in higher economic growth. The gains, however, are ragile, and

retreating on investment now would not only reverse todays progress

but also allow malaria to reemerge. Luckily, the costs are small:

$4 provides an insecticide-treated bed net that lasts three years.

$1.40 provides artemisinin-based combination therapy

treatment or an adult.

$0.60 provides rapid diagnostic testing or children and adults.4

Purpose Justication


$670 million

Malaria


Erin Jeery


Coordinator

InterAction

[email protected]

21

Enacted



Funding History

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Mumile lives with her husband and their new baby in the village

o Wakuan in northeastern Ghana, near the Togo border.

Malaria is endemic there, and since the nearest health clinic

is 10 kilometers (over six miles) away, protective measures like

mosquito nets and antenatal care can prevent emergencies and

save lives.

With support rom USAID, Episcopal Relie & Development and

its malaria prevention partnership, NetsorLie, are working with

Ghanaian partner ADDRO (the Anglican Diocesan Development

and Relie Organization) to address the need or preventive care

at the grassroots level. Active in 17 countries throughout sub-

Saharan Arica, NetsorLie is training local volunteers, called

malaria control agents (MCAs), to educate their communities

about malaria, hang nets in homes, and provide ollow-up to

ensure the nets are being properly used and maintained. In

many places, the MCAs also do broader health monitoring

and advocacy, including encouraging pregnant women to

seek out prenatal care. This helps ensure that they receive the

recommended number o check-ups during pregnancy, along

with IPTp (Intermittent Preventive Treatment in pregnancy) to

protect them rom malaria.

MCAs visited Mumile in Wakuan, stressing the importance o IPTp or malaria protection during pregnancy, a time

when women and the babies they are carrying are especially vulnerable to inection. For Mumile and her newly

expanded amily, having mosquito nets above their sleeping areas and using IPTp has had a major impact.

I visited the hospital at least six times a year [due to malaria] and it was taking a heavy toll on my nances, said

Mumile. But since last year [when I received the mosquito net] I have not visited the hospital except or my IPTp,

which the volunteers told me was necessary or my health. I am very happy and want to thank them or doing this.

Reerences

1 Impact o Malaria, Centers or Disease Control and Prevention (2010).

2 World Malaria Report, World Health Organization. http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html.

3 World Malaria Report 2011, World Health Organization. http://www.who.int/malaria/publications/atoz/9789241564403/en/index.html.

4 Ibid.

HarveyWang/EpiscopalRelie&Development

Success Story:Local Volunteers Help Prevent Malaria
http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.htmlhttp://www.who.int/malaria/publications/atoz/9789241564403/en/index.htmlhttp://www.who.int/malaria/publications/atoz/9789241564403/en/index.htmlhttp://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html

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Tuberculosis (TB) is a contagious,

airborne disease that inectsapproximately 8.8 million people

per year, nearly one-third o whom

are also living with HIV, and kills

about 1.4 million people annually. TB

unding is used to nd and treat the

disease, prevent the development o

drug-resistant strains, and support

the research and development o

new tools to ght the disease.

As TB has no borders, strong global TB control is in the national

interest o the United States to prevent a costly increase in TBcases, particularly o drug-resistant TB. Drug-resistant TB poses a

particular challenge to domestic TB control due to high treatment

costs, estimated at $100,000-$300,000 per case.1 It is estimated

that in some countries, the loss o productivity attributed to TB is

4-7% o a countrys GDP.2

However, signicant progress has been achieved: rom 1995-2011,

51 million TB patients were treated successully through TB control

programs saving up to 20 million lives. Globally, deaths due to TB

have allen by more than one-third since 1990.3 With continued and

sustained unds, by 2014, the United States will have:

Successully treated at least 85% o TB cases detected in

countries with established U.S. government programs;

Diagnosed and treated at least 57,200 new multidrug-resistant

TB cases; and

Contributed to a 50% reduction in TB deaths and disease

burden since 1990.

Congress authorized $4 billion in unding over ve years in 2008,

an authorization level that congressional appropriations have never

reached. InterAction thereore believes $400 million a number with

strong congressional support is a reasonable down payment on

that commitment, which will hopeully allow or urther deployment

o updated diagnostics and drug regimens as well as increased

development and introduction o new tools.

Purpose Justication


$400 million

Tuberculosis


Erin Jeery


Coordinator

InterAction

[email protected]

23

Enacted



Funding History

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Grace Tsawe runs a prayer camp in the Lower Manya Krobo District o Ghana

where, on clinic days, she sees over 100 patients, many o whom suer rom

tuberculosis (TB). Until recently, Tsawe did not reer her patients to health

acilities, because she believed only prayer could heal them. However, last

year, she developed a persistent cough and began losing weight. When

months o prayer did not alleviate her symptoms, Tsawe nally visited a

hospital where she was diagnosed with TB. Six months o TB treatment cured

her o all TB symptoms. Having learned o Tsawes role in the community

as a prayer leader, the hospitals TB coordinator asked to teach her about

TB screening. She agreed and, with support rom the USAID-unded TB

CARE project, the TB coordinator trained Tsawe to identiy patients with TB

symptoms and reer them to the hospital or testing.

In 2010, approximately 21,000 Ghanaians developed TB, and, o these, 34% o

the cases were never detected. One possible explanation or the nations poor

TB control is that many Ghanaians believe TB is a spiritual illness and rely on

prayer or healing, rather than medical care. For those who eventually do seek

treatment, it is oten too late to avert death. To address these challenges, TB

CARE has been implementing new standard operating procedures or TB screening at health acilities in Ghana

or over two years. The project is also training health teams to educate community leaders, such as Tsawe, to

identiy TB symptoms and make timely reerrals.

Tsawes recovery rom TB has inspired her to train other prayer camp owners in TB screening and reerrals. She is

also now using radio and TV interviews to encourage TB testing in her community.

Reerences

1 US House o Representatives TB Elimination Caucus letter. 2012.

2 R.Laxminarayan, et. al. Economic Benet o TB Control, Policy Research Working Paper 4295. World Bank. 2007.

3 Global Facts on Tuberculosis, 2012, World Health Organization. http://www.who.int/tb/publications/actsheet_global.pd.

Success Story:Local Leader Encourages TB Testing
http://www.who.int/tb/publications/factsheet_global.pdfhttp://www.who.int/tb/publications/factsheet_global.pdf

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NeglectedTropical

Diseases

Funding or Neglected Tropical

Diseases (NTDs) helps to prevent,control, eliminate and eradicate

17 diseases that inect 1 billion o

the worlds poorest people. One in

six people worldwide suer rom

NTDs such as dengue, rabies, river

blindness, leprosy, trachoma and

hookworm. These diseases are

deadly, debilitating and can cause

blindness, disgurement, disability,

cognitive developmental delays and

social stigma.

Each year, 400,000 people die rom NTDs.1 But as little as 50

cents per person per year can provide prevention treatmentagainst the most common NTDs. Over the past ve years, the

U.S. government has leveraged taxpayer dollars and $3.1 billion in

donated medicines to provide 584.6 million sae and eective NTD

treatments to approximately 257.9 million people.2

The World Health Organization estimates that in addition to industry

contributions such as pharmaceutical drugs it would only cost

$2 billion to prevent and treat all individuals at risk o contracting an

NTD rom 2012 to 2015.3 It is critical that the ongoing NTD control

programs be supported and continued in order to reach all those

aficted, in addition to supporting research or new tools to ght

NTDs.

Currently, NTD research and development (R&D) programs are

underunded. R&D or new tools is essential to ultimately combating

NTDs; however, USAID which plays a unique and critical role in

product development or new NTD technologies does not und

NTD R&D. Unortunately, many current NTD medications have

severe side eects. Research into these diseases could lead to

new vaccines, better drugs and improved diagnostic tools. Strong

support or successul control and elimination programs, combined

with robust unding or NTD R&D is the key to success against

NTDs.

Funding History

Purpose Justication


$125 million


Erin Jeery


Coordinator

InterAction

[email protected]

25

Enacted



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Reerences

1 U.S. Department o State (2011) Foreign Operations Congressional Budget Justication Fiscal Year 2011: Vol. 2.

2 USAIDs Neglected Tropical Diseases Program, USAID. http://www.neglecteddiseases.gov/about/index.html.

3 Accelerating work to overcome the global impact o Neglected Tropical Diseases: A Roadmap or Implementation, World Health Organization.http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pd.

Maroua, the bustling capital o the Far North Region o Cameroon, is an extremely

hot, dry and dusty city with a population o approximately 250,000 people.

Recently, the city has struggled to achieve high coverage rates or various public

health initiatives.

Launched in 2010 and continuing today, a campaign by the Neglected Tropical

Disease Control Program to combat onchocerciasis and lymphatic lariasis

reaches Maroua and all 28 health districts o the Far North Region. Knowing that

social mobilization strategies would be essential to achieve high coverage rates,

Helen Keller International and the Ministry o Health use a variety o innovative

channels to communicate the need or everyone to participate in drug distribution

events. Ministry leaders appear on popular radio programs, traditional storytellers

spread the word, and engaging posters catch peoples attention on nearly every

street corner.

One poster used during the campaign pictures a man with a very swollen leg, one o the symptoms o lymphatic

lariasis. A man who was suering unknowingly, rom lymphatic lariasis saw the poster and noticed that his

leg looked just like that o the man in the poster. Armed with this new inormation, he immediately visited his

health center and was happy to learn that drugs to alleviate the symptoms o his disease would be distributed

to him or ree. Thanks to the public awareness campaign, not only did this man seek and receive treatment, but

now he also is an active community health educator who travels house-to-house and mobilizes his neighbors to

participate in the campaign against lymphatic lariasis and onchocerciasis so that others do not suer like he has.

Due to social mobilization strategies, signicant progress has been made in reaching vulnerable populations in

Maroua. As a result, 84% o the people at risk o lymphatic lariasis have received essential treatment in 2011.

These results would not be possible without crucial unding rom USAID.

HelenKellerInternational

Success Story:Education Campaigns Help Stop Neglected Tropical Diseases
http://www.neglecteddiseases.gov/about/index.htmlhttp://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdfhttp://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdfhttp://www.neglecteddiseases.gov/about/index.html

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HIV/AIDS, PEPFARand the GlobalFund to Fight AIDS,Tuberculosis and

Malaria

Funding or State and USAID or

HIV/AIDS programs supports the

Presidents Emergency Plan or

AIDS Relie (PEPFAR), the Global

Fund to Fight AIDS, Tuberculosis

and Malaria, and other multicountry

initiatives. This unding is used to

prevent, treat and care or those

inected with HIV/AIDS and to build

country-level capacity to transer

operation o HIV/AIDS programs to

implementing countries.

PEPFAR combats HIV/AIDS through prevention, treatment, care

and the strengthening o health systems through bilateral andmultilateral programs. As o September 30, 2012, PEPFAR had

directly supported antiretroviral treatment to almost 5.1 million

people. In FY2012 alone, PEPFAR directly supported HIV testing

and counseling or more than 49 million people and provided care

and support or nearly 15 million people including more than 4.5

million orphans and vulnerable children. By reaching nearly 750,000

HIV-positive pregnant women in FY2012 with drugs to prevent

transmission o HIV rom mother to child, PEPFAR helped avert

230,000 HIV inections in newborn children.1

Global Fund: As o December 2012, the Global Fund had provided

HIV/AIDS treatment to 4.2 million people, as well as service to 1.7

million pregnant women to prevent transmission o HIV to their

children. In addition, the Global Fund has distributed 310 million

insecticide-treated bed nets, detected and treated 9.7 million

cases o tuberculosis, and treated 290 million cases o malaria. On

average, the Global Fund saves 100,000 lives each month.2

The Global Fund works in close partnership with PEPFAR and

the Presidents Malaria Initiative to create highly successul

collaboration around the world. The U.S. is the Global Funds

largest donor; however, by law, the U.S. contribution is capped

at one-third o total contributions. This means that or every

$1 contributed by the U.S., at least $2 must come rom the

international community.

Funding or the Global Fund is critical to ensuring that we build on

the successes o the past decade and that we can provide care

to the millions around the globe waiting or access to antiretroviral

therapies, tuberculosis treatments and insecticide-treated nets.

USAIDs HIV/AIDS programs scale up proven interventions, while

promoting newly-developed innovations and best practices.

Funding History

Purpose

Justication


Erin Jeery


Coordinator

InterAction

[email protected]

27


$350 millionor USAIDs HIV/AIDS programs

$4.49 billionor PEPFAR

$1.65 billionor the Global Fund

Enacted



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All her lie, Laurence, who is 70 and HIV-positive, has struggled to care or hersel

and her amily. Then in 2010 she joined an Internal Savings and Lending Group

(ISLG) and started taking nutrition classes through the Higa Ubeho program in

Rwanda, implemented by Global Communities/CHF International. With the loan

she obtained through the ISLG and the skills she learned in nutrition training, she

was able to make her arm a source o resh, healthy vegetables or hersel and heramily. She began generating a sustainable income rom the extra crops she grew.

She now has access to treatment, health insurance and electricity in her home.

Laurence also shares her training with people in her village who are replicating

her methods. Laurence said that because o the program, I am no longer sick all

the time. And though I have health insurance, I hardly ever have to go to hospital

anymore. Not only am I not a burden to anyone, I also am supporting others by

teaching them the importance o improved nutrition. I am proud that I have gained

knowledge and skills that I can use the rest o my lie.

The Higa Ubeho program, which is unded by USAID and PEPFAR, works with people in Rwanda living with

HIV/AIDS, orphans and other vulnerable children to reduce the impact o the disease on their lives, and works

with local institutions to increase their access to education, psychosocial support, medicine and ood. It serves

more than 70,000 amilies in 20 districts to develop sustainable ways o coping with the health and economic

challenges that aect the most vulnerable communities in Rwanda.

LauraGingerich

Funding or two essential partnerships the Commodity Fund and the International AIDS Vaccine Initiative help

increase condom availability and promote the development o an eective HIV vaccine.

The global fght against HIV/AIDS is at a critical juncture. The knowledge and innovations acquired over the last

10 years have brought the end o the HIV/AIDS epidemic within reach. The United States must not let current

budgetary constraints undo the success o the past ew years. I we do not act, we may lose our best chance to

end this epidemic.

References

1 World AIDS Day 2012 Update: Latest PEPFAR Results, PEPFAR. http://www.pepfar.gov/funding/results/index.htm.

2 Fighting AIDS, The Global Fund. http://www.theglobalfund.org/en/about/diseases/hivaids/.

Success Story:

Living Long, Full Lives With HIV/AIDS

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NIH Global

Health

National Institutes o Health

(NIH) Global Health undingsupports basic and applied

scientic research to identiy new

interventions and more eective

ways to improve health and combat

disease. These research activities

are complemented by programs that

train new researchers and scientists

in partner countries so they can

better undertake uture global

health research.

As a premier research institution, NIH conducts and supports a

range o biomedical and behavioral research activities, as well astraining or young scientists. Continued investments in medical

scientic research help lead to new, innovative, and lie-saving

technologies and medicines that improve health and combat

disease both in the United States and around the world.

Global health research at NIH spans 27 institutes and centers,

including the National Institute o Allergy and Inectious Diseases,

which continues to lead in global breakthroughs to combat HIV/

AIDS, malaria, tuberculosis and neglected tropical diseases. NIH

unding also supports the Fogarty International Center, which

supports approximately 400 research and training projects with

more than 100 U.S. universities that partner with other research

institutions around the world.

NIH-supported research, which led to the codiscovery o HIV, has

saved an estimated 14.4 million years o lie since 1995 through

AIDS therapies alone.1 NIH research has also led to other medical

breakthroughs, such as treatments or HIV-associated coinections,

the development o the rst microbicide gel eective or preventing

HIV/AIDS, strategies to prevent mother-to-child transmission o the

HIV/AIDS virus and steps to developing a malaria vaccine.

Sustained unding or NIHs global health research and trainingactivities is critical to identiying new cures, nding more ecient

and eective interventions to combat disease, and acilitating the

training o new researchers, all while supporting U.S. universities

and research jobs.

Purpose Justication


$605.7 million


Erin Jeery


Coordinator

InterAction

[email protected]

29

Enacted



Funding History

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Onchocerciasis, commonly known as river blindness, aects

37 million people with an estimated 180 million people in Arica

at risk. Transmitted to humans through bites o blackfies,

individuals who become inected experience intense itching,

severe skin disguration, and with years o repeated exposure

permanent blindness. In addition to its health eects, the

disease leads to massive economic losses when productive

agricultural lands are abandoned or ear o inection. Although

a treatment exists, it needs to be taken or up to 20 years by the

entire aected community through mass drug administration.

Once ree rom the disease, communities must be closely

monitored to prevent reintroduction o the disease and the need

or additional mass drug administration.

Scientists at the National Institutes o Health (NIH) discovered

an antigen to river blindness that could lead to easier testing. However, there was little interest rom potential

commercial partners in pursuing its production because companies did not see much potential prot in

manuacturing a test or a disease rampant in poor countries. Utilizing the discovery o NIH scientists, PATH, a

nonprot global health organization, developed a simple, rapid test that could accurately diagnose river blindness

and partnered with the NIH to evaluate the technology. PATH identied Standard Diagnostics, Inc., as a partner

or manuacture and distribution, and the two organizations are working to develop a commercially viable test or

use in aected countries. Because o a discovery made in NIH labs, people living in remote areas can get tested

in their own communities. This will improve their lives and help eliminate river blindness in Arica.

Funding or NIHs global health program allows or research that provides valuable innovations in our collective

response to river blindness and other diseases. Ultimately, U.S. investment enables communities to overcometremendous health challenges that limit economic productivity and perpetuate poverty.

PAT

H/AllisonGolden

Reerences

1 Estimating the impact o antiretroviral therapy: regional and global estimates o lie-years gained among adults, NIH, National Center orBiotechnology Inormation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173805/.

Success Story:NIH Discovery Turning the Tide Against River Blindness

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CDC Global

Health

Centers or Disease Control and

Prevention (CDC) global healthunding helps track diseases,

provides public health leadership,

assists oreign ministries o health

in strengthening their research and

laboratory inrastructure, and trains

new health proessionals. This type

o collaboration draws on the CDCs

technical expertise and improves

the ability o partner countries to

lead in the uture.

As one o the premier public health agencies in the world, the

CDC works in partnership with ministries o health, internationalorganizations and other partners to strengthen global health

capacity, increase security and support evidence-based global

health programs. It makes signicant contributions to global health

research and development, monitors and tracks inectious diseases

worldwide, alerts researchers when new disease strains emerge,

and provides critical intelligence or the control and prevention o

diseases.

With over 60 years o experience, CDC works alongside oreign

ministries o health to prevent the spread o disease worldwide.

CDC is a key partner in the U.S. Presidents Emergency Plan or

AIDS Relie (PEPFAR) in over 75 countries and provides technical

assistance on how to implement the latest science, such as scaling

up HIV treatment and preventing mother-to-child transmission.

CDC is also a leader in global immunization and disease eradication

eorts. For example, CDC programs helped reduce the number

o new polio cases globally by more than 99% between 1988 and

2010,1 and the CDC-led global campaign to eradicate Guinea worm

disease has helped reduce the disease burden rom 3.5 million

cases per year in 1986 to near eradication today.2

The CDC also continuously investigates and responds to disease

outbreaks, such as the measles outbreak in 2010 in our Arican

countries. The CDCs eorts address critical global issues while

also protecting the health o Americans. Continued, sustained

unding or CDC programs is crucial.

Funding History

Purpose Justication


$362.9 million


Erin Jeery


Coordinator

InterAction

[email protected]

31

Enacted



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During her annual exam at a health clinic, Mariam Ciss, a

41-year-old mother o three who is HIV positive, was screened

or cervical cancer using a technique called visual inspection

with acetic acid (VIA). This technique is a cost-eective

alternative to the Pap smear. During a VIA screening, a doctor or

nurse swabs the cervix with acetic acid, the main component o

vinegar. I there are precancerous cells, the cervix turns white.

Cisss cervix showed a large white lesion.

She was stunned a screening a year earlier had been negative.

But as an HIV positive woman, Ciss was at greater risk to

develop aggressive precancerous lesions. Her lesion was too large or the routine treatment. Normally, doctors

use a reezing technique known as cryotherapy to destroy abnormal tissue. This would not help Ciss and she

was worried.

Hope arrived in the orm o a phone call. A midwie told Ciss that the University Hospital Centre could treat large

cervical lesions using loop electrical excision procedure (LEEP), which uses a thin wire heated by electric current

to cut away the cells. Not only was the treatment available, but it was also ree. Ciss was successully treated.

Greater access to screening and treatment drastically reduces the number o deaths rom cervical cancer.

Jhpiego an aliate o Johns Hopkins University is working with the U.S. Centers or Disease Control, the

Presidents Emergency Plan or AIDS Relie, and National HIV/AIDS Care and Treatment Program to make

screening and treatment available to the women in Cte dIvoire. Since 2009, the number o screening and

treatment sites has grown to 20. To date, 7,343 HIV-positive women have been screened with VIA. O these

women, 429 women including Ciss have been treated or precancerous lesions.

These are important strides in a country where only 5.8% o women are screened or cervical cancer every three

years, and where almost 70% o the 1,600 women who are diagnosed annually with cervical cancer die rom the

disease, according to the World Health Organization.

I am a living testimony to the success o this approach, said Ciss. Other women could have the same chance.

Reerences

1 Post-Polio Syndrome Face Sheet, National Institute o Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm.

2 Guinea Worm Frequently Asked Questions, CDC. http://www.cdc.gov/parasites/guineaworm/gen_ino/aqs.html.

ToureOumar/Jhpiego

Success Story:Saving Lives Through Cervical Cancer Screenings and Treatments
http://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.cdc.gov/parasites/guineaworm/gen_info/faqs.htmlhttp://www.cdc.gov/parasites/guineaworm/gen_info/faqs.htmlhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm

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Development

Assistance

The Development Assistance (DA)

account is the bedrock o U.S.investments to help the worlds

poorest obtain access to education

and clean water, grow nutritious

ood, protect the environment,

promote economic development,

support good governance, respond

to climate change and create

more sustainable, sel-sucient

democratic societies.

Despite the act that the Development Assistance (DA) account is at

the core o U.S. investments in creating sustainable, sel-sucientsocieties, unding or the account has remained fat since FY2010.

This is even more concerning given increasing ood prices, threats

to development rom climate events, expanded engagement by

geopolitical competitors and historic opportunities to advance

democracy in the Arab world.

The recommended $3.175 billion is the minimum level necessary

to cover the challenges and opportunities in each major sector

(including ood security and agriculture, micronance, basic

education, climate change, biodiversity and water), without squeezing

out other equally worthwhile programming, such as democracy

unding, economic growth, trade capacity-building, technology,

innovation and evaluation. The $3.175 billion level refects the Senate

FY2013 unding level plus an increase in $125 million over the Senate

FY2013 unding levels or basic education. For more details, see the

sectoral justications on the ollowing pages.

Funding History

Purpose Justication


$3.175 billion


Katie Lee



InterAction

[email protected]

Erin Jeery


Coordinator

InterAction

[email protected]

33

Enacted



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FoodSecurity and

Agriculture

The recommended $1.445 billion

unding level or Food Securityand Agriculture includes support

or Feed the Future programs and

ood security programs in rontline

states: $1.2 billion would und Feed

the Future at the Senate FY2013

level, while an additional $245

million, based on the Presidents

FY2013 budget request, is needed

to ensure ood security in rontline

states.

Globally, 870 million people suer rom malnutrition and hunger,1

while some 2.5 million children under 5 die each year rommalnutrition.2 Hunger and malnutrition rob poor people o healthy,

productive lives and stunt the mental and physical development

o uture generations. Food price volatility and extreme weather

patterns, such as those that caused the droughts in the Horn

o Arica and the Sahel, are pushing more and more people into

extreme hunger and malnutrition.

Ater decades o declining support or armers in developing

countries, renewed U.S. leadership has sparked a global

commitment to helping people eed themselves. Feed the Future

takes a comprehensive and sustainable approach to agricultural

development. Investments ocus on country-owned plans

developed through engagement with local government and civil

society, and emphasize the importance o gender, nutrition,

climate change and natural resource management. Drawing upon

resources and expertise o agencies across the U.S. government,

this initiative is helping countries, including 19 ocus countries,

transorm their agriculture sectors to sustainably grow enough ood

to eed their people. In FY2011, U.S. agricultural assistance helped

1.8 million armers adopt improved technologies or management

practices, and reached nearly 9 million children through nutrition

programs such as micronutrient supplementation and ood

ortication.3

Additionally, with ood prices remaining volatile and weather

patterns threatening water availability and agricultural productivity,

it is critical that we maintain or increase the level o unding or Feed

the Future and agricultural development in the rontline states o

Aghanistan, Pakistan and Iraq, in order to help promote stability in

these areas.

Funding History

Purpose Justication


$1.445 billionacross all bilateral accounts


Katie Lee



InterAction

[email protected]

35

Enacted



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The Yaajeende Agricultural Development Program in Senegals

eastern regions is transorming the lives o one million

individuals in 100,000 households, and is part o USAIDs

Feed the Future project. Yaajeende means abundance or

prosperity in the local Pulaar language, and refects the goals

o the project: to improve the nutrition and income o one million

people across 60 regional communities.

The project brings together ve organizations: Counterpart

International, Heier International, Manobi Inc., The National

Cooperative Business Association, and Sheladia Associates Inc.

For its part, Heier is placing livestock (poultry, sheep and goats) among 5,500 households. Using the passing

on the git model, amilies who receive one o the 12,000 sheep and goats or 12,500 poultry will then pass on the

ospring to their neighbors. Through this process the program will reach 19,500 households over ve years.

When you are poor, you will never neglect the sheep because they are a way to move orward, said Kumba

Daranjay, president o a armers association. You know how bad poverty is, and you dont want to go back. The

sheep will help eed our children and take care o their health.

Heier International estimates the increased economic activity resulting rom the project will double the household

incomes o armer participants, which in turn will substantially reduce the number o underweight children

and allow them to grow and reach their ull potential. The livestock will not only allow amilies to better eed

themselves, it will also give them money so that they can send their children to school.

Reerences

1 The State o Food Insecurity in the World, Food and Agriculture Organization. http://www.ao.org/docrep/016/i3027e/i3027e.pd.

2 Committing to Child Survival: A Promise Renewed Progress Report 2012, UNICEF.

3 Feed the Future Progress Report 2012, Feed the Future. http://eedtheuture.gov/resource/eed-uture-progress-report-2012.

OliverAsselin/HeierInternational

Success Story:Passing On the Git or Sustainability
http://www.fao.org/docrep/016/i3027e/i3027e.pdfhttp://feedthefuture.gov/resource/feed-future-progress-report-2012http://feedthefuture.gov/resource/feed-future-progress-report-2012http://www.fao.org/docrep/016/i3027e/i3027e.pdf

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Micronance

Micronance provides access to

nancial services like credit orsavings or the worlds poor and

marginalized people, enabling poor

amilies to start businesses or meet

health, education, or emergency

needs, thus helping them lit

themselves out o poverty.

An estimated 2.5 billion people have no access to ormal nancial

services.1

Micronance began as a way to nance sel-employmentventures by poor people who had ew employment or income-

generating opportunities or who could not obtain credit. It has

since expanded to include poor households management o their

nances through savings, credit and insurance or such things as

enterprise, education, housing and health care. U.S. micronance

assistance ocuses on improving access to these nancial services

or the very poor (those living on less than $1.25 a day) and the

people most marginalized by the societies in which they live.

Public unding is critical or reaching these populations because

very little private oreign investment capital in micronance goes to

the countries with the greatest need or to the most marginalized

populations within these countries. For instance, in sub-Saharan

Arica, which has the highest percentage o people living in extreme

poverty o any region, 640 o the 800 million o the people in the

region have no access to any nancial institution micronance or

otherwise.2 USAID microenterprise unding plays a critical role in

expanding nancial opportunities or the underserved in these high-

need countries.

Strong congressional support has demonstrated U.S. leadership in

micronance and microenterprise development, recognizing these

tools as a cost-eective and successul way to reduce poverty

and promote economic growth. In FY2011, U.S. microenterprise

development assistance helped provide approximately 3 mil

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