11 December 2006

USAID still far from achieving transparency and accountability in foreign aid assistance

Despite changes introduced by the United States Secretary of State to promote transparency and effectiveness at USAID, the aid assistance agency is still far from achieving capable management of disease control in developing countries, according to a new article.

Written by Roger Bate of the American Enterprise Institute of Public Policy, the article is published in Britain’s Journal of the Royal Society of Medicine as part of a series examining leadership in international health.

“Appointing USAID Administrator, Randall Tobias, as Director of Foreign Assistance reverses the agency’s more than 40 years of independence and aligns its work with the State Department,”

said Dr Bate.

“The changes introduced by the United States Secretary of State have been welcomed as a positive development to promote transparency and effectiveness at USAID, however, after nearly a year, the agency’s efforts still fall short.

“USAID is still unable to provide strong evidence to show that any of its programs helped save lives or built sustainable local infrastructures. The agency cannot even show any performance outcomes because, until very recently and only in its work on malaria, it only measured inputs such as the purchase of drugs and very little has changed.”

The United States Agency for International Development was established in 1961 as an independent agency that furthers American foreign policy interests by expanding democracy, opening markets to American goods and improving the lives of people in the developing world.

Following a series of Congress-led investigations into USAID’s malaria control programmes between September 2004 and January 2006 and changes introduced by the Bush Administration, USAID has enacted some reforms to improve transparency, accountability and performance, and improvements have been noticed in the malaria program, but its is too early to say whether they will be mirrored in other health programmes or other parts of USAID.

“Tobias’ ability to move forward is hindered by organisational stipulations. While he has influence over the Millennium Challenge Account and the President’s Emergency Plan for AIDs Relief, he will not control aid dispersed by either body. In fact the MCA is chartered by Congress and will require bipartisan support, something that doesn’t look likely in the current climate,”

said Dr Bate.

“At this crucial juncture in American foreign aid policy, with many competing national security concerns afloat, aid is becoming even more a tool of US foreign policy. The simple fact that funds for malaria and TB eradication are being given to African countries with oil resources such as Angola and those that serve as allies in the war on terror, like Ethiopia, has not escaped anyone’s notice, especially since these countries are not necessarily performing best on institutional or human rights grounds - something that was key to the changes made by Secretary of State Rice.

“USAID occupies a unique position in global health development. It is the world’s largest bilateral donor with a larger budget than the World Health Organization yet remains plagued by a lack of transparency and accountability,”

Dr Bate said.

[ends]

USAID’s health challenge: improving US foreign assistance [PDF 67k]

‘USAID’s health challenge: improving US foreign assistance’ by R Bate will be published in the January 2007 issue (Vol. 100) of the Journal of the Royal Society of Medicine.

JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.