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For the past 50 years, USAID's programs in global health have helped to prevent suffering, save lives, and create a brighter future for families in the developing world.
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Maternal and Child Health and Family Planning

The U.S. Agency for International Development (USAID) has been a leader in efforts to both improve maternal and child health around the world and provide access to family planning. By allowing women to practice healthy spacing and timing of pregnancy, family planning could prevent as many as one in three of the more than 358,000 maternal deaths that occur every year. Since the Agency began providing family planning services in 1965, the use of modern family planning in the developing world, excluding China, has increased by a factor of four, from less than 10 percent on average to more than 40 percent. In the 39 countries with the largest USAID-supported programs, the average number of children per family has dropped from more than six to four.

Through its investments in maternal and neonatal health programs, USAID improves the health and quality of life of millions of women and children worldwide. The Agency’s approach to maternal and neonatal health follows a continuum of care from pre-pregnancy through the postpartum period. USAID programs foster community involvement, promote evidence-based interventions, improve access to and quality of health services, and equip birth attendants with the knowledge, skills, drugs, and supplies to deliver lifesaving care and reduce preventable maternal and neonatal mortality. USAID-supported programs empower families and communities to prepare for childbirth by using skilled birth attendants; improving self-care and nutrition; recognizing complications; and finding means to overcome barriers to care.

Under the Global Health Initiative (GHI), USAID has engaged in strategic partnerships to improve donor coordination and country ownership for family planning and maternal health programs. The Alliance for Reproductive, Maternal, and Newborn Health unites USAID, the UK Department for International Development, the Australian Agency for International Development, and the Bill & Melinda Gates Foundation to contribute to the goal of reducing the unmet need for family planning by 100 million women, expand skilled birth attendance and facility-based deliveries, and increase the numbers of women and newborns receiving quality post-natal care by 2015.

In one of the great success stories of the modern era, women around the world now bear half as many children as their grandmothers did, contributing greatly to maternal and child health and global economic growth. USAID has been instrumental in this achievement and in reducing the burden of poverty and disease worldwide. To learn more visit the Maternal Health and Family Planning home pages.

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HIV/AIDS

Since the inception of its HIV/AIDS program in 1986, USAID has been on the forefront of the global AIDS crisis, investing more than $7 billion to fight the pandemic. Today, with more than 33 million people living with or affected by HIV/AIDS, USAID is a key partner in the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), a bold initiative announced in 2003 to stem the growing epidemic. It is also the largest and most diverse HIV/AIDS prevention, care, and treatment initiative in the world.

Addressing the global AIDS crisis is a chief concern for USAID. Virtually unmatched in its scope and depth of work, USAID is the backbone of all U.S. foreign assistance efforts, providing economic and humanitarian aid worldwide. Even at the onset, USAID’s HIV/AIDS development program was cutting-edge – from inception in 1986, just two years after HIV – the virus that causes AIDS – was isolated and identified, to five years after the first few cases were reported in the United States. Now, 25 unprecedented years later, USAID works in partnership with PEPFAR.

Drawing on its 50-year development history, USAID mobilizes its best resources and expertise across all sectors to fight the HIV/AIDS pandemic, including a vast network of international and indigenous partners. Rooted in sound development theory and practice, USAID’s work fighting AIDS can be best described in three words: dynamic, adaptive, responsive.

USAID’s Office of HIV/AIDS is implementing programs in several critical technical areas, including prevention, care and support, treatment, strategic information, research, sustainability and systems strengthening, and multisectoral and multilateral cooperation.

Today, an estimated 33.3 million people worldwide are infected with HIV/AIDS. In 2009, 1.8 million people died due to HIV/AIDS and another 2.6 million were newly infected. More than 68 percent (approximately 22.5 million people) of those infected are in sub-Saharan Africa.

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Tuberculosis

Global efforts to control tuberculosis (TB) have made significant gains. However, this treatable disease still accounted for 9.4 million cases and 1.7 deaths worldwide in 2009. TB is a disease of poverty that disproportionately affects poor countries and marginalized populations. Ninety-five percent of all TB cases and 98 percent of all TB deaths occur in developing countries, with most deaths occurring in sub-Saharan Africa and Asia. People living with HIV/AIDS are particularly at risk. TB accounted for about 20 percent of all AIDS-related deaths in 2009.

The U.S. Government is a global leader in combating TB, and USAID is the lead U.S. Government agency working to control TB internationally. The Agency focuses its programs on working with national TB control programs to expand TB services in the countries most affected by this disease. The goal of USAID’s TB program is to make a significant contribution to the reduction of TB transmission and deaths globally. The Agency is committed to a 50 percent reduction in TB deaths and disease burden from the 1990 baselines. And it is dedicated to helping countries achieve and exceed the global targets of 70 percent case detection and 85 percent treatment success rates among patients with active TB.

USAID’s TB program focuses on 20 high-burden countries and provides more limited funding to 20 other countries for targeted assistance. These countries were selected based on the following criteria: high burden of TB, high incidence of TB, high HIV/AIDS prevalence, high burden or prevalence of drug-resistant TB, and lagging case detection and treatment success rates.

USAID provides vital global technical leadership in epidemiology and surveillance, laboratory strengthening, and research to accelerate actions to control TB and addresses the multiple other dimensions and challenges. These challenges include TB-HIV/AIDS co-infection, drug-resistant TB, improvements in health delivery systems, and stronger community awareness. USAID also works with international partners and has established strong relationships with national TB control programs, nongovernmental organizations, technical partners, and communities.

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Malaria

Achieving near zero childhood deaths from malaria is possible, and the world is committed to this goal. More importantly, we know this goal can be met by scaling up current control methods and accelerating and integrating high-impact interventions at the front line of malaria. In a tough economic environment, it is more critical than ever to leverage and mobilize resources through new partnerships with the private sector and civil society organizations. We must also strengthen the health systems that will be required to deliver drugs and other lifesaving commodities and ensure high-quality health care is available to those hardest to reach.

The United States is uniquely positioned to lead a global effort to refocus efforts to reduce malaria deaths to near zero by 2017. When the United States builds and joins global partnerships, using flexible and integrated programs together with cutting-edge technologies that help those most in need, our nation displays its values of compassion and justice.

Malaria remains a major public health problem. In Africa, where 90 percent of the world’s malaria deaths occur, about 80 percent of malaria deaths occur in children under 5 years of age. Malaria also places a heavy burden on individual families and national health systems. And because most malaria transmission occurs in rural areas, the greatest burden usually falls on low-income families in areas where access to health care is most limited.

USAID has been committed to the fight against malaria since the 1950s. Since 2005, USAID has led and implemented, along with the U.S. Centers for Disease Control and Prevention, the President’s Malaria Initiative (PMI). To fight malaria, PMI bases its activities on a combination of internationally accepted interventions, which include insecticide-treated nets, indoor residual spraying with insecticides, intermittent preventive treatment of pregnant women, and diagnosis of malaria and prompt treatment with artemisinin-based combination therapy. Of the nine PMI focus countries where baseline and follow-up health surveys have been conducted, mortality among children under 5 has dropped between 16 percent and 50 percent.

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Vaccines

The evidence is clear: Vaccines are the most transformative technology at our disposal to ensure protection against killer diseases, whether children are immunized by pediatricians in the United States or by health workers in rural clinics in Africa. We must break from the western medical paradigm and focus more intensely on investing in solutions that extend the reach of good health to the poorest settings on the planet. By making quality vaccines available at affordable and sustainable prices, manufacturers are contributing to an international commitment to protect children from preventable illness. If we expand the coverage of existing vaccines and introduce new vaccines against pneumonia and diarrhea, we can save the lives of 4 million children over the next 5 years.

We have seen the power of vaccinations for debilitating diseases such as polio, diagnostic tools for rural clinics, and drug delivery devices that prevent reuse. In fact, just this year at the Bill & Melinda Gates Malaria Forum in Seattle, USAID welcomed the initial news of the Phase 3 efficacy trial that confirmed the RTS,S malaria vaccine is safe and effective. This vaccine is a new addition to our present package of malaria control interventions and could result in further major reductions in severe malaria cases and deaths. The development of RTS,S, as a first-generation vaccine, is an important first step in collaborative efforts to develop the next generation of even more effective vaccines.

The investments the United States is making today in vaccine development, cold chains, and last-mile delivery systems around the world are preparing us for the transformational medical and systems advances of the future.

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