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The Journey of Life for Children Living with HIV – From Diagnosis to Adulthood

Not long ago, it was expected that children living with HIV would not survive to adulthood.  Today, children living with HIV are thriving through adolescence into adulthood, and doing so in large numbers.

Though effective antiretroviral treatment is allowing many to live long and healthy lives, living with HIV remains a complex burden for these age groups. Treatment, care and support needs are challenging and ever-changing.  Focusing on clinical services alone is insufficient.  Children and adolescents living with HIV have a range of other essential needs that must be supported.  They require psychosocial support, sexual and reproductive health education, alcohol and substance use counseling, and information on voluntary and safe disclosure, loss, grief, and bereavement.   Children and adolescents are often confronted with a multitude of emotions, questions, and concerns regarding the complexities of disclosure, their health, and their future.

PEPFAR, WHO, UNICEF, national governments, NGOs, organizations of people living with HIV, and others are working to support children living with HIV as they transition from childhood to adolescence and adulthood.

One of USAID’s foremost concerns is how best to support and address the unique health, psychological, and social needs of adolescents living with HIV as they transition into adulthood and into adult care environments.  Only an estimated 15% of HIV-exposed infants are identified and in southern Africa less than 12% those between 15 and 24 years of age have been tested and know their HIV status results.   USAID acknowledges the urgent need for age-appropriate HIV testing and counseling for children and youth to identify those that remain undiagnosed. 

With the participation of children and adolescents living with HIV in USAID programs, we continue to better understand how best to reach adolescents with the services they need.   For one, HIV remains highly stigmatized.  Children and adolescents living with HIV are confronted with complex challenges regarding disclosure with their peers and even family members.   They are in need of support to practice voluntary and safe disclosure, maintain treatment literacy and adherence, and have healthy relationships.

This is a historic moment in human history. We know what works in the effort to combat major killers of children and we are in a unique position to further reduce childhood all-cause mortality and virtually eliminate new pediatric HIV infections while keeping mothers healthy.

The focus on adolescents living with HIV is important to USAID and part of a greater initiative to meet the health needs of children.  For fifty years, USAID has been committed to improving child health.

In June, the Child Survival Call to Action challenged the world to reduce child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035.  Reaching this historic target will save an additional 45 million children’s lives by 2035.

Fifty-six governments and over 100 civil society partners committed to sharpening national plans for child survival, monitoring results, and focusing greater attention on the most disadvantaged and vulnerable children.

For children and adolescents living with HIV, we must manage their care with the desire and actions that show their self-worth including treatment and clinic adherence.  And let’s continue to prioritize meeting essential needs so children and adolescents can make a healthy transition into adulthood and a fruitful, productive life thereafter.

Join the USAID-sponsored International AIDS Society satellite:  Journey of Life for Children Living with HIV – From Diagnosis to Adulthood Sunday, July 22, 2012 from 9:00-11:00.

Progress in Haiti

Thomas C. Adams serves as Haiti Special Coordinator at the U.S. Department of State, and Mark Feierstein serves as Assistant Administrator for Latin America and the Caribbean at the U.S. Agency for International Development (USAID).

The government of Haiti recently addressed the double bind their country often faces when the international media covers the development that is occurring in Haiti, identifying either how development is slow in coming or that the development that is occurring is harmful. We anticipate an upcoming AP article may reflect this same perspective. Haiti is working tirelessly to overcome adversity that existed even before the earthquake and to begin to build a stable and sustainable foundation for economic prosperity and societal stability.

Like many other Haiti donors, the United States government has been a proud partner of the government and people of Haiti. We have approached our work in a fundamentally different way. We have followed the lead of the government and people of Haiti, and we have sought for our development assistance not only to provide aid, but long-term sustainable investment as well. Our investments fall into four areas prioritized by the government: agriculture, health care, infrastructure and rule of law/security. And, while the assistance the United States is providing today is not always immediately apparent, the investments we are making will be lasting.

Haiti has a long way to go. Yet, there are successes. We want to share a few that sometimes go unreported.

  1. More than 1.1 million Haitians have moved out of temporary tent camps. The U.S. government, through USAID, has worked with the government and people of Haiti to repair damaged homes, build transitional shelters and provide rental support. These efforts alone have benefited more than 328,000 people.
  2. The government of Haiti ensured more children are attending school, paying the tuition of 850,000 primary school students and enabling 142,000 new students to attend school this past year alone.
  3. In the North, one of the poorest regions of the country, the government of Haiti is leading one of the largest and most ambitious regional development efforts in the country’s history. Haiti has lead the U.S. government, the Inter-American Development Bank, and businesses — including domestic and foreign — to invest in the future of the region. The Caracol Industrial Park, for example, began operations at one factory in April. A modern power plant that provides electricity to the Park’s factories and surrounding communities is up and running. There is a new vocational training center, a modern university provided by the Dominican Republic, and an improving community-based health care system. An airport expansion, construction of a new settlement with more than 1,280 hurricane and earthquake resistant houses with electricity, potable water, and flush sanitation in every home, and engineering drawings for a new container port are underway. These projects are part of Haiti’s vision for a more prosperous and stable future that harnesses the economic potential of Haiti’s impoverished regions, which the Haitian government put forward, and which donor partners and development experts endorsed.
  4. With more than 60 percent of Haitians reliant on agriculture for income, the United States has expanded agricultural programs, deploying the strategy of Feed the Future, the U.S. government food security initiative. To date we have worked with more than 9,700 farmers, introducing improved seeds, fertilizer and technologies. These efforts have resulted in a 118 percent increase in rice yields, 368 percent increase in corn, 85 percent increase in bean yields, and 21 percent increase in plantain yields. Our goal is to support 100,000 farmers in our three geographical regions of focus.
  5. The U.S. government, through USAID, is funding the services of an experienced management firm to help improve the commercial and operational sustainability of Haiti’s electric utility in Port-au-Prince. In a country where only 12 percent of the population has legal access to electricity, the firm is also seeking to expand services to another 60,000 active customers by next April, which will increase the active customers in Haiti by a third. Since November 2011, the USG has been rehabilitating five electrical substations in Port-au-Prince, ensuring that available power in the system reaches households and businesses. To date, the U.S. government has signed contracts in the energy sector worth $52 million that are in different stages of implementation, half of which focus on the Port-au-Prince area.

The U.S. Government Is Working in Partnership

Dozens of countries, multilateral organizations, non-governmental organizations (NGOs) and private sector entities are supporting Haiti. Together, we all pledged more than $12 billion in March 2010 in humanitarian and recovery funding over 10 years — a testament to the wide-spread commitment Haiti’s partners share to its future prosperity. The United States pledged $1.15 billion or about 12 percent of the total funds. The government of Haiti and its partners are striving to ensure each dollar invested yields maximum results and complements, rather than overlaps, with other investments. The U.S. government development strategy can be found at: www.state.gov/s/hsc/. In addition to direct assistance, the United States funds efforts in Haiti through multilateral institutions such as the United Nations, the Inter-American Development Bank, and the World Bank. We are the largest donor in the health and agriculture sectors; the IDB is the largest donor in the education sector, as well as one of the lead donors on water, sanitation and hygiene programs (WASH). Today, because of coordination with the government of Haiti, the IDB and the government of Spain, more Haitians have access to clean water than before the earthquake — yet there is still much more progress that needs to be made.

The U.S. Government is Focused on Productive Infrastructure for Haiti’s Renewal

If you don’t look closely, numbers can be deceiving. The United States used existing funds from 2009 and 2010 and redirected existing programs to jumpstart recovery assistance, rehabilitate the electric grid and upgrade neighborhoods and health clinics before emergency supplemental funds were made available by Congress. Infrastructure projects don’t begin or get completed overnight, and with good reason. So while the United States is on track to disburse all $475 million we committed to housing, energy and ports, disbursements for these types of complex projects are slower. To build a new port, power plant, hospital or housing complex — all of which the United States is in various stages of implementing — in a collaborative, responsible manner requires feasibility studies, consultations and planning with relevant government entities and communities at the local and national level, environmental studies, and plans for staffing and operations and maintenance. For Haiti to become an economically prosperous nation, we need to support sustainable projects. To do so means providing assistance in a deliberate manner.

Disbursements of U.S. Development Assistance to Haiti
$ in thousands for all items

Humanitarian Relief Assistance
Available funding through 03/31/2012: $1,289,024
Obligations: $1,289,024
Disbursements: $1,289,024
Percentage of available funding disbursed: 100%

Recovery and Reconstruction Assistance
Available funding through 03/31/2012: $1,891,743
Of which is the March 2010 New York pledge: $1,170,196
Obligations: $1,129,985
Of which is the March 2010 New York pledge: $649,842
Disbursements: $988,320
Of which is the March 2010 New York pledge: $463,102
Percentage of available funding disbursed: 48%
Of which is the March 2010 New York pledge: 40%

Total
Available funding through 03/31/2012: $3,180,767
Obligations: $2,419,010
Disbursements: $2,277,345
Percentage of available funding disbursed: 72%

You can see how we are investing in Haiti by going to www.foreignassistance.gov and for information on specific contracts you can visit https://www.fpds.gov/fpdsng_cms/.

The U.S. Government is Committed to Transparency and Accountability

The State Department and USAID regularly provide information to the public and consult with Congress. In the last nine months alone, we have held more than 50 briefings for Members of Congress and their staffers, submitted strategies and reports, and have made ourselves available to answer inquiries via letters, emails, phone calls and meetings. And, for U.S. development projects, USAID provides Congress with a progress report every two weeks.

Importantly, we consulted extensively with the government of Haiti and other stakeholders in Haiti in the design of our assistance strategy, to ensure it reflected the priorities of Haiti. As part of this process, we have shared how much funding is available for investments in each sector and the impact the government of Haiti could anticipate from these initiatives. In the North, we have built community kiosks in different townships to share information in French and Creole about the investments the United States is making to receive feedback and remain accountable to local communities. Our commitments are public and tangible, supported by performance benchmarks that allow the people of Haiti and U.S. taxpayers to hold us accountable for our successes and failures.

We have also taken great strides to make the contracting process more transparent and accessible, especially to Haitian-owned companies. Online, any one can readily find the scope of work and information about the projects, excluding company’s business confidential information, to ensure full and open competition for contracts (by avoiding competing companies knowing the costs structures of their competitors).

We are working hard to ensure the United States is the best partner it can be to the government and people of Haiti, while investing the American taxpayers’ resources wisely and sustainably. Our goal is to continually improve our processes and programs, maintain the integrity of our investments, work in a coordinated manner with all stakeholders, and above all else measure our impact by whether the lives of Haitians are improving.

USAID and Partners Kick Off LAUNCH: Beyond Waste Forum in Pasadena

The intense aura of intelligence that permeates NASA’s Jet Propulsion Laboratory in Pasadena, CA seems to signal that it is the perfect place for USAID and our partners to kick off this week’s LAUNCH: Beyond Waste Forum.  It is an incredible privilege—and, to be honest, a great deal of fun—to be at LAUNCH with a world-class group of experts and innovators.  This impressive group that crosses many sectors and industry boundaries will spend the next three days focusing on breakthrough technologies and problems that address some of the world’s toughest waste problems.

USAID and our partners NASA, Nike, and the Department of State formed LAUNCH to showcase and support extremely high potential innovators addressing the world’s most critical sustainability challenges.  LAUNCH: Beyond Waste is our fourth LAUNCH program cycle (previous cycles focused on water, health, and energy).  After a rigorous application and vetting process, we selected nine innovators we believe will make an outsized impact on waste issues in both the developed and developing worlds.  Through LAUNCH, we will spend the next six months working with them to accelerate that impact.

Waste is unfortunately one of the most neglected issues in international development practice.  While many donors in our field have only a few programs worldwide dedicated to waste issues, the waste challenges developing world citizens, organizations, and governments face are daunting.  In most major developing world cities and countries, the vast majority of municipal solid waste streams are not formally processed, while ‘eWaste’, medical waste, and agricultural waste streams (among others) often go unaddressed as well.  At the same time, “untapped” waste streams represent enormous potential resources when waste-to-energy and “upcycling” or recycling methods are applied.

Many of our LAUNCH: Beyond Waste innovators are building thriving businesses and programs based on that very premise: waste is often a resource and an opportunity, not an unfortunate byproduct of modern life.  This impressive group of innovators includes, for example:

Attero Reycling: India’s leading provider of “end-to-end” electronic and electrical goods e-Waste management services—likely the only such full service company in the developing world.

re:char: A leading developer and provider of ‘biochar’ operating in Kenya and the United States.  Biochar is a carbon-negative charcoal that can be used as a charcoal substitute and as a powerful soil amendment, which boosts crop yields.

Sanergy: A provider of sanitation infrastructure for Nairobi, Kenya’s slums and of fertilizer and electricity from its byproducts.

You can see the full list of the LAUNCH: Beyond Waste innovators and descriptions of their innovations.

We are thrilled with the bright and diverse group of people who have joined the LAUNCH Council, which will advise the innovators.  During the Forum, the innovators will engage in three days of collaboration with the Council, a group representing the waste, business, investment, international development, policy, engineering, science, communications, and sustainability sectors.  We have assembled the Council to give individualized advice to the innovators and to form a network that can help accelerate their progress in the coming months. Check out profiles of the LAUNCH Council members.

Please follow the LAUNCH: Beyond Waste Forum this Friday and Saturday (July 20 and 21, beginning at 1 PM EDT/10 AM PDT) and participate right along with us.  The Twitter hashtag is #beyondwaste and portions of the Forum will be streamed live.  You can also view and participate in the live conversation about the innovations.

Visit LAUNCH to learn more.

One Year On: Looking Back on Famine and a Smarter Response in the Horn

About six months into my tenure as Director of Food for Peace, in July 2011, I remember calling Nancy Lindborg, the Assistant Administrator of our Bureau, to let her know that famine had been officially declared in Somalia. It was with an air of both sadness and disbelief that I myself absorbed the news that we had actually reached this point. I had left the world of humanitarian aid for development and governance work in the mid-1990s, shortly after one of the most intense periods of my working life, responding to the 1991 Somalia famine. I was in the Office of U.S. Foreign Disaster Assistance (OFDA) in those years, and we broke records by mounting the largest-ever (at that time) Disaster Assistance Response Team (DART) in the office’s history and spending more on a single disaster in a short span of time than the office ever had before. As a member of USAID’s DART in Somalia, I witnessed the crisis firsthand. I traveled with Fred Cuny, a great humanitarian, as he shared his insights into the nature of famine and the challenges of response. As the months unfolded and relief operations ramped up with the support of the U.S. military, names of towns like Belet Huen, Baidoa, Merca and Kismayo all became commonplace, as did the terrible images of starving children and sprawling graveyards.

We learned a lot from that famine response, and looking back I can say that we played it smarter this time around. Recognizing that mortality rates often spike due to outbreaks of preventable diseases, USAID prioritized health and hygiene programs such as vaccination campaigns and providing clean water and hand washing soap before the rainy season, when disease rates are known to spike. Much improved early warning systems gave us a clear picture of both nutritional needs and market prices. Based on this information, we prioritized cash and voucher programs that allowed people to stay in their villages and buy food and other supplies in their local markets. We found that markets did indeed respond to the increase in demand, inflation was kept at bay, and traders brought goods to areas that were off limits or too dangerous for aid workers.

The in-kind food distributions we supported through the United Nations World Food Program WFP) were also smarter. Thanks to the early warnings received from the experts at Famine Early Warning System (FEWS) and Food Security and Nutrition Analysis Unit (FSNAU), our food aid was already pre-positioned in the region. WFP largely set aside general food distributions, which are often chaotic at best and violent at worst. Instead WFP focused on more efficiently reaching those in need by working together with health facilities to provide families with food aid, and if needed, supplementary nutrition. For many years USAID has been providing funds for partners to purchase ready-to-use therapeutic food (RUTF) to help those in crisis, but for the first time ever, Food for Peace provided an RUTF that it helped create. And we now have RUTF in our stockpiles.

While the food security conditions in Somalia have improved, our response this past year reflects our understanding of the fragility of the situation: Along with our partners, we are continuing to provide assistance that saves lives while also protecting and advancing livelihoods.

Last night I attended a celebration in honor of Senator George McGovern’s 90th birthday. He was feted with toasts that acknowledged his extraordinary contributions to feeding hungry children around the world. As an American citizen and public servant, I am proud to be part of the U.S. government effort that stays true to the spirit of Senator McGovern’s vision. In far flung and difficult places, including Somalia, we make a difference and make evident every day the compassion and generosity of the American people.

One Year Later: Reflections on the Humanitarian Response in the Horn

Communities in the Horn of Africa are enduring their second summer of poor rains, failed crops, and withering livestock. In a region where the majority of the population makes under $2 a day in the best of times, this emergency has stretched to the breaking point many families’ ability to put food on the table.

One year ago, the extent of this environmental crisis was made clear when the United Nations declared a famine in Somalia—the first to strike the region in nearly 30 years. In Djibouti, Ethiopia, and Kenya, the longterm investments in development paid off, preventing their slide into famine.

Thanks to better seeds and other technologies provided through USAID rural finance assistance, more than 867,000 households have seen their income grow. Photo credit: Mariantonietta Peru/USAID

But relief efforts weren’t easy. The drought severely affected more than 13 million people—more than the populations of New York City and Los Angeles combined—requiring a vast
humanitarian response that could reach the remote, isolated, and often nomadic populations that had the greatest need. In Somalia, conflict and violence limited the reach of humanitarian assistance, and those hardest-hit by the drought were often the hardest to get to.

A year later, despite the unflagging drought, conditions have improved across the Horn, thanks in part to the international community’s quick and aggressive response. USAID’s relief efforts in the Horn were designed to attack the emergency from two sides. Our work aims not only to save lives, but also to enable communities to recover faster and better withstand the next shock. Learning from previous droughts and famines, we prioritized:

  • Food aid—to stop the hunger
  • Health, nutrition, water, hygiene, and sanitation services—to combat disease, which kills more people in emergencies than a lack of food 
  • Support for livelihoods–to enable families to access food where markets were functioning

Since 2011, USAID has provided more than $1 billion in humanitarian assistance to the Horn, targeting more than 4.5 million people.

However, the gains made over the past year are fragile. More than 9 million people in Djibouti, Ethiopia, Kenya, and Somalia still require humanitarian assistance, and the situation could worsen over the next few months. The core vulnerabilities of drought, conflict, poor governance, and chronic poverty continue to threaten the future of millions. Within USAID, we’re working hard to tackle these chronic threats and continue to be flexible in our response. The future will continue to present challenges, but USAID is committed to working with our partners to hold onto the gains we’ve all worked so hard to achieve.

The one-year anniversary of the famine declaration in Somalia is a somber reminder of the continuing crisis and an opportunity to reflect on the need for communities to come together to help those in need.

One Year After Famine: The Need for a Continued Comprehensive Response

On July 20, 2011, I got a call from Dina Esposito, USAID’s Director of the Office of Food for Peace, alerting me of the official declaration of famine in Somalia. That moment, more than a year ago, is still deeply, vividly and painfully with me.

Famines are entirely man-made and have become increasingly rare. In my confirmation hearing, I quoted Amartya Sen’s famous words that famines don’t happen in democracies. So as the worst drought in 60 years gripped the Horn of Africa last year, it was only in Somalia, racked by 20 years of conflict and instability, and with limited access for humanitarian action, that famine was declared. The United States’ commitment and long-term work with Ethiopia, Kenya, and many of their neighbors have reduced the populations’ vulnerability to crises like this one and greatly reduced the need for emergency assistance.

In the humanitarian community, famine is a very specific technical term to describe only those most severe food crises that reach three clear sets of conditions. In famine, more than 30 percent of children are acutely malnourished; at least 20 percent of the population consumes fewer than 2,100 calories of food a day; and the mortality rate exceeds two deaths or four child deaths per 10,000 people on a daily basis.

This translates into unforgivable conditions in any country at any time — yet at this time last year, in parts of southern Somalia, the mortality rate reached as high as six deaths per 10,000 people with one child death estimated to occur every six minutes. These are staggering numbers — and this marked a tragic, unacceptable, unnecessary loss of life.

Because of lessons learned during the last Somalia famine in the early 1990s, we were able to mount a smart and effective response. Our disaster experts from the Office of U.S. Foreign Disaster Assistance and Food for Peace used market prices and nutritional data to chart a strategy that focused on highly targeted cash and vouchers, attention to market dynamics. We also kept a focus on health programs, knowing that the leading cause of death for children in famines is preventable disease.

USAID worked around the clock in the region and in Washington to ensure strategies, supplies and partners were in place, including creative approaches to address the limited humanitarian access in many parts of Somalia.

By February, famine conditions had abated, thanks to a massive humanitarian mobilization and decent winter rains. However, the situation remains tenuous in Somalia and underscores that as natural disasters continue to strike, it is imperative to address the need for a stable, legitimate government that can meet the needs of the Somalia people. This is a priority of the U.S. government and our international partners.

Learn more about our response in the Horn of Africa and our Productive Safety Net Program.

From Evidence to Action: What Works for Women and Girls

In the coming days, thousands of political leaders, public health experts, activists, people living with HIV and other delegates from around the world will gather in Washington D.C. to debate, discuss, reflect upon, and celebrate the achievements that have been made in the fight against HIV/AIDS.

But in Lesotho, and other southern African countries, the epidemic remains a painful reality.

During my recent trip to the Mountain Kingdom, a tiny country surrounded on all sides by South Africa, conversations about the epidemic inevitably turned to the fact that women and girls are a much greater risk for HIV due to a combination of biological, structural, and cultural conditions. In many ways, Lesotho clearly illustrates the nature of the epidemic in sub-Saharan Africa, where 60% of those living with HIV are women. In the nine countries in southern Africa most affected by HIV, prevalence among young women aged 15-24 years is on average about three times higher than among men of the same age.

In Lesotho, where women and girls have much higher rates HIV than men, our U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Country Team and implementing partners are acutely aware of the realities facing women and girls and are continuously seeking ways to ensure that programs and services use the most up-to-date evidence to meet their needs.

Fortunately, the evidence of what works for women and girls is just a click away.

What Works for Women and Girls: Evidence for HIV/AIDS Interventions

First launched at the International AIDS Conference in Vienna in 2010, this groundbreaking resource is a comprehensive website documenting the evidence for effective HIV interventions. Spanning more than 2,000 articles and reports with data from more than 90 countries, What Works for Women and Girls contains—in one centralized, searchable location—the evidence of successful gender-specific programming from global programs and studies, with a focus on the Global South.

Having the evidence of what works is crucial for organizations working on the front line of the HIV/AIDS response. In Kenya, for example, the evidence has been essential for crafting national policies on gender-based violence and HIV prevention for women.

From Evidence to Action

As we celebrate the rich evidence base in What Works for Women and Girls, we must now focus on what this means for the implementation and scaling up of the HIV/AIDS response. How can we ensure that the evidence is applied correctly and consistently to ensure quality programs at scale? Are our programs and services addressing the underlying gender inequities that not only put women and girls at risk for HIV, but men and boys too? How will we use the evidence to inform sound public health policies and priorities?

Most importantly, how can we ensure that the available evidence helps us to maximize the benefits so that we can, finally, turn the tide against HIV/AIDS?

For the women and girls of Lesotho, and across the southern Africa, there is not a moment to lose.

Keeping Faith in Afghanistan

This post originally appeared on Foreign Policy.

Just over a decade ago, in January 2002, the world came together in Tokyo in the wake of the fall of the Taliban regime to pledge our common support for political, economic and social transition in Afghanistan.

We were well aware of the long-term nature of the commitment we were making, in line with the ancient Afghan proverb, “One flower will not make a spring.”

As key world leaders convene this weekend in Tokyo to reaffirm this commitment and keep faith with the Afghan people in advance of the draw-down of international combat forces, it is important to also reflect on the significant achievements made in Afghanistan over the past decade, especially for women and girls.

Afghan women today live an average of 15 years longer than they did a decade ago, thanks to dramatically increased access to health care, increased midwife assisted births, a tripling of gross domestic product per capita, and a large decline in the number of people living in extreme poverty.

Educational opportunities for women and girls have expanded dramatically: nearly 40 percent of students enrolled in schools are girls and 120,000 female students have graduated from secondary schools in the last five years alone.

About 40,000 young women are enrolled in public and private universities, with more enrolling each year.

Some observers are concerned that these achievements, will unravel with the departure of international combat forces and that these gains could be reversed.  But, the Afghan people – with our support – are not prepared to sacrifice the gains they have made, particularly by Afghan women, as they understand that no country can get ahead if it leaves half of its people behind.

Read the rest of this entry »

Chronic Crisis in the Sahel Calls for a New Approach

Originally published in the Huffington Post.

It is the lean season in the Sahel, a spine of arid and dry lands that runs from Senegal to Chad in western Africa, and once again we are seeing the devastating images of children gaunt with hunger. This is a region that faces high childhood malnutrition and underdevelopment even under the best of circumstances so one poor harvest can push millions of the most vulnerable into severe risk. In the aftermath of poor rains, and with food prices stubbornly stuck on high since the food crisis of 2008, some 18.7 million people across eight affected countries in the Sahel are at risk of food insecurity this year alone. At least 8 million people are already in need of emergency assistance.

At USAID, we are determined to get ahead of these kinds of chronic crises. We know that millions of Africans living in the dry lands of the Horn and Sahel regions need new solutions. Last year, the worst drought in 60 years ravaged the Horn of Africa, driving 13.3 million people into crisis. And this summer, families in the Sahel are feeling the peril of depleting food supplies, high food prices, and rising malnutrition.

We can’t prevent what appears to be increasing cycles of drought, but we can and are working to create better solutions and build greater resilience among the most vulnerable.

Every crisis is complex, and the Sahel is no exception. A regional drought has been overlaid with instability stemming from the coup in Mali and conflict in the northern part of that country where armed militant groups have forced the suspension of critical relief operations. More than 184,000 refugees have fled to communities in neighboring countries that are already deeply stressed from drought. Though still functioning, local and regional markets have been disrupted, driving food prices even higher. And as of mid-June, swarms of locusts from southern Algeria and Libya had arrived in northern Mali and Niger; now expected to move southward, these infestations could result in crop destruction exacerbating an already worsening situation.

In these cases of chronic crisis, recurring shocks erase development gains and set local populations back into urgent need over and over again. With many in the Sahel still struggling to recover from the region’s last food crisis in 2010, they now face a new crisis of food access. Borrowing money to buy food or the seeds to plant this rainy season has the farmers of Chad, Niger, Burkina Faso, and their neighbors incurring amounts of debt that are crippling, and a vicious cycle of suffering persists.

We cannot and should not accept this course as inevitable. Through smarter programming and a coordinated response, we can help make these recurring shocks less devastating. To this end and so that our relief work enables greater growth, we are committed to doing business differently in four key ways:

1. Early action in response to early warning: Last fall, thanks to early warning systems, we saw signs of the tough lean season ahead for the Sahel. USAID began committing food commodities as early as November and, in February, I traveled to Niger and Burkina Faso to assess the worsening situation and identify programs that work firsthand. As of July 1, 2012, more than 74,000 metric tons of food has arrived in the region out of a total of approximately 107,000 metric tons purchased, the rest of which will arrive in the next 30 to 45 days. This food will reach approximately 3.2 million people. The U.S. commitment to a strong humanitarian response and helping those in need remains unwavering.

2. A smarter, targeted and market-sensitive humanitarian response: We are determined to ensure our assistance is building resilience even as we save lives. Because food markets are still functioning in the Sahel — albeit at higher than normal prices — our cash-based programs allow vulnerable families and communities to access locally available food and basic goods in addition to our in-kind food aid. Through food vouchers, cash transfers, and temporary work opportunities, we support local markets and develop land reclamation and sustainable agriculture practices even while responding to acute needs now. In addition to including new food products and efforts to strengthen nutrition, our emergency programs are helping families keep livestock healthy and alive, as cows, sheep and goats are tantamount to savings accounts for many pastoralist families. And we are focused especially on women, as we know they are key to their families’ futures and to the health of their children.

3. More effectively connecting our relief and development programs: As we did in the Horn of Africa, we are bringing our relief and development teams together to identify ways to layer, integrate, and sequence programs with the goal of creating long term resilience. Later this month, I will return to the region to join colleagues in Dakar, Senegal who are leading our Sahel Joint Planning Cell (JPC), a comprehensive effort to connect our range of relief and development work in the field and in Washington to apply our humanitarian resources for the greatest good. Moreover, the JPC is working in lockstep with Feed the Future, President Obama’s landmark initiative to increase food security by battling the root causes of poverty and undernutrition through increased investments in agriculture-led economic growth.

4. Working in partnership with the international community to support effective country-led plans: At a recent high-level meeting with the EU Commission in Brussels, along with other donor governments, U.N. agencies, regional institutions, and humanitarian and development aid organizations, we reaffirmed our commitment to helping communities in the Sahel improve their ability to withstand future emergencies by forming the Global Alliance for Resilience Initiative-Sahel (AGIR-Sahel). This new partnership is linked to the Global Alliance for Action for Drought Resilience and Growth stood up together with international partners and African leaders in Nairobi this April with a focus on new country frameworks and mutual accountability.

The steps we are taking now are a direct result of the lessons we learned last year through our successful response to crisis in the Horn: that all tools must be applied in ways that are context-specific and cause no harm; that our impact multiplies tenfold when we work in close coordination with the international community and local leadership; and that to make the greatest difference, even during acute crisis, major donors from the humanitarian and development sectors must come together to identify causes of vulnerability to build resilience going forward.

Resilience programming can make a difference in the Sahel just as it has in the Horn. I have seen the effects firsthand in Burkina Faso, where USAID programs that have diversified livelihoods, introduced new seeds and highly nutritious crops, improved nutrition and increased access to water and irrigation have helped women farmers stand strong and feed their children even amidst drought.

With a total Fiscal Year 2012 commitment of more than $321.5 million in U.S. humanitarian assistance for drought-affected and conflict-displaced communities in the Sahel, we must use these resources in ways that both alleviate the dire situation at hand and lay the foundation for longstanding gains. Our mission to achieve real sustainable development — and millions of livelihoods — depends on it.

Ask the Celebrity: PSI Ambassador Mandy Moore on International Development Efforts

At the Frontiers in Development forum we had the opportunity to sit down back-stage with PSI Healthy Lives Ambassador and singer Mandy Moore and get her thoughts on international development. Below are our questions and her video answers. 

Q:”What would you tell young people that want to get involved in international development?” 

Singer Mandy Moore

 

Q: As a non-traditional figure in development, Mandy shares her insights on the best way to gain credibility from the broader international community.  We asked her, “How would you recommend other outside actors prepare themselves to engage development issues in an appropriate and responsible manner?” 

Mandy Moore

 

Q: How did you personally get involved with development, coming from a non-traditional background?

Mandy Moore

To see more questions and answers from our Frontiers in Development panelists, visit USAID’s Crowdhall page.

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