When you think about who is going to be hit the hardest by pollution, whether it’s conventional air water and soil pollution or climate change, it is very often low-income communities and communities of color. The undercutting of these kinds of protections is going to have a disproportionate impact on these very same communities.
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Agency for International Development
Focusing on Holistic Health Care and Support for Women, Children, and Families. The continued high rate of maternal and infant mortality is a persistent global tragedy. Contrary to current publicity, this problem is not solved by abortion. Families genuinely cherish children. The next leadership at USAID must focus attention on women and children’s health (including unborn children) as well as health risks across life spans, including childhood infections, cervical cancer, adolescent risks, and family stability, by utilizing a coordinated approach. The Bureau should implement a “Request for Application for Resilient Families” that harvests collaborative funds from siloed programs and makes individuals and the family, not diseases or conditions, the true focus of intervention.
Increasing USAID Collaboration with Faith-Based Organizations. F BOs historically have been much more successful in outreach to remote and vulnerable populations, based on trust built through decades of service. The value of collaborating with FBOs was demonstrated in the October 2020 Evidence Summit on Religious Engagement. In sub-Saharan Africa, FBOs often provide more than 80 percent of health care, especially to the extremely poor. In contrast, the Global Health Bureau historically has provided 85 percent of its funding to large U.S. NGOs with significant overhead costs, as a result of which only 20 percent-30 percent of funding reaches people in need.
Leveraging the Strength and Experience of Presidential Initiatives. Millions of people are alive today because of the American people’s investment in PEPFAR and PMI. The training, laboratory, clinical intervention, health education, data collection, and organizational platforms of these programs became the bedrock for responding to the COVID pandemic. It is time for these programs to become part of an integrated, strong, and sustainable network of health care and public health in developing countries. A smooth transition to national ownership and funding, however, will require better coordination of USAID’s own stovepiped programs with PEPFAR and PMI.
Strengthening the Collection and Use of Data. Good decisions are based on accurate data. For decades, global health programs have relied mostly on statistical modeling (rather than actual data) or survey data (the weakest type of data). Poor data quality undermines both the evaluation and improvement of desired outcomes achieved by our global health programs. The Trump Administration implemented critical updates of PEPFAR’s systems for the collection and reporting of data to increase transparency and hold funded partners and overseas missions accountable. The next conservative Administration should apply these reforms to all of USAID’s global health programs.
Strengthening Private-Sector Engagement. The Bureau’s Center for Innovation and Impact (CII) should be empowered to expand networks of private and faith-based health organizations that can develop projects using development-impact bonds, capital funds, and innovative technologies, including with the