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Development &HumanitarianRelief
Chooseto Invest in
FY2014
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Choose toInvest inDevelopment &HumanitarianRelie
FY2014
Contents
4 List o InterAction Member Organizations
Introduction
5 What is Poverty-Focused Development and Humanitarian Assistance?
6 Compassionate and Moral Leadership8 Invest in Future Trading Partners
9 Alleviating Poverty is Key to Americas Security10 Results Start With Transparency and Accountability
11 InterAction FY2014 Funding Recommendations Summary Table
Investing in Long-Term Development
13 Global Health Programs
15 Maternal and Child Health17 Family Planning and Reproductive Health
19 Nutrition21 Malaria23 Tuberculosis
25 Neglected Tropical Diseases27 HIV/AIDS, PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria
29 NIH Global Health31 CDC Global Health
33 Development Assistance35 Food Security and Agriculture37 Micronance
39 Basic Education41 Climate Change Response (Bilateral)
43 Climate Change Response (Multilateral)45 Biodiversity
47 Water49 Millennium Challenge Account51 International Organizations and Programs
53 International Development Association55 Global Agriculture and Food Security Program
57 International Fund or Agricultural Development59 McGovern-Dole International Food or Education and Child Nutrition
Humanitarian Relie to Cope with Disasters and Crises
61 International Disaster Assistance63 Migration and Reugee Assistance
65 Emergency Reugee and Migration Assistance67 Food or Peace Title II
Creating the Conditions or Development and Peace
69 Contributions to International Peacekeeping Activities71 Peacekeeping Operations
Strengthening U.S. Development Capacity
73 USAID Operating Expenses
75 Other Key Development and Humanitarian Accounts
77 InterAction FY2014 Budget Table
3
Cover photo:Esther Havens,Concern WorldWide
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GOOD360
Habitat or Humanity International
Handicap International USA
Heart to Heart International
Heartland Alliance
Heier International
Helen Keller International
HelpAge USA
Helping Hand or Relie and Development
HIAS
Himalayan Cataract Project
Humane Society International (HSI)
The Hunger Project
Inormation Management and Mine Action Programs (IMMAP)
INMED Partnerships or Children
InsideNGO
Institute or Sustainable Communities
Interchurch Medical Assistance, Inc. (IMA World Health)
International Catholic Migration Commission (ICMC)
International Center or Not-or-Prot Law
International Center or Research on Women (ICRW)
International Emergency and Development Aid (IEDA Relie)International Foundation or Electoral Systems (IFES)
International Housing Coalition (IHC)
International Medical Corps
International Medical Health Organization (IMHO)
International Orthodox Christian Charities (IOCC)
International Relie & Development
International Relie Teams
International Rescue Committee (IRC)
International Social ServiceUnited States o America
Branch, Inc
International Youth Foundation
IntraHealth International, Inc.
Islamic Relie USA
Jesuit Reugee Service/USA
Jhpiego an aliate o The Johns Hopkins UniversityJoint Council on International Childrens Services
Keystone Humane Services International
Latter-day Saint Charities
Lie or Relie and Development
LINGOs
Lutheran Immigration and Reugee Service
Lutheran World Relie
MAG America
Management Sciences or Health (MSH)
MAP International
Medical Care Development
Medical Emergency Relie International (Merlin)
MedShare International
Mennonite Central Committee U.S.
Mercy Corps
Mercy-USA or Aid and Development
Millennium Water Alliance
Mobility International USA
National Association o Social Workers
National Cooperative Business Association
ONE Campaign
One Economy Corporation
Operation USA
Oxam America
Pact
Pan American Development Foundation
Pan American Health and Education Foundation (PAHEF)
PATH
Pathnder International
InterAction Member Organizations
ACDI/VOCA
Action Against Hunger USA
ActionAid International USA
Adeso
Adventist Development and Relie Agency International
(ADRA)
Arican Medical & Research Foundation
Arican Methodist Episcopal Service and Development
Agency (AME-SADA)
Aga Khan Foundation USA
All Hands Volunteers
Alliance or Peacebuilding
Alliance to End Hunger
American Friends Service Committee
American Jewish Joint Distribution Committee
American Jewish World Service
American Red Cross International Services
American Reugee Committee
AmeriCares
Americas Development Foundation (ADF)
AmericasRelie Team
Amigos de las AmricasAnanda Marga Universal Relie Team (AMURT & AMURTEL)
Baptist World Alliance
Basic Education Coalition (BEC)
Bethany Christian Services Global, LLC
Bethesda Lutheran Communities
BRAC USA
Bread or the World
Bread or the World Institute
Brothers Brother Foundation
Buddhist Tzu Chi Foundation
Build Change
CARE
Catholic Relie Services
CBM
CDA Collaborative Learning ProjectsCenter or Civilians in Confict
Center or Health and Gender Equity (CHANGE)
ChildFund International
Church World Service
Concern America
CONCERN Worldwide U.S., Inc.
Congressional Hunger Center
Convoy o Hope
Counterpart International
Creative Learning
Development Gateway
Direct Relie International
Disability Rights Education and Deense Fund (DREDF)
The Eagles Wings Foundation
Education Development Center (EDC)
Episcopal Relie & Development
Ethiopian Community Development Council
Family Care International
Feed the Children
Food For The Poor, Inc. (FFP)
Freedom rom Hunger
Friends o ACTED
Friends o the Global Fight
Giving Children Hope
Global Communities
GlobalGiving
Global Health Council
Global Links
Global Washington
PCI
Perkins International
Physicians or Peace
Plan International USA
Planet Aid
Plant with Purpose
Population Action International
Population Communication
Presbyterian Disaster Assistance and Hunger Program
Project C.U.R.E.
Reugees International
Relie International
Religions or Peace
RESULTS
ReSurge International
Salvation Army World Service Oce
Save the Children
Seva Foundation
ShelterBox USA
Society or International Development (SID)
Solar Cookers International
Solidarity CenterStop Hunger Now
Transparency International USA
Trickle Up Program
Unitarian Universalist Service Committee
United Cerebral Palsy
United Methodist Committee on Relie
United Nations Foundation
United States International Council on Disabilities (USICD)
U.S. Climate Action Network (USCAN)
U.S. Committee or Reugees and Immigrants
U.S. Fund or UNICEF
VAB (Volunteers Association o Bangladesh)
WaterAid America
Water or South Sudan
WellShare InternationalWinrock International
Women or Women International
Women Thrive Worldwide
World Concern
World Connect
World Food Program USA
World Learning
World Neighbors
World Rehabilitation Fund
World Renew
World Society or the Protection o Animals
World Wildlie Fund
World Vision
Zakat Foundation o America
ASSOCIATE MEMBERS
Center or Justice and Peacebuilding, Eastern Mennonite
University
Disaster Resilience Leadership Academy (DRLA) at Tulane
University
Enough Project: a project o the Center or American
Progress (CAP)
Global Masters in Development Practice Secretariat o the
Earth Institute at Columbia University
Transnational NGO Initiative o the Moynihan Institute o
Global Aairs at Maxwell School o Syracuse University
(as o 3/27/13)
4
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InterAction is the nations leading policy advocate
or international humanitarian relie and development
programs and represents millions o Americans who
provide nancial support to over 180 U.S.-based
nongovernmental organizations (NGOs). InterAction
member organizations are aith-based and secular,
large and small, and deliver the kinds o services that
save and improve lives, while promoting sel-suciency
around the world.
The ollowing pages outline InterActions FY2014
unding recommendations or the U.S. governments
poverty-ocused international development and
humanitarian relie programs. Our recommendations
are built on decades o eld experience partnering with
local communities to deliver assistance.
We hope these one-pagers will help members o
Congress, their sta and other U.S. policymakers
improve the lives o those most in need: the poorest
and the most vulnerable. We look orward to working
with you in the coming year to promote U.S. leadershipin ending global poverty and addressing humanitarian
crises.
What is poverty-ocused developmentand humanitarian assistance?
Poverty-ocused development assistance reers to
oreign aid that helps the worlds poorest and most
vulnerable citizens.
Development programs help people and countries
lit themselves out o poverty, building better lives or
themselves and their children. These programs build
sustainability by helping amily armers increase their
productivity, improving health care, getting children to
attend and stay in school, or providing access to sae
water and sanitation.
Humanitarian relie programs help save lives and
alleviate the suering o those who have been aected
by natural and man-made disasters such as confict,
drought and foods by providing emergency access to
ood, medical assistance, water and shelter.
The United States has a unique role
InterAction member NGOs are mostly unded by private
donations: about 70% o unds are raised privately.1 While
NGOs are not as reliant on congressional appropriations
as in the past, we still believe in robust U.S. investments
in development because the U.S. government has a
unique role to play in reducing global poverty.
The United States has the unparalleled ability to
convene a broad range o stakeholders rom the
public, private, corporate and nonprot sectors who
together have the resources and expertise to develop
more integrated country strategies to address extreme
poverty. NGO partners are a key pillar o this collective
orce, leveraging the generosity o millions o individual
Americans who trust and nancially support NGOs.
1 InterAction analysis o members 2009 IRS Form 990s.
InterActionsFY2014 FundingRecommendations or
Foreign Assistance
InterAction member NGOs
are supported by millions
o private contributions,
180+
volunteers and more than1.5 million
Christian, Jewish, Muslim and Buddhist
congregations and aith communities
60,000
5
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Our compassion, and or some our aith,calls us to do the right thing
InterActions more than 180 member organizations
support poverty-ocused development and
humanitarian relie because we believe America can
be a orce or good in the world. Helping those most inneed is a moral imperative. Whether driven by religious
convictions or a sense o common humanity, we share
the view that the United States should be a moral
leader in helping people around the world who live in
extreme poverty.
We believe our actions should t our values. We
believe every person has dignity and rights that
cannot be denied, including lie, liberty and the pursuit
o happiness. People around the world share our
aspirations: a desire to create better lives or their
children with access to basic necessities such as cleanwater, nutritious ood, sae shelter, education and
health care.
Children are precious wherever they are born. With the
right investments, America can be a orce or change
to make sure every person has the opportunity to
help themselves. It is a undamental part o who we
are as Americans; whatever our political background,
we rmly believe the United States has a role to play
in advancing prosperity or the worlds poor andvulnerable people.
Increased needs around the world
Robust levels o assistance are needed now more than
ever to meet the needs created by a dramatic increase
in natural disasters, armed confict, drought and amine
worldwide. From the Haiti earthquake, the Indian
Ocean tsunami and the amine in the Horn o Arica, to
the millions o people in Syria who have been orced to
fee their homes, needs are increasing at an alarming
rate. The United States should be there to help them
get back on their eet.
By investing a tiny raction o our national budget lessthan 1% we can provide people emergency access
to ood, medical assistance, water and shelter. And we
can help them begin the process o healing and moving
one step closer to resuming normal lie.
Success is achievable
A great example o success
is PEPFAR the Presidents
Emergency Plan or AIDS
Relie. Initiated with bipartisan
support by President GeorgeW. Bush, PEPFAR has
directly supported liesaving
antiretroviral treatment or
over 5 million men, women
and children in 2012. Since
its inception, millions o
people have been able to once again become healthy,
productive members o their communities.
around the world live on
2.47 billionpeople
less than$2 per day
Victims othe 2004Indian Oceantsunami receivesupplies sentby the U.S.
PhotographersMate3
rdClassRebeccaJ.Moat/U.S.Navy
6
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When the United States makes an investment, others
ollow suit. Nations in Europe, Asia or the Americas,
and other private donors, leverage and ampliy the
investments made by the United States. The Global
Fund to Fight AIDS, Tuberculosis and Malaria is a great
example o this leveraging. While the United States
is the Global Funds largest donor, the U.S. portion is
capped at one-third o total contributions. This means
that or every $1 contributed by the United States, at
least $2 must come rom the international community.
Creating sel-suciency
We believe oreign assistance plays a critical role in
creating sel-suciency in developing nations. Eective
aid helps people help themselves. Ater all, the greatest
human dignity is being able to provide or onesel and
ones amily. This is why we invest heavily in programs
that teach people how to sh.
It is also why we strongly support programs that grant
people access to the resources they need to start their
own businesses and invest in their utures.
We know this is not easy. But we see the ruits o our
labor every day, such as when a microloan helps a
woman in Kenya start a business, or when a child in
India graduates rom college even though her parents
did not nish grade school.
When we choose to invest in humanity, we help all
people to live with dignity.
In September 2012,
InterAction members pledged
$1 billionin private, nongovernmental
resources to help small-holder
armers improve their yields and
better provide or their amilies.
UnitedStatesAirForce
7
Destroyed buildings inJacmel, Haiti ollowingthe 2010 earthquake.
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Invest in uture trading partners
While InterActions support or poverty-ocused
development assistance stems primarily rom our belie
that it is the right thing to do, there are also strong
economic reasons why investing in oreign assistance
can help Americans at home.
Now, more than ever beore, U.S. economic growth
is linked with global trade: about 95% o the worlds
consumers are overseas, representing 80% o the
worlds purchasing power.1 For American businesses
to prosper, they will most likely need to nd people
beyond our borders to buy their goods. By helping
people around the globe to increase their economic
buying power, we help them buy American products
and grow our economy here at home.
In numerous instances when the U.S. has
invested in building markets overseas,
the investment has more than paid
or itsel. South Korea, Taiwan and
Colombia once recipients o our
aid are all now major U.S. trading
partners. In act, two-thirds o
Americas top 15 trading partners
were once recipients o U.S. oreign
assistance. This should not come as
a surprise, since developing countries
represent some o the astest growing
markets in the world. Today, they alreadypurchase over hal o all U.S. exports, a number
that is only growing with time.2
One o the best ways o creating jobs at home is
through international trade, which already supports
one in three U.S. manuacturing jobs. As o 2010,
over 38 million U.S. jobs depended on global trade,
representing over one-th o all jobs in our country. In
Texas and Caliornia alone, over 7 million jobs depend
on global trade.3 That trend is only likely to grow in the
uture as our economy becomes urther intertwined
with those overseas.
These economic benets are
also surprisingly inexpensive.
At less than 1% o the ederal
budget, oreign assistance
programs bring remarkable
dividends or a relatively small
investment. Whether your interest
is in preserving Americas global
economic edge or in growing jobs here
at home, supporting poverty-ocuseddevelopment assistance is a smart, cost-
eective investment and one that is likely to bring great
benet to the U.S. or years to come.
1 Over 50 Top Business Leaders Urge Congress to SupportInternational Aairs Budget, USGLC. http://www.usglc.org/downloads/2012/07/FY13-Business-Leaders-Letter-to-Congress.pd.
2 Ibid.
3 Trade and American Jobs, Business Roundtable. http://businessroundtable.org/uploads/studies-reports/downloads/Trade_
and_American_Jobs.pd.
U.S. businesses understand that
diplomacy and development assistance
play vital roles in building economic
prosperity, protecting our national
security, and promoting Americas
humanitarian values. The International
Aairs Budget is critical to U.S.
economic engagement with the world,
especially at a time when there is a
wide recognition o the need to boost
U.S. exports to createAmerican jobs.
U.S. Chamber o Commerce
Letter to Congress, March 29, 2011
8
http://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdfhttp://www.usglc.org/wp-content/uploads/2011/03/Chamber-Letter-to-Congress-3292011.pdf7/30/2019 Cti 2013 Final Web 1
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Alleviating poverty is keyto Americas security
We live in an interconnected world and work in
partnerships to address global problems like hunger,
disease and human rights abuses. When we do so, we
demonstrate our core values and the kind o leadershipthat builds goodwill toward the United States.
Most global problems do not require military solutions.
To alleviate poverty, halt the spread o disease and
prevent confict, we need strong diplomatic and
assistance programs. By ailing to make adequate
investments in nonmilitary policy tools, we miss
important opportunities to create shared prosperity
and enhance our own security.
Helping responsible governments gain strength
and create the environment or their own citizens
to succeed is a smart investment in global stability.
People who have a stake in their society, and the
opportunity to create their own uture and express their
concerns are less likely to be angry, rustrated and
resentul towards the United States.
A wise investment
Why is it that, year ater year, Americas military and
diplomatic leaders ask Congress to support our
international development budget? It is because they
believe that robust U.S. investment overseas can help
prevent confict, spread peace and security, and give
people hope in their utures.
Recent U.S. National Security Strategies see our
national security apparatus as three-pronged, with
deense, diplomacy and development each having
important roles. As a group o retired fag and generalocers rom all branches o the U.S. Armed Services
wrote in a March 2012 letter to Congress: We rmly
believe the development and diplomacy programs in
the International Aairs Budget are critical to Americas
national security Development and diplomacy keep
us saer by addressing threats in the most dangerous
corners o the world and by preventing conficts beore
they occur.1 The 2010 National Security Strategy
similarly calls international development a strategic,
economic, and moral imperative or the United States.
U.S. oreign policy has long been guided by the beliethat people are more peaceul and less likely to become
entangled in confict when they have hope, dignity and
the power to shape their own destinies: when they have
a sense o human security. One o the best ways to
create an environment o peace around the world is to
support poverty-ocused development assistance.
1 U.S. Global Leadership Coalition, Military Leaders Letter to Congress,March 27, 2012. http://www.usglc.org/wp-content/uploads/2012/03/NSAC-Letter-2012.pd.
9
We frmly believe the development and
diplomacy programs in the International
Aairs Budget are critical to Americas
national security. Military Leaders Letter to Congress
AlissaEverett
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Results start with transparencyand accountability
NGOs dont just advocate or resources. We support
ongoing, comprehensive eorts to modernize and
reorm the way aid is delivered. Transparency and
accountability are key components o successul andeective aid delivery.
Todays scal climate requires us to take a resh look at
the best way to maximize impact rom limited taxpayer
resources while responding to humanitarian crises
and tackling global poverty. America provides aid to
countries worldwide and taxpayers deserve to know
that their money is being invested wisely and that itimproves peoples lives.
Our vision o eective assistance
Our vision o eective aid delivery ocuses on people,
not governments. Where governments are legitimate,
have measures in place to prevent corruption, have the
capacity to do what is needed and are accountable to
their own citizens, the United States should supporttheir development agendas. But where governments
are weak, corrupt and unaccountable, the United
States should support communities directly to meet
their own needs and strengthen their ability to demand
better perormance rom their governments.
More eective aid
Recent international conerences on strengthening
the eectiveness o oreign assistance have ocused
on enhancing transparency and accountability. At
the November 2011 conerence in Busan, SouthKorea, donors promised to publish comprehensive
and timely inormation on the resources devoted
to development using a common standard
that allows inormation to be compared. Timely,
comprehensive, accessible and easily comparable
inormation on how aid dollars are spent, and the
results o that aid, allows Americans to hold our
government accountable and lets local development
actors give their own eedback on the quality o that
assistance.
We applaud the U.S. decision to publish aid inormation
under the International Aid Transparency Initiative
(IATI). The purpose behind IATI is to make inormation
about aid spending easier to nd, use and compare.
InterAction has encouraged the administration
to publish inormation rom all U.S. agencies that
distribute oreign aid to the Foreign Assistance
Dashboard (www.oreignassistance.gov), a website
devoted to showing where our oreign aid money goes
and the impact o that assistance. We have also called
or the establishment o an advisory panel on U.S.oreign aid transparency to provide guidance on how
the United States can become more transparent.
We rmly believe these actions will improve
transparency and accountability in oreign assistance
and signicantly improve the return on investment o
American taxpayer dollars.
10
Where governments are weak, corrupt
and unaccountable, the U.S. should
support communities directlyto
meet their own needs.
AugustoCamba
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11
Accounts and Subaccounts
FY2014 FundingRecommendations
(in $ thousands)
Global Health Programs USAID 3,268,000
Maternal and Child Health 750,000
Family Planning in All Accounts 750,000
Nutrition 200,000
Vulnerable Children 23,000
HIV/AIDS 350,000
Malaria 670,000
Tuberculosis 400,000
Neglected Tropical Diseases 125,000
Global Health Programs State (PEPFAR Only)4,492,860
Global Fund to Fight AIDS, Tuberculosis & Malaria 1,650,000
NIH Global Health 605,700
CDC Global Health 362,900
Development Assistance 3,175,000
Food Security and Agriculture in All Bilateral Accounts 1,445,000
Micronance 265,000
Basic Education in All Accounts 925,000
Climate Change in Bilateral Accounts 468,000
Biodiversity in All Accounts 200,000
Water in All Accounts 400,000
Millennium Challenge Account 900,000
International Organizations and Programs 385,000
International Development Association 1,408,500
Global Agriculture and Food Security Program 158,330
International Fund or Agricultural Development 32,243
McGovern-Dole International Food or Education & Child Nutrition 209,500
Least Developed Countries Fund & Special Climate Change Fund 50,000
Green Climate Fund 5,000
Strategic Climate Fund 100,000
Clean Technology Fund 300,000
International Disaster Assistance 1,600,000
Migration and Reugee Assistance 2,800,000
Emergency Reugee & Migration Assistance 100,000
Food or Peace Title II 1,840,000
Contributions to International Peacekeeping Activities 2,179,000
Peacekeeping Operations 257,000
USAID Operating Expenses 1,400,000
InterAction FY2014 Funding Recommendations
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GlobalHealth
Programs
State and USAID global health
unding helps to reduce childmortality, slow the spread o
diseases such as HIV/AIDS, respond
to health emergencies, prevent
malnutrition and support initiatives
such as the Presidents Malaria
Initiative and Presidents Emergency
Plan or AIDS Relie (PEPFAR).
Relatively modest investments by
the United States have not only
saved lives, but also improved the
economic growth and stability odeveloping nations.
Investments in global health save lives and ensure the progress
made thus ar is not lost. Since national borders do not stop thespread o disease, addressing global health issues is also important
to protect the health o Americans.
U.S. global health programs have treated approximately 5.1 million
people living with HIV and prevented HIV transmission to millions
more.1 Immunization programs save more than 3 million lives each
year2 and in FY 2011 alone, the Presidents Malaria Initiative and its
partners distributed more than 42 million long-lasting insecticide-
treated mosquito nets and provided treatment to 45 million
individuals.3 Programming also addresses diseases such as polio,
tuberculosis and neglected tropical diseases as well as preventing
malnutrition, decreasing maternal mortality, improving inant health,
developing new health technologies and vaccines, and assisting
women with the proper timing and spacing o pregnancies.
Global health eorts also ocus on training capable health workers
throughout developing nations in order to strengthen health
systems abroad. Building the capacity o country health systems
ensures healthier and saer populations, creates more prosperous
economies and reduces dependency on oreign aid.
Additionally, global health programs develop and implement new
technologies and tools to help countries get ahead o healthchallenges. Sustaining U.S. investments in global health is crucial;
health problems will only be more expensive and dicult to resolve
in the uture.
Funding History
Purpose Justication
FY2014 Recommendation:
$9.41 billion
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
13
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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Reerences
1 World AIDS Day 2012 Update, PEPFAR. http://www.pepar.gov/unding/results/index.htm.
2 Combination Prevention in PEPFAR: Treatment, PEPFAR. http://www.pepar.gov/documents/organization/183299.pd.
3 Sixth Annual Report to Congress, Presidents Malaria Initiative. http://pmi.gov/resources/reports/pmi_annual_execsum12.pd.
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Maternaland Child
Health
Investing in MCH is critical to making good on U.S. commitments
as a global leader in maternal and child health and to buildhealth and prosperity or the worlds children. Each year, USAID
interventions help save the lives o more than 6 million children
under the age o 5 and help signicantly reduce maternal deaths
rom pregnancy-related causes.1 These interventions range rom
prenatal care and preventing maternal deaths during childbirth to
pediatric immunizations and child nutrition.
However, each year, 6.9 million children under the age o 5 die rom
preventable causes such as pneumonia, malnutrition, diarrhea
and malaria;2 and each day, approximately 800 women die rom
preventable causes during pregnancy and childbirth.3
MCH unding supports cost-eective interventions like vaccines
and nutritional supplements, and trains community health workers
on basic prevention, treatment and management o maternal and
child illness, such as malaria, diarrhea, pneumonia and malnutrition.
Scaling up these programs will help put a stop to child and
maternal mortality. MCH unding also ullls U.S. commitments
to polio eradication and the Global Alliance or Vaccinations and
Immunizations (GAVI).
Additionally, unding or child and maternal health is directly
connected to unding or global nutrition, water and sanitation,UNICEF, PEPFAR and global health research supported by NIH
and CDC.
Justication
Funding History
FY2014 Recommendation:
$750 million
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
Funding or maternal and child
health (MCH) programs supportsproven, cost-eective interventions
that protect the lives o children
and mothers. In 2012, the United
States led the world in pledging
to end preventable child deaths
in a generation. To make a
down payment on this and other
commitments, the United States
should provide a least $750 million
or MCH.
Purpose
15
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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In 2007, Sadios rst child, Matar, died at just 9 months old, rom diarrhea
and respiratory inection. The nearest health post was a 7.5-mile round trip
too ar to travel or a poor amily with a sick baby. Now she has 2-year-old
twins, Adama and Awa, who also suer rom recurrent respiratory troubles.
But things are dierent this time around.
ChildFund International is in its second year as lead on a $40 million
community health grant rom USAID to establish health care services
or children and amilies throughout Senegal, whose 800 doctors are
concentrated in the capital, Dakar. The project provides community-level
health huts staed by trained health workers, traditional birth attendants
and outreach workers all volunteers to provide basic health care and
teach about hygiene, nutrition and more. These volunteers spread their
knowledge throughout their communities.
By the grants end in 2015, ChildFund and its partners Aricare, Catholic Relie Services, Plan International,
World Vision, and Senegals Enda Gra Sahel and Enda Santa will have established 2,151 health huts and 1,717
outreach sites nationwide, in both rural and underserved urban areas. The project also ocuses on neglected
tropical diseases and education about the health dangers o emale genital cutting. By 2015, 9 million people
across Senegal will have access to health care, which will be networked rom the national to the community level.
A health hut was built in Sadios village in 2010. My twins have never suered rom diarrhea or malaria because I
wash my hands with soap and water beore giving them ood, she explained. And we sleep under bed nets. She
added that one o the twins, Adama, oten struggles with respiratory inection, and that the health volunteers reer
her or proessional care when she needs it. Sadio watches, but she no longer worries.
Reerences
1 USAID Maternal and Child Health, USAID. http://www.usaid.gov/what-we-do/global-health/maternal-and-child-health.
2 Committing to Child Survival: A Promise Renewed, Progress Report 2012, UNICEF. http://uni.c/QQB5wA.
3 Maternal Mortality World Health Organization. http://www.who.int/mediacentre/actsheets/s348/en/index.html.
ChildFundInternational
Success Story:Community Health Huts Save Lives in Senegal
http://www.usaid.gov/what-we-do/global-health/maternal-and-child-healthhttp://uni.cf/QQB5wAhttp://www.who.int/mediacentre/factsheets/fs348/en/index.htmlhttp://www.who.int/mediacentre/factsheets/fs348/en/index.htmlhttp://uni.cf/QQB5wAhttp://www.usaid.gov/what-we-do/global-health/maternal-and-child-health7/30/2019 Cti 2013 Final Web 1
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FamilyPlanning andReproductive
Health
Funding in this account expands
access to voluntary contraceptiveand amily planning methods,
reduces maternal mortality and
improves inant health. Since
1965, the 27 countries with the
largest USAID investments in
amily planning have increased
contraceptive use rom under 10%
to 37%, and reduced the number o
children per amily rom more than
6 to 4.5.1
According to the Guttmacher Institute, in 2012 the use o modern
contraceptives in the developing world prevented an estimated 218million unintended pregnancies, 55 million unplanned births, 138
million abortions, 118,000 maternal deaths and 1.1 million inant
deaths.2 Family planning provides women with the ability to time
and space pregnancies.
These programs are cost-eective and deliver real and sustainable
results. Data rom seven countries across three continents shows
that or every dollar invested in amily planning, there are signicant
savings to governments in the health and education sectors,
ranging rom $2 in Ethiopia to more than $6 in Bangladesh and
Guatemala, and up to $9 in Bolivia.3 Additionally, several countries,
including Brazil, Mexico, Korea and Thailand, no longer require U.S.
government support or amily planning programs.4
One hundred members o Congress signed a letter on December
19, 2012, requesting $1 billion or amily planning or FY2014; and
while InterAction supports that amount, we believe $750 million is
the absolute minimum to continue these essential programs.
Purpose Justication
FY2014 Recommendation:
$750 million
Funding History
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
17
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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In the Amhara region o Ethiopia, Masreshah Abebe
works to improve the health o women. A health
extension worker, she routinely walks rom one end o
her village to another to reach her neighbors a trip
that can take more than an hour.
When I rst started, she remembered, women were
a voiceless group. Few used amily planning. But that
is changing.
With support rom USAID, Abebe delivers amily
planning and reproductive health services to 1,700
households. I track the number o women who use
amily planning, and there has been real change.
Across Ethiopia, more women are able to make choices about their bodies and their utures. Preliminary data
rom the 2011 Ethiopian Demographic and Health Survey show that Ethiopias contraceptive prevalence rate has
increased rom 29% to 96% in just six years.
Abebe will do whatever she can to sustain this remarkable achievement. But she cannot do it alone. So today, she
stands, surrounded by more than 60 community members. They le in rom every side to sit in olding chairs and
lean against ences, to take part in a Community Conversation.
Guided by Abebe and other project sta, villagers discuss problems they ace, such as todays topic: early
marriage. To change villagers minds about this long-held practice, which can have devastating eects on girls,
Abebe has enlisted the help o infuential religious leaders.
Abebe steps to the side, granting Alam Ababa the foor.
This tradition o early marriage has done more harm than good or our girls, he says. Parents must no longer
arrange marriages or orce them to have too many children. We must send our gir ls to school.
Ababa turns to Abebe, who is beaming. There are many good messages rom our health extension workers, and
we must listen.
Reerences
1 Family Planning, USAID. http://www.usaid.gov/what-we-do/global-health/amily-planning.
2 Costs and Benets o Investing in Contraceptive Services in the Developing World, Guttmacher Institute (2012).
3 Family Planning Saves Lives, Population Reerence Bureau. http://www.prb.org/pd09/amilyplanningsaveslives.pd.
4 Fast Facts: Family Planning, USAID. http://transition.usaid.gov/our_work/global_health/pop/news/issue_bries/p_astacts.pd.
SalaLewis/Pathfnder
Success Story:Giving Women Control o Their Futures
http://www.usaid.gov/what-we-do/global-health/family-planninghttp://www.prb.org/pdf09/familyplanningsaveslives.pdfhttp://transition.usaid.gov/our_work/global_health/pop/news/issue_briefs/fp_fastfacts.pdfhttp://transition.usaid.gov/our_work/global_health/pop/news/issue_briefs/fp_fastfacts.pdfhttp://www.prb.org/pdf09/familyplanningsaveslives.pdfhttp://www.usaid.gov/what-we-do/global-health/family-planning7/30/2019 Cti 2013 Final Web 1
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Nutrition
Despite the ar-reaching
consequences o malnutritionand its impact on child mortality,
nutrition has been a low priority
on global health and development
agendas. InterAction recommends
$200 million in the Global Health
Programs account to adequately
und integrated nutrition programs
and recommends additional ocus
on the integration o nutrition within
Feed the Future.
Malnutrition, one o the worlds most serious yet least addressed
development challenges, contributes to the death o some 2.5million children under 5 each year.1 For the 165 million children
characterized as stunted,2 malnutrition is a lie sentence, resulting in
irreversible physical and cognitive damage.
Research has shown that early nutrition, particularly during the
1,000 days between a womans pregnancy and her childs second
birthday, can determine the uture o a persons health, educational
attainment and lietime earning potential. Thus, poor nutrition
becomes a signicant drain on economic productivity and a burden
on health care systems, making progress on poverty alleviation
harder and costlier to achieve. In some cases, child malnutrition
costs as much as 11% o a countrys GDP.3
Yet globally, nutrition unding represents only 0.3% o total ocial
development assistance4 and 1.2% o the FY2012 Global Health
Programs account within the U.S. oreign assistance budget.
Research has ound that every $1 invested in nutrition generates
as much as $138 in better health and increased productivity.5 U.S.
government investments and continued leadership are critical
to achieving a signicant and lasting progress in preventing
malnutrition.
Purpose Justication
FY2014 Recommendation:
$200 million
For more inormation, contact:
Katie Lee
Advocacy and Policy Coordinator or
International Development
InterAction
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
19
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
Funding History
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Chisomo Boxer is a community health worker in Malawi. He is
proud that no children under 5 have died in his village since it
opened its health clinic two years ago. But he was araid that
3-year-old Vekelani might be the rst.
He had swelling o his ace, legs and both eet, said Boxer. He
lost his appetite and his skin was very shiny. These are signs o
edema, and his case was very serious. There are our grades o
edema; his was grade three, which meant his lie was in danger.
Boxer told the boys parents they must take Vekelani to the
hospital right away. Boxer was very concerned about Vekelani because a childs development in the rst ew years
will inorm the rest o his lie. But when Boxer checked back two days later he was surprised they had not gone.
They are superstitious. They thought someone was using witchcrat and black magic against their children. Theysaid that was the only possible explanation or why their children were sick so much.
Boxer went back to the amilys house many times to try to convince them to take Vekelani to the hospital. Finally,
ater three weeks, he succeeded.
The district hospital admitted Vekelani to its outpatient therapeutic program and gave him a ready-to-use-ood:
a special mixture o powdered milk, peanut paste, vitamins and minerals. Vekelani likes it, and his health is
improving gradually.
Boxer, who was trained in Save the Childrens community-based maternal and newborn care (CBMNC) program
unded by USAID/Child Survival 22, still visits the amily oten to check on Vekelanis progress and to counsel the
parents about nutrition and hygiene. I go with them to their garden and give advice about how to make balancedmeals, he said. They are beginning to take my recommendations.
The last time I was there, or the rst time, Vekelani looked happy and he smiled at me!
Reerences
1 Committing to Child Survival: A Promise Renewed Progress Report 2012, UNICEF. http://www.unice.org/publications/les/APR_Progress_Report_2012_11Sept2012.pd.
2 Ibid.
3 Black, R.E., L.H. Allen et al. Maternal and child undernutrition global and regional exposures and health consequences, The Lancet, 2008, Vol.371.
4 World Bank Global Monitoring Report: 2012: Food Prices, Nutrition and the Millennium Development Goals, World Bank. http://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pd.
5 Copenhagen Consensus Challenge Paper, Copenhagen Consensus, 2012.
ElvisSukali/SavetheChildren
Success Story:Community Health Workers Teach Parents about Nutrition
http://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://siteresources.worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdfhttp://www.unicef.org/publications/files/APR_Progress_Report_2012_11Sept2012.pdf7/30/2019 Cti 2013 Final Web 1
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Malaria unding prevents and
treats illness and death associatedwith malaria. Annually, 216 million
people contract malaria and 655,000
individuals die as a result. Eighty-six
percent o malaria deaths occur in
children under the age o 5. Thanks
to the leadership o the Presidents
Malaria Initiative, the U.S. operates
in 19 countries to combat this
disease.
Malaria is prevalent in 106 countries and imposes signicant costs
to both individuals and governments. Direct costs such as illness,treatment or premature death have an estimated price tag o at
least $12 billion per year.1
U.S. investments through the bilateral Presidents Malaria Initiative
and the Global Fund to Fight AIDS, Tuberculosis and Malaria have
had a signicant impact on containing the disease and creating
innovative tools and technologies poised to deliver urther successes:
50 countries are on track to reduce malaria incidence
by 75% by 2015;2
Estimated new cases o malaria have decreased by17% globally since 2000;
The overall annual malaria death toll has declined rom 985,000 to
655,000 people a 26% reduction in global malaria mortality;3 and
U.S. unding has advanced several vaccine candidates into the
human testing stage.
Malaria prevention and treatment programming is a model o cost-
eective success: by sharing responsibility, we are saving millions o
lives while strengthening emerging economies and health systems.
In 2012, the United Nations released a study showing that or every$1 invested in malaria control in Arica, on average, $40 is returned
in higher economic growth. The gains, however, are ragile, and
retreating on investment now would not only reverse todays progress
but also allow malaria to reemerge. Luckily, the costs are small:
$4 provides an insecticide-treated bed net that lasts three years.
$1.40 provides artemisinin-based combination therapy
treatment or an adult.
$0.60 provides rapid diagnostic testing or children and adults.4
Purpose Justication
FY2014 Recommendation:
$670 million
Malaria
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
21
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
Funding History
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Mumile lives with her husband and their new baby in the village
o Wakuan in northeastern Ghana, near the Togo border.
Malaria is endemic there, and since the nearest health clinic
is 10 kilometers (over six miles) away, protective measures like
mosquito nets and antenatal care can prevent emergencies and
save lives.
With support rom USAID, Episcopal Relie & Development and
its malaria prevention partnership, NetsorLie, are working with
Ghanaian partner ADDRO (the Anglican Diocesan Development
and Relie Organization) to address the need or preventive care
at the grassroots level. Active in 17 countries throughout sub-
Saharan Arica, NetsorLie is training local volunteers, called
malaria control agents (MCAs), to educate their communities
about malaria, hang nets in homes, and provide ollow-up to
ensure the nets are being properly used and maintained. In
many places, the MCAs also do broader health monitoring
and advocacy, including encouraging pregnant women to
seek out prenatal care. This helps ensure that they receive the
recommended number o check-ups during pregnancy, along
with IPTp (Intermittent Preventive Treatment in pregnancy) to
protect them rom malaria.
MCAs visited Mumile in Wakuan, stressing the importance o IPTp or malaria protection during pregnancy, a time
when women and the babies they are carrying are especially vulnerable to inection. For Mumile and her newly
expanded amily, having mosquito nets above their sleeping areas and using IPTp has had a major impact.
I visited the hospital at least six times a year [due to malaria] and it was taking a heavy toll on my nances, said
Mumile. But since last year [when I received the mosquito net] I have not visited the hospital except or my IPTp,
which the volunteers told me was necessary or my health. I am very happy and want to thank them or doing this.
Reerences
1 Impact o Malaria, Centers or Disease Control and Prevention (2010).
2 World Malaria Report, World Health Organization. http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html.
3 World Malaria Report 2011, World Health Organization. http://www.who.int/malaria/publications/atoz/9789241564403/en/index.html.
4 Ibid.
HarveyWang/EpiscopalRelie&Development
Success Story:Local Volunteers Help Prevent Malaria
http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.htmlhttp://www.who.int/malaria/publications/atoz/9789241564403/en/index.htmlhttp://www.who.int/malaria/publications/atoz/9789241564403/en/index.htmlhttp://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html7/30/2019 Cti 2013 Final Web 1
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Tuberculosis (TB) is a contagious,
airborne disease that inectsapproximately 8.8 million people
per year, nearly one-third o whom
are also living with HIV, and kills
about 1.4 million people annually. TB
unding is used to nd and treat the
disease, prevent the development o
drug-resistant strains, and support
the research and development o
new tools to ght the disease.
As TB has no borders, strong global TB control is in the national
interest o the United States to prevent a costly increase in TBcases, particularly o drug-resistant TB. Drug-resistant TB poses a
particular challenge to domestic TB control due to high treatment
costs, estimated at $100,000-$300,000 per case.1 It is estimated
that in some countries, the loss o productivity attributed to TB is
4-7% o a countrys GDP.2
However, signicant progress has been achieved: rom 1995-2011,
51 million TB patients were treated successully through TB control
programs saving up to 20 million lives. Globally, deaths due to TB
have allen by more than one-third since 1990.3 With continued and
sustained unds, by 2014, the United States will have:
Successully treated at least 85% o TB cases detected in
countries with established U.S. government programs;
Diagnosed and treated at least 57,200 new multidrug-resistant
TB cases; and
Contributed to a 50% reduction in TB deaths and disease
burden since 1990.
Congress authorized $4 billion in unding over ve years in 2008,
an authorization level that congressional appropriations have never
reached. InterAction thereore believes $400 million a number with
strong congressional support is a reasonable down payment on
that commitment, which will hopeully allow or urther deployment
o updated diagnostics and drug regimens as well as increased
development and introduction o new tools.
Purpose Justication
FY2014 Recommendation:
$400 million
Tuberculosis
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
23
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
Funding History
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Grace Tsawe runs a prayer camp in the Lower Manya Krobo District o Ghana
where, on clinic days, she sees over 100 patients, many o whom suer rom
tuberculosis (TB). Until recently, Tsawe did not reer her patients to health
acilities, because she believed only prayer could heal them. However, last
year, she developed a persistent cough and began losing weight. When
months o prayer did not alleviate her symptoms, Tsawe nally visited a
hospital where she was diagnosed with TB. Six months o TB treatment cured
her o all TB symptoms. Having learned o Tsawes role in the community
as a prayer leader, the hospitals TB coordinator asked to teach her about
TB screening. She agreed and, with support rom the USAID-unded TB
CARE project, the TB coordinator trained Tsawe to identiy patients with TB
symptoms and reer them to the hospital or testing.
In 2010, approximately 21,000 Ghanaians developed TB, and, o these, 34% o
the cases were never detected. One possible explanation or the nations poor
TB control is that many Ghanaians believe TB is a spiritual illness and rely on
prayer or healing, rather than medical care. For those who eventually do seek
treatment, it is oten too late to avert death. To address these challenges, TB
CARE has been implementing new standard operating procedures or TB screening at health acilities in Ghana
or over two years. The project is also training health teams to educate community leaders, such as Tsawe, to
identiy TB symptoms and make timely reerrals.
Tsawes recovery rom TB has inspired her to train other prayer camp owners in TB screening and reerrals. She is
also now using radio and TV interviews to encourage TB testing in her community.
Reerences
1 US House o Representatives TB Elimination Caucus letter. 2012.
2 R.Laxminarayan, et. al. Economic Benet o TB Control, Policy Research Working Paper 4295. World Bank. 2007.
3 Global Facts on Tuberculosis, 2012, World Health Organization. http://www.who.int/tb/publications/actsheet_global.pd.
Success Story:Local Leader Encourages TB Testing
http://www.who.int/tb/publications/factsheet_global.pdfhttp://www.who.int/tb/publications/factsheet_global.pdf7/30/2019 Cti 2013 Final Web 1
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NeglectedTropical
Diseases
Funding or Neglected Tropical
Diseases (NTDs) helps to prevent,control, eliminate and eradicate
17 diseases that inect 1 billion o
the worlds poorest people. One in
six people worldwide suer rom
NTDs such as dengue, rabies, river
blindness, leprosy, trachoma and
hookworm. These diseases are
deadly, debilitating and can cause
blindness, disgurement, disability,
cognitive developmental delays and
social stigma.
Each year, 400,000 people die rom NTDs.1 But as little as 50
cents per person per year can provide prevention treatmentagainst the most common NTDs. Over the past ve years, the
U.S. government has leveraged taxpayer dollars and $3.1 billion in
donated medicines to provide 584.6 million sae and eective NTD
treatments to approximately 257.9 million people.2
The World Health Organization estimates that in addition to industry
contributions such as pharmaceutical drugs it would only cost
$2 billion to prevent and treat all individuals at risk o contracting an
NTD rom 2012 to 2015.3 It is critical that the ongoing NTD control
programs be supported and continued in order to reach all those
aficted, in addition to supporting research or new tools to ght
NTDs.
Currently, NTD research and development (R&D) programs are
underunded. R&D or new tools is essential to ultimately combating
NTDs; however, USAID which plays a unique and critical role in
product development or new NTD technologies does not und
NTD R&D. Unortunately, many current NTD medications have
severe side eects. Research into these diseases could lead to
new vaccines, better drugs and improved diagnostic tools. Strong
support or successul control and elimination programs, combined
with robust unding or NTD R&D is the key to success against
NTDs.
Funding History
Purpose Justication
FY2014 Recommendation:
$125 million
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
25
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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Reerences
1 U.S. Department o State (2011) Foreign Operations Congressional Budget Justication Fiscal Year 2011: Vol. 2.
2 USAIDs Neglected Tropical Diseases Program, USAID. http://www.neglecteddiseases.gov/about/index.html.
3 Accelerating work to overcome the global impact o Neglected Tropical Diseases: A Roadmap or Implementation, World Health Organization.http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pd.
Maroua, the bustling capital o the Far North Region o Cameroon, is an extremely
hot, dry and dusty city with a population o approximately 250,000 people.
Recently, the city has struggled to achieve high coverage rates or various public
health initiatives.
Launched in 2010 and continuing today, a campaign by the Neglected Tropical
Disease Control Program to combat onchocerciasis and lymphatic lariasis
reaches Maroua and all 28 health districts o the Far North Region. Knowing that
social mobilization strategies would be essential to achieve high coverage rates,
Helen Keller International and the Ministry o Health use a variety o innovative
channels to communicate the need or everyone to participate in drug distribution
events. Ministry leaders appear on popular radio programs, traditional storytellers
spread the word, and engaging posters catch peoples attention on nearly every
street corner.
One poster used during the campaign pictures a man with a very swollen leg, one o the symptoms o lymphatic
lariasis. A man who was suering unknowingly, rom lymphatic lariasis saw the poster and noticed that his
leg looked just like that o the man in the poster. Armed with this new inormation, he immediately visited his
health center and was happy to learn that drugs to alleviate the symptoms o his disease would be distributed
to him or ree. Thanks to the public awareness campaign, not only did this man seek and receive treatment, but
now he also is an active community health educator who travels house-to-house and mobilizes his neighbors to
participate in the campaign against lymphatic lariasis and onchocerciasis so that others do not suer like he has.
Due to social mobilization strategies, signicant progress has been made in reaching vulnerable populations in
Maroua. As a result, 84% o the people at risk o lymphatic lariasis have received essential treatment in 2011.
These results would not be possible without crucial unding rom USAID.
HelenKellerInternational
Success Story:Education Campaigns Help Stop Neglected Tropical Diseases
http://www.neglecteddiseases.gov/about/index.htmlhttp://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdfhttp://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdfhttp://www.neglecteddiseases.gov/about/index.html7/30/2019 Cti 2013 Final Web 1
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HIV/AIDS, PEPFARand the GlobalFund to Fight AIDS,Tuberculosis and
Malaria
Funding or State and USAID or
HIV/AIDS programs supports the
Presidents Emergency Plan or
AIDS Relie (PEPFAR), the Global
Fund to Fight AIDS, Tuberculosis
and Malaria, and other multicountry
initiatives. This unding is used to
prevent, treat and care or those
inected with HIV/AIDS and to build
country-level capacity to transer
operation o HIV/AIDS programs to
implementing countries.
PEPFAR combats HIV/AIDS through prevention, treatment, care
and the strengthening o health systems through bilateral andmultilateral programs. As o September 30, 2012, PEPFAR had
directly supported antiretroviral treatment to almost 5.1 million
people. In FY2012 alone, PEPFAR directly supported HIV testing
and counseling or more than 49 million people and provided care
and support or nearly 15 million people including more than 4.5
million orphans and vulnerable children. By reaching nearly 750,000
HIV-positive pregnant women in FY2012 with drugs to prevent
transmission o HIV rom mother to child, PEPFAR helped avert
230,000 HIV inections in newborn children.1
Global Fund: As o December 2012, the Global Fund had provided
HIV/AIDS treatment to 4.2 million people, as well as service to 1.7
million pregnant women to prevent transmission o HIV to their
children. In addition, the Global Fund has distributed 310 million
insecticide-treated bed nets, detected and treated 9.7 million
cases o tuberculosis, and treated 290 million cases o malaria. On
average, the Global Fund saves 100,000 lives each month.2
The Global Fund works in close partnership with PEPFAR and
the Presidents Malaria Initiative to create highly successul
collaboration around the world. The U.S. is the Global Funds
largest donor; however, by law, the U.S. contribution is capped
at one-third o total contributions. This means that or every
$1 contributed by the U.S., at least $2 must come rom the
international community.
Funding or the Global Fund is critical to ensuring that we build on
the successes o the past decade and that we can provide care
to the millions around the globe waiting or access to antiretroviral
therapies, tuberculosis treatments and insecticide-treated nets.
USAIDs HIV/AIDS programs scale up proven interventions, while
promoting newly-developed innovations and best practices.
Funding History
Purpose
Justication
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
27
FY2014 Recommendation:
$350 millionor USAIDs HIV/AIDS programs
$4.49 billionor PEPFAR
$1.65 billionor the Global Fund
Enacted
FY13 CR Post-Sequestration (estimated)
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All her lie, Laurence, who is 70 and HIV-positive, has struggled to care or hersel
and her amily. Then in 2010 she joined an Internal Savings and Lending Group
(ISLG) and started taking nutrition classes through the Higa Ubeho program in
Rwanda, implemented by Global Communities/CHF International. With the loan
she obtained through the ISLG and the skills she learned in nutrition training, she
was able to make her arm a source o resh, healthy vegetables or hersel and heramily. She began generating a sustainable income rom the extra crops she grew.
She now has access to treatment, health insurance and electricity in her home.
Laurence also shares her training with people in her village who are replicating
her methods. Laurence said that because o the program, I am no longer sick all
the time. And though I have health insurance, I hardly ever have to go to hospital
anymore. Not only am I not a burden to anyone, I also am supporting others by
teaching them the importance o improved nutrition. I am proud that I have gained
knowledge and skills that I can use the rest o my lie.
The Higa Ubeho program, which is unded by USAID and PEPFAR, works with people in Rwanda living with
HIV/AIDS, orphans and other vulnerable children to reduce the impact o the disease on their lives, and works
with local institutions to increase their access to education, psychosocial support, medicine and ood. It serves
more than 70,000 amilies in 20 districts to develop sustainable ways o coping with the health and economic
challenges that aect the most vulnerable communities in Rwanda.
LauraGingerich
Funding or two essential partnerships the Commodity Fund and the International AIDS Vaccine Initiative help
increase condom availability and promote the development o an eective HIV vaccine.
The global fght against HIV/AIDS is at a critical juncture. The knowledge and innovations acquired over the last
10 years have brought the end o the HIV/AIDS epidemic within reach. The United States must not let current
budgetary constraints undo the success o the past ew years. I we do not act, we may lose our best chance to
end this epidemic.
References
1 World AIDS Day 2012 Update: Latest PEPFAR Results, PEPFAR. http://www.pepfar.gov/funding/results/index.htm.
2 Fighting AIDS, The Global Fund. http://www.theglobalfund.org/en/about/diseases/hivaids/.
Success Story:
Living Long, Full Lives With HIV/AIDS
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NIH Global
Health
National Institutes o Health
(NIH) Global Health undingsupports basic and applied
scientic research to identiy new
interventions and more eective
ways to improve health and combat
disease. These research activities
are complemented by programs that
train new researchers and scientists
in partner countries so they can
better undertake uture global
health research.
As a premier research institution, NIH conducts and supports a
range o biomedical and behavioral research activities, as well astraining or young scientists. Continued investments in medical
scientic research help lead to new, innovative, and lie-saving
technologies and medicines that improve health and combat
disease both in the United States and around the world.
Global health research at NIH spans 27 institutes and centers,
including the National Institute o Allergy and Inectious Diseases,
which continues to lead in global breakthroughs to combat HIV/
AIDS, malaria, tuberculosis and neglected tropical diseases. NIH
unding also supports the Fogarty International Center, which
supports approximately 400 research and training projects with
more than 100 U.S. universities that partner with other research
institutions around the world.
NIH-supported research, which led to the codiscovery o HIV, has
saved an estimated 14.4 million years o lie since 1995 through
AIDS therapies alone.1 NIH research has also led to other medical
breakthroughs, such as treatments or HIV-associated coinections,
the development o the rst microbicide gel eective or preventing
HIV/AIDS, strategies to prevent mother-to-child transmission o the
HIV/AIDS virus and steps to developing a malaria vaccine.
Sustained unding or NIHs global health research and trainingactivities is critical to identiying new cures, nding more ecient
and eective interventions to combat disease, and acilitating the
training o new researchers, all while supporting U.S. universities
and research jobs.
Purpose Justication
FY2014 Recommendation:
$605.7 million
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
29
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
Funding History
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Onchocerciasis, commonly known as river blindness, aects
37 million people with an estimated 180 million people in Arica
at risk. Transmitted to humans through bites o blackfies,
individuals who become inected experience intense itching,
severe skin disguration, and with years o repeated exposure
permanent blindness. In addition to its health eects, the
disease leads to massive economic losses when productive
agricultural lands are abandoned or ear o inection. Although
a treatment exists, it needs to be taken or up to 20 years by the
entire aected community through mass drug administration.
Once ree rom the disease, communities must be closely
monitored to prevent reintroduction o the disease and the need
or additional mass drug administration.
Scientists at the National Institutes o Health (NIH) discovered
an antigen to river blindness that could lead to easier testing. However, there was little interest rom potential
commercial partners in pursuing its production because companies did not see much potential prot in
manuacturing a test or a disease rampant in poor countries. Utilizing the discovery o NIH scientists, PATH, a
nonprot global health organization, developed a simple, rapid test that could accurately diagnose river blindness
and partnered with the NIH to evaluate the technology. PATH identied Standard Diagnostics, Inc., as a partner
or manuacture and distribution, and the two organizations are working to develop a commercially viable test or
use in aected countries. Because o a discovery made in NIH labs, people living in remote areas can get tested
in their own communities. This will improve their lives and help eliminate river blindness in Arica.
Funding or NIHs global health program allows or research that provides valuable innovations in our collective
response to river blindness and other diseases. Ultimately, U.S. investment enables communities to overcometremendous health challenges that limit economic productivity and perpetuate poverty.
PAT
H/AllisonGolden
Reerences
1 Estimating the impact o antiretroviral therapy: regional and global estimates o lie-years gained among adults, NIH, National Center orBiotechnology Inormation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173805/.
Success Story:NIH Discovery Turning the Tide Against River Blindness
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CDC Global
Health
Centers or Disease Control and
Prevention (CDC) global healthunding helps track diseases,
provides public health leadership,
assists oreign ministries o health
in strengthening their research and
laboratory inrastructure, and trains
new health proessionals. This type
o collaboration draws on the CDCs
technical expertise and improves
the ability o partner countries to
lead in the uture.
As one o the premier public health agencies in the world, the
CDC works in partnership with ministries o health, internationalorganizations and other partners to strengthen global health
capacity, increase security and support evidence-based global
health programs. It makes signicant contributions to global health
research and development, monitors and tracks inectious diseases
worldwide, alerts researchers when new disease strains emerge,
and provides critical intelligence or the control and prevention o
diseases.
With over 60 years o experience, CDC works alongside oreign
ministries o health to prevent the spread o disease worldwide.
CDC is a key partner in the U.S. Presidents Emergency Plan or
AIDS Relie (PEPFAR) in over 75 countries and provides technical
assistance on how to implement the latest science, such as scaling
up HIV treatment and preventing mother-to-child transmission.
CDC is also a leader in global immunization and disease eradication
eorts. For example, CDC programs helped reduce the number
o new polio cases globally by more than 99% between 1988 and
2010,1 and the CDC-led global campaign to eradicate Guinea worm
disease has helped reduce the disease burden rom 3.5 million
cases per year in 1986 to near eradication today.2
The CDC also continuously investigates and responds to disease
outbreaks, such as the measles outbreak in 2010 in our Arican
countries. The CDCs eorts address critical global issues while
also protecting the health o Americans. Continued, sustained
unding or CDC programs is crucial.
Funding History
Purpose Justication
FY2014 Recommendation:
$362.9 million
For more inormation, contact:
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
31
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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During her annual exam at a health clinic, Mariam Ciss, a
41-year-old mother o three who is HIV positive, was screened
or cervical cancer using a technique called visual inspection
with acetic acid (VIA). This technique is a cost-eective
alternative to the Pap smear. During a VIA screening, a doctor or
nurse swabs the cervix with acetic acid, the main component o
vinegar. I there are precancerous cells, the cervix turns white.
Cisss cervix showed a large white lesion.
She was stunned a screening a year earlier had been negative.
But as an HIV positive woman, Ciss was at greater risk to
develop aggressive precancerous lesions. Her lesion was too large or the routine treatment. Normally, doctors
use a reezing technique known as cryotherapy to destroy abnormal tissue. This would not help Ciss and she
was worried.
Hope arrived in the orm o a phone call. A midwie told Ciss that the University Hospital Centre could treat large
cervical lesions using loop electrical excision procedure (LEEP), which uses a thin wire heated by electric current
to cut away the cells. Not only was the treatment available, but it was also ree. Ciss was successully treated.
Greater access to screening and treatment drastically reduces the number o deaths rom cervical cancer.
Jhpiego an aliate o Johns Hopkins University is working with the U.S. Centers or Disease Control, the
Presidents Emergency Plan or AIDS Relie, and National HIV/AIDS Care and Treatment Program to make
screening and treatment available to the women in Cte dIvoire. Since 2009, the number o screening and
treatment sites has grown to 20. To date, 7,343 HIV-positive women have been screened with VIA. O these
women, 429 women including Ciss have been treated or precancerous lesions.
These are important strides in a country where only 5.8% o women are screened or cervical cancer every three
years, and where almost 70% o the 1,600 women who are diagnosed annually with cervical cancer die rom the
disease, according to the World Health Organization.
I am a living testimony to the success o this approach, said Ciss. Other women could have the same chance.
Reerences
1 Post-Polio Syndrome Face Sheet, National Institute o Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm.
2 Guinea Worm Frequently Asked Questions, CDC. http://www.cdc.gov/parasites/guineaworm/gen_ino/aqs.html.
ToureOumar/Jhpiego
Success Story:Saving Lives Through Cervical Cancer Screenings and Treatments
http://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.cdc.gov/parasites/guineaworm/gen_info/faqs.htmlhttp://www.cdc.gov/parasites/guineaworm/gen_info/faqs.htmlhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htmhttp://www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm7/30/2019 Cti 2013 Final Web 1
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Development
Assistance
The Development Assistance (DA)
account is the bedrock o U.S.investments to help the worlds
poorest obtain access to education
and clean water, grow nutritious
ood, protect the environment,
promote economic development,
support good governance, respond
to climate change and create
more sustainable, sel-sucient
democratic societies.
Despite the act that the Development Assistance (DA) account is at
the core o U.S. investments in creating sustainable, sel-sucientsocieties, unding or the account has remained fat since FY2010.
This is even more concerning given increasing ood prices, threats
to development rom climate events, expanded engagement by
geopolitical competitors and historic opportunities to advance
democracy in the Arab world.
The recommended $3.175 billion is the minimum level necessary
to cover the challenges and opportunities in each major sector
(including ood security and agriculture, micronance, basic
education, climate change, biodiversity and water), without squeezing
out other equally worthwhile programming, such as democracy
unding, economic growth, trade capacity-building, technology,
innovation and evaluation. The $3.175 billion level refects the Senate
FY2013 unding level plus an increase in $125 million over the Senate
FY2013 unding levels or basic education. For more details, see the
sectoral justications on the ollowing pages.
Funding History
Purpose Justication
FY2014 Recommendation:
$3.175 billion
For more inormation, contact:
Katie Lee
Advocacy and Policy Coordinator or
International Development
InterAction
Erin Jeery
Advocacy and International Development
Coordinator
InterAction
33
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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FoodSecurity and
Agriculture
The recommended $1.445 billion
unding level or Food Securityand Agriculture includes support
or Feed the Future programs and
ood security programs in rontline
states: $1.2 billion would und Feed
the Future at the Senate FY2013
level, while an additional $245
million, based on the Presidents
FY2013 budget request, is needed
to ensure ood security in rontline
states.
Globally, 870 million people suer rom malnutrition and hunger,1
while some 2.5 million children under 5 die each year rommalnutrition.2 Hunger and malnutrition rob poor people o healthy,
productive lives and stunt the mental and physical development
o uture generations. Food price volatility and extreme weather
patterns, such as those that caused the droughts in the Horn
o Arica and the Sahel, are pushing more and more people into
extreme hunger and malnutrition.
Ater decades o declining support or armers in developing
countries, renewed U.S. leadership has sparked a global
commitment to helping people eed themselves. Feed the Future
takes a comprehensive and sustainable approach to agricultural
development. Investments ocus on country-owned plans
developed through engagement with local government and civil
society, and emphasize the importance o gender, nutrition,
climate change and natural resource management. Drawing upon
resources and expertise o agencies across the U.S. government,
this initiative is helping countries, including 19 ocus countries,
transorm their agriculture sectors to sustainably grow enough ood
to eed their people. In FY2011, U.S. agricultural assistance helped
1.8 million armers adopt improved technologies or management
practices, and reached nearly 9 million children through nutrition
programs such as micronutrient supplementation and ood
ortication.3
Additionally, with ood prices remaining volatile and weather
patterns threatening water availability and agricultural productivity,
it is critical that we maintain or increase the level o unding or Feed
the Future and agricultural development in the rontline states o
Aghanistan, Pakistan and Iraq, in order to help promote stability in
these areas.
Funding History
Purpose Justication
FY2014 Recommendation:
$1.445 billionacross all bilateral accounts
For more inormation, contact:
Katie Lee
Advocacy and Policy Coordinator or
International Development
InterAction
35
Enacted
FY13 CR Post-Sequestration (estimated)
FY14 InterAction Recommendation
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The Yaajeende Agricultural Development Program in Senegals
eastern regions is transorming the lives o one million
individuals in 100,000 households, and is part o USAIDs
Feed the Future project. Yaajeende means abundance or
prosperity in the local Pulaar language, and refects the goals
o the project: to improve the nutrition and income o one million
people across 60 regional communities.
The project brings together ve organizations: Counterpart
International, Heier International, Manobi Inc., The National
Cooperative Business Association, and Sheladia Associates Inc.
For its part, Heier is placing livestock (poultry, sheep and goats) among 5,500 households. Using the passing
on the git model, amilies who receive one o the 12,000 sheep and goats or 12,500 poultry will then pass on the
ospring to their neighbors. Through this process the program will reach 19,500 households over ve years.
When you are poor, you will never neglect the sheep because they are a way to move orward, said Kumba
Daranjay, president o a armers association. You know how bad poverty is, and you dont want to go back. The
sheep will help eed our children and take care o their health.
Heier International estimates the increased economic activity resulting rom the project will double the household
incomes o armer participants, which in turn will substantially reduce the number o underweight children
and allow them to grow and reach their ull potential. The livestock will not only allow amilies to better eed
themselves, it will also give them money so that they can send their children to school.
Reerences
1 The State o Food Insecurity in the World, Food and Agriculture Organization. http://www.ao.org/docrep/016/i3027e/i3027e.pd.
2 Committing to Child Survival: A Promise Renewed Progress Report 2012, UNICEF.
3 Feed the Future Progress Report 2012, Feed the Future. http://eedtheuture.gov/resource/eed-uture-progress-report-2012.
OliverAsselin/HeierInternational
Success Story:Passing On the Git or Sustainability
http://www.fao.org/docrep/016/i3027e/i3027e.pdfhttp://feedthefuture.gov/resource/feed-future-progress-report-2012http://feedthefuture.gov/resource/feed-future-progress-report-2012http://www.fao.org/docrep/016/i3027e/i3027e.pdf7/30/2019 Cti 2013 Final Web 1
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Micronance
Micronance provides access to
nancial services like credit orsavings or the worlds poor and
marginalized people, enabling poor
amilies to start businesses or meet
health, education, or emergency
needs, thus helping them lit
themselves out o poverty.
An estimated 2.5 billion people have no access to ormal nancial
services.1
Micronance began as a way to nance sel-employmentventures by poor people who had ew employment or income-
generating opportunities or who could not obtain credit. It has
since expanded to include poor households management o their
nances through savings, credit and insurance or such things as
enterprise, education, housing and health care. U.S. micronance
assistance ocuses on improving access to these nancial services
or the very poor (those living on less than $1.25 a day) and the
people most marginalized by the societies in which they live.
Public unding is critical or reaching these populations because
very little private oreign investment capital in micronance goes to
the countries with the greatest need or to the most marginalized
populations within these countries. For instance, in sub-Saharan
Arica, which has the highest percentage o people living in extreme
poverty o any region, 640 o the 800 million o the people in the
region have no access to any nancial institution micronance or
otherwise.2 USAID microenterprise unding plays a critical role in
expanding nancial opportunities or the underserved in these high-
need countries.
Strong congressional support has demonstrated U.S. leadership in
micronance and microenterprise development, recognizing these
tools as a cost-eective and successul way to reduce poverty
and promote economic growth. In FY2011, U.S. microenterprise
development assistance helped provide approximately 3 mil