Mark Green: USAID pick could be a silver lining if he does it right

This post was developed collaboratively by the Section’s Communications Committee.


The Trump administration’s nomination of Mark Green, former congressman, ambassador, and frequent NGO board-sitter, was one of those hard-to-find silver linings in the current political thunderstorm (or downward spiral, if you prefer). He is a political unicorn of sorts, enjoying both bipartisan support from Congress and respect from development professionals, someone who knows how to navigate both the political and technical aspects of the job. Green, a four-term Congressional representative from Wisconsin, also served as the ambassador to Tanzania under George W. Bush and was involved with the creation of PEPFAR. He has served on the board of directors for Malaria No More and the Millennium Challenge Corporation, a bilateral aid agency that administers grants to countries for recipient-led initiatives based on a series of economic and governance indicators. He is currently the president of the International Republican Institute, which promotes democracy, civil society, and good governance practices abroad. Politicians like him, old USAID hats like him, think tanks like him – even aid groups (including ONE and Save the Children) like him.

All of this is lovely, but hold the champagne. The inevitable next question is, what will Mark Green be able to accomplish as head of a hamstrung agency with no money?

As many have been quick to point out, USAID is not without its problems and could benefit from some major reforms. The agency has certainly not been immune to criticism from global health and development commentators, including this Section. Many of its programs have been of questionable utility or badly managed (or both), and it has been slow to respond to calls for its programs to be rigorously and transparently evaluated.

However, USAID may at this point be facing a more fundamental, existential crisis. Explains the AP, “[t]he agency faces a starkly uncertain future, including potentially big budget cuts and the possibility of being folded entirely into a restructured State Department.”

Restructured” in this case meaning disorganized, rudderless, and full of disgruntled and anxious employees.

An additional wrench was thrown in this week (although completely buried under ever more sensationalist headlines) with the announcement that the Global Gag Rule would be expanded to apply to all global health programs:

[T]he State Department [Monday] confirmed that, indeed, a massive expansion of the Global Gag Rule is underway. Whereas previous iterations of the Global Gag Rule only affected funds earmarked for reproductive health, the Trump version encapsulates all US global health programs. This includes programs for AIDS, Malaria, Measles, cancer care, diabetes, child nutrition — everything except emergency humanitarian relief.

In monetary terms, this expands the scope of the Global Gag Rule from about $600 million in reproductive health assistance to $8.8 billion in global health assistance around the world, including the $6 billion anti-AIDS program created by President George W. Bush known as PEPfAR.

So even if Congress pushes back against the administration to preserve USAID’s budget, Mr. Green may not have any recipients to give the money to.

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Guest Blog: The DevelopmentXChange Pitch Competition

Guest Blogger: Amanda Hirsch


Saving Lives at Birth, along with the U.S. Agency for International Development (USAID), hosted DevelopmentXChange, the fifth annual pitch competition held by the partnership to call upon innovators from around to identify and scale up groundbreaking prevention and treatment approaches for pregnant women and newborns in poor, hard-to-reach communities.

Fifty-three finalists from the pool of innovators joined this year’s DevelopmentXChange in Washington, DC to participate in the final stage of the competition. They gathered to actively network their ideas with innovators, investors and partners, display their innovations in an open Marketplace, and compete for grants to make their innovations reality.

Amongst the 53 finalists, the first to present was a representative of the Pumani by 3rd Stone Design. Half of premature babies struggle to breath upon birth. This product expands upon the existing Bubble Continuous Positive Airway (bCPAP) technologies that are commonly used in the developed world to treat neonates with compromised respiratory systems by maintaining positive airway pressure during breathing, preventing airway collapse and improving oxygenation.

The Pumani, named after the Malawian term for “breathe restfully,” is as cheaper, easily-transportable version of the original bCPAP. The Pumani is currently being used by 700 clinical staff in 40 hospitals in Malawi and surrounding African countires. 2,000 patients have been treated with 170 Pumani devices to date and have seen survival rates of 64.6% with usage compared to rates of 23.5% from the use of oxygen alone. Creators of the Pumani hope to receive sufficient funds to manufacture hundreds more devices and to develop a sales and distribution team.

Next, innovators of Emory University pitched their Skin Immunization Microneedle Patch. Each year 1.5 million babies and children die of vaccine-preventable diseases. Low socioeconomic status, little-to-no access to healthcare facilities to receive vaccinations, and difficulty transporting and storing vaccines to remote and rural populations have severely impacted vaccination rates in hard-to-reach communities.

The vaccination patch, a small square covered in microneedles that will vaccinate a subject against one or multiple diseases within minutes is proposed to be the solution to this problem. The Skin Immunization Microneedle patch can be stored in unfavorable elements, transported easily, requires minimal storage space, and eliminates the burden of biohazard sharps. So far, the patch has successfully provoked immune responses to H1N1 and tetanus. Innovators of the Emory University team wish for funding to begin conducting human studies for the patch.

Third, innovators from the University of Toronto sought to address iron deficiency in pregnant women, particularly in Southeast Asia. Iron deficiency causes 150,000 maternal deaths each year. To address this problem, the Toronto teamed proposed food fortification- to fortify tea with iron. Tea was chosen to be fortified because it is the sole product that is universally purchased across Southeast Asia. People from all walks of life- rich, poor, urban, rural, must go to purchase tea.

Mimicking the iron fortification of salt which has cured one million people of anemia, it was proposed that iron be microencapsulated into tea that can be processed in the body. Innovators of the iron-fortified tea seek funds to work on managing the taste, distribution, and exploration of their product.

The remaining of the 53 innovators also presented at the DevelopmentXChange pitch competition. To learn more about the innovators, products, competition, and organization, visit http://www.savinglivesatbirth.net.


twitter photoAmanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.

Screwing Global Health for the Sake of Spying

Two weeks ago, my husband and I visited a couple that we knew from university that I hadn’t seen since before we left for Korea in 2012. The wife actually got her Master’s in international development and worked in DC for a few years after graduating, but returned to Texas with a general distaste for the development industry. “I always wanted to work for USAID,” she told me, “until I figured out that they were just a tool of US foreign policy. I felt kind of betrayed – I thought they just helped people!”

usaid branded aid
Photo credit: USAID.

My friend’s complaint is common among development professionals. Many in the industry believe that US foreign assistance should come without political strings attached to it, and they object to practices such as obvious branding of foreign aid supplies and using aid as a tool to strong-arm other countries into going along with American foreign policy moves. Personally, I get that foreign aid is one of many tools in a country’s foreign policy toolkit – it may not be ideal, but it’s at least logical.

What’s not logical to me, however, is the use of aid – specifically, of global health interventions – as a cover for intelligence operations.

Development types will remember the uproar over the CIA’s use of a vaccination drive as a cover for collecting DNA in a (failed) effort to locate Osama bin Laden in Pakistan. (Widely reported as a polio vaccination drive, the CIA scheme actually used hepatitis B vaccine.) Pundits predicted – correctly – that it would set polio eradication efforts back and put aid workers in danger. Luckily for us, the CIA has now promised not to do it again – which is lovely, but a shame that it took three years for them to get around to doing.

Now it would seem that USAID is trying its hand at endangering global health efforts through half-baked intelligence schemes. Last week, the AP released its major investigative journalism report on a USAID operation that used young and inexperienced Latin American activists to try to stir up dissent in Cuban civil society. Aside from major issues such as the fact that the Latin American youths were poorly trained (and paid!) and not prepared for the risks they faced (particularly when USAID’s management of the scheme was utterly amateur), or the fact that this really is not USAID’s job, development professionals have been irate that yet another government covert operation has jeopardized global health – in this case, HIV/AIDS prevention efforts, in response to the revelation that one of the operatives used an HIV workshop to “recruit promising individuals”:

The choice of a U.S.-sponsored HIV workshop in Cuba is an interesting one, since Cuba’s HIV infection rate is one of the lowest in the world, and one-sixth that of the U.S. But it appears the disease was not necessarily the focus of the workshop, which was attended by 60 people. Fernando Murillo, after returning from Cuba, put together a report detailing his activities for Creative Associates, the USAID contractor hired to work against Cuba’s government. His only mention of HIV says it was “the perfect excuse for the treatment of the underlying theme,” meaning anti-government organizing.

In a press release, Congresswoman Barbara Lee (D-CA) blasted the program. “As co-chair of the Congressional HIV/AIDS Caucus, I am particularly concerned by the revelation that HIV-prevention programs were used as a cover,” she said. “This blatant deception undermines U.S. credibility abroad and endangers U.S. government supported public health programs which have saved millions of lives in recent years around the world.”

Frankly, I am scratching my head at why USAID thought that this kind of operation, or the “Cuban Twitter” called Zunzuneo that was uncovered earlier this year, was a good idea. Perhaps they are fighting to stay relevant in an era of US global health policy when the State Department and the White House are also jockying for position, but it’s no excuse. Jeopardizing global health programs, particularly programs that target HIV/AIDS – which is universally acknowledged as at the top of the global health agenda – is just a way to shoot yourself in the foot. In the end, they only lose credibility – and USAID, as a development agency, should understand what that can cost. They should know better.

FYI: Upcoming USAID Webinar on New Climate Change Document

The USAID Office of Global Climate Change is introducing a new climate resilient development framework to the Adaptation Community.

On April 8, 2014, at 4 p.m. EST, Kit Batten, USAID/GCC Coordinator, and the adaptation team at USAID will lead a special presentation covering in detail a new publication on climate adaptation for developing countries: Climate-Resilient Development: A Framework for Understanding and Addressing Climate Change. Working with decision makers in governments and across sectors, the framework has been applied in Barbados, Jamaica, Nepal, Peru, Philippines, St. Lucia, Tanzania, West Africa, and other countries that are preparing communities for a climate resilient future. The framework describes USAID’s “development-first” approach, which aims to achieve development goals despite climate change. This framework is an update of the approach presented in 2007 in USAID’s Adapting to Climate Variability and Change: A Guidance Manual for Development Planning.

The event will take place on Tuesday, April 8, from 4 to 5:30 p.m. EST.

In-person: Engility, 1211 Connecticut Avenue NW, 8th floor conference room, Washington, DC 20036

Online webinarhttp://irgltd.adobeconnect.com/climate/
Enter page as a Guest and type in your first and last name. Please include the name of your organization in parentheses.

Call-in number:
United States: 1-877-685-7326   Conference code: 8170974215
International: 1-678-735-7838    Conference code: 8170974215

Please send your RSVP by April 6th and questions about the presentation to Joyce-Lynn.Njinga@engilitycorp.com.

Happy International Women’s Day!

Today is International Women’s Day (IWD) and the official theme for this year is “Equality for women is progress for all.”

The origin of International Women’s Day dates back to the early 1900’s and now every year on March 8, people around the world rally together to commemorate and support women. International Women’s Day is not only a time to celebrate achievements, but also a time to reflect on the progress made and call for increased changes. From women’s rights and gender equality to abuse and sex trafficking, various social, political, and economic issues concerning women are highlighted and become points of discussion (and even protest) around IWD.

The Millennium Development Goals call for the promotion of gender equality and the empowerment of women and during the IWD opening ceremony at the United Nations today, Hilary Clinton, known for being a champion of women, said “women and girls and the cause of gender equality must be at the heart” of the UN’s agenda to promote development around the world. UN Secretary General Ban Ki-moon echoed her sentiments, saying in his message, “This International Women’s Day, we are highlighting the importance of achieving equality for women and girls not simply because it is a matter of fairness and fundamental human rights, but because progress in so many other areas depends on it.”

This plays nicely into the ongoing debate on the post-2015 development agenda. We all know there are major issues around the access, quality, and availability of health services to women in developing countries, and that these issues are often further complicated by cultural and religious norms. I think it’s safe to say that although IWD is only one day a year, the discussion on women’s rights as a core component of global development will continue. It is essential.

Here’s a roundup of some IWD 2014 content in case you missed it:

“The fastest way to change society is to mobilize the women of the world.” — Charles Malik

What does International Women’s Day mean to you? Tell us in the comments below.