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Openly LGBTI and in Office: A Historic Election for Guatemala

USAID elections projects promote transgender rights with lessons learned from the region. / NDI

USAID elections projects promote transgender rights with lessons learned from the region. / NDI

In Guatemala’s recent elections, Sandra Morán became the first openly LGBTI member of the Guatemalan Congress. She hopes to use her position to advance human rights throughout the country.

“My promise is to all people,” she said. “Although most identify me as a feminist, I believe in rights for all. I am a lesbian and I live as that. I hope that the global fight for lesbian, gay, bisexual, transgender and intersex rights advances to a point where it transcends to the smallest towns and communities worldwide.”

Morán’s election is no light feat for Guatemala; a nationwide survey conducted by George Washington University in 2012 found that 74 percent of Guatemalans would not vote for an openly LGBTI candidate, making Morán’s win against the odds.

But the Sept. 6 elections embodied a spirit of change, reflecting a growing sentiment against problems within Guatemalan government and society. “The elections occurred in the context of a fight against corruption and traditional politics; my election to Congress is a representation of that,” Morán said.

LGBTI Inclusion in Guatemala’s 2015 Elections

Congresswoman Morán, who has participated in USAID’s Elections Project: More Inclusion, Less Violence roundtables, feels a sense of hope for the future of LGBTI community. “It is about creating visibility. I hope to be able to enact legislation that supports equal rights and creates public policy change for the LGBTI community. It is my hope that as the movement strengthens, the communities lagging behind can progress.”

A transgender woman votes in Guatemala’s 2015 elections. / Shannon Schissler, USAID

A transgender woman votes in Guatemala’s 2015 elections. / Shannon Schissler, USAID


Morán’s election to Congress, in addition to projects that foster dialogue, visibility and respect for the LGBTI community, are laying a foundation for inclusion and tolerance, promoting a more democratic future for Guatemala.

USAID’s project helped launch a “Get Out the Vote” campaign to ensure that the LGBTI community had the opportunity to vote.

In partnership with Guatemala’s Election Tribunal, the project organized an LGBTI voter registration day. More than 200 community members registered to vote, helping make this election one with the highest voter turnout in recent Guatemalan history.

The project also enlisted eight transgender women to participate as election observers – another first for Guatemala.

“It is impossible to become comfortable with what we don’t see, know or live personally,” said Eduardo Nunez, the Guatemala country director of the National Democratic Institute, as he underscored the importance of encouraging dialogue, civic engagement and participation for the LGBTI community.

Debby Linares Sandoval — a transgender woman, LGBTI activist and advisor on USAID’s project — said she was proud of the experience she shared with other LGBTI voters.

“In the hour I was there, I interacted with eight gay voters and three transgender voters,” she said. “None of the transgender voters got harassed about their identity. I think that’s a big step for electoral awareness and opening to the community – for me, that is the start of something positive.”

USAID has helped Guatemala’s Election Tribunal update election manuals and provide trainings to electoral officials on how to be sensitive to people whose appearances are not congruent with the birth name on their personal identification card.

In the past, if a woman came to vote with an ID card with a male name, her ability to vote would be jeopardized. Recent efforts, through institutional changes and promoting internal dialogues, seek to extend tolerance and respect to all people.

My fight as an activist is about giving people voices that do not have one,” said Debby. “It’s to provoke civil society and the government to give us the same opportunities as any other citizen, with respect.”

ABOUT THE AUTHOR

Alana Marsili is a strategic communications advisor in USAID’s Democracy, Rights, and Governance Office working on citizen security, youth political leadership and urban municipal governance. Follow her @AlanaMarsili.

What Does Water, Sanitation and Hygiene Have to Do With Nutrition? Everything.

Children watch as a woman and child practice hand washing in Mali. / WASHplus

Children watch as a woman and child practice hand washing in Mali. / WASHplus

In Yarou Plateau, a village in Mali, people used to use any open space for bathroom needs. You can imagine the consequences.

Flies could easily find fecal matter lying around, and from there land on food, spreading diseases like diarrhea and intestinal worms. Fecal matter in open areas also contaminated the groundwater, which villagers use for drinking and preparing food. In Yarou Plateau, frequent diarrhea was much too common among mothers and children.

This created a vicious cycle. Diarrhea can worsen malnutrition, and the undernourished already have weakened immune systems — making them more susceptible to intestinal infections and more severe episodes of diarrhea.

The situation in Yarou Plateau changed two years ago when the village’s chief, Hamidou Samakan, visited the neighboring village of Gouna. Gouna had transformed since Hamidou had last visited; it looked clean, with no noticeable feces and fewer flies. But it wasn’t just the pristine environment that impressed him. Hamidou noticed the villagers there appeared much healthier.

How did this happen? The people of Gouna had started sweeping their public spaces and building affordable latrines, and as a result fewer villagers were getting diarrhea and fewer children were malnourished. It was then that Hamidou decided to bring better sanitation to Yarou Plateau, too.

Men show onlookers an open toilet in Mali. / WASHplus

Men show onlookers an open toilet in Mali. / WASHplus

Holding up the village of Gouna as an example, Hamidou motivated the people of Yarou Plateau to improve the sanitation in their village. Now, after almost a year, the village has built over 60 latrines, and rehabilitated ones that had never been used.

Yarou Plateau is one of 180 villages supported by USAID’s WASHplus project in Mali, and more than 70 percent of them have been certified as free of open defecation. With access to a covered latrine and soap and water for handwashing in every household, villagers are noticing a drop in cases of diarrhea and fewer malnourished children.

To achieve this, WASHplus took a multi-sectoral approach. The project set out to work with communities in Mali not only to improve water, sanitation and hygiene (WASH) but also to reduce diarrheal diseases and malnutrition. Beyond building latrines, WASHplus works to change behaviors. In villages like Yarou Plateau, people are now using latrines, washing their hands, treating their drinking water, and preparing and storing food safely.

What is WASH? WASH is everything from handwashing with soap, to safely disposing of adult and child feces, to preparing and storing food safely.

Today, on World Toilet Day, WHO, UNICEF and USAID are releasing a jointly-produced document with guidelines on integrating WASH into nutrition programs in order to achieve positive gains in the fight against undernutrition.

The document, called Improving Nutrition Outcomes With Better Water, Sanitation and Hygiene: Practical Solutions for Policies and Programmes, details WASH practices that help improve nutrition and how they can be incorporated into programs focused solely on nutrition. This will springboard global efforts to integrate WASH intro nutrition programming, helping implementing partners and USAID achieve greater results.

By using WASH in programs that work across sectors to address malnutrition in all its forms, we can help reach the 2025 Global Nutrition Targets and the Sustainable Development Goals and work to end preventable child and maternal deaths.

Undernutrition is an underlying factor in almost half of all child deaths. Malnourishment significantly increases the risk of a child dying from diseases like pneumonia and diarrhea. When an unhealthy and unsanitary environment leads to frequent diarrhea or other diseases associated with unclean water, this can lead to loss of appetite, nutrients not being absorbed properly, and anemia.

Villagers like those in Yarou Plateau know first-hand how poor WASH practices can lead to undernutrition. USAID will continue to scale up nutrition and WASH  programs to reduce maternal and child deaths in places like Mali and around the world. This document shares best practices to integrate water, sanitation and hygiene practices into nutrition programs to ultimately create a healthier future and bring a higher quality of life to the developing world.

ABOUT THE AUTHOR

Merri Weinger is the Environmental Health Team Leader in USAID’s Bureau for Global Health.

Back in the Classroom: Displaced Students in Nigeria Find Education & Hope

Ikilima Shuib Chiroma teaches a class of adolescent girls on Sept. 21 in a non-formal education facility in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Ikilima Shuib Chiroma teaches a class of adolescent girls on Sept. 21 in a non-formal education facility in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Like most 10-year-old students, Dinah solves her math problems in the old-fashioned way—with her fingers. She counts to six and jots down the number.

For Dinah’s extended family, they are counting something entirely different—the months since the girl lost her mother during a raid by Boko Haram insurgents on her village in northern Nigeria.

After the vicious attack, the young girl eventually made it to a center for internally displaced persons. Dinah’s uncle drove from the city of Bauchi to bring her to his home.

Today, some seven months after the incident, Dinah is adjusting to a new school and a new future.

An insurgency has wreaked havoc on parts of Nigeria, forcing some 2.2 million people from their homes—one of the largest concentrations of internally displaced persons in Africa. Hundreds of thousands of school-aged children have been set adrift inside the country, ripped from their communities and their schools.

With the magnitude of the situation, USAID, state officials and NGOs stepped in with the Education Crisis Response program.

Launched in 2014, the goal of the program is to expand access to quality and protective non-formal education and alternative education opportunities for out-of-school children, ages 6 to 17, in three Nigerian states and reduce the burden on local schools already stretched thin by limited resources. It is implemented by Creative Associates International and the International Rescue Committee, along with local NGOs.

The project has established 294 non-formal learning centers that provide education, in-class meals and psycho-social services to the displaced children, says Ayo Oladini, director of the Education Crisis Response program.

Local facilitators identified and trained by the program use a government-approved curriculum to teach basic literacy, numeracy and life skills. The learning centers are housed in existing structures like schools or meeting houses that are made available by the local community.

The students attend class three days a week for at least two hours each day and are provided basic school materials.

Adolescent girls in a non-formal education class on Sept. 21 at a school in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Adolescent girls in a non-formal education class on Sept. 21 at a school in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Paving the way for mainstream education

State officials evaluating the non-formal learning centers say they are working.

“The type of education they do receive is a good one,” says Halilu Usman Rishi of Bauchi’s State Education Secretariat. “That is going to [pave the] way for them to mainstream to a formal system of education.”

The opportunity to return to class is life changing, especially for the many who have been displaced and out of school for years.

“For the kids who had forgotten most of what they have learned [and are] now coming back to a classroom — to say it is therapeutic is an understatement,” Oladini said. “It’s a thing of joy.”

Youth displaced by Boko Haram take part in a non-formal learning class in Gombe, Nigeria on Sept. 26 as part of USAID’s Education Crisis Response program. / David Snyder for USAID

Youth displaced by Boko Haram take part in a non-formal learning class in Gombe, Nigeria on Sept. 26 as part of USAID’s Education Crisis Response program. / David Snyder for USAID

Addressing psychosocial needs

And while education is the foundation of the program, children traumatized by conflict and upheaval can only learn when their fears are also addressed.

USAID responded to the psychological needs of the displaced children by incorporating a psychosocial approach to teaching. Facilitators are trained to teach in a student-friendly manner by incorporating group exercises and encouraging positive, interactive student-teacher relations. Working through local partner agencies, the program also encourages the local community to spread messages of peace.

“We make sure that we don’t create any more trauma, either for these children or within the community where they live,” Oladini explained. “We tell them ‘Look, the future is still there for you. You [may] have lost this, you [may] have lost that…but there is still hope for you.’”

Officials in Bauchi are embracing this strategy to help students deal with what has happened to them and their families.

“The program is, in fact, doing as much as possible to ensure that the children are associating with their friends in the learning centers,” says Bauchi’s Rishi. “Some of them used to tell us as we go around to discuss with them, that initially, they found it very difficult to associate with the other children. But as they interact so much with their friends in the learning centers, they forget thinking about such ugly happenings.”

Preparing for sustained success

Scheduled to phase out in 2017, the Education Crisis Response program is supported by Nigeria’s state and federal governments, which, Oladini said, will help ensure the long-term sustainability of the program.

From the outset, government education officials have been involved in every detail of program planning and worked with the program to identify communities, develop a teacher training manual and sit in on classes.

For every learning center, Education Crisis Response has also trained two local government education officials to serve as mentor teachers whose job is to work with the facilitators and provide feedback to teachers.

“From day one, we made sure [the government understood] that this is your program, it’s not our program,” Oladini said. “So from year one before the end of year two, they’ll be able to plan within their budget to see how they can scale up all these programs.”

And while government’s support of the Education Crisis Response program is essential, it is one part of an overall effort that also depends largely on the communities themselves.

“We’re letting them know that with or without parents, there is what we call ‘your own mindset’ – your own ability to move forward and persevere in a state of difficulty,” Oladini said. “This is what we are teaching them.”


Produced for USAID by Creative Associates International, with reporting by Michael J. Zamba and Ernest Akoma in Nigeria.

ABOUT THE AUTHOR

Michael J. Zamba is senior director of communications at Creative Associates International and David Snyder is a photographer and writer. Creative Associates International is implementing USAID’s Education Crisis Response program in northern Nigeria. Follow Creative @1977Creative.

Cote d’Ivoire Election to Mark Turning Point After Years of Healing From Conflict

Women sell their goods at a market in Duékoué, Côte d’Ivoire, on Sept. 30. USAID’s Office of Transition Initiatives helped strengthen dialogue and positive interaction between the market women after tensions between their different ethnic communities led them to minimally engage with each other. Read more here. / Kendra Helmer, USAID

Women sell their goods at a market in Duékoué, Côte d’Ivoire, on Sept. 30. USAID’s Office of Transition Initiatives helped strengthen dialogue and positive interaction between the market women after tensions between their different ethnic communities led them to minimally engage with each other. / Kendra Helmer, USAID

Today in Côte d’Ivoire, three in four people are under 35 years old, and many can’t find work.

After the last presidential election in 2010, violence erupted across this West African country. An estimated 3,000 people were killed, and hundreds of thousands were displaced. The youth were largely the instigators and victims of the violence, frustrated that neither presidential candidate would concede defeat.

For the young, the unemployed and discontent, elections matter.

Their vote in the upcoming presidential election Oct. 25 represents a new opportunity to participate peacefully in choosing the next leader. And a peaceful election can help ensure that economic growth and the promise of more jobs is realized.

I moved to Côte d’Ivoire to support post-conflict reconciliation through a program with USAID’s Office of Transition Initiatives. Over the past three years, I’ve seen how communities have addressed the trauma and reconciliation has begun to take hold.

The dark years

Côte d’Ivoire has a history of military coups, counter coups and political assassinations. For many years, the government provided few public services. In many areas, administrative clerks did not issue birth certificates or national identification cards, courts failed to punish criminals, and police officers could not guarantee safety and security on the streets.

After the 2010 post-election violence, President Gbagbo was captured and transferred to the International Criminal Court to stand trial for war crimes. His challenger, Alassane Ouattara, became the new president.

A stronger community

Ethnic and political division and fighting had torn neighborhoods apart, destroyed people’s sense of togetherness and instilled distrust and hatred. In response, USAID organized hundreds of activities, inviting every political, ethnic and social group in the targeted community to participate in sports tournaments, cultural festivals, community service events and public forums.

There was a strong emphasis on engaging youth, who took part in information campaigns with community leaders and in public discussions  to confront sources of recent community conflict and identify ways to overcome them.

As people began interacting together regularly and in positive ways, they recognized that conflict had affected every person at some level, which connected them to each other. People began confronting their collective suffering and loss. The healing process was set in motion.

A local elections official in Duékoué, Côte d’Ivoire, explains the tabulation of votes from a previous election. Ahead of next week's presidential election, USAID's Office of Transition Initiatives has implemented activities focused on capacity-building of electoral institutions, improved access to credible information, increased inter-community dialogue, and widespread community mobilization and engagement in the electoral process. / Kendra Helmer, USAID

A local elections official in Duékoué, Côte d’Ivoire, explains the tabulation of votes from a previous election. Ahead of next week’s presidential election, USAID’s Office of Transition Initiatives has implemented activities focused on capacity-building of electoral institutions, improved access to credible information, increased inter-community dialogue, and widespread community mobilization and engagement in the electoral process. / Kendra Helmer, USAID

A stronger government

During the crisis, the government had a limited presence across the country and provided few public services. To strengthen government services to marginalized communities, USAID has supported renovations of government buildings and facilitated roundtables to encourage community involvement. USAID’s support helped the new government demonstrate that it was helping Côte d’Ivoire recover from years of stagnation. The new government’s improved public image helped increase trust for Ivorians to move beyond the conflict.

The infrastructure has improved, as well. It used to take 30 minutes to travel 2 miles — due to restrictive security measures, traffic jams and crumbling infrastructure. Today, noticeable investments in roads and bridges and increased commercial activity from new boutiques and restaurants now creates a perception that Côte d’Ivoire is finally healing from the conflict.

A view of Abidjan, the economic capital of Côte d’Ivoire. The country, which accounts for 40 percent of West Africa’s economic activity, is a leading producer of cocoa, rubber, coffee, cashew and palm oil and serves as the home of the African Development Bank and many international companies. / Kendra Helmer, USAID

A view of Abidjan, the economic capital of Côte d’Ivoire. The country, which accounts for 40 percent of West Africa’s economic activity, is a leading producer of cocoa, rubber, coffee, cashew and palm oil and serves as the home of the African Development Bank and many international companies. / Kendra Helmer, USAID

A stronger economy

As the country moved beyond the conflict, the economy quickly rebounded from economic decline. It now ranks among the top 10 fastest growing economies in the world — with 9 percent annual growth.

As a leading producer of cocoa, rubber, coffee, cashew and palm oil, as well as serving as the home of the African Development Bank and many international companies, Côte d’Ivoire accounts for 40 percent of West Africa’s economic activity.

The potential here is enormous, and there is no better place than Abidjan to observe the economic explosion. Towering modern hotels, luxury shopping centers and shiny banks are mushrooming throughout the pulsating metropolis. New roads and an expansive bridge spanning the lagoon have opened to provide vital links across the city.

Women in Duékoué, Côte d’Ivoire, ask the mayor about the upcoming elections and other issues during a meeting Sept. 30. USAID’s Office of Transition Initiatives is supporting social cohesion activities, including the coalition of area women to strengthen dialogue and positive interaction between women from different ethnic communities. / Kendra Helmer, USAID

Women in Duékoué, Côte d’Ivoire, ask the mayor about the upcoming elections and other issues during a meeting Sept. 30. USAID’s Office of Transition Initiatives is supporting social cohesion activities, including the coalition of area women to strengthen dialogue and positive interaction between women from different ethnic communities. / Kendra Helmer, USAID

Stronger security

Security reforms and increased community resilience have helped Côte d’Ivoire build a protective buffer. Using its community-based approach, USAID partnered with opposing groups, including ex-combatants, at-risk youth, women’s associations, and administrative and traditional leaders to overcome their differences and work together to re-establish social and political ties.

In a region increasingly threatened by terrorism, the country offers a strong contrast. Terrorist organizations like Boko Haram and the Islamic State are not gaining ground in Côte d’Ivoire. Strong community networks in addition to the nationally-focused security measures will help reduce the outside influence of violent extremist organizations.


This month’s vote is a critical turning point. Peaceful elections will show the world that Ivorians, young and old, have moved beyond the conflict and division of the previous decades. They will also serve as a reminder across Africa that international support for peaceful transitions is important for development and prosperity.

As for the youth, they understand that they are powerful change agents among their peers and the wider general public. With USAID support, they are becoming actively engaged in a peaceful electoral process to ensure their prominent place in their country’s future.

ABOUT THE AUTHOR

Mark David Emmert is the country representative for USAID’s Office of Transition Initiatives in Côte d’Ivoire.

Q&A: How Power Africa is Investing in a Brighter Planet

The energy sector is the world’s largest source of carbon pollution – yet two out of three people in sub Saharan Africa lack access to electricity.  Power Africa – a partnership among African governments, the U.S. Government, the private sector, and the donor community – aims to double access to electricity in sub Saharan Africa.  Building cleaner, more climate-resilient power sectors that serve all people will require the inclusion and participation of all stakeholders – including those that have traditionally been sidelined from the energy industry.

In Africa alone, about 60 million homes and businesses are poised to access power for the first time in the coming years. President Obama launched Power Africa in 2013 to meet this need. On World Energy Day and every day, Power Africa is working to bring more affordable, reliable, sustainable and modern forms of energy to users once reliant on kerosene, diesel and disposable batteries.

In working toward the newly established Sustainable Development Goal on energy, Power Africa and USAID are ahead of the curve by pushing forward new models of development for clean energy. Our teams of experts on the ground are working to establish a better “enabling environment” where the legal, regulatory and financial frameworks clear the path for the energy sector to meet the demands of all customers.

In an interview, Power Africa Coordinator Andrew M. Herscowitz shares some insight into how we’re empowering the next generation of energy consumers.

 

Herscowitz_IMG_3295C_PAdams EWhat have been Power Africa’s greatest accomplishments since President Obama established the initiative two years ago?
Power Africa has become a global effort and has helped over 4,100 megawatts (MWs) of transactions reach financial close since 2013.

In a two-year period that’s an important accomplishment. Around the world, and even in the United States, it can take up to a decade for an energy project to be completed. With our African partners leading the way, we’re helping to reduce the legal, financial, and regulatory barriers that for too long have stood in the way of projects moving forward.

In August of 2014 President Obama tripled Power Africa’s goals 10,000 MW and 20 million connections to 30,000 MW and 60 million connections. More importantly though, the collaboration now includes more than 100 private sector partners.

How does Power Africa promote our mission of ending extreme poverty? How does this way of doing business reflect USAID’s new model of development?
Access to electricity is a critical part of ending extreme poverty around the world. The 600 million people in Africa who are “off-grid” spend a significant portion of their household income on kerosene for lighting, batteries for radios and paying someone to charge their mobile phone. This expenditure traps them in poverty by limiting their ability to invest in education and economic opportunities.

Power Africa is working with the private sector to deploy large scale electricity projects that will help expand grid connections, as well as with our Beyond the Grid partners, who are using innovative technologies and business models to provide electricity services in areas that are far from the grid. Instead of directly financing these projects and businesses, Power Africa encourages investment by offering loans, insurance and technical support.

Can you talk about a community that you visited that has been impacted by Power Africa?
A few months ago I visited East Africa’s largest grid-connected solar project east of Kigali, Rwanda. Built by Gigawatt Global, the 8.5 MW solar project was built on the same land as the Agahozo Shalom Youth Village, a home for orphans of Rwanda’s genocide. In addition to producing clean energy, the project also provides employment opportunities. Not only is this new model adding vibrancy to the local community, but also increasing Rwanda’s power generation capacity by 6 percent.

Partnerships play an important role in the success of Power Africa. Can you speak to the role of partnerships in development more generally?
To tackle the world’s biggest challenges, the world’s leading problem solvers need to work together. As the world addresses global challenges, partnerships across all sectors will be required to pull together in new ways. Our partners bring their expertise, capital, and the commitment to solving Africa’s energy crisis.

In addition to carrying the collective resources of the U.S. Government, Power Africa is achieving success by partnering public partners including the World Bank, the African Development Bank, the Government of Sweden, the European Union, the African Union, and the United Nations’ Sustainable Energy. These public sector partners bring an additional $11.8 billion in resources to support Power Africa’s goals; this includes the African Development Bank ($3B), the World Bank Group ($5B), the Swedish Government ($1B) and the European Union ($2.8B).

With nearly $31 billion in private-sector commitments from more than 100 Power Africa private sector stakeholders, the program is making a visible difference in the lives of people who are on and off the grid.

Looking towards 2030, the target date for achieving the recently adopted Sustainable Development Goals, how do you think financing for development will evolve?
Over the next 15 years we hope that the private sector’s investment in emerging and developing markets will become even more commonplace.”Development financing” may not even be required. With that hope in mind, Power Africa is focused on not only supporting private companies, but also working with governments to create an enabling environment that will encourage sustained investment and growth.

Pooja Singhi, an intern with USAID’s Bureau for Legislative and Public Affairs, contributed to this blog.

Andrew M. Herscowitz is the Coordinator of President Obama’s Power Africa initiative.  Follow him @aherscowitz and use #PowerAfrica to join the conversation.

Saving Mothers, Giving Life

The Chikomeni Rural Health Centre in eastern Zambia offers Basic Emergency Obstetrics and Newborn Care services to its clients. / Anne Jennings, Rabin Martin.

The Chikomeni Rural Health Centre in eastern Zambia offers Basic Emergency Obstetrics and Newborn Care services to its clients. / Anne Jennings, Rabin Martin.

For the staff at the Matanda Rural Health Center in northern Zambia, help during emergencies was hard to find. The nearest hospital is 60 kilometers away—40 of them over a rough gravel road. Lacking a cell tower, health center staff would walk or ride 27 kilometers in order to call for an ambulance. Until recently, nurse Esther Kabaye was the center’s only clinician; she treated women in the region when complications arose during pregnancy.

Through Saving Mothers, Giving Life, a public-private partnership launched in 2012, Kabaye began a mentorship program in which she met once a month with a district mentor, developing the necessary skills and knowledge for emergency obstetric and neonatal care.

These efforts were rewarded after only a few months, when Helen, a 35-year-old woman from a nearby village, was brought to the health center in labor. She successfully delivered a healthy baby, but afterwards began bleeding heavily. Kabaye identified the emergency as a postpartum hemorrhage, and promptly performed a bimanual compression of the uterus, saving Helen’s life.

“I am so happy that I am able to effectively handle emergencies and save lives that would have been lost,” Kabaye said. She now teaches other nurses, amplifying the lifesaving impact that she has had on her own community and others nearby.

Stories like Kabaye’s are not uncommon within Saving Mothers, Giving Life districts. USAID is a founding member of the partnership, launched in 2012 by then Secretary of State Hillary Clinton as an innovative, integrated approach to health systems. Saving Mothers, Giving Life seeks to reduce maternal and newborn mortality by increasing the demand for services, facilitating access to lifesaving care, and strengthening health systems at the district level.

The initiative is supported by a range of partners, including the governments of Uganda, Zambia, the United States and Norway; Merck for Mothers; Every Mother Counts; Project C.U.R.E.; and the American College of Obstetricians and Gynecologists.

Target districts in Uganda (left) and Zambia. High levels of success during Phase 1 (June 2012-June 2013) led to the expansion of the program during Phase 2. Mid-Initiative results show even greater improvements in maternal mortality during Phase 2. / Saving Mothers, Giving Life

Target districts in Uganda (left) and Zambia. High levels of success during Phase 1 (June 2012-June 2013) led to the expansion of the program during Phase 2. Mid-Initiative results show even greater improvements in maternal mortality during Phase 2. / Saving Mothers, Giving Life

Initially implemented in four districts each in Uganda and Zambia, Saving Mothers, Giving Life emphasizes adequate and timely care for pregnant women and new mothers. The initiative focuses on three primary delays to lifesaving maternal care: the delay in seeking services, reaching services, and receiving high-quality care. The initiative generated astounding results: The target facilities in both Uganda and Zambia saw a 35 percent drop in maternal mortality in a single year.

Based on such astonishing success, the program was expanded in 2014 to an additional 12 districts in Zambia, and another 6 districts in Uganda. This week, I am excited to share the continued success of the initiative with our 2015 Mid-Initiative Report.

In Uganda, the institutional maternal mortality rate has fallen by 45 percent since the beginning of the initiative. This reflects a 30 percent increase in the rate of delivery in facilities that provide emergency obstetric and newborn care. Such inspiring results are not limited to health facilities, however: Across the target districts as a whole, maternal deaths have decreased by 41 percent—not just among women who delivered in a facility, but among the districts’ entire population

Women queue up for health services at the Chikomeni Rural Health Centre in eastern Zambia. / Anne Jennings, Rabin Martin.

Women queue up for health services at the Chikomeni Rural Health Centre in eastern Zambia. / Anne Jennings, Rabin Martin.

In Uganda’s Kabarole District, District Health Officer Dr. Richard Mugahi faced a challenge. “We had enough midwives and equipment, but mothers were not delivering in facilities,” he says. “They preferred delivering with the support of traditional birth attendants.”

With the support of Saving Mothers, Giving Life, the Kabarole District established a Demand Creation Committee to encourage women to take advantage of family planning services, prenatal care visits, and health facility deliveries. The Kabarole District has also used radio broadcasts to educate communities about the risks of giving birth at home and encourage them to give birth in a facility. The initiative is community-owned, sustainable in the long term, and—most importantly—effective.

The results from Zambia are equally as encouraging. Since the launch of Saving Mothers, Giving Life, institutional maternal mortality has fallen by 53 percent in the target districts. Nearly 90 percent of women are now giving birth in a facility, compared to 63 percent at the outset of the initiative. And the number of women who have received treatment to prevent the spread of HIV/AIDS to their infants has increased by 81 percent.

Mwasemphangwe Zonal Rural Health Centre in Zambia offers Basic Emergency Obstetrics and Newborn Care services to its clients. / Anne Jennings, Rabin Martin.

Mwasemphangwe Zonal Rural Health Centre in Zambia offers Basic Emergency Obstetrics and Newborn Care services to its clients. / Anne Jennings, Rabin Martin.

These results are heartening. They speak to the success of the approach employed through Saving Mothers, Giving Life that revolves around localized, evidence-based interventions. Efforts at the district level strengthen districts’ health systems as a whole, while community-level interventions generate demand for services among women and their families by changing social norms. The initiative is active in two dozen districts across Uganda and Zambia, with expansions underway in additional districts, as well as in Nigeria.

Yet perhaps even more encouraging is the potential that Saving Mothers, Giving Life has to extend far beyond the borders of Uganda, Zambia and Nigeria. The approach has proven to be successful, and is continuously fine-tuned and developed through extensive monitoring and feedback. The organizing principles employed by Saving Mothers, Giving Life can serve as an example to countries across the globe, who can adapt the model for use in their own communities.

The partnership has brought together the diverse strengths of a variety of organizations, contributing substantially to the mission to end preventable child and maternal deaths within a generation. Saving Mothers, Giving Life has amazed and inspired me over the past two and a half years that I have directed the Secretariat, and I am excited to see what we are able to accomplish in two and a half more.

ABOUT THE AUTHOR

Claudia Morrissey Conlon is USAID’s Senior Maternal and Newborn Health Advisor and the U.S. Government lead for Saving Mothers, Giving Life.

Bracing for El Niño: How USAID is Helping Countries Prepare and Respond

Our oceans, atmosphere and land are intricately connected. When the balance of one changes, it affects the others.

El Niño is a naturally occurring global phenomenon in which the tropical Pacific Ocean warms up more than usual. When this happens, precipitation, temperature and wind patterns can change. This year’s El Niño is predicted to be a strong event, triggering floods, drought, and fires in some countries while also affecting the path and number of tropical cyclones. It also has the potential to drive people from their homes, hurt their ability to earn an income, trigger food shortages, and increase or exacerbate vulnerability to other disasters.

This map illustrates an average range of meteorological impacts caused by El Niño based on historical data. It also shows damages caused by the two most recent El Niño events. / USAID/OFDA

This map illustrates an average range of meteorological impacts caused by El Niño based on historical data. It also shows damages caused by the two most recent El Niño events. / USAID/OFDA

Even without El Niño, disasters take a heavy toll. In 2014 alone, natural disasters took the lives of more than 18,000 people, affected nearly 107 million others, and caused $97 billion in economic damages. But we are not resigned to let Mother Nature take its course.  Today, on the International Day for Disaster Reduction, we focus on how USAID is working with partners and communities to prepare for the shocks of extreme weather and other natural hazards.

El Niño is expected to deliver a wet wallop to some parts of the world, triggering more tropical storms, monsoon rains, flooding and landslides. / Ye Aung Thu, AFP

El Niño is expected to deliver a wet wallop to some parts of the world, triggering more tropical storms, monsoon rains, flooding and landslides. / Ye Aung Thu, AFP

Disaster Risk Reduction

Disaster risk reduction is everything that we do to prevent or reduce the loss of life and damage caused by natural hazards like earthquakes, floods, droughts and storms. Recognizing the need to increase these efforts, nearly 170 countries adopted the Hyogo Framework for Action in 2005, a 10-year framework to make the world safer from natural hazards.

With the framework set to expire this year, the international community—including a delegation from USAID—gathered in March for the Third UN World Conference on Disaster Risk Reduction to reflect on the progress made over the last decade and, more importantly, to focus on what remains to be done to address shifting needs. At this conference, the Sendai Framework for Disaster Risk Reduction was adopted, showing the world’s continued dedication to reducing the impacts of natural disasters.

Building Resilience

Through the Office of U.S. Foreign Disaster Assistance (OFDA), USAID responds to an average of 65 disasters in 50 countries each year. In just the past 10 years, we’ve responded to the 2010 Haiti earthquake, super typhoons in the Philippines, avalanches and hurricanes across Latin America, large-scale flooding in Asia, and the 2015 earthquake in Nepal.

In Ethiopia, where drought and famine affect more people than any other type of disaster, USAID works to build the resilience of pastoral communities by providing emergency feed to sustain livestock, animal vaccinations to avert disease, and opportunities for farmers to diversify their income. / Kelly Lynch, Mercy Corps

In Ethiopia, where drought and famine affect more people than any other type of disaster, USAID works to build the resilience of pastoral communities by providing emergency feed to sustain livestock, animal vaccinations to avert disease, and opportunities for farmers to diversify their income. / Kelly Lynch, Mercy Corps

But we don’t just respond to disasters. Since 1989, OFDA has worked with 130 countries to strengthen their ability to deal with weather-related hazards, including those caused by El Niño.

We do this by strengthening early warning systems and preparedness, like in Latin America; integrating disaster risk reduction with disaster response, as we did in Bangladesh; providing training such as improved farming methods in Afghanistan to help people withstand future disasters; and helping build resilience to the effects of climate change, as in Vietnam and Mozambique.

This year, we are also helping countries before, and during, El Niño to better prepare for the shocks of adverse weather and respond to people in need.

Responding to El Niño in Papua New Guinea

El Niño has already caused Papua New Guinea to be hit with both drought and frost, which damaged the country’s main sweet potato crop. USAID worked to get farmers back on their feet and help communities cope with drought. / Ben Hemingway, USAID/OFDA

El Niño has already caused Papua New Guinea to be hit with both drought and frost, which damaged the country’s main sweet potato crop. USAID worked to get farmers back on their feet and help communities cope with drought. / Ben Hemingway, USAID/OFDA

In Papua New Guinea, El Niño has already begun to wreak havoc, bringing widespread drought that is causing a shortage in safe drinking water and plaguing crops—affecting an estimated 1.8 million people. To make matters worse, in August 2015, frosts descended upon Papua New Guinea, quickly killing much of the country’s staple sweet potato crop and leaving many rural villages to face food and income shortages. In response, USAID is working with the International Organization for Migration to provide agricultural training to farmers, as well as technical support to communities to help them cope with drought.

With each disaster, development gains are threatened as infrastructure is destroyed, poverty increases, and economic opportunities are interrupted or lost. Given this year’s El Niño predictions, focusing on reducing the impacts of natural disasters has never been more important.

ABOUT THE AUTHOR

Sezin Tokar is a Hydrometeorological Hazards Adviser with USAID’s Office of U.S. Foreign Disaster Assistance.

USAID Salutes Nobel Laureates Whose Discoveries Help Fight Malaria, River Blindness, Elephantiasis

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This year’s Nobel laureates in medicine developed therapies that revolutionized the treatment of some of the most devastating diseases caused by parasites.

On Monday, William Campbell and Satoshi Ōmura were cited for their discovery of the drug Avermectin, the derivatives of which have radically lowered the incidence of river blindness and elephantiasis. And Youyou Tu was rewarded for her research on malaria therapy. USAID relies on these medicines to protect millions of people at risk.

Parasitic worms afflict one-third of the world’s population, causing diseases like river blindness and elephantiasis. Before the development and widespread use of the avermectin-derivative ivermectin, river blindness left whole communities in Africa blind from the disease. Adults would be led around by children holding a stick. Agricultural productivity and development were at a standstill. Decades later, these communities are thriving agricultural centers, and children are in school instead of caring for the blind.

A child leads two individuals blinded by the parasite that causes river blindness through a village. / Bill VanderDecker

A child leads two individuals blinded by the parasite that causes river blindness through a village. / Bill VanderDecker

USAID’s neglected tropical diseases (NTD) program targets both river blindness and elephantiasis, as well as other diseases. Each year we distribute ivermectin, the drug used to treat river blindness, to more than 25 million people.

Since 2006, USAID has supported the delivery of more than 1 billion preventive drug treatments for NTDs – to almost a half a billion people. The neglected diseases team also manages the largest public-private partnership in USAID’s history, having secured more than $8 billion in drug donations to date. We estimate that for every tax dollar spent by USAID, more than $26 in drugs is donated in-country.

Inspired by a description in a 1,700-year-old Chinese text of the use of sweet wormwood to combat fever, it was Tu who discovered artemisinin. ​This medicine remains the most effective treatment for malaria today, saving millions of lives.

The parasite responsible for the most lethal human malaria started to resist the drug chloroquine in South America and Southeast Asia in the late 1950s and early 1960s. By the late 1960s, efforts to eradicate malaria had failed and the disease was on the rise.

At that time, Tu turned to traditional herbal medicine to find novel malaria therapies. In China, the qinghaosu plant was used in fever remedies for thousands of years. Tu examined 2,000 recipes for traditional Chinese remedies and discovered one derived from sweet wormwood (Artemisia annua) reduced malaria parasites in the blood.

USAID has been fighting malaria since the 1950s, helping develop the tools relied on today. For example, USAID funded trials showing that mosquito nets, treated with safe insecticide, were effective in significantly reducing child deaths and preventing malaria in pregnancy.

Habiba Suleiman, 29, a district malaria surveillance officer in Zanzibar, naps with her little girl Rahma under a mosquito net. She lives in Tanzania, where up to 80,000 people die from malaria each year. Hariba is working to change that. Read her story on USAID’s storytelling hub. / Morgana Wingard, USAID

Habiba Suleiman, 29, a district malaria surveillance officer in Zanzibar, naps with her little girl Rahma under a mosquito net. She lives in Tanzania, where up to 80,000 people die from malaria each year. Hariba is working to change that. Read her story on USAID’s storytelling hub. / Morgana Wingard, USAID

The U.S. President’s Malaria Initiative (PMI), launched in 2005, represents the U.S. Government’s bilateral commitment to massively scaling up proven malaria prevention and control efforts. Led by USAID, PMI has advanced game-changing innovations, like insecticide-treated mosquito nets and more effective drugs.

Through PMI, USAID funds operational research to improve uptake and scale of interventions, to preserve intervention effectiveness in the face of both drug and insecticide resistance, and to respond to changes in malaria epidemiology.

More than 6 million deaths have been averted, primarily among children under 5 in sub-Saharan Africa through the expansion of malaria control efforts by affected countries — with the support of PMI and other key partners.

This success would not have been achieved without access to high quality malaria treatments, diagnostics, and tools like bed nets and indoor spraying to kill or repel malaria carrying mosquitoes. Since the initiative began, PMI has purchased more than 318 million quality-assured artemisinin combination therapies, as well as more than 174 million rapid diagnostic tests to support appropriate malaria case management.

The financial and technical contributions of the U.S. Government are a major catalyst in the remarkable progress that has been achieved in many countries to reduce the devastating burden of parasitic worms and malaria. But the work is far from complete.

More than 1 billion people suffer from one or more NTDs. Almost all are poor who live in rural areas and urban slums of low-income countries. Nearly half a million people still die each year from malaria. When children fall ill, students miss school, and adults stop working and are unable to provide for their families.

We admire Campbell, Ōmura and Tu for their inspiration and celebrate their discoveries that helped mankind.

ABOUT THE AUTHOR

Chris Thomas is a communications advisor in the Bureau for Global Health.

Countering Violent Extremism Through Development

Richard Bernardo, 18, from conflict-affected Mindanao, Philippines, now works at an automotive shop in Zamboanga City after completing a two-month course offered by USAID for out-of-school youth in the region. USAID/Philippines provides skills trainings for out-of-school youth in Mindanao to help them gain access to income opportunities. / Rojessa Tiamson-Saceda, EQuALLS2 Project

Richard Bernardo, 18, from conflict-affected Mindanao, Philippines, now works at an automotive shop in Zamboanga City after completing a two-month course offered by USAID for out-of-school youth in the region. USAID/Philippines provides skills trainings for out-of-school youth in Mindanao to help them gain access to income opportunities. / Rojessa Tiamson-Saceda, EQuALLS2 Project

Where does the fight against violent extremism fit within the broad spectrum of development?

USAID’s mission – to end extreme poverty and promote resilient, democratic societies while advancing our security and prosperity – outlines the answer.

It is through USAID’s approach to development that we can prevent the underlying causes of discontent from turning into radicalization. It is this inclusive approach that also drives our commitment to advancing the Global Goals.

Over half of U.S. foreign assistance goes to countries in the midst of conflict, or trying to prevent conflict or state failure. While we have made remarkable gains, the scourge of violent extremism undermines the work we and our partners are doing.

Violent extremism impedes growth by discouraging long-term investment – not only by international corporations, but by local entrepreneurs who hesitate before setting up shop in a market or fear investing in inventory.

Violent extremists’ actions tax health systems, overcrowd hospitals, create refugees and displace people from their homes. Responding to attacks consumes government services and resources, stymieing development.

This is why we must focus more effort on preventing the growth of violent extremism before it starts.

Addressing the root causes of violent extremism successfully starts by resolving issues at the community level. While each case is different, our experience indicates it is often a combination of social and economic marginalization, unaccountable governance, and inadequate institutions, among other push factors, that are at the root of extremism.

A generation in northern Uganda lost touch with the environment during years of conflict. Children grew up in crowded IDP camps knowing little about the lands around them. USAID and the Wildlife Conservation Society are advising officials on how to bring back the wild. Koch Lii School, once used by rebels as a base, now has a Wildlife Club where students learn to perform drama on subjects related to biodiversity. / Julie Larsen Maher, Wildlife Conservation Society

A generation in northern Uganda lost touch with the environment during years of conflict. Children grew up in crowded IDP camps knowing little about the lands around them. USAID and the Wildlife Conservation Society are advising officials on how to bring back the wild. Koch Lii School, once used by rebels as a base, now has a Wildlife Club where students learn to perform drama on subjects related to biodiversity. / Julie Larsen Maher, Wildlife Conservation Society

These issues are also at the heart of what impedes economic growth. These grievances create opportunities for pulling forces that draw vulnerable people into the compelling, but ultimately empty, narratives of violent extremism.

Recognizing this, USAID developed its 2011 policy The Development Response to Violent Extremism and Insurgency to help guide the use of our tools effectively, and balance our broader development objectives with these security priorities. It affirms the necessity of identifying and addressing drivers of extremism, while remaining flexible and locally focused.

USAID manages programs that specifically address drivers of violent extremism in Africa, the Middle East and Asia. These programs are working in coordination and often through local and national governments, the private sector and NGOs to address issues of exclusion and injustice. These partnerships enhance USAID’s traditional development tools to address the drivers of extremism before they metastasize into a much larger problem.

Tomorrow’s event at the United Nations on balancing security and development will explore how USAID and like-minded partners can partner to prevent violent extremism. Development professionals care about violent extremism, and those on the security side recognize that development tools and expertise are needed to succeed against violent extremists.

We are confident that we can work together and make progress in key areas.  Already, we are making progress on a foundational step: understanding the local drivers of violent extremism and what works to address them.

A new network to support research focused on these issues, RESOLVE, was launched just last week and is supported through a partnership between USAID, the State Department and the U.S. Institute of Peace. Other efforts, like guidelines for good practices on gender and countering violent extremism by the Global Counterterrorism Forum, create operational approaches for local partnership.

As Secretary Kerry called for in the Quadrennial Diplomacy and Development Review, we have to get ahead of the next ISIL. Development that reduces the allure of violent extremist groups has immeasurable payoffs, both in terms of making us more secure and by ensuring we reach our ambitious Global Goals targets by 2030.

ABOUT THE AUTHOR

Russell Porter is Executive Director for the Secretariat for Countering Violent Extremism at USAID.

Change and Transformation @USAID: Modernizing Development Assistance

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Larwanou Mahamane, a vegetation ecologist, presents aerial imagery of the Ader-Doutchi region of Niger to community members of Laba under a USAID–U.S. Geological Survey partnership. Sustainable land management practices help mitigate the impacts of climate change. / Gray Tappan, USGS, Earth Resources Observation and Science Center

This is the perfect year to solidify a transformation in foreign aid. As world leaders nail down the Sustainable Development Goals, it is a key moment to underline the global consensus around strategies for progress. It will help ensure the international community permanently modernizes its approach to development.

Fall 2015 presents myriad opportunities to spotlight encouraging efforts. The June Financing for Development conference in Addis Ababa created a foundation that will be reinforced this month at the United Nations General Assembly in New York, where world leaders will adopt the 2030 Agenda for Sustainable Development that outlines a vision for ending extreme poverty and promoting sustainable development.

Declarations from those summits will be complemented by outcomes from climate change negotiations to be held in Paris in December, as well as other important deliberations focused on key topics such as countering violent extremism and promoting gender equality.

So what promising changes should be spotlighted?

Data

Increasingly, data is driving planning and decision-making. The growth in results-based management helps ensure we invest wisely, discuss accomplishments concretely and constantly learn and refine our efforts. USAID is benefitting enormously from its enhanced ability to quantify and discuss, for example, the number of farmers whose incomes have increased as a result of Feed the Future.

We are striving to collect better data across a range of sectors, including health and agriculture, and to make that data more widely available. We also increasingly use data to better oversee operations. (And we are part of a wave of donors employing data to close gaps in information.)

USAID and NASA are working together to use satellite data in forecasting severe weather and natural disasters; lives are being saved because we can now chart floods and wildfires, and better predict drought and landslides.

Our Development Credit Authority, which has unlocked over $3 billion of private capital in over 70 countries, has improved how it tracks over 140,000 borrowers to better target and enhance USAID investments improving health care, food security and infrastructure, among various sectors. And internally, the USAID leadership team now uses a management system to ensure and track progress against specific management priorities and targets.

The push for evidence must continue and it must be complemented by a drive to ensure data is fully analyzed, used and disseminated. That’s the only way development agencies will truly become learning institutions where decisions are consistently well-informed and where gaps in knowledge are ever-smaller barriers to progress.

New Partners

Today, an exciting range of new partners and funders drive development efforts around the world. This comes at a time when funding from foreign direct investment outpaces traditional bilateral donor assistance to developing countries and domestic revenues in developing economies are increasing by an average of 14 percent per year.

The potential is huge. Last year alone, USAID started working with 450 new government agencies, private firms, foundations and other NGOs. Those partnerships leverage hundreds of millions of dollars in resources each year.

The relationships bring tremendous new energy, ideas and funding. They help the global community align work and target investments. And they close gaps in financing to meet priority needs. Three new broad partnerships announced during Financing for Development — the Addis Tax Initiative, Global Financing Facility and the Sustainable Development Investment Partnership — are emblematic of the potential for collaboration and alignment. They may prove models for the future.

Innovation

Jharana Kumari Tharu, a female community health volunteer in Nepal, demonstrates how a simple tube of chlorhexidine antiseptic gel could help prevent infection and even death when applied to a baby’s cut umbilical cord stump. / Thomas Cristofoletti, USAID

Jharana Kumari Tharu, a female community health volunteer in Nepal, demonstrates how a simple tube of chlorhexidine antiseptic gel could help prevent infection and even death when applied to a baby’s cut umbilical cord stump. / Thomas Cristofoletti, USAID

There is also enormous potential to harness innovation, science and technological advances for development. USAID christened its Global Development Lab last year. The Agency is having noteworthy success reducing neonatal mortality in Nepal using chlorhexidine, an umbilical cord antiseptic. Crop yields in Africa are increasing substantially as a result of the development and distribution of drought-tolerant maize. And efforts to promote mobile banking are improving transparency and governance, and increasing the accessibility of financial services globally.

Continuing to encourage and invest in innovation offers enormous potential for reducing poverty, but science and technologies will only deliver fully on their promise if they are rolled out in locally appropriate ways and they reach millions, especially the marginalized and vulnerable groups who are often left behind.

Game-changing technologies will also have to be developed and deployed with just-as-smart strategies that minimize risk—and sharpen recognition that all investments will not bear fruit. The possibility of under-performance should not stifle innovation.

Taken together, these trends embody a promising foundation. But a cautionary note is warranted. None of the strategies emerging from the conversations this year will enable us to end extreme poverty, unless they consider our ever-changing world. Quite simply, the targets we all hope to achieve won’t stand still while we come up with solutions.

Today, many of the world’s extreme poor are living in unstable nations often dealing with prolonged, profound crises. Development efforts are increasingly concentrated in these environments made fragile from conflict, extremist threats, recurrent natural disasters or climatic shifts. Unless we factor in these threats, reductions in poverty will be fleeting.

William Gibson is credited with saying, “The future is already here; it’s just not evenly distributed.” Nowhere is this truer that in the field of development aid. Promising changes in the approach to assistance offer enormous potential for widespread success.

As heads of state convene, donors must ensure we carry forward the transformation of foreign aid so that it delivers broadly, enabling us to meet the goals we are setting for 2030.

ABOUT THE AUTHOR

Carla Koppell is USAID’s Chief Strategy Officer. You can follow her @CarlaKoppell.
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