The Foreign Service Journal, May 2017

34 MAY 2017 | THE FOREIGN SERVICE JOURNAL A Long-Term Commitment to Saving and Improving Lives Global health programs have been a USAID core activity since President John F. Kennedy established the agency in November 1961. USAIDwas created in the aftermath of two world wars with the intent of building a more stable world through sustained and well-targeted bilateral interventions. It was an act of leadership in an increasingly interdependent world. Working to save lives in some of the poorest countries around the world has created strong relationships among a variety of stakeholders, including national health authorities and local communities. It has also given the agency a thorough under- standing of health needs and gaps in a variety of contexts. After all, many USAID Foreign Service health officers spend their careers overseas working shoulder to shoulder with their local counterparts. This translates into a level of trust that manifests itself in long-lasting partnerships. “Unlike other donors, USAID is very local in its approach, and this is one of our strengths,” says Adams. “We have maintained a long-term commitment in about 80 missions around the world. We still rely on local hires, some of whom have worked for USAID for more than 30 years. We therefore have history, institutional memory and capacity to build on that is unique to us.” Furthermore, U.S. leadership in global health often sets the tone, pushing other countries to take health issues seriously and to establish commitments on a global level. Pelzman was working in Russia when former Secretary of State Colin Powell visited and referred to HIV as a “virus of mass destruction.” It was in part as a result of his advocacy, she says, that the government of Russia submitted an applica- tion to the Global Fund to Fight HIV, TB and Malaria, a first for that country. Pelzman also points to USAID’s success in Child Survival: Call to Action, a global effort launched in June 2012 to reduce maternal and childmortality. USAID’s groundwork in India led that government to become a key founding member of this initiative, helping to drive the country’s ownmaternal health agenda. Lastly, Pelz- man lauds the impact of significant and long-term investment by the U.S. government in PEPFAR in South Africa and the partner- ship that has resulted from this resource commitment. “In all three of these cases,” says Pelzman, “U.S. government funds have by no means been the lion’s share of health budgets. But our technical expertise, the global best practices we brought to bear, the groundbreaking pilots and evidence we helped to develop—often advanced even further by our remarkable local staff and their ability to establish effective relationships with senior government officials—all had impacts far beyond the dol- lar amounts.” Beyond the Health Sector Global health programs that address national priorities such as improving mother and child health or combating infectious diseases like HIV/AIDS or malaria unfold on multiple levels (national, state or region, and district) and require building rela- tionships with a variety of stakeholders. These types of programs can be vehicles for strengthening other areas that are important to diplomacy, including good governance, decentralization, private sector engagement, domestic resource mobilization, community involvement and civil society participation. Adams experienced this synergy when she served in Senegal. At that time, the government was decentralizing control, pushing resources to provincial and district levels. “Through our health programs, USAID worked closely on the rollout of these plans, helping communities identify what their priorities were and how best to capture and control public resources. We also helped A child in the Dolo Ado refugee camp, on the border between Ethiopia and Somalia, is measured to determine if he is malnourished. Addressing malnutrition from an early age can prevent stunting and ensure healthy growth. USAID supports programs that integrate nutrition interventions across sectors. BEATRICEM.SPADACINI