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Saving Mothers & Children: The Importance of Providing a Continuum of Care

Dr. Flavia Bustreo is the Assistant Director-General - Family, Women's and Children's Health, World Health Organization

The Millennium Development Goals (MDGs) brought needed and increased attention to child survival.  Globally, significant progress has been made in reducing child mortality.  The number of under-five deaths declined from 9.6 million in 2000 to 7.6 million in 2010. Under-five mortality fell from 73 per thousand in 1990 to 57 per thousand in 2010. On average, under-five mortality has been falling at a rate of 2.5 per cent per year compared with 1.9 per cent per year over 1990–2000.

The rate of reduction doubled in Sub-Saharan Africa when compared with the previous decade.  There is evidence that this rate of decline is accelerating as we approach 2015.  New initiatives, such as the UN Secretary General’s Global Strategy for Women’s and Children’s Health, have added guidance and resources to the achievement of the goals.  The subsequent establishment of  the Commissions on Information and Accountability and on Life-Saving Commodities will add to the benefits for women’s and children’s health.

Still, despite accelerated progress, the global burden of maternal and child mortality is still unacceptably high.  Over 280,000 maternal lives and 7.6 million under-fives’ lives were lost in 2010.  Most of these losses would have been preventable with interventions that already exist.  We know what these interventions are and what they require to be implemented. Unfortunately, we still fail to reach a large proportion of mothers and children with them, particularly in sub-Saharan Africa and South Asia, where most of maternal and child deaths occur. We need to find the ways to ensure that every mother and child has access to these interventions and can benefit from them. 

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Faith Communities: The Untapped Resource for Development

Kay Warren is an evangelical leader, author, and founder of the HIV/AIDS Initiative at Saddleback Church. Elizabeth Styffe is the Director of Global Orphan Care Initiatives of the PEACE Plan at Saddleback Church. Gil Odendaal is the Global Director for the HIV/AIDS initiative at Saddleback Church. Below is an excerpt from their contribution to the Frontiers in Development essays.

Engaging, Equipping, and Mobilizing Untapped Resources

Celeste doesn’t know much about for­eign aid or development, but she’s an expert on hunger, stigma, and disease. Sitting alone on a hand-woven mat in the African sun, Celeste is covered with lesions, having been expelled from her village due to her HIV-positive status and waiting for death.

Down the road, a local church resonates with the sound of 50 people singing, clapping, and dancing. The pastor preaches passionately to his small congregation about Jesus’ call to care for the poor and hurting in His name. A church member leaves the exuberant worship service and makes her way toward Celeste’s mat under a tree. Soon, Celeste will feel the volunteer’s soothing touch, receive needed medications from a church-based clinic or a government hospital linked to the local congregation, and begin to rebuild her life.

This church member does not have a medical degree—in fact, she is just learning to read
and write—but she understands community ­development because her church has provided extensive, yet simple, training in how to be a volun­teer community health worker. The humble church member calls herself a “Community PEACE Servant.” She represents more than 3,000 volun­teers in the Western Province of Rwanda who are improving health, inluencing development, reduc­ing poverty, and changing the world, one family at a time. More than 22,000 home-health visits will be made in this rural region this month because churches are taking the lead. Empowered U.S. and indigenous churches are connecting with each other and partnering with governments and other organizations to engage and equip ordinary people in local churches to actively address development issues in the lives of real people everywhere.

Read the complete article in USAID’s Frontiers in Development publication.  

Foreign Assistance, Innovation, and Progress

Bill Gates is the chairman of Microsoft, U.S.A. and the co-founder and co-chair of the Bill & Melinda Gates Foundation.  The following in an excerpt of the essay he wrote for USAID’s Frontiers in Development publication

As I write this, my wife, Melinda, has just returned from a visit to Tanzania with members of a congressional delegation, led by Senator Lindsey Graham, to learn more about global health and development programs.

Reflecting on the trip, Melinda said the high point was meeting Joyce and Raymond Sandir, small farmers who eke out a living growing maize and a few other crops and selling milk from their single cow. When Melinda asked them about their experience with a new, higher-yielding, diseaseresistant maize seed, Joyce said their income had more than doubled. Although the Sandir family lives without running water or electricity, Joyce didn’t hesitate when one Senator asked what she planned to do with the extra money. She said she would pay for more education for her children.

For Melinda, the visit was another reminder of why we do this work. For members of the congressional delegation, it was a chance to see first-hand the impact that development aid has on people’s lives. A few pounds of healthy seed that wouldn’t be given a second thought in wealthy countries can trigger a virtuous cycle of health and productivity in poor countries. Farmers can feed their families. Children can go to school and become valuable members of the community.

Local economies grow, strengthening the social and economic fabric of nations. Eventually, these countries are in a position to offer development assistance to other poor countries.  Some, like Korea, have made the full transition and no longer rely on official development assistance (ODA). Others, such as Mexico, Brazil, India, and China, are following a similar path. These aren’t isolated examples in a few lucky countries. In the past 50 years, advances in agriculture saved a billion people from starvation. Vaccines and other medical advances reduced childhood deaths by more than 80%. The proportion of people in extreme poverty has been cut in half. The Sandir family is one example among many millions.

Read the full article in USAID’s Frontiers in Development publication.

Pressures on the Plundered Planet

Director, Centre for the Study of African Economies, Oxford University

Director, Centre for the Study of African Economies, Oxford University

Paul Collier, Professor of Economics at Oxford University, spoke earlier today at USAID’s Frontiers in Development Forum, and will speak again tomorrow morning. Below is an excerpt from his contribution to the Frontiers in Development essays.

As the world economy grows, it increasingly faces natural constraints. These provide both new opportunities and new risks for the poorest countries; managing them well will be central to their exit from poverty. These were the themes of The Plundered Planet. Here I bring out some of the key current issues. Industry needs natural resources, for energy and material inputs, but many of the natural resources we use for these purposes have a fixed endowment, which we are depleting. A growing global population needs food, and food needs land, but land suitable for agriculture is finite.

Both industry and agriculture emit carbon dioxide into the atmosphere, but the stock that can be safely absorbed by the atmosphere is finite, and as it builds up it gradually changes the climate. How concerned should we be about these constraints, and what do they imply for development?

I think that the concerns about industrialization grinding to a halt because of shortages of vital natural-resource inputs are misplaced. As any particular resource becomes depleted, its price rises. In turn, this induces fresh investment in prospecting and so furthers discoveries, and ultimately research into innovation. This has happened so many times across such a wide range of activities that we can be fully confident of it. The past decade of rising prices for natural resources has already triggered these waves of investment. Currently, by far the highest-valued natural resource is carbon-based energy, from oil, coal, and gas. The high prices of the past decade have triggered an astonishing wave of new technologies that enable us to tap into endowments that were previously inaccessible: The United States has already discovered enough additional resources through these new technologies to be self-sufficient for several decades. Beyond technology-based discoveries are technology-based
substitutes: For example, in the 19th century, nitrates were considered vital and finite; then we discovered modern fertilizers.

Similarly, the global population will not face hunger because of land shortages. There are still huge areas of grossly underutilized fertile land; beyond that are drip-feed and greenhouse technologies that open up lands that are currently too dry or cold. Nor will we face a stark choice between energy shortage and overheating. Although global supplies of carbon-based energy are finite, there are many non-carbon sources of energy waiting to be developed. Indeed, modern physics tells us that the endowment of other forms of energy is infinite: The challenge of permanently sustained energy supply is entirely technological, and we can be confident that innovations will be forthcoming. But although we are not facing a natureimposed Armageddon, natural resources, climate, and food are interconnected in ways that pose new opportunities and new risks for the poorest developing countries.

Read the full article in USAID’s Frontiers in Development publication.

Photo of the Week: Spotlight on Panama

This week USAID announced that it will close its Mission to Panama in September, a reflection of Panama’s own great advances in development. Our assistance program to Panama began in 1940 with technical assistance for the establishment of a rubber plantation. Since then, we have provided $1.2 billion in economic assistance to Panama.

Our development initiatives in Panama have facilitated public-private partnerships and strategic development alliances leveraging local and external resources. As a result the sustainability of our joint activities will continue long after our Mission closes.

View the complete the photo series of our work in Panama.

Democracy and Development in Sub-Saharan Africa

Ellen Johnson Sirleaf, President of the Republic of Liberia, and Carol Lancaster, Dean of Georgetown University’s School of Foreign Affairs spoke today at USAID’s Frontiers in Development Forum. Below is an excerpt from their contribution to the Frontiers in Development essays.

Twenty-five years ago, Sub-Saharan Africa (SSA) was a region of despair. Outside of Botswana and Mauritius, democracy was but a distant dream. Unelected and unaccountable governments held power across the subcontinent. Dictators treated their countries as personal fiefdoms, ruling by force and intimidation, taking what they wanted, doling out riches to a favored few, and sprinkling a handful of crumbs to the rest. The terrible scar of apartheid made a mockery of justice and plunged the entire southern region into conflict and crisis. And the politics of the Cold War made a bad situation worse, as East and West propped up unsavory rulers for their own purposes with little regard for the effect on Africans themselves.

The leadership crisis translated into an economic crisis that left the region effectively bankrupt. Authoritarian leaders used the state to try to control the economic commanding heights, in part to finance their patronage systems. In the end, their control only destroyed economic assets and personal livelihoods. For 20 years starting in the mid-1970s, nearly all of the countries of SSA saw zero or negative economic growth in per capita incomes. Promising businesses were ruined, and new investment virtually stopped, except for the grab for natural resources. Unemployment soared, and working men and women could no longer provide for their families. Schools and health facilities deteriorated badly. The only things that seemed to thrive were poverty, graft, and conflict.

But that was then. Today, all of that has begun to change—not across all of SSA, but across much of the region. Dictators are being replaced by democracy. Authoritarianism is giving way to accountability. Economic stagnation is turning to resurgence, with SSA today one of the fastest-growing regions in the world. Poverty rates are falling. Investors who never would have considered Africa a decade ago are lining up to look at new opportunities. Political conflict has subsided, and governments are strengthening the protection of civil liberties and political freedoms.

About half of the countries in the region have embraced democracy, fragile and imperfect, to be sure, but a far cry from the dictatorships of old. And most important, despair is being replaced by hope—hope that people can live in peace with their neighbors, that parents can provide for their families, that children can go to school and receive decent health care, and that people can speak their minds without fear.

What happened in SSA? How did authoritarianism begin to give way to democracy? How has the economic resurgence affected the move toward democracy, and how has democracy affected the economic turnaround? How is democracy likely to evolve in the future in SSA?

Read the full article on page 32 of USAID’s Frontiers in Development publication.

Video of the Week: Tony Blair addresses Frontiers in Development

Live from the conference:  Tony Blair addresses the crowd at Frontiers in Development with a message on global development in 2012. For real time conference highlights, watch our livestream of the event and follow #DevelopmentIs on Twitter.

Welcome to the USAID Frontiers in Development Forum!

Frontiers in Development is an effort to engage with the most innovative and experienced development practitioners around the world; seizing pivotal opportunities to leave behind legacies of success. Over the past year, Frontiers in Development launched an essay competition to collect ideas from some of the brightest minds and best practitioners in development. This compilation is now a publication that is available for public distribution through our website. The essay competition set the stage for the forum, where 40 panelists will speak about the past, present, and future of development.

The USAID Frontiers in Development forum is centered around a three-day conference to be held at Georgetown University in Washington, DC from June 11-13. This forum will draw together development practitioners and recipients, leaders from government and the private sector, academics and concerned actors from throughout the broader community. Frontiers in Development is much more than a great lineup of outstanding speakers (including Bill Gates, Ellen Johnson Sirleaf, James Stavridis, and Rakesh Rajani). It is more than a chance for networking, or a few days to interact with talented colleagues and counterparts. It is more than the essays from a range of authors and thinkers included in our companion publication. Rather, Frontiers in Development is an opportunity to focus our joint attention on what comes next – promising solutions, innovative technologies, cutting-edge ideas, and novel applications to development.

Through the USAID Frontiers in Development forum, you are invited to engage on a range of topics and issues – from managing the pressures of demography and climate change on our planet, to adapting democracy and economic growth programming to conflict situations, from seeking means to improve the sustainability of development efforts to communicating the importance of this critical work to a public audience.

As a longstanding leader in the development community, USAID is proud to be hosting this event. The excellent support and cooperation of our partners at Georgetown University, the Gates Foundation, the Hewlett Foundation, the MacArthur Foundation, and the Rockefeller Foundation reflect the changing landscape of the development sphere, including the welcome emergence of an increasing number of active contributors. In fact, this changing development landscape is just one of the themes to be discussed in the days to come and months to follow.

We hope that you will engage in the Frontiers in Development forum – in person or online, by submitting questions for the panels or by reading the thoughtful essays included in the Frontiers in Development publication. Most of all, we hope you will join the conversation on what comes next, and how best to tackle the challenges we face at the Frontiers in Development.

U.S. Small Businesses: Thriving In USAID’s Changing Environment

On June 5, my staff and I were delighted to host USAID’s 5th Annual Small Business Conference at the Ronald Reagan Building in Washington, D.C. Over 200 small business representatives had the unique opportunity to hear insightful presentations from our Administrator, Dr. Rajiv Shah, Congressman Chris Van Hollen (D-MD), SBA Associate Administrator John Shoraka, and USAID senior officials. It was an incredible time to celebrate the success of USAID in expanding our engagement of U.S.-based small businesses and to have in-depth dialogue on how small businesses may continue to thrive in our changing environment.

The energy at the conference was electric. What I witnessed was a reaffirmation of our commitment and renewed focus on the importance of small businesses for the continued growth of our economy and for their important contribution to our core development objectives. There was also a collective focus on USAID’s Implementation and Procurement Reform (IPR) initiative and the fact that IPR is not only about working with host country systems and developing local capacity, but also about expanding our partner base to include the increased use of U.S.-based small businesses.

Achieving strong cooperation between USAID and the small business community has been a long and sometimes arduous path. Historically, we have not done well in leveraging the talents and expertise of small business partners to achieve our goals. However, in recent years, we have increased our awards to small businesses by 50% and for the first time in many years, exceeded our overall small business goals in FY 2011. We’re also improving our accomplishments at the Mission level. For example, in FY 2011, the El Salvador Mission awarded 26% of its acquisition dollar obligations to U.S.-based small businesses while increasing local capacity development; and the Haiti Mission awarded 20% of its acquisition dollar obligations to U.S.-based 8(a) certified small businesses.

We recognize that there is so much more to be done to further enhance our relationship with the small business community. Through continued dialogue, I believe that we can improve the quality of development programs, bring new thought and innovation to the Agency, and improve the efficiency of how we carry out our mission.

For more information about how your small business can work with USAID, visit our Small and Disadvantaged Business Utilization and Minority Resource Center.

Make Every Mother and Baby Count

In early May, we witnessed a spectacular commitment to “making every mother and baby count” here in Dhaka, Bangladesh.  The United States Agency for International Development (USAID), through their Maternal and Child Health Integrated Program, and in partnership with the Bangladesh Ministry of Health and Family Welfare (MOHFW), convened an important series of meetings focused on saving the lives of mother and their babies.  We wanted to tally for you the numbers that express just how much every mother and baby count:

  • Participation included more than 275 international maternal and newborn health professionals;
  • With over 29 countries represented;
  • Including over 100 individuals from Bangladesh.
  • But why?  Because just 1 maternal or child death is more than just a tragic occurrence. It affects the entire family, it affects social cohesion, and it dampens the economic growth of the countries. Data shows that after a mother dies there is an increased risk of death for surviving children.
  • Here in Bangladesh, about 20 women die every day from childbirth, about half of these due to 2 main causes, postpartum hemorrhage that is to say excessive bleeding and eclampsia (high blood pressure leading to convulsions). These are the very 2 factors that kill 50% of mothers in developing countries around the world.

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