The Foreign Service Journal - May 2017
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MAY 2017



A Long-Term Commitment to Saving

and Improving Lives

Global health programs have been a USAID core activity since

President John F. Kennedy established the agency in November

1961. USAIDwas created in the aftermath of two world wars with

the intent of building a more stable world through sustained and

well-targeted bilateral interventions. It was an act of leadership in

an increasingly interdependent world.

Working to save lives in some of the poorest countries around

the world has created strong relationships among a variety of

stakeholders, including national health authorities and local

communities. It has also given the agency a thorough under-

standing of health needs and gaps in a variety of contexts. After

all, many USAID Foreign Service health officers spend their

careers overseas working shoulder to shoulder with their local

counterparts. This translates into a level of trust that manifests

itself in long-lasting partnerships.

“Unlike other donors, USAID is very local in its approach, and

this is one of our strengths,” says Adams. “We have maintained a

long-term commitment in about 80 missions around the world.

We still rely on local hires, some of whom have worked for USAID

for more than 30 years. We therefore have history, institutional

memory and capacity to build on that is unique to us.”

Furthermore, U.S. leadership in global health often sets the

tone, pushing other countries to take health issues seriously and

to establish commitments on a global level. Pelzman was working

in Russia when former Secretary of State Colin Powell visited and

referred to HIV as a “virus of mass destruction.” It was in part as

a result of his advocacy, she

says, that the government of

Russia submitted an applica-

tion to the Global Fund to

Fight HIV, TB and Malaria, a

first for that country.

Pelzman also points to

USAID’s success in Child

Survival: Call to Action, a

global effort launched in

June 2012 to reduce maternal

and childmortality. USAID’s

groundwork in India led that

government to become a

key founding member of this

initiative, helping to drive

the country’s ownmaternal

health agenda. Lastly, Pelz-

man lauds the impact of significant and long-term investment by

the U.S. government in PEPFAR in South Africa and the partner-

ship that has resulted from this resource commitment.

“In all three of these cases,” says Pelzman, “U.S. government

funds have by no means been the lion’s share of health budgets.

But our technical expertise, the global best practices we brought

to bear, the groundbreaking pilots and evidence we helped to

develop—often advanced even further by our remarkable local

staff and their ability to establish effective relationships with

senior government officials—all had impacts far beyond the dol-

lar amounts.”

Beyond the Health Sector

Global health programs that address national priorities such

as improving mother and child health or combating infectious

diseases like HIV/AIDS or malaria unfold on multiple levels

(national, state or region, and district) and require building rela-

tionships with a variety of stakeholders. These types of programs

can be vehicles for strengthening other areas that are important

to diplomacy, including good governance, decentralization,

private sector engagement, domestic resource mobilization,

community involvement and civil society participation.

Adams experienced this synergy when she served in Senegal.

At that time, the government was decentralizing control, pushing

resources to provincial and district levels. “Through our health

programs, USAID worked closely on the rollout of these plans,

helping communities identify what their priorities were and how

best to capture and control public resources. We also helped

A child in the Dolo Ado refugee camp, on the border between Ethiopia and Somalia, is measured to

determine if he is malnourished. Addressing malnutrition from an early age can prevent stunting and

ensure healthy growth. USAID supports programs that integrate nutrition interventions across sectors.