New video from last month’s Feed the Future: Partnering with Civil Society event featuring Secretary of State Hillary Clinton, President Joyce Banda of Malawi, and journalist Nicholas Kristof.
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At USAID, transparency is an important part of our commitment to achieving sustainable development results and to doing business well. It is a core tenet of who we are as an Agency rather than a set of actions and ensures that we are good stewards of taxpayers’ dollars.
Last week, I had the opportunity to discuss this Administration’s commitment to transparency on a panel with Gayle Smith, special assistant to the President and senior director at the National Security Council; Robert Goldberg, director of Foreign Assistance at the State Department; Sheila Herrling, vice president for Policy and Evaluation; David Hall-Matthews, managing director of Publish What You Fund; and Paul O’Brien, vice president of Oxfam America. The event, hosted by Publish What You Fund and ONE, featured the launch of Publish What You Fund’s informative and authoritative Aid Transparency Index 2012. The Administration welcomes civil society efforts to monitor foreign aid progress on transparency and hopes that the index will continue to expand as more non-governmental organizations make their aid data available.
Along with our inter-agency partners, USAID has been pursuing innovative ways to increase transparency, and I highlighted some of the steps we’re taking:
- A completely redesigned USAID.gov website, including an interactive map that allows you to navigate around the world to view projects and programs;
- Detailed program information on the Foreign Assistance Dashboard, which shows in a visual, easy-to-understand way USAID and other U.S. Government agencies’ foreign assistance information;
- Crowdsourcing and hackathon efforts, like the Food Security Open Data Challenge, that make open data accessible to technology developers, decision makers and citizens so they can make better informed decisions and inspire entrepreneurial innovation;
- Our Evaluation Policy that helps us all understand what we have done well and what we need to improve, and is made available within 90 days of completion on the Development Experience Clearinghouse; and
- USAID’s posting of U.S. Overseas Loan and Grants to Data.gov that has been viewed 63,500 times, and is currently the second most popular data set on that site.
USAID also represents the U.S. Government in international negotiations on transparency principles and standards in venues like the Global Partnership for Effective Development Cooperation, the OECD-DAC and the International Aid Transparency Initiative (IATI). With the publication of last week’s OMB Bulletin, a document that sets policy and institutionalizes the collection and management of foreign assistance data, we’re moving forward to complete and publish a U.S. IATI Implementation Plan by December.
President Obama has made transparency a key priority of this Administration – one that goes beyond just making data available but making data useful. At USAID, we know that transparency is vital to achieving the development impacts that we and our partners seek, and we will continue to take a leadership role in working with our partners inside and outside of government to make our information more transparent, accessible and useful for development work. I encourage you to read more about USAID’s activities to promote transparency.
Book: The Alchemy of Air by Thomas Hager
Synopsis: The publisher of “The Alchemy of Air: A Jewish Genius, a Doomed Tycoon, and the Scientific Discovery That Fed the World but Fueled the Rise of Hitler” calls this 2008 book by Thomas Hager a story of “tragic genius, cutting-edge science, and the discovery that changed billions of lives.” Who knew there could be so much drama surrounding fertilizer?
Hager tells how two men – “brilliant, self-important Fritz Haber and reclusive, alcoholic Carl Bosch” – answered a call at the start of the 20th Century for the world’s scientists to address what was then a looming global disaster of starvation. Though the personal stories of the scientists prove tragic, the overarching narrative is an account the publisher describes as “a discovery that changed the way we grow food and the way we make war–and that promises to continue shaping our lives in fundamental and dramatic ways.”
This book reminds us of the serendipity of scientific inquiry. It’s about the invention of fixed nitrogen fertilizer, a single invention that dramatically improved food production and helped support the massive population growth that took place over the last 70 years.
When people think about fertilizer, “world changing” may not be the first phrase that comes to mind. But fertilizer has made modern life possible. In retrospect, it’s one of the most important technological innovations of the 20th century.
How countries apply nitrogen-based fertilizer varies. Where it is overused it can have significant negative consequences for local ecosystems. In some countries, like China, they use almost 160 kilograms of fertilizer per hectare. While in the United States, the number was 60 or 70 kilograms per hectare a few years ago.
And then there are the countries that use virtually no fertilizer. In sub-Saharan Africa or dry-land South Asia – where most of the world’s poor farmers struggle to produce enough food to feed their families – they use about 8 kilograms per hectare.
Where fertilizer is not used, you see children going to bed hungry every night and an increase in the number of children who are stunted over 30 or 40 years ago. If children don’t get adequate nutrition, their brains don’t develop; and they can’t learn and contribute to society to the extent of their capacity. So the story of the application of fertilizer and the disparities of that application tell the story of both environmental and human consequences.
- What about this scientific discovery surprised or impacted you the most?
- What lessons can developing countries striving to build their agriculture sectors take away from this book?
- How can countries balance the immediate need to increase food production and the long-term need to be good stewards of the soil in which the food is grown?
- Is it more cost effective for international development organizations to risk their limited funds on backing potential scientific discoveries or to spend those resources on strategies with proven track records that help people survive today?
Get Involved: Use the comments section of this blog post to share your answers, or tweet them to us at #fallsemester
Gary Juste is the Office Chief of USAID/Haiti’s Office of Acquisition and Assistance.
There is a myth that when USAID enters into an agreement with a U.S.-based non-governmental organization or contractor, most of the money stays in the United States.
The reality is much different. A significant amount of resources is spent locally.
- A case in point: one of our health partners in Haiti employs 963 people; 950 are national staff and only 14 are international staff; this means that Haitians represent 98.5 percent of the staff. Also, international staff contributes to Haiti’s economy through routine purchases from local markets for food, fuel, clothing and electricity.
- U.S.-based organizations working in Haiti purchase items from the local economy. For example, a democracy and governance project spent nearly $500,000 on the local market for computer rentals, printers, Internet service, office rental, equipment and supplies during start-up.
At the same time, we understand the importance of partnering more directly with a variety of organizations, including local entities. However, U.S. law demands that grantees meet strict U.S. Government criteria to be fully accountable and liable for spending U.S. taxpayer dollars. It would be irresponsible of me as a USAID employee—and also unfair to me as a U.S. taxpayer—to make awards to organizations unable to track funds.
Immediately after the January 2010 earthquake, we worked with existing partners to quickly provide life-saving assistance. Following the emergency phase, we have continued to increase contracting to local partners and build the capacity of Haitian organizations to receive direct funding—in line with USAID Forward procurement reforms. Since the earthquake, we have worked directly or through sub-awards with over 400 Haitian non-governmental organizations and firms.
To increase the number of new firms who compete, we have reached out to local entities and made them aware of U.S. government contracting opportunities and requirements.
- Since the earthquake, the U.S. government has hosted or participated in more than 30 Haitian diaspora-focused events. I have personally participated in 10 or more of these events in areas with significant Haitian Diaspora populations, such as Miami, New York, Chicago, Houston, New Jersey and Washington, D.C.
- In Haiti, we regularly conduct “How to Do Business with USAID” seminars. When we host pre-award conferences, on average more than 50 individuals from various organizations attend, including Government of Haiti representatives.
Many of our prime contractors use a variety of local sub-grantees. Sub-recipients of contracts make great implementers and it affords the prime contractor the opportunity to build the financial tracking capacity of the sub-grantee. We are making very deliberate efforts to build the capacity of these sub-awardees to receive U.S. funds directly in the future.
- A solicitation for a new, large procurement recently closed; the awardee is required to identify five local organizations to qualify as primary implementers by the third year and be eligible to receive direct awards from USAID, or face financial consequences (making them “walk the talk”).
- We have agreements in place with Haitian certified public accounting firms to provide financial services to our partners and work with local organizations to build their financial capacity to receive direct awards.
And we are making progress. Between March 2011 and April 2012, more than 40 percent of our funding went to non-traditional USAID partners—or partners which had never before received funding from USAID. Among them are two Haitian-American firms that were previous sub-awardees and which are now managing multi-million dollar contracts. One of the best ways to become a direct recipient of USAID funding is to begin as a sub-awardee.
Although this new way of doing business is much more time intensive, we also realize this is the best way to build local capacity and move USAID Forward.
Visit our FAQ Page for additional information on how we do business with local firms.
Each Fall, world leaders from every sector descend on New York City for the United Nations General Assembly (UNGA). The 67th session was no exception. From the official high-level meeting at the UN, to side events and multiple individual meetings, UNGA provides an opportunity for leaders to come together and achieve important outcomes. This was the third year at UNGA for USAID Administrator, Dr. Rajiv Shah. His focus was on food security and nutrition, child survival, maternal health, humanitarian assistance and the Agency’s commitment to achieving the Millennium Development Goals (MDGs).
We had trouble keeping up with Dr. Shah as he delivered remarks at the Better Than Cash Alliance launch event, a global public-private partnership dedicated to supporting organizations’ transition away from cash to electronic payments; launched Women and Girls Lead Global, a public-private alliance focused on using the power of documentary film and new media to empower women and girls around the world; highlighted child survival, technology and innovation at the Social Good Summit; and co-hosted a high-level event with Rockefeller Foundation President Dr. Judith Rodin on the new international commitment to building resilience for vulnerable communities.
Is Dr. Shah’s words, “Our engagement at the end of the day makes the difference between a safer, more secure, more economically prosperous world and one that is less so.”
As the Olympics came to a close last month, British Prime Minister David Cameron opened the doors of 10 Downing Street to a small gathering of world leaders. They met to announce new initiatives addressing the global challenge of malnutrition, which affects two billion people worldwide. Perhaps the most promising pledge to emerge from this Hunger Summit was the commitment to greater cooperation between governments, civil society and business.
While we share the same goal—healthy, well-nourished families and communities—too often, agencies, ministries, donors and businesses operate in silos, hindering action and missing key opportunities for collaboration that could improve the health and lives of millions.
We have made tremendous progress in the last five years in terms of prioritizing the issue, and we now have a number of global commitments to address malnutrition. It would, therefore, seem that we are no longer lacking political will. In addition, we now know just how cost effective it is to invest in nutrition: there is literally no greater investment we can make in health and development. The Copenhagen Consensus named micronutrient solutions the single smartest way to allocate global aid dollars, with every $1 spent generating $30 in benefits. The fact is combating malnutrition is at the top of the list because its impact can be felt across sectors—from health to agriculture to the economy. Improving nutrition is the most effective way to secure a better future.
Although conversations like the UK Hunger Summit are important in tackling malnutrition, preventing stunting and improving the life chances of millions of children, ultimately, we won’t have the impact we seek to achieve through conversations alone. Yes, we need to convene and collaborate—but the reality is we need to come away with concrete actions clearly outlining how we will all work together across sectors, and be held accountable for our commitments. Cameron and fellow host Michel Temer, Vice President of Brazil, urged the world to take decisive action on malnutrition before the 2016 Olympic Games inRio. That’s just four years away. Between now and then, partnerships between governments, civil society and business have to move from talk to action—that is, effective nutrition programs in countries.
This week, as world leaders gather at the UN General Assembly (UNGA), we have the opportunity to again meet as a global community under the banner of the Scaling Up Nutrition (SUN) Movement, and to outline how we will strengthen current partnerships and explore new ones to accelerate implementation. Global convenings, like the Hunger Summit and UNGA, provide us with the space to create and sustain dialogue, and share knowledge. But then it’s up to each of us, as organizations and individuals, to carry the torch. Together, we can improve nutrition and give millions of children the opportunity to grow, thrive and reach their full potential.
Klaus Kraemer, Ph.D. is Director of Sight and Life, a not-for-profit nutrition think tank of DSM, which cares about the world’s most vulnerable populations and exists to help improve their nutritional status. Acting as their advocates, Sight and Life guides original nutrition research, disseminates its findings and facilitates dialogue to bring about positive change.
Day three at UNGA included two marquee events spotlighting progress to date on the Millennium Development Goals (MDGs) and the New Alliance for Food Security and Nutrition. We also announced a new partnership to expand access to contraception for 27 million women and girls in low-income countries.
With only 15 months until the Millennium Development Goals (MDGs) deadline, USAID partnered on an event with the UK Department for International Development for a second year to draw attention to the importance of the global community working together to reach the MDG targets by 2015. The event brought to life the enormous development advancements made on the way to achieving the MDGs and featured innovators from across the development community sharing transformative programs and policies. The world has met two MDG targets ahead of the 2015 deadline – poverty has been cut by 50 percent globally and the proportion of people with no safe drinking water has been cut in half.
That afternoon, Administrator Shah co-hosted with other G8 members the New Alliance: Progress and the Way Forward event. President Obama announced the New Alliance for Food Security & Nutrition earlier this year, in which G8 nations, African partner countries and private sector partners aim to help lift 50 million people in sub-Saharan Africa out of poverty in the next 10 years by supporting agricultural development. Initially launched in Ethiopia, Ghana, and Tanzania, at the event, representatives from the New Alliance, G8 countries and the private sector announced the expansion to other African countries, including Burkina Faso, Cote d’Ivoire, and Mozambique.
Finally, Administrator Shah took part in the UN Commission on Life-Saving Commodities for Women and Children. Prior to the meeting, Dr. Shah joined the Commission Co-Chairs, Prime Minister Jens Stoltenberg of Norway and President Goodluck Jonathan of Nigeria, alongside former President Bill Clinton, to launch a new partnership to make a safe, effective, long-acting, reversible method of contraception available to more than 27 million women in the world’s poorest nations. Under the agreement, Bayer is reducing by more than half the current 18 USD price of its long-acting, reversible method of contraception, Jadelle, in return for a commitment to assure funding for at least 27 million contraceptive devices over the next six years. Dr. Shah stated, “The US Agency for International Development is proud to have funded the development of this life-saving product. Today is a major step forward to making this product more accessible to millions of women, empowering them with the ability to make decisions about their health and family.”
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I am proud to serve as the Assistant Administrator for Global Health, where I’ve often remarked that I feel like a kid in a candy store when I think about all of the important work going on at USAID, especially in global health. Recently, we reorganized the Bureau to establish an Office of Health Systems, which will be the hub for the Agency’s worldwide leadership network of technical experts in health systems strengthening. This is a key to focusing our work on country ownership, sustainability, and broadening access to critical health services to the most vulnerable populations, as envisioned by the Global Health Initiative.
The new office is important for two main reasons: first, it responds to the changing landscape of health and development and second, it will help meet all of other health goals in global health.
The development landscape is changing. Many countries in Africa and around the world are seeing an unprecedented growth of GDP. World per capita GDP has rocketed from around $2,000 in 1950 to more than $7,500 by 2008, and the MDG for poverty alleviation was met already, years before 2015. This represents an incredible success of the development enterprise launched by President Kennedy half a century ago.
As developing economies grow, they will inevitably spend more on health. Without thoughtful organization of the system, however, there tends to be an explosion of unregulated private services paid for out-of-pocket, which leads to inefficiencies and health bills that cause families to sink back into poverty. But we know this is avoidable.
The time to work on health systems and universal health coverage is now—countries need technical assistance that helps create and sustain an efficient, quality and equitable health system. The political momentum for universal health coverage is growing, and is part of the discussion, on a global level, of framing the post-MDG goals. Because we have aligned ourselves with the changing global health environment, if feel confident that USAID is ready and positioned to respond to this changing needs of our country partners.
As the world moves toward increasing health coverage and financial protection for more and more people through mixed public and private sectors, work on health systems is a way to make a dramatic difference in health and development. The key is not adding more capital from donors, but increasing local capacity to reorganize and manage growing domestic resources. The gains we have made in public health are amazing, and cause for great hope. The new office will allow us to galvanize our work in health systems, examine and communicate successes and gaps, and plot a course for an end game where everyone has access to appropriate health services at a cost that they can afford.
Recently, in Oslo, Secretary Clinton noted the “powerful, inescapable correlation” between strong health systems and saving lives. As a development agency, we have a mandate from the American people to help make lasting changes that ensure a more hopeful future. Good health systems include not only medical care but also public health, and not only diseases of old but new ones as well. And we know that strengthening health systems makes it possible to successfully graduate countries that no longer need financial assistance; so work ourselves out of jobs. That is our ultimate measure of success.
Tjada McKenna is the Deputy Coordinator for Development for Feed the Future and Jonathan Shrier is Acting Special Representative for Global Food Security and Deputy Coordinator for Diplomacy for Feed the Future.
This post was originally featured on FeedtheFuture.gov
In May 2012 we answered a few of the most common questions about the New Alliance for Food Security and Nutrition in the blog post Five Questions about the New Alliance for Food Security and Nutrition. This blog post follows with additional answers to other common questions about the New Alliance and progress.
1. What has happened with the New Alliance since the G8 announced it at the Camp David Summit in May 2012?
While it has only been a few months, we’re excited about the progress and momentum of the New Alliance for Food Security and Nutrition, which is a unique partnership between African governments, members of the G8, and the private sector to work together to accelerate investments in agriculture to improve productivity, livelihoods and food security for smallholder farmers. This New Alliance aims to raise 50 million people out of poverty over the next 10 years through sustained and inclusive agricultural growth.
In May, President Obama launched the New Alliance with three initial countries—Ethiopia, Ghana and Tanzania. Each partner country developed a Country Cooperation Framework outlining key commitments by governments, donors, and the private sector. These commitments totaled more than $3 billion from more than 45 African and multinational companies.
Over the past 4 months, 21 additional private sector companies, most of them African, signed letters of intent, committing themselves to invest an additional $500 million in African agriculture—and more companies are lining up to sign letters of intent.
We’ve been very encouraged that despite some unexpected and difficult leadership transitions in Ghana and Ethiopia, the governments of all three initial New Alliance countries demonstrated continued country ownership, hosting New Alliance planning meetings. A wide range of stakeholders, including senior government officials, the private sector, and civil society met to discuss:
- The alignment of New Alliance activities with existing country plans, processes and institutions.
- Progress against policy reform commitments to create a positive enabling environment for the private sector.
- Coordination of all partners to achieve shared objectives.
- Priority-setting to show tangible outcomes and progress in the near term.
- A way forward with tracking New Alliance implementation in each country.
And three more African countries have developed—jointly with private sector and G8 partners—their own Country Cooperation Frameworks. Burkina Faso, Cote d’Ivoire and Mozambique officially announced these new frameworks on the margins of the United Nations General Assembly meetings in New York City in September 2012.
2. What is the relationship between the Feed the Future initiative and the New Alliance?
The New Alliance for Food Security and Nutrition is a commitment made by the G8 leaders to work in close partnership with African governments and the private sector toward a common goal to raise productivity and address global food security, nutrition and poverty. As a G8 member, the United States contributes to this new global partnership through whole-of-government efforts such as President Obama’s global hunger and food security initiative, Feed the Future.
Feed the Future embodies many of the core principles of the New Alliance, including:
- Strengthening and building upon existing country plans and processes.
- Coordinating and collaborating with other donors to create transformative change in a country.
- Leveraging innovation and private sector investment to transform agricultural value chains for smallholder farmers, especially women.
3. How does nutrition factor in to the New Alliance?
The United States and other G8 members are committed to improving global nutrition, especially for women and children. And we recognize that nutrition interventions historically have high rates of return on impacting development.
In the context of the New Alliance, the G8 committed to:
- Actively support the Scaling Up Nutrition movement and welcome the commitment of African partners to improve the nutritional well-being of their populations, especially during the critical first 1,000 days from pregnancy to a child’s second birthday.
- Improve tracking and disbursements for nutrition across sectors and ensure coordination of nutrition activities across sectors.
- Support the accelerated release, adoption and consumption of biofortified crop varieties, crop diversification, and related technologies to improve the nutritional quality of food in Africa.
- Develop a nutrition policy research agenda and support the efforts of African institutions, civil society and private sector partners to establish regional nutritional learning centers.
4. How will the New Alliance ensure that partners uphold their commitments?
In order to implement and track progress of the New Alliance over time, we are implementing a new approach to development that enlarges the development sphere beyond the donor and partner government paradigm to include private sector and civil society actors and build upon existing effective and collaborative accountability initiatives. Impact for smallholder farmers and women at the country level drives this new approach.
The New Alliance is committed to mutual accountability of all partners, and partners have expressed a strong desire to ensure that activities and investments are consistent with the Voluntary Guidelines on the Responsible Governance of Tenure of Land, Fisheries and Forests in the Context of National Food Security and the Principles for Responsible Agricultural Investment.
The New Alliance intends to build on the accountability work of the Comprehensive African Agriculture Development Program and L’Aquila Food Security Initiative, which respectively track the commitments, investments and impacts of African governments and donors. At the Camp David Summit, the G8 agreed to convene a Leadership Council to drive and track implementation. This Council will report to the G8 and African Union on progress toward achieving the commitments under the New Alliance, including commitments made by the private sector.
The G8 also agreed to report to the 2013 Summit on the implementation of the New Alliance (including the actions of the private sector) in collaboration with the African Union. The Leadership Council convened its first meeting in September 2012 and continues to discuss options about how to best ensure mutual accountability.
5. Why does the New Alliance focus on Africa? What is the United States doing to improve food security elsewhere in the world?
As part of our commitment to do development differently and work in partnership behind country-led plans, the New Alliance is working in partnership to strengthen African commitments to promote and protect food security and nutrition—articulated in multiple settings since 2003 and validated by tremendous progress made in Africa since 2009.
Africa is home to seven of the world’s 10 fastest-growing economies and the rate of return on foreign investment is higher in Africa than in any other developing region. Doing business in Africa makes good business sense. It is a growing place of opportunity for both business and agriculture. The New Alliance is combining smart assistance with leveraged private sector investments in African agriculture to benefit both resource-poor smallholder farmers and increase private sector growth.
While the New Alliance focuses on Africa, the U.S. Government also works to improve food security—in partnership with countries—throughout the world through the Feed the Future initiative.
Read more about the New Alliance on the Feed the Future website.
Tjada McKenna is Deputy Coordinator for Development for Feed the Future and Jonathan Shrier is Acting Special Representative for Global Food Security and Deputy Coordinator for Diplomacy for Feed the Future
When was the last time you heard a woman say, “I went to the hospital to have my baby, but they sent me to the drug shop down the street to buy supplies?” Or a health worker say, “I knew what medicine my patient needed, but I haven’t had that medicine for months?”
If you live in the U.S. or any other developed country, you’ve probably never heard this, or would think this woman and health worker were joking. But for women, families, and providers in developing countries, these stories and others are all too common…and it’s definitely not a joke. As my colleague, Mary Ellen Stanton, eloquently captures in her post earlier this week on Saving Mothers, Giving Life, lifesaving medicines are frustratingly unavailable to millions of women and children each year. It is unimaginable that simple and affordable medicines could save millions of lives, yet are still so far out of reach for millions.
The medicine oxytocin is needed to prevent and treat severe bleeding after childbirth. Oral rehydration salts (ORS) and zinc are needed to prevent deaths from childhood diarrhea. And family planning commodities are needed to ensure women and their families can decide when or whether to have children – all key factors in maternal and child survival.
Over the past few years, I’ve been working on access to maternal health medicines or commodities. During this time, I’ve learned that the issues related to lack of availability, access, and demand for maternal, newborn, and child health and family planning commodities have many causes, including lack of manufacturers; lack of quality control at many points in the supply chain; providers are unfamiliar with or untrained in newer medicines or equipment; supplies don’t reach the “last mile” to remote health centers; and people don’t know that treatments are available.
But I’ve also learned that these are not insurmountable challenges. Commodities of various types do reach distant and hard-to-reach areas. One often cited example is Coca-Cola, a beverage enjoyed by millions every day, which is both affordable and available even in the most remote villages. You can actually get a Coke in remote Tshikaji, DRC!
And now, we are seeing renewed commitment among donors, country governments, and other stakeholders to make lifesaving health commodities accessible, affordable and available to millions of women, children and families around the world.
Today, the UN Commission on Life-Saving Commodities for Women and Children released 10 bold recommendations which, if achieved, will ensure women and children will have access to 13 life-saving commodities.
USAID’s long term, strategic vision looks to integrate these life-saving commodities as part of the next steps to other key efforts, like the Child Survival Call to Action and London Summit on Family Planning, in order to increase the speed at which we scale-up in host countries. It is important that we learn from our experiences and successes in getting vaccines and malaria, HIV/AIDS, and family planning commodities into the hands and homes of those most in need. Additionally, we need to integrate systems across commodities to better and more efficiently serve women and children everywhere, and scale up programs to have nation-wide impact.
Country leadership is also a vital component to successfully addressing many of the Commission’s recommendations. Getting pallets of commodities in warehouses is just one step. Medicines and drugs must reach people, and health care workers have to be present and skilled to administer them.
With our host country partners in the lead, we are working to strengthen supply chains for commodities, which include use of mHealth solutions; support local market shaping; improve the quality of medicines; and increase demand by mothers for necessary medicines. This needs to happen if we are to ensure the poorest and most vulnerable women and children have the commodities they need.
These two themes, integration and country ownership, form the cornerstones of our work. My hope is that someday soon, I’ll walk past a market in a remote part of Africa with fully stocked shelves of Coke, and into a health clinic fully stocked with life-saving commodities and medicines.