Transcript Document

A USAID Perspective
on Foreign Assistance
Dr. Randy Kolstad, PHN Director
USAID/Zambia
May 2008
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Presentation Outline
• Overview of U.S. Foreign Assistance
• Mechanics of U.S. Foreign Assistance
• The U.S. and the Paris Declaration, SWAps and the
IHP+
• USAID Health Activities in Zambia
• NOTE: This presentation represents informed
personal opinion, NOT the official position of USAID
or the U.S. government.
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Overview of the US Foreign Assistance
Paradigm
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Brief Statistics
• Worldwide, the U.S. provided $23.5 billion in ODA in
2006
– Sub-Saharan Africa received $5.6 billion
– Humanitarian assistance was more than $3 billion
– U.S. is largest contributor to the UN and multilateral
development banks, a total of $2.4 billion
• $637 million to the UN
• $827 to the World Bank Group
– The U.S. has provided over $2.5 billion to the Global Fund
since its launch, or nearly one-third of the total resources
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We know this data due to reforms prompted by a
question from
the US Secretary of State:
How much does the US spend on democracy?
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With this web of
roles and
responsibilities for
foreign assistance,
no wonder it was
difficult to develop
an accurate
answer…
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New US Foreign Assistance Strategic Framework
• All programs designed to support one of five
functional objectives
1.
2.
3.
4.
5.
•
Under each functional objective are
•
•
•
•
Peace and Security
Governing Justly and Democratically
Investing in People
Economic Growth
Humanitarian Assistance
Program areas
Program elements
Program sub-elements
Specific definitions and indicators for each and every
component
•
Guidance in 2006 was 446 pages
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Strategic Framework includes Country Categories
• Country categories are intended to:
– Provide a way to measure progress along a continuum
– Establish basis for “graduating” countries from USG
assistance
– Assist with / inform program choices
• No direct correlation between budgets and categories
• Country categories in Africa
–
–
–
–
–
Rebuilding (6 - including DRC, Liberia, Somalia, Sudan)
Developing (30 - including Zambia, Ethiopia, Nigeria)
Transforming (5 - including Mali, Tanzania)
Sustaining Partnership (5 - including South Africa)
Restrictive (1 - Zimbabwe)
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• This process and categorization covered 155
countries in 2008
THEREFORE
• The task at the country level is:
To translate the global strategic framework paradigm
into activities that optimally support country-led
priorities and strategic plans
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Mechanics of US Foreign Assistance
• In most cases, bilateral agreements between governments
outline terms, objectives and funding amounts
• Projects carry out the work outlined in the bilateral agreement
– Grants, cooperative agreements and contracts are the vehicles by
which the objectives are reached
• Technical assistance
– Training, curriculum development, policy development, specific
assessments, etc.
• Commodities
• Renovation
– Both country level and global level agreements
– Designed in collaboration with host-country partners
– Most managed in-country
• USG projects are results-oriented with a very high degree of
funds accountability
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The U.S. Government and the Paris Declaration
• The U.S. Government
has endorsed the Paris
Declaration
5. Managing for Development Results
Ownership
Alignment
Harmonization
Managing for
results
– Mutual
accountability
1 Ownership
(Partner countries)
2
Alignment
(Donor — Partner)
3 Harmonisation
(Donor — Donor)
4 5 Mutual accountability
–
–
–
–
Partners
set the
agenda
Aligning with Using
partners’ partners’
agenda systems
Establishing Simplifying Sharing
common procedures information
arrangements
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Paris is not all about the money
• Ownership begins with a host-country owned
development strategy
• Alignment calls for using country systems
(procurement, PFM) where they meet acceptable
standards, and for strengthening them where not
• Harmonization is not synonymous with budget
support, but coordination that ensures effective use
of resources toward a common goal
• Complementarity of efforts is the key
• Results and accountability are key features of all
USG programs
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SWAps and the IHP+: Many common objectives
• In the context of SWAps and the IHP+, the USG, nearly
universally, does NOT pool funds
• Equally universally, many common objectives exist between the
USG and SWAps / IHP+
– Ownership: Developing countries exercising leadership over their
health policies, strategies, and relationships
– Alignment: External partners assistance is aligned in a way that
supports national health strategies, and SWAps make full use of
country systems
– Coordination: Donors and international agencies coordinate their
funding around national strategies
– Results-based: National strategies and support from external
partners targets delivering improvements in health outcomes
– Graduation: Investments by foreign partners set developing
countries on a course that moves them off of dependence on
foreign assistance
– Mutual accountability: Partners agree to a review of progress in
implementing these principles
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What this means at the Zambia level…
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USAID/Zambia
• USAID supports Zambia’s National Health Strategic
Plan, specifically to
– Prevent HIV & provide care and treatment for those infected
and affected by AIDS
– Control and prevent malaria
– Improve maternal & child health
– Promote family planning & reproductive health
– Reduce the burden of TB
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USAID/Zambia – PHN Funding Through Time
PHN Funding FY 2004 – FY 2007 (millions)
100
93.7
90
80
73
70
FP, MCH, TB & Malaria
60
Total
HIV
10
40
30
9.5
9
50
8
38
7
6
26.3
5
20
4
3
10
5.8
4.5
3.9
3.2
4.4
FP
MCH
Malaria
TB
2
0
1
2004
2005
2006
2007
0
1
0
2004
2005
2006
2007
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PHN Inputs by Partner, Account and Level (FY 2007 Amounts)
Bilaterals
Field Support
Centrally funded
Total = $93.7m
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Example activities in Zambia
•
HIV
– Purchase ARVs, test kits and
laboratory commodities
– Improve ARV, CT and PMTCT
service delivery
– Care and support at clinic and
community level
– BCC to reduce stigma and
increase use of family planning
for HIV positives
– HR planning and retention
•
•
– Support emergency obstetric
care
– Community and facility IMCI
– EPI
•
Family planning / reproductive
health
– Purchase FP commodities
– Post abortion care
•
TB
– Expanding DOTS
– Improving laboratories
Malaria
– Support indoor residual
spraying
– Purchase and distribute bed
nets, RDTs and ACTs
– Support case management and
treatment during pregnancy
Maternal child health
•
Cross-cutting
– Planning systems
– HIV and essential drugs supply
chain system
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Questions?
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