The United States is the The greatest donor government to global health and has Prioritized health in its foreign assistance activities to a greater measure than the other governments of donors. In addition to being the largest donor, the United States operates programs, provide technical assistance, participates in international health organizations, research and more. Since the start of his second term, President Trump has taken many measures on US global health efforts, in particular Go to a foreign aid While examining existing programs, the elimination of the American agency for international development (USAID), which manages the The majority of global funding of global healthand by signing several executive actions Place restrictions on US global health activities. These efforts are significant Implications for existing American programs and on the left Large gaps in the donor landscape.
More recently, as part of its foreign aid review, the Trump administration Wise congress In the number of USAID awards, he intends to terminate and those he will continue. THE list Included more than 6,200 awards, more than 5,300 of which were listed as finished and nearly 900 as remaining active. These attributions total more than $ 36.0 billion in non -compulsory funding, including $ 27.7 billion in dismissed awards and $ 8.3 billion for the remaining awards. Although it is not known if it will be the final list, it has provided the first official indication of the administration’s plans for the foreign aid portfolio in the United States, including for global health activities. A recent kff analysis examined some of the questions raised by the list. This analysis provides an assessment of the number of active and terminated prices of the global health project (detailed methods are provided below).
Results
World health prices represent 12% of all the awards on the list, but the majority (53%) of all non -obliged funding. Of the more than 6,200 prices on the list, 770 (12%) are identifiable as global health prices. These attributions represent approximately $ 19.1 billion in funding not obliging (defined by the administration as the difference between the total attribution value and the already obliged amount), or 53% of all non -bounded funding.
80% of world health prices are listed as terminated, totaling $ 12.7 billion in non -obliging funding. Of the 770 world health prices identified, 615 (80%) are listed as terminated, slightly lower than the share of all the awards finished (86%). These interrupted prices include support for polio vaccination programs, activities to improve maternal and child health (MCH), efforts to strengthen the detection systems for infectious diseases worldwide, HIV treatment projects, family planning support, etc. Collectively, dismissed health scholarships total $ 12.7 billion in non -compulsory funding, or 67% of funding not obliged to global health ($ 19.1 billion). The remaining 155 global scholarships remain active, totaling $ 6.3 billion, or 33%, of the total financing of world health not compulsory.
Many world health prices are multisectoral, covering more than one global health area, HIV / AIDS representing the greatest number. Of the 770 awards identified, 289 specifies activities which deal with more than one of the six main sub-sectors of global health, in particular: HIV / AIDS; tuberculosis (TB); malaria; Maternal and child health (MCH); Family planning / Reproductive health (FPRH); and nutrition. The awards including HIV / AIDS activities represented the greatest number (379), followed by MCH (266) and FP / HR (233) (see Figure 1).
By sub-sector activity, the share of awards ended varies between 71% for HIV and 86% for MCH and nutrition. Most of the awards for each sub-sector activity have been completed. MCH and nutrition had the biggest share of awarded awards (86%for the two sub-sectors), followed by RPF (85%), malaria (80%), tuberculosis (79%) and HIV (71%) (see Figure 2).
Methodology |
| To assess the rewards on the list of the dedicated USAID, we first tried to match the reward identifiers for all the prices in the list (6,232) with project of activity in activity in https://www.foreignsistance.gov/The American government’s database of any foreign assistance financing. This database includes the area of the American government sector for rewards (for example, health, education, agriculture, etc.) and sub-sectors within each of these (for example, HIV, TB, malaria), allowing the official coding of data for any paired reward. On the total, 3,129 rewards correspond. For the 3,103 which did not correspond, we first excluded a prize on the list published by the USAID’s Bureau for Humanitarian Assistance (BHA) and the office for Democracy, Conflict and Humaninitarian Assistance (DCHA), which are considered as humanitarian assistance prices, but not assistance in health, leaving prices awarded by all other offices, including the Office for World Health (GH) and USAID individual missions. Among these, we have examined their reward text descriptions to determine whether the price included identifiable health activities and if there was information to identify the activities of the price sub-sector, including HIV, tuberculosis (TB), malaria, maternal and child health (MCH), nutrition and family planning (FPRH). A price that included HIV / TB activities was coded like HIV. We have not included water, sanitation and hygiene (WASH) awards as a health because these prices may include infrastructure projects, water management programs and other activities that are not included in US global health programs. Where a reward description included activities in more than one sub-sector (i.e. in https://www.foreignsistance.gov/ Or in our manual coding), all of these sub-sectors have been counted, which has led to a greater number of award activities by the health sub-sector than the total number of health prices. Our approach probably underestimates the total number of global health awards (and the amount of associated financing) due to the limited nature of the information included in the description of numerous prices which did not correspond to https://www.foreignsistance.gov/ data. For example, there were many prices for ocean freight contracts that did not indicate what was shipped, which could have included articles for global health programs, as well as numerous prizes rewarding the names of individual consultants or construction projects, some of which could also be related to health. Our analysis of health sub-sectors is also limited in that it is possible that for those which cover more than one sector, only part of the price has been maintained active (or finished), and our approach would include all sub-sectors. Finally, if a price has been listed twice, each with the same status (the two have been listed as assets or completed), one of the duplicated lines has been removed (a case for global health); If a reward has been listed twice, each with a different status (an asset and a finished), the two have been deleted from the list (a case for global health). |