Keeping it simple, global aid work supports global health, and improvements to global aid support can positively impact global health. Because local, national, global and military involvement in global health are intertwined, improvement can be just as integrated.
Recent strategic dialogue discussions between the US and WHO are a step in the right direction [1].
Strategies for WHO plans and for partnering organizations could improve alignment. For example, what is the alignment between the USAID objective “to reduce child mortality to 20 or fewer deaths per 1,000 live births in every country by 2035”, WHO and HHS maternal and child health strategies, global health objectives and nonprofit goals [2] ?
Strategies for WHO and partnering organizations could coordinate health issues organized away from the global health branches. For example, when nutrition and child development are funded separately from global health, how are opportunities to create aligned strategic objectives[3] taken?
US global health aid is outlined in national budgets, and the USAID budgets and Congressional asks are outlined really well[4].
Congress should be expected to set expectations with US taxpayer dollars across agencies that distribute aid. Congress could expect that requests for aid be set in the context of total financial support or resource support for health or other issues. For example, how much is USAID budgeting for tuberculosis in the context of how much the US is supporting tuberculosis aid from all involved US government agencies?
Congress should request clear reports with standardized methods to estimate aid provided by the military, as part of the whole US aid distributed. For example, how are the resources involved with the Department of Defense’s Global Health Engagement programs, including medical ships, factored into any diplomatic agency or national agency’s global health aid budgeting?
Evaluations on global health efforts are driven. For example, the spotlight on US global health efforts often highlights USAID, and USAID evaluations on department work are detailed [5].
Expectations on evaluations should be set. What are the expectations set by funders and multi-agency planners, or by the government? What expectations have been set toward the partnering agencies, regarding evaluations or sustainable medical home development impact evaluations? Have evaluation templates been replicated and refined for multi-agency use?
Impact evaluation work is improving. USAID Impact Evaluation work is autonomous, and development assistance evaluations seek objective accuracy [6].
IE evaluations could be mirrored. The IE improvement recommendations should be shared with partner agencies, including international partners, for potential duplication and adoption. In other words, other nonprofit peers may also value impact evaluation improvement using similar models.
IE expectations could be tied to future funding or future collaboration.
IE expectations could be the location for rejection and denial reports. USAID and other global health response should include denied and rejected requests, so that we understand where taxes did not go. Duplication and inefficiency is global aid remain, and presenting what isn’t cared for helps improvement urgency.
Federal accountability should be expected with global aid.
A federal accounting for how much money and resource is spent, per health issue or per development issue across all agencies, should be produced. This report could include biomedical research development factors, and this report should include if other nonprofits are knowingly leaned on. It matters if the government is asked for health assistance and taps a private foundation on the shoulder instead.
The updated WHO program funding site is outstanding [7]. It is nice to know which countries contribute what resources to the World Health Organization.
A program area specific to laboratory safety, a program specific to international regulation harmonization, or a program specific to biomedical research standards could be considered for potential future inclusion.
A program area that better understands medical missions trips, including evidence based practices, equipment and pharmaceutical supply, cultural consideration and impact analysis, should be initiated. This department should seek clarification on what guidelines, rules and parameters medical missions are following when entering host countries. This department should also establish frameworks for analytics on medical home models and sustained practices after guest mission departure.
The US military supports global health with direct care, and this work is impactful.
How the US military’s global health work factors into global health analyses and reports, as well as in national and USAID strategies, should be accounted for [8].
References
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