INSIDE DEVELOPMENT
In this section:
Agency Sets $77 Million Supply Chain Partnership
for AIDS Drugs
Process Speeds Malaria Nets
Staff Says Agency Improved
Central European Doctors Help Out in Africa,
Asia
Butterfield’s New History of U.S. Foreign
Aid Published
Andrew Herscowitz Receives Legal Award
USAID Working Urgently to Further Africa’s
Economic Development
Sesame Street Comes to India
$254 Million in U.S. Aid Improves Afghan Health
Agency Sets $77 Million Supply Chain Partnership for AIDS
Drugs
WASHINGTON—To deliver drugs and other supplies
to people living with or affected by HIV/AIDS in developing
countries, USAID announced Sept. 28 the creation of the Partnership
for Supply Chain Management, a consortium of 15 private sector,
nonprofit, and faith-based institutions.
Operating under a $77 million, three-year contract, the
USAID-managed partnership comprises organizations with expertise
in delivering HIV/AIDS medicines and supplies.
Drugs and supplies handled through the partnership could
reach $500 million or more in value during the life of the
contract, USAID and the Office of the U.S. Global AIDS Coordinator
estimate.
The partnership was created to help advance the $15 billion
President’s Emergency Plan for AIDS Relief by providing
an “effective and accountable supply chain system to
help developing countries,” USAID said in an announcement.
While there are many HIV/AIDS programs in developing countries,
the efforts are often stymied by gaps in services. The limited
healthcare systems in some of the poorest countries cannot
always afford the medicines or supplies needed to combat HIV/AIDS.
“By building human and institutional supply-chain capacity
in developing countries, this system will help rapidly expand
prevention, care, and treatment for people living with and
affected by HIV/AIDS,” said Administrator Andrew S. Natsios.
Forty million people were living with HIV/AIDS in 2004,
according to the World Health Organization, with the majority
of infections among people in developing countries. That year,
there were nearly 5 million new HIV infections recorded.
“The need for this is apparent to anyone working in
the field now,” Dr. Mark Dybul, deputy U.S. Global AIDS
Coordinator, told the Associated Press.
The partnership will provide one-stop shopping for organizations
and nations that want to provide HIV/AIDS-related products
to the developing world.
Products will include medicines that slow HIV and related
opportunistic infections, testing kits and other laboratory
materials, and medical supplies such as gowns and gloves.
“When it comes to AIDS drugs, the need is enormous,
and the logistics are demanding and complicated,” said
Steve Hawkins, director of antiretroviral supply and logistics
at the Elizabeth Glaser Pediatric AIDS Foundation, which carries
out HIV/AIDS programs in poor countries, many of them for
USAID.
The new partnership “will allow those of us working
on the frontlines to get HIV/AIDS drugs more quickly and more
efficiently to people who desperately need them….The
result will be more lives saved and more families kept together,”
he said.
PARTNERSHIP FOR SUPPLY CHAIN MANAGEMENT
Affordable Medicines for Africa
Johannesburg, South Africa
AMFA Foundation
St. Charles, Ill.
Booz Allen Hamilton
McLean, Va.
Crown Agents Consultancy Inc.
Washington, D.C.
Fuel Logistics Group (Pty) Ltd.
Sandton, South Africa
International Dispensary Association
Amsterdam, Netherlands
JSI Research and Training Institute Inc.
Boston, Mass.
Management Sciences for Health Inc.
Boston, Mass.
The Manoff Group Inc.
Washington, D.C.
MAP International
Brunswick, Ga.
The North-West University
Potchefstroom, South Africa
Northrop Grumman Information Technology
McLean, Va.
Program for Appropriate Technology in Health
Seattle, Wash.
UPS Supply Chain SolutionsAtlanta, Ga.
Voxiva Inc.Washington, D.C.
Process Speeds Malaria Nets
NAIROBI, Kenya—A new, mechanized process for
converting regular mosquito nets into long-lasting insecticide-treated
nets (LLINs) will substantially accelerate their production
and delivery to regions hit by malaria, USAID officials announced
in late September.
LLINs have been effective at preventing the spread of malaria,
which affects between 300 million and 500 million people annually.
But up until now their production has been stymied because
there are only two brands on the market. The companies that
make these brands report six- to 18-month ordering backlogs,
which have led to global shortages of LLINs.
The announcement from USAID partner NetMark was made before
87 representatives from net manufacturers and agencies and
groups that promote LLINs. The process will be available to
all companies that wish to use it.
“The practical benefits of this new approach are that
it will make LLINs more widely available in Africa through
a combination of increased global supply and local production,”
said Dr. Dennis Carroll, a malaria expert in the Bureau for
Global Health and cognizant technical officer for NetMark.
“Increased competition within the LLIN market should
also result in lower prices for donors, NGOs, and commercial
distributors.”
NetMark, which has worked with USAID since 1999 to reduce
malaria in sub-Saharan Africa, joined its technical team with
experts from Bayer Environmental Science and SiamDutch Mosquito
Netting Co. to come up with the “misting approach”
to create LLIN technology. The process uses an industrial
washer system, combined with a large dryer, to lace and then
bind nets with an insecticide formula. It will allow for mass
production of LLINs.
The equipment can be built with off-the-shelf industrial
equipment, and costs will vary, depending on the size of the
equipment a company purchases.
“The great thing about this new technology is that
it can be easily added to any net manufacturing facility and
scaled to whatever their production is. It can also be set
up in countries that have a lot of nets coming in that need
treatment, but no local production,” Dr. Carroll said.
The treated nets could be a lifesaver for the 40 percent
of the world’s population that is at risk for the mosquito-borne
disease.
More than 2 million people in Africa alone will die this
year from malaria. Regions south of the Sahara account for
90 percent of the world’s malaria cases, according to
the World Health Organization.
Children and women who are pregnant are most at risk. One
of every 20 children in Africa dies of malaria before age
5, and those who survive the infection may end up with learning
disabilities or brain damage. Malaria also threatens 24 million
pregnancies in Africa every year, and has been linked to illnesses
in both mother and child.
Most disease-carrying mosquitoes bite at night, and mosquito
nets can provide a barrier between people and insects.
NetMark says treated nets are twice as effective as those
that haven’t been sprayed with an insecticide.
SiamDutch expects to produce 6 million LLINs during the
first year of production. Other manufacturers have said they
too are eager to explore the new technology.
Staff Says Agency Improved
USAID was ranked among five agencies deemed “most improved”
in an employee survey that measures the best places to work
in federal government.
The survey results for 2004 found the Agency had gained
13 percentage points over its score in a survey conducted
in 2002. That year, USAID ranked 24th in a field of 28 federal
agencies.
By 2004, the Agency moved up to 18th place out of 30 large
federal agencies.
The five most improved included USAID, the Office of Management
and Budget, and the departments of State, Justice, and Energy.
“We basically came from the bottom tier to the middle
tier,” said Patrick Brown, deputy director of human resources
for the Agency.
The Partnership for Public Service, which analyzed the survey,
singled out USAID and the State Department for experiencing
double-digit increases since the last survey.
“In both cases, the sharp upswing in employee engagement
was assisted by large gains in the training and development
workplace dimension, which increased by 14 percent at AID
and 25 percent at State in just two years,” the partnership
said.
Brown backs up that assessment. With increases in the training
budget has come a menu of courses—many available online—to
prepare new leaders in the Agency, boost skills of the rank-and-file
workers, and train foreign service nationals. Further proof:
the percentage of workers who praised electronic access to
learning and training programs at USAID jumped from 40 percent
to 72 percent in the latest survey.
Improvements can also be traced to consistent leadership,
Brown said, citing Administrator Andrew S. Natsios’ tenure
with the Agency and his background in international development.
Increased hiring is another factor. The Agency downsized
in the 1990s, but began hiring in earnest in 2004. “It
was the first year in a decade that we hired more people than
we lost,” Brown said. “Just seeing that turn around
a little bit, I think, meant a lot to people.”
The Federal Human Capital Survey is conducted by the Office
of Personnel Management to help federal agencies manage their
employees. The raw data from the survey and an analysis of
the responses are provided to individual agencies.
Nearly 150,000 employees completed the 88-question survey.
Questions covered views on leadership qualities and performance
culture. The overall results were first published in May.
USAID was tied for eighth in the rankings for effective
leadership, and also scored eighth in pay and benefits, performance-based
rewards, and advancement.
Support for diversity, teamwork, and the match between an
employee’s skills and his or her mission all came in
at 10th place.
Still, the survey revealed that some of the areas where
the Agency needs improvement relate to diversity. White males
reported a higher level of satisfaction with working conditions
at USAID than did women and minorities.
The Agency also scored near the bottom in the categories “family-friendly
culture and benefits” and “work/life balance.”
Executives and managers responded with significantly higher
scores on more than half the questions in the survey; non-supervisors
responded with lower scores on almost all the questions in
the survey.
Brown said USAID is looking for ways to improve. For example,
the Executive Diversity Council, which was formed earlier
this year, is actively seeking solutions to bridge the diversity
divide.
Central European Doctors Help Out in Africa, Asia
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Dr. Andrea Doczeova comforts a young boy in Cambodia
while one of her colleagues draws blood for a diagnostic
test.
Courtesy of Andrea Doczeova |
Following the collapse of the Soviet Union at the end of
1991, the American International Health Alliance (AIHA) moved
in to assist countries in Central and Eastern Europe and Eurasia
reforming their health systems.
Now a former AIHA partnership that received USAID support
is taking the lessons of humanitarian assistance learned in
the former Soviet bloc to other regions of the world in need.
Dr. Vladimir Krcmery is dean of the School of Public Health
at Trnava University in Slovakia and a member of the Slovakia/Scranton
Partnership, an organization AIHA supported and that USAID
funded from 1996 to 1999. He saw images of slums in Kenya
flash across his television screen nearly eight years ago
and decided he wanted to help.
He formed an outreach team that went to Kenya and set up the
first Mary Immaculate Clinic in Nairobi in 1998 as a primary
care center serving more than 100 outpatients a day.
“We provide HIV counseling and testing to 150 people
every month, and are currently managing highly active antiretroviral
therapy for 21 adults and five children,” said Dr. Andrea
Doczeova, an associate professor of medicine at Trnava University.
In 2000, the Trnava team moved north to southern Sudan,
where it opened the second Mary Immaculate Clinic, the only
full-service hospital in the region.
Dr. Krcmery called the region “the worst place I’ve
ever visited in my life. South Sudan is characterized by a
total lack of infrastructure—no roads, no power, no schools,
no clean water, no sanitation. There is…an almost total
lack of healthcare services, including the administration
of primary vaccinations against easily preventable communicable
diseases.”
In 2003, the team started working in Phnom Penh, Cambodia,
spurred on by the large number of homeless children there,
many living with HIV/AIDS.
The team opened Blessed Max Kolbe Clinic for Sick Children
and provides homes and medicines for children and some of
their parents.
“It is a tribute to the partners and to AIHA that this
USAID investment over five years ago has produced such an
enduring gift that keeps on giving,” said Forest Duncan,
a health development officer at USAID.
Since 1998, USAID has given AIHA about $122 million to initiate
partnerships with U.S. health institutions and universities—such
as the University of Scranton, the other half of the Slovakia/Scranton
Partnership—to work in developing countries.
Although the partnership no longer receives AIHA funds,
USAID staffers returned to the region in October to evaluate
its impact and that of 29 other AIHA partnerships the Agency
has supported since 1994.
“Our collaboration with the University of Scranton
introduced us to a whole new world, as far as the practice
of medicine is concerned,” Dr. Doczeova said.
“Before we became involved with the AIHA partnership,
our system did not allow for the integration of other disciplines—such
as psychology, social work, education, or philosophy—into
clinical care. We had no understanding of how important these
varied fields are to the true concept of health.”
This article was adapted from an article in the spring
2005 edition of CommonHealth, the journal of the American
International Health Alliance.
Butterfield’s New History of U.S. Foreign Aid Published
By Ben Barber
During 50 years of U.S. foreign aid, 25 countries with a
combined population of 675 million people graduated from aid
dependence, reports former Agency official Sam H. Butterfield
in a new book documenting the history of U.S. aid.
“What difference did all the [U.S. and other] aid make?”
asks Butterfield, who worked for 22 years at USAID and then
spent another 20 years teaching the theory and practice of
international development.
“The Third World’s positive development record
provides circumstantial evidence that foreign aid was beneficial,
especially in developing countries with dedicated leaders
and good policies,” writes Butterfield in his U.S. Development
Aid—An Historic First, published in 2004 by Praeger Publishers.
The book’s subtitle—Achievements and Failures in
the Twentieth Century—indicates it includes more than
just the Agency’s successes.
Butterfield, who now lives in Idaho, describes in readable
prose “how and why the U.S. government, drawing on the
skills of thousands of dedicated Americans over 50 years (1950–2000)
provided development aid on a global scale.”
Butterfield is a retired foreign service officer who served
from 1958 to 1980 with USAID in Africa, South Asia, and Washington,
D.C.
His book is a welcome explanation, free of jargon and academic
language, that would be useful to many USAID recent hires
as well as the wider general public interested in aid.
His book is a clearly written account of the history of
the U.S. foreign aid program from its beginnings, as an outgrowth
of the Point Four concept of the Truman administration to
aid the war-ravaged economies of Europe as well as the agrarian
nations of Asia, Africa, and Latin America.
While the Marshall Plan helped Europe, the Technical Cooperation
Administration, created in 1950, soon was working in 28 Third
World countries, plus Spain and Greece. USAID, its successor,
was created in 1961.
At first, aid officials were experts in farming, water,
teaching, and other activities that they practiced directly
with people in developing countries.
However, Butterfield recalls, these technical experts soon
became managers of contracts that enabled them to affect a
far larger number of people, but also removed them from the
people-to-people work in their chosen fields.
American aid programs were also sharply affected by the
Cold War, as President Kennedy created USAID in part to deflect
the spread of socialist ideas of central planning and authoritarian
rule in the Third World.
Butterfield tells of the creation of the Peace Corps as
the belief spread that, through advisors and aid, newly decolonized
countries of the Third World could rapidly attain modern living
standards.
However, he also tells of battles with Congress and the
State Department, as each branch of government pushed for
its own favorite programs or recipient countries.
The former mission director also tells about the difficulty
of winning popular support for foreign aid. He notes that
the Agency was hamstrung by law from playing an advocacy or
lobbying role in support of its programs.
He talks of the early years of work in Afghanistan, Chile,
India, and Taiwan before USAID was born, and he explains the
role USAID took during the Vietnam War years.
He also describes the shifts in approach to aid during the
Carter and Reagan years and the evolution of the view—still
widely held today—that aiding the growth of the market
economy is a key to fostering development.
Butterfield continues with discussions of the most recent
administrations, explaining how they approached foreign aid
and going into some detail on how the Agency was staffed and
funded.
Separate chapters on “Africa’s lagging development”
and women in development complete what is truly a tour de
force for anyone wanting to gain broad, historical, and in-depth
understanding of foreign aid.
Andrew Herscowitz Receives Legal Award
USAID’s regional legal advisor for the Caribbean, Andrew
M. Herscowitz, recently received the Federal Bar Association’s
2005 Younger Federal Lawyers Award.
The annual award is bestowed upon five federal lawyers under
the age of 36 to encourage and recognize outstanding performance
Nominees’ professional achievements are judged according
to the resulting benefit and contribution to the government,
legal profession, and public law.
Herscowitz’s achievements include structuring bilateral
and multilateral agreements to expedite U.S. emergency relief
assistance in his region of responsibility, drafting loan
guarantee agreements to support the private sector, and spearheading
an initiative to clarify and protect the Agency’s intellectual
property rights. In addition, after traveling to areas in
the Caribbean affected by hurricanes last year, he provided
timely information to the U.S. Embassy to target relief efforts.
“The USAID legal team is the best I’ve ever seen,”
commented Arnold Haiman, the Agency’s acting general
counsel. “Our people work in forward areas, take on the
toughest issues, and reflect the highest level of customer
service. Andy is a terrific example, and I’m proud to
be his colleague.”
USAID Working Urgently to Further Africa’s Economic
Development
By Charles W. Corey
Washington File staff writer
USAID’s Africa Bureau is working “in an urgent
way” to help sub-Saharan Africa achieve its economic
growth and development goals, in line with President Bush’s
strong commitment to the continent, USAID Assistant Administrator
for Africa Lloyd O. Pierson said.
“We are approaching what we do in terms of development
in an urgent way. People need jobs…education…food…good
health…a good quality of life. And our view is we want
results—we want to show that we can respond in a very
prompt, timely way,” Pierson told Washington File on
Sept. 29.
Pierson, a longtime Africa specialist, says the wants and
needs of people in Africa are the same as those elsewhere
in the world. “Better health care…education…a
better quality of life,” is what they want, he said.
“The ability to grow their crops and get them to market.
And a government that works.”
USAID’s budget for Africa has doubled in the past decade,
Pierson said. Africa spending for FY 2005 exceeded $1.4 billion
in development assistance, child survival and health, and
Global AIDS Initiative funding.
Twelve of the 15 focus countries under the President’s
Emergency Plan for AIDS Relief are in Africa, and USAID is
one of the key implementers of the initiative.
USAID’s Africa programs contribute directly to the
priorities outlined in the joint State Department/USAID Strategic
Plan Fiscal Years 2004–2009, particularly those that
advance sustainable development and global interests.
The centerpieces of the Agency’s aid to Africa are
the four presidential initiatives launched in FY 2002: the
Initiative to End Hunger in Africa, the Congo Basin Forest
Partnership Initiative, the Africa Education Initiative, and
the President’s emergency AIDS plan, launched last year.
Other key elements of the programs include the continuation
of the African Anti-Corruption Initiative, the Conflict Initiative,
and the Leland Initiative to increase access to information
technology.
The Bush administration made renewed commitments to Africa
at the recent meeting of the Group of Eight major industrialized
democracies in Gleneagles, Scotland, and at the African Growth
and Opportunity Act Forum in Dakar, Senegal. “We are
talking about addressing the issues in Africa…malaria,
famine, HIV/AIDS, economic development. That commitment is
there,” Pierson said.
Although it is “not an easy road,” Pierson said,
the Bush administration will fight for the continued dedication
of resources to Africa, a continent he called “strategically
important.”
Looking to the future, Pierson said his bureau plans to
focus more on working with youth. “When you look at the
projections over the next five years of 40 million AIDS orphans,
…an incredible number of Africans will be growing up
without family connections,” he said.
Ways must be found, he said, through agribusiness and other
ventures, to increase the opportunity for these children,
as they grow, to stay in the rural areas.
Washington File is a product of the Bureau of International
Information Programs, U.S. Department of State.
Sesame Street Comes to India
Sesame India, an Indian take on the venerable Sesame
Street brand that has entertained children for more than three
decades, is coming to that country in mid-2006.
The show is the latest in a series of USAID-backed Sesame
Street productions in more than 20 countries, including South
Africa, Bangladesh, Russia, and Egypt, with plans for a Lebanese
version underway.
Work on the Indian broadcasts is now moving into high gear.
On Sept. 30, Sesame Street and Turner Broadcasting Systems
Inc., which is spending millions of dollars on the effort,
named India-based Miditech as the producer for the first 65
half-hour episodes of the series.
The show will air on two cable channels Turner owns in India—the
Cartoon Network and its sister network, POGO.
This is the second phase of the show’s development.
In the first phase in late 2004, USAID provided $500,000 and
technical expertise to help get the series off the ground.
Since then, that amount has been leveraged several times
over, as Turner and other private-sector partners from the
United States and India have come on board, said Madhumita
Gupta, USAID/India’s information and communications technologies
coordinator.
As in those countries, Sesame India—in Hindi, it’s
Gali Gali Sim Sim—will use counterparts to the fuzzy,
rainbow-colored muppets familiar to American children, such
as Big Bird and Cookie Monster, to resonate with children
from a different culture.
Indian educators are collaborating on Sesame India to incorporate
the country’s multiculturalism into lessons of literacy
and arithmetic.
“The collaboration will combine the rich understanding
and unique expertise of each partner to create groundbreaking,
premium-quality content that is guaranteed to stimulate and
engage young kids,” said Ian Diamond, senior vice president
and general manager of Turner Entertainment Networks Asia.
The Cartoon Network and POGO are the top two channels children
in India watch, and reach close to 40 million television homes.
Through Sesame India, USAID/India wants to show that cutting-edge
“tools” like television can be used to strengthen
India’s development efforts, especially in underserved
communities, Gupta said. Education is also among the top priorities
for India, as it moves forward with its development agenda.
About 70 percent of Indians live in rural areas, where delivering
a consistent and quality education through traditional methods
is a challenge. But most people who live in these areas have
access to television.
And Sesame Workshop, the nonprofit organization that produces
Sesame Street, is pursuing broadcasting the program through
India’s national broadcaster and on radio. The two media
would expand Sesame India’s outreach considerably, Gupta
said.
“We liked what Sesame Workshop had to offer: a sustainable
project that will not only be a TV program, but one that will
support and contribute to a preschool education movement in
India,” Gupta said.
$254 Million in U.S. Aid Improves Afghan Health
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Health workers distribute free bottles of safe water
solution and specially designed water storage vessels
in Kabul, Afghanistan, to avert diarrheal disease.
Population Services International |
WASHINGTON—Soon after Jim Kunder arrived in Afghanistan
in January 2002, he made his way to the Ministry of Public
Health, where he found a handful of workers trying to provide
health services to a war-ravaged country from a building they
shared with squatters and that had no electricity or windows.
In the field, 400 clinics struggled to provide some care,
unable to pay their staff.
“It is almost impossible to imagine the level of destruction
that took place in Afghanistan,” Kunder, USAID’s
assistant administrator for Asia and the Near East, said Aug.
30 at a Woodrow Wilson International Center for Scholars talk.
Kunder was joined by Afghanistan Minister of Public Health
Dr. Sayed Mohammid Amin Fatimie, who said that although the
past three years have brought marked improvements, more work
is needed to bring modern healthcare to the country of nearly
30 million.
Dr. Fatimie said two years after the fall of the Taliban,
the percentage of people receiving a basic package of health
services grew from 9 percent to 77 percent, with the assistance
of USAID and other donors. The number of community-based health
workers and midwives is growing, with assistance from USAID-funded
efforts.
He said the demand is growing for health clinics, physicians,
nurses, paramedics, and other kinds of health workers. But
hospital care is the “biggest challenge” because
it is so expensive.
USAID has spent $254 million on health programs since 2001.
The Agency provides health coverage for 7.1 million Afghans
in 14 of the 30 provinces; about 300,000 patients are treated
monthly through USAID-funded projects.
The challenges are immense, Kunder said. About 80 percent
of Afghans are illiterate, making health education difficult.
There are four mental health workers to help a country deal
with psychic wounds that stretch back to 1979, and the lack
of medical professors means many of the country’s new
doctors will be undertrained.
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Estimates suggest there are about 14,000 pharmacies
in Afghanistan for the country’s nearly 30 million
residents. USAID has supplied $2 million in essential
drugs to the country since 2003.
Martin Lueders |
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These Afghan women gathered outside a health clinic
in February 2004. In many rural areas of the country,
people must travel great distances for healthcare. USAID
is reconstructing roadways so people can travel more
easily and quickly to health clinics and other services.
USAID/Afghanistan |
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