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Development & Humanitarian Relief

FY2014

Choose to Invest in

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List of InterAction Member Organizations

Introduction
5 6 8 9 10 11 What is Poverty-Focused Development and Humanitarian Assistance? Compassionate and Moral Leadership Invest in Future Trading Partners Alleviating Poverty is Key to America’s Security Results Start With Transparency and Accountability InterAction FY2014 Funding Recommendations Summary Table

Choose to Invest in Development & Humanitarian Relief FY2014

Investing in Long-Term Development

Contents

13 Global Health Programs 15 Maternal and Child Health 17 Family Planning and Reproductive Health 19 Nutrition 21 Malaria 23 Tuberculosis 25 Neglected Tropical Diseases 27 HIV/AIDS, PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria 29 NIH Global Health 31 CDC Global Health 33 Development Assistance 35 Food Security and Agriculture 37 Microfinance 39 Basic Education 41 Climate Change Response (Bilateral) 43 Climate Change Response (Multilateral) 45 Biodiversity 47 Water 49 Millennium Challenge Account 51 International Organizations and Programs 53 International Development Association 55 Global Agriculture and Food Security Program 57 International Fund for Agricultural Development 59 McGovern-Dole International Food for Education and Child Nutrition

61 63 65 67

Humanitarian Relief to Cope with Disasters and Crises
International Disaster Assistance Migration and Refugee Assistance Emergency Refugee and Migration Assistance Food for Peace Title II

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Creating the Conditions for Development and Peace
Contributions to International Peacekeeping Activities Peacekeeping Operations

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Strengthening U.S. Development Capacity
USAID Operating Expenses

Cover photo: Esther Havens, Concern WorldWide

75 Other Key Development and Humanitarian Accounts 77 InterAction FY2014 Budget Table

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InterAction Member Organizations
ACDI/VOCA Action Against Hunger USA ActionAid International USA Adeso Adventist Development and Relief Agency International (ADRA) African Medical & Research Foundation African Methodist Episcopal Service and Development Agency (AME-SADA) Aga Khan Foundation USA All Hands Volunteers Alliance for Peacebuilding Alliance to End Hunger American Friends Service Committee American Jewish Joint Distribution Committee American Jewish World Service American Red Cross International Services American Refugee Committee AmeriCares America’s Development Foundation (ADF) AmericasRelief Team Amigos de las Américas Ananda Marga Universal Relief Team (AMURT & AMURTEL) Baptist World Alliance Basic Education Coalition (BEC) Bethany Christian Services Global, LLC Bethesda Lutheran Communities BRAC USA Bread for the World Bread for the World Institute Brother’s Brother Foundation Buddhist Tzu Chi Foundation Build Change CARE Catholic Relief Services CBM CDA Collaborative Learning Projects Center for Civilians in Conflict Center for Health and Gender Equity (CHANGE) ChildFund International Church World Service Concern America CONCERN Worldwide U.S., Inc. Congressional Hunger Center Convoy of Hope Counterpart International Creative Learning Development Gateway Direct Relief International Disability Rights Education and Defense Fund (DREDF) The Eagles Wings Foundation Education Development Center (EDC) Episcopal Relief & Development Ethiopian Community Development Council Family Care International Feed the Children Food For The Poor, Inc. (FFP) Freedom from Hunger Friends of ACTED Friends of the Global Fight Giving Children Hope Global Communities GlobalGiving Global Health Council Global Links Global Washington GOOD360 Habitat for Humanity International Handicap International USA Heart to Heart International Heartland Alliance Heifer International Helen Keller International HelpAge USA Helping Hand for Relief and Development HIAS Himalayan Cataract Project Humane Society International (HSI) The Hunger Project Information Management and Mine Action Programs (IMMAP) INMED Partnerships for Children InsideNGO Institute for Sustainable Communities Interchurch Medical Assistance, Inc. (IMA World Health) International Catholic Migration Commission (ICMC) International Center for Not-for-Profit Law International Center for Research on Women (ICRW) International Emergency and Development Aid (IEDA Relief) International Foundation for Electoral Systems (IFES) International Housing Coalition (IHC) International Medical Corps International Medical Health Organization (IMHO) International Orthodox Christian Charities (IOCC) International Relief & Development International Relief Teams International Rescue Committee (IRC) International Social Service—United States of America Branch, Inc International Youth Foundation IntraHealth International, Inc. Islamic Relief USA Jesuit Refugee Service/USA Jhpiego – an affiliate of The Johns Hopkins University Joint Council on International Children’s Services Keystone Humane Services International Latter-day Saint Charities Life for Relief and Development LINGOs Lutheran Immigration and Refugee Service Lutheran World Relief MAG America Management Sciences for Health (MSH) MAP International Medical Care Development Medical Emergency Relief International (Merlin) MedShare International Mennonite Central Committee U.S. Mercy Corps Mercy-USA for Aid and Development Millennium Water Alliance Mobility International USA National Association of Social Workers National Cooperative Business Association ONE Campaign One Economy Corporation Operation USA Oxfam America Pact Pan American Development Foundation Pan American Health and Education Foundation (PAHEF) PATH Pathfinder International PCI Perkins International Physicians for Peace Plan International USA Planet Aid Plant with Purpose Population Action International Population Communication Presbyterian Disaster Assistance and Hunger Program Project C.U.R.E. Refugees International Relief International Religions for Peace RESULTS ReSurge International Salvation Army World Service Office Save the Children Seva Foundation ShelterBox USA Society for International Development (SID) Solar Cookers International Solidarity Center Stop Hunger Now Transparency International USA Trickle Up Program Unitarian Universalist Service Committee United Cerebral Palsy United Methodist Committee on Relief United Nations Foundation United States International Council on Disabilities (USICD) U.S. Climate Action Network (USCAN) U.S. Committee for Refugees and Immigrants U.S. Fund for UNICEF VAB (Volunteers Association of Bangladesh) WaterAid America Water for South Sudan WellShare International Winrock International Women for Women International Women Thrive Worldwide World Concern World Connect World Food Program USA World Learning World Neighbors World Rehabilitation Fund World Renew World Society for the Protection of Animals World Wildlife Fund World Vision Zakat Foundation of America ASSOCIATE MEMBERS Center for Justice and Peacebuilding, Eastern Mennonite University Disaster Resilience Leadership Academy (DRLA) at Tulane University Enough Project: a project of the Center for American Progress (CAP) Global Master’s in Development Practice Secretariat of the Earth Institute at Columbia University Transnational NGO Initiative of the Moynihan Institute of Global Affairs at Maxwell School of Syracuse University (as of 3/27/13)

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InterAction’s FY2014 Funding Recommendations for Foreign Assistance
InterAction is the nation’s leading policy advocate for international humanitarian relief and development programs and represents millions of Americans who provide financial support to over 180 U.S.-based nongovernmental organizations (NGOs). InterAction member organizations are faith-based and secular, large and small, and deliver the kinds of services that save and improve lives, while promoting self-sufficiency around the world. The following pages outline InterAction’s FY2014 funding recommendations for the U.S. government’s poverty-focused international development and humanitarian relief programs. Our recommendations are built on decades of field experience partnering with local communities to deliver assistance. We hope these one-pagers will help members of Congress, their staff and other U.S. policymakers improve the lives of those most in need: the poorest and the most vulnerable. We look forward to working with you in the coming year to promote U.S. leadership in ending global poverty and addressing humanitarian crises.

member NGOs 180+ InterAction are supported by millions of private contributions,

1.5 million volunteers and more than 60,000
Christian, Jewish, Muslim and Buddhist congregations and faith communities

Humanitarian relief programs help save lives and alleviate the suffering of those who have been affected by natural and man-made disasters such as conflict, drought and floods by providing emergency access to food, medical assistance, water and shelter.

The United States has a unique role
InterAction member NGOs are mostly funded by private donations: about 70% of funds are raised privately.1 While NGOs are not as reliant on congressional appropriations as in the past, we still believe in robust U.S. investments in development because the U.S. government has a unique role to play in reducing global poverty. The United States has the unparalleled ability to convene a broad range of stakeholders from the public, private, corporate and nonprofit sectors who together have the resources and expertise to develop more integrated country strategies to address extreme poverty. NGO partners are a key pillar of this collective force, leveraging the generosity of millions of individual Americans who trust and financially support NGOs.
1 InterAction analysis of members’ 2009 IRS Form 990s.

What is poverty-focused development and humanitarian assistance?
Poverty-focused development assistance refers to foreign aid that helps the world’s poorest and most vulnerable citizens. Development programs help people and countries lift themselves out of poverty, building better lives for themselves and their children. These programs build sustainability by helping family farmers increase their productivity, improving health care, getting children to attend and stay in school, or providing access to safe water and sanitation.

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Our compassion, and for some our faith, calls us to do the right thing
InterAction’s more than 180 member organizations support poverty-focused development and humanitarian relief because we believe America can be a force for good in the world. Helping those most in need is a moral imperative. Whether driven by religious convictions or a sense of common humanity, we share the view that the United States should be a moral leader in helping people around the world who live in extreme poverty. We believe our actions should fit our values. We believe every person has dignity and rights that cannot be denied, including life, liberty and the pursuit of happiness. People around the world share our aspirations: a desire to create better lives for their children with access to basic necessities such as clean water, nutritious food, safe shelter, education and health care.

Victims of the 2004 Indian Ocean tsunami receive supplies sent by the U.S.

2.47 billion people
around the world live on

less than $2 per day
Children are precious wherever they are born. With the right investments, America can be a force for change to make sure every person has the opportunity to help themselves. It is a fundamental part of who we are as Americans; whatever our political background, we firmly believe the United States has a role to play in advancing prosperity for the world’s poor and vulnerable people.

Ocean tsunami and the famine in the Horn of Africa, to the millions of people in Syria who have been forced to flee their homes, needs are increasing at an alarming rate. The United States should be there to help them get back on their feet. By investing a tiny fraction of our national budget – less than 1% – we can provide people emergency access to food, medical assistance, water and shelter. And we can help them begin the process of healing and moving one step closer to resuming normal life.

Success is achievable
A great example of success is PEPFAR – the President’s Emergency Plan for AIDS Relief. Initiated with bipartisan support by President George W. Bush, PEPFAR has directly supported lifesaving antiretroviral treatment for over 5 million men, women and children in 2012. Since its inception, millions of people have been able to once again become healthy, productive members of their communities.

Increased needs around the world
Robust levels of assistance are needed now more than ever to meet the needs created by a dramatic increase in natural disasters, armed conflict, drought and famine worldwide. From the Haiti earthquake, the Indian

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Photographer’s Mate 3rd Class Rebecca J. Moat/U.S. Navy

Destroyed buildings in Jacmel, Haiti following the 2010 earthquake.

When the United States makes an investment, others follow suit. Nations in Europe, Asia or the Americas, and other private donors, leverage and amplify the investments made by the United States. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a great example of this leveraging. While the United States is the Global Fund’s largest donor, the U.S. portion is capped at one-third of total contributions. This means that for every $1 contributed by the United States, at least $2 must come from the international community.

India graduates from college even though her parents did not finish grade school. When we choose to invest in humanity, we help all people to live with dignity.

Creating self-sufficiency
We believe foreign assistance plays a critical role in creating self-sufficiency in developing nations. Effective aid helps people help themselves. After all, the greatest human dignity is being able to provide for oneself and one’s family. This is why we invest heavily in programs that “teach people how to fish.” It is also why we strongly support programs that grant people access to the resources they need to start their own businesses and invest in their futures. We know this is not easy. But we see the fruits of our labor every day, such as when a microloan helps a woman in Kenya start a business, or when a child in

In September 2012, InterAction members pledged

$1 billion

in private, nongovernmental resources to help small-holder farmers improve their yields and better provide for their families.

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United States Air Force

Invest in future trading partners
While InterAction’s support for poverty-focused development assistance stems primarily from our belief that it is the right thing to do, there are also strong economic reasons why investing in foreign assistance can help Americans at home. Now, more than ever before, U.S. economic growth is linked with global trade: about 95% of the world’s consumers are overseas, representing 80% of the world’s purchasing power.1 For American businesses to prosper, they will most likely need to find people beyond our borders to buy their goods. By helping people around the globe to increase their economic buying power, we help them buy American products and grow our economy here at home. In numerous instances when the U.S. has invested in building markets overseas, the investment has more than paid for itself. South Korea, Taiwan and Colombia – once recipients of our aid – are all now major U.S. trading partners. In fact, two-thirds of America’s top 15 trading partners were once recipients of U.S. foreign assistance. This should not come as a surprise, since developing countries represent some of the fastest growing markets in the world. Today, they already purchase over half of all U.S. exports, a number that is only growing with time.2 One of the best ways of creating jobs at home is through international trade, which already supports one in three U.S. manufacturing jobs. As of 2010, over 38 million U.S. jobs depended on global trade, representing over one-fifth of all jobs in our country. In Texas and California alone, over 7 million jobs depend on global trade.3 That trend is only likely to grow in the future as our economy becomes further intertwined with those overseas.

“U.S. businesses understand that diplomacy and development assistance play vital roles in building economic prosperity, protecting our national security, and promoting America’s humanitarian values. The International Affairs Budget is critical to U.S. economic engagement with the world, especially at a time when there is a wide recognition of the need to boost U.S. exports to create American jobs.”
– U.S. Chamber of Commerce Letter to Congress, March 29, 2011

These economic benefits are also surprisingly inexpensive. At less than 1% of the federal budget, foreign assistance programs bring remarkable dividends for a relatively small investment. Whether your interest is in preserving America’s global economic edge or in growing jobs here at home, supporting poverty-focused development assistance is a smart, costeffective investment and one that is likely to bring great benefit to the U.S. for years to come.
1 “Over 50 Top Business Leaders Urge Congress to Support International Affairs Budget,” USGLC. http://www.usglc.org/ downloads/2012/07/FY13-Business-Leaders-Letter-to-Congress.pdf. 2 Ibid. 3 “Trade and American Jobs,” Business Roundtable. http:// businessroundtable.org/uploads/studies-reports/downloads/Trade_ and_American_Jobs.pdf.

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Alleviating poverty is key to America’s security
We live in an interconnected world and work in partnerships to address global problems like hunger, disease and human rights abuses. When we do so, we demonstrate our core values and the kind of leadership that builds goodwill toward the United States. Most global problems do not require military solutions. To alleviate poverty, halt the spread of disease and prevent conflict, we need strong diplomatic and assistance programs. By failing to make adequate investments in nonmilitary policy tools, we miss important opportunities to create shared prosperity and enhance our own security. Helping responsible governments gain strength and create the environment for their own citizens to succeed is a smart investment in global stability. People who have a stake in their society, and the opportunity to create their own future and express their concerns are less likely to be angry, frustrated and resentful towards the United States.

“We firmly believe the development and diplomacy programs in the International Affairs Budget are critical to America’s national security.”
– Military Leaders Letter to Congress

Recent U.S. National Security Strategies see our national security apparatus as three-pronged, with defense, diplomacy and development each having important roles. As a group of retired flag and general officers from all branches of the U.S. Armed Services wrote in a March 2012 letter to Congress: “We firmly believe the development and diplomacy programs in the International Affairs Budget are critical to America’s national security … Development and diplomacy keep us safer by addressing threats in the most dangerous corners of the world and by preventing conflicts before they occur.”1 The 2010 National Security Strategy similarly calls international development “a strategic, economic, and moral imperative for the United States.” U.S. foreign policy has long been guided by the belief that people are more peaceful and less likely to become entangled in conflict when they have hope, dignity and the power to shape their own destinies: when they have a sense of human security. One of the best ways to create an environment of peace around the world is to support poverty-focused development assistance.

A wise investment
Why is it that, year after year, America’s military and diplomatic leaders ask Congress to support our international development budget? It is because they believe that robust U.S. investment overseas can help prevent conflict, spread peace and security, and give people hope in their futures.

1 U.S. Global Leadership Coalition, Military Leaders’ Letter to Congress, March 27, 2012. http://www.usglc.org/wp-content/uploads/2012/03/ NSAC-Letter-2012.pdf.

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Alissa Everett

Results start with transparency and accountability
NGOs don’t just advocate for resources. We support ongoing, comprehensive efforts to modernize and reform the way aid is delivered. Transparency and accountability are key components of successful and effective aid delivery. Today’s fiscal climate requires us to take a fresh look at the best way to maximize impact from limited taxpayer resources while responding to humanitarian crises and tackling global poverty. America provides aid to countries worldwide and taxpayers deserve to know that their money is being invested wisely and that it improves people’s lives.

Where governments are weak, corrupt and unaccountable, the U.S. should support communities directly to meet their own needs.
Augusto Camba

Our vision of effective assistance
Our vision of effective aid delivery focuses on people, not governments. Where governments are legitimate, have measures in place to prevent corruption, have the capacity to do what is needed and are accountable to their own citizens, the United States should support their development agendas. But where governments are weak, corrupt and unaccountable, the United States should support communities directly to meet their own needs and strengthen their ability to demand better performance from their governments.

government accountable and lets local development actors give their own feedback on the quality of that assistance. We applaud the U.S. decision to publish aid information under the International Aid Transparency Initiative (IATI). The purpose behind IATI is to make information about aid spending easier to find, use and compare. InterAction has encouraged the administration to publish information from all U.S. agencies that distribute foreign aid to the Foreign Assistance Dashboard (www.foreignassistance.gov), a website devoted to showing where our foreign aid money goes and the impact of that assistance. We have also called for the establishment of an advisory panel on U.S. foreign aid transparency to provide guidance on how the United States can become more transparent. We firmly believe these actions will improve transparency and accountability in foreign assistance and significantly improve the return on investment of American taxpayer dollars.

More effective aid
Recent international conferences on strengthening the effectiveness of foreign assistance have focused on enhancing transparency and accountability. At the November 2011 conference in Busan, South Korea, donors promised to publish comprehensive and timely information on the resources devoted to development using a common standard that allows information to be compared. Timely, comprehensive, accessible and easily comparable information on how aid dollars are spent, and the results of that aid, allows Americans to hold our

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InterAction FY2014 Funding Recommendations
FY2014 Funding Recommendations
(in $ thousands)

Accounts and Subaccounts
Global Health Programs – USAID Maternal and Child Health Family Planning in All Accounts Nutrition Vulnerable Children HIV/AIDS Malaria Tuberculosis Neglected Tropical Diseases Global Health Programs – State (PEPFAR Only) Global Fund to Fight AIDS, Tuberculosis & Malaria NIH Global Health CDC Global Health Development Assistance Food Security and Agriculture in All Bilateral Accounts Microfinance Basic Education in All Accounts Climate Change in Bilateral Accounts Biodiversity in All Accounts Water in All Accounts Millennium Challenge Account International Organizations and Programs International Development Association Global Agriculture and Food Security Program International Fund for Agricultural Development McGovern-Dole International Food for Education & Child Nutrition Least Developed Countries Fund & Special Climate Change Fund Green Climate Fund Strategic Climate Fund Clean Technology Fund International Disaster Assistance Migration and Refugee Assistance Emergency Refugee & Migration Assistance Food for Peace Title II Contributions to International Peacekeeping Activities Peacekeeping Operations USAID Operating Expenses

3,268,000 750,000 750,000 200,000 23,000 350,000 670,000 400,000 125,000 4,492,860 1,650,000 605,700 362,900 3,175,000 1,445,000 265,000 925,000 468,000 200,000 400,000 900,000 385,000 1,408,500 158,330 32,243 209,500 50,000 5,000 100,000 300,000 1,600,000 2,800,000 100,000 1,840,000 2,179,000 257,000 1,400,000

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Global Health Programs
FY2014 Recommendation:

Funding History

$9.41 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Investments in global health save lives and ensure the progress made thus far is not lost. Since national borders do not stop the spread of disease, addressing global health issues is also important to protect the health of Americans. U.S. global health programs have treated approximately 5.1 million people living with HIV and prevented HIV transmission to millions more.1 Immunization programs save more than 3 million lives each year2 and in FY 2011 alone, the President’s Malaria Initiative and its partners distributed more than 42 million long-lasting insecticidetreated mosquito nets and provided treatment to 45 million individuals.3 Programming also addresses diseases such as polio, tuberculosis and neglected tropical diseases – as well as preventing malnutrition, decreasing maternal mortality, improving infant health, developing new health technologies and vaccines, and assisting women with the proper timing and spacing of pregnancies. Global health efforts also focus on training capable health workers throughout developing nations in order to strengthen health systems abroad. Building the capacity of country health systems ensures healthier and safer populations, creates more prosperous economies and reduces dependency on foreign aid. Additionally, global health programs develop and implement new technologies and tools to help countries get ahead of health challenges. Sustaining U.S. investments in global health is crucial; health problems will only be more expensive and difficult to resolve in the future.

State and USAID global health funding helps to reduce child mortality, slow the spread of diseases such as HIV/AIDS, respond to health emergencies, prevent malnutrition and support initiatives such as the President’s Malaria Initiative and President’s Emergency Plan for AIDS Relief (PEPFAR). Relatively modest investments by the United States have not only saved lives, but also improved the economic growth and stability of developing nations.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

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References
1 “World AIDS Day 2012 Update,” PEPFAR. http://www.pepfar.gov/funding/results/index.htm. 2 “Combination Prevention in PEPFAR: Treatment,” PEPFAR. http://www.pepfar.gov/documents/organization/183299.pdf. 3 “Sixth Annual Report to Congress,” President’s Malaria Initiative. http://pmi.gov/resources/reports/pmi_annual_execsum12.pdf.

Maternal and Child Health
FY2014 Recommendation:

Funding History

$750 million
Purpose
Funding for maternal and child health (MCH) programs supports proven, cost-effective interventions that protect the lives of children and mothers. In 2012, the United States led the world in pledging to end preventable child deaths in a generation. To make a down payment on this and other commitments, the United States should provide a least $750 million for MCH.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Investing in MCH is critical to making good on U.S. commitments as a global leader in maternal and child health and to build health and prosperity for the world’s children. Each year, USAID interventions help save the lives of more than 6 million children under the age of 5 and help significantly reduce maternal deaths from pregnancy-related causes.1 These interventions range from prenatal care and preventing maternal deaths during childbirth to pediatric immunizations and child nutrition. However, each year, 6.9 million children under the age of 5 die from preventable causes such as pneumonia, malnutrition, diarrhea and malaria;2 and each day, approximately 800 women die from preventable causes during pregnancy and childbirth.3 MCH funding supports cost-effective interventions like vaccines and nutritional supplements, and trains community health workers on basic prevention, treatment and management of maternal and child illness, such as malaria, diarrhea, pneumonia and malnutrition. Scaling up these programs will help put a stop to child and maternal mortality. MCH funding also fulfills U.S. commitments to polio eradication and the Global Alliance for Vaccinations and Immunizations (GAVI). Additionally, funding for child and maternal health is directly connected to funding for global nutrition, water and sanitation, UNICEF, PEPFAR and global health research supported by NIH and CDC.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

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Success Story: Community Health Huts Save Lives in Senegal
In 2007, Sadio’s first child, Matar, died at just 9 months old, from diarrhea and respiratory infection. The nearest health post was a 7.5-mile round trip — too far to travel for a poor family with a sick baby. Now she has 2-year-old twins, Adama and Awa, who also suffer from recurrent respiratory troubles. But things are different this time around. ChildFund International is in its second year as lead on a $40 million community health grant from USAID to establish health care services for children and families throughout Senegal, whose 800 doctors are concentrated in the capital, Dakar. The project provides community-level health huts staffed by trained health workers, traditional birth attendants and outreach workers — all volunteers — to provide basic health care and teach about hygiene, nutrition and more. These volunteers spread their knowledge throughout their communities. By the grant’s end in 2015, ChildFund and its partners — Africare, Catholic Relief Services, Plan International, World Vision, and Senegal’s Enda Graf Sahel and Enda Santa — will have established 2,151 health huts and 1,717 outreach sites nationwide, in both rural and underserved urban areas. The project also focuses on neglected tropical diseases and education about the health dangers of female genital cutting.  By 2015, 9 million people across Senegal will have access to health care, which will be networked from the national to the community level. A health hut was built in Sadio’s village in 2010. “My twins have never suffered from diarrhea or malaria because I wash my hands with soap and water before giving them food,” she explained. “And we sleep under bed nets.” She added that one of the twins, Adama, often struggles with respiratory infection, and that the health volunteers refer her for professional care when she needs it. Sadio watches, but she no longer worries.

References
1 “USAID Maternal and Child Health,” USAID. http://www.usaid.gov/what-we-do/global-health/maternal-and-child-health. 2 “Committing to Child Survival: A Promise Renewed, Progress Report 2012,” UNICEF. http://uni.cf/QQB5wA. 3 “Maternal Mortality” World Health Organization. http://www.who.int/mediacentre/factsheets/fs348/en/index.html.

ChildFund International

Family Planning and Reproductive Health
FY2014 Recommendation:

Funding History

$750 million
Purpose
Funding in this account expands access to voluntary contraceptive and family planning methods, reduces maternal mortality and improves infant health. Since 1965, the 27 countries with the largest USAID investments in family planning have increased contraceptive use from under 10% to 37%, and reduced the number of children per family from more than 6 to 4.5.1

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
According to the Guttmacher Institute, in 2012 the use of modern contraceptives in the developing world prevented an estimated 218 million unintended pregnancies, 55 million unplanned births, 138 million abortions, 118,000 maternal deaths and 1.1 million infant deaths.2 Family planning provides women with the ability to time and space pregnancies. These programs are cost-effective and deliver real and sustainable results. Data from seven countries across three continents shows that for every dollar invested in family planning, there are significant savings to governments in the health and education sectors, ranging from $2 in Ethiopia to more than $6 in Bangladesh and Guatemala, and up to $9 in Bolivia.3 Additionally, several countries, including Brazil, Mexico, Korea and Thailand, no longer require U.S. government support for family planning programs.4 One hundred members of Congress signed a letter on December 19, 2012, requesting $1 billion for family planning for FY2014; and while InterAction supports that amount, we believe $750 million is the absolute minimum to continue these essential programs.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

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Success Story: Giving Women Control of Their Futures
In the Amhara region of Ethiopia, Masreshah Abebe works to improve the health of women. A health extension worker, she routinely walks from one end of her village to another to reach her neighbors — a trip that can take more than an hour. “When I first started,” she remembered, “women were a voiceless group. Few used family planning. But that is changing.” With support from USAID, Abebe delivers family planning and reproductive health services to 1,700 households. “I track the number of women who use family planning, and there has been real change.” Across Ethiopia, more women are able to make choices about their bodies and their futures. Preliminary data from the 2011 Ethiopian Demographic and Health Survey show that Ethiopia’s contraceptive prevalence rate has increased from 29% to 96% in just six years. Abebe will do whatever she can to sustain this remarkable achievement. But she cannot do it alone. So today, she stands, surrounded by more than 60 community members. They file in from every side to sit in folding chairs and lean against fences, to take part in a “Community Conversation.” Guided by Abebe and other project staff, villagers discuss problems they face, such as today’s topic: early marriage. To change villagers’ minds about this long-held practice, which can have devastating effects on girls, Abebe has enlisted the help of influential religious leaders. Abebe steps to the side, granting Alam Ababa the floor. “This tradition of early marriage has done more harm than good for our girls,” he says. “Parents must no longer arrange marriages or force them to have too many children. We must send our girls to school.” Ababa turns to Abebe, who is beaming. “There are many good messages from our health extension workers, and we must listen.”
Sala Lewis/Pathfinder

References
1 “Family Planning,” USAID. http://www.usaid.gov/what-we-do/global-health/family-planning. 2 “Costs and Benefits of Investing in Contraceptive Services in the Developing World,” Guttmacher Institute (2012). 3 “Family Planning Saves Lives,” Population Reference Bureau. http://www.prb.org/pdf09/familyplanningsaveslives.pdf. 4 “Fast Facts: Family Planning,” USAID. http://transition.usaid.gov/our_work/global_health/pop/news/issue_briefs/fp_fastfacts.pdf.

Funding History

Nutrition
FY2014 Recommendation:

$200 million
Purpose
Despite the far-reaching consequences of malnutrition and its impact on child mortality, nutrition has been a low priority on global health and development agendas. InterAction recommends $200 million in the Global Health Programs account to adequately fund integrated nutrition programs and recommends additional focus on the integration of nutrition within Feed the Future.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Malnutrition, one of the world’s most serious yet least addressed development challenges, contributes to the death of some 2.5 million children under 5 each year.1 For the 165 million children characterized as stunted,2 malnutrition is a life sentence, resulting in irreversible physical and cognitive damage. Research has shown that early nutrition, particularly during the 1,000 days between a woman’s pregnancy and her child’s second birthday, can determine the future of a person’s health, educational attainment and lifetime earning potential. Thus, poor nutrition becomes a significant drain on economic productivity and a burden on health care systems, making progress on poverty alleviation harder and costlier to achieve. In some cases, child malnutrition costs as much as 11% of a country’s GDP.3 Yet globally, nutrition funding represents only 0.3% of total official development assistance4 and 1.2% of the FY2012 Global Health Programs account within the U.S. foreign assistance budget.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

Research has found that every $1 invested in nutrition generates as much as $138 in better health and increased productivity.5 U.S. government investments and continued leadership are critical to achieving a significant and lasting progress in preventing malnutrition.

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Success Story: Community Health Workers Teach Parents about Nutrition
Chisomo Boxer is a community health worker in Malawi. He is proud that no children under 5 have died in his village since it opened its health clinic two years ago. But he was afraid that 3-year-old Vekelani might be the first.
Elvis Sukali/Save the Children

“He had swelling of his face, legs and both feet,” said Boxer. “He lost his appetite and his skin was very shiny. These are signs of edema, and his case was very serious. There are four grades of edema; his was grade three, which meant his life was in danger.” Boxer told the boy’s parents they must take Vekelani to the hospital right away. Boxer was very concerned about Vekelani because a child’s development in the first few years will inform the rest of his life. But when Boxer checked back two days later he was surprised they had not gone. “They are superstitious. They thought someone was using witchcraft and black magic against their children. They said that was the only possible explanation for why their children were sick so much.” Boxer went back to the family’s house many times to try to convince them to take Vekelani to the hospital. Finally, after three weeks, he succeeded. The district hospital admitted Vekelani to its outpatient therapeutic program and gave him a ready-to-use-food: a special mixture of powdered milk, peanut paste, vitamins and minerals. Vekelani likes it, and his health is improving gradually. Boxer, who was trained in Save the Children’s community-based maternal and newborn care (CBMNC) program funded by USAID/Child Survival 22, still visits the family often to check on Vekelani’s progress and to counsel the parents about nutrition and hygiene. “I go with them to their garden and give advice about how to make balanced meals,” he said. “They are beginning to take my recommendations.” “The last time I was there, for the first time, Vekelani looked happy and he smiled at me!”

References
1 “Committing to Child Survival: A Promise Renewed – Progress Report 2012,” UNICEF. http://www.unicef.org/publications/files/APR_Progress_ Report_2012_11Sept2012.pdf. 2 Ibid. 3 Black, R.E., L.H. Allen et al. “Maternal and child undernutrition – global and regional exposures and health consequences,” The Lancet, 2008, Vol. 371. 4 “World Bank Global Monitoring Report: 2012: Food Prices, Nutrition and the Millennium Development Goals,” World Bank. http://siteresources. worldbank.org/INTPROSPECTS/Resources/334934-1327948020811/8401693-1327957211156/8402494-1334239337250/Full_Report.pdf. 5 “Copenhagen Consensus Challenge Paper,” Copenhagen Consensus, 2012.

Funding History

Malaria
FY2014 Recommendation:

$670 million
Purpose
Malaria funding prevents and treats illness and death associated with malaria. Annually, 216 million people contract malaria and 655,000 individuals die as a result. Eighty-six percent of malaria deaths occur in children under the age of 5. Thanks to the leadership of the President’s Malaria Initiative, the U.S. operates in 19 countries to combat this disease.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Malaria is prevalent in 106 countries and imposes significant costs to both individuals and governments. Direct costs such as illness, treatment or premature death have an estimated price tag of at least $12 billion per year.1 U.S. investments through the bilateral President’s Malaria Initiative and the Global Fund to Fight AIDS, Tuberculosis and Malaria have had a significant impact on containing the disease and creating innovative tools and technologies poised to deliver further successes: • 50 countries are on track to reduce malaria incidence by 75% by 2015;2 • Estimated new cases of malaria have decreased by 17% globally since 2000; • The overall annual malaria death toll has declined from 985,000 to 655,000 people – a 26% reduction in global malaria mortality;3 and • U.S. funding has advanced several vaccine candidates into the human testing stage. Malaria prevention and treatment programming is a model of costeffective success: by sharing responsibility, we are saving millions of lives while strengthening emerging economies and health systems. In 2012, the United Nations released a study showing that for every $1 invested in malaria control in Africa, on average, $40 is returned in higher economic growth. The gains, however, are fragile, and retreating on investment now would not only reverse today’s progress but also allow malaria to reemerge. Luckily, the costs are small: • $4 – provides an insecticide-treated bed net that lasts three years. • $1.40 – provides artemisinin-based combination therapy treatment for an adult. • $0.60 – provides rapid diagnostic testing for children and adults.4
21

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

Success Story: Local Volunteers Help Prevent Malaria
Mumile lives with her husband and their new baby in the village of Wakuan in northeastern Ghana, near the Togo border. Malaria is endemic there, and since the nearest health clinic is 10 kilometers (over six miles) away, protective measures like mosquito nets and antenatal care can prevent emergencies and save lives. With support from USAID, Episcopal Relief & Development and its malaria prevention partnership, NetsforLife, are working with Ghanaian partner ADDRO (the Anglican Diocesan Development and Relief Organization) to address the need for preventive care at the grassroots level. Active in 17 countries throughout subSaharan Africa, NetsforLife is training local volunteers, called malaria control agents (MCAs), to educate their communities about malaria, hang nets in homes, and provide follow-up to ensure the nets are being properly used and maintained. In many places, the MCAs also do broader health monitoring and advocacy, including encouraging pregnant women to seek out prenatal care. This helps ensure that they receive the recommended number of check-ups during pregnancy, along with IPTp (Intermittent Preventive Treatment in pregnancy) to protect them from malaria. MCAs visited Mumile in Wakuan, stressing the importance of IPTp for malaria protection during pregnancy, a time when women and the babies they are carrying are especially vulnerable to infection. For Mumile and her newly expanded family, having mosquito nets above their sleeping areas and using IPTp has had a major impact. “I visited the hospital at least six times a year [due to malaria] and it was taking a heavy toll on my finances,” said Mumile. “But since last year [when I received the mosquito net] I have not visited the hospital except for my IPTp, which the volunteers told me was necessary for my health. I am very happy and want to thank them for doing this.”

References
1 “Impact of Malaria,” Centers for Disease Control and Prevention (2010). 2 “World Malaria Report,” World Health Organization. http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html. 3 “World Malaria Report 2011,” World Health Organization. http://www.who.int/malaria/publications/atoz/9789241564403/en/index.html. 4 Ibid.

Harvey Wang/Episcopal Relief & Development

Funding History

Tuberculosis
FY2014 Recommendation:

$400 million
Purpose
Tuberculosis (TB) is a contagious, airborne disease that infects approximately 8.8 million people per year, nearly one-third of whom are also living with HIV, and kills about 1.4 million people annually. TB funding is used to find and treat the disease, prevent the development of drug-resistant strains, and support the research and development of new tools to fight the disease.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
As TB has no borders, strong global TB control is in the national interest of the United States to prevent a costly increase in TB cases, particularly of drug-resistant TB. Drug-resistant TB poses a particular challenge to domestic TB control due to high treatment costs, estimated at $100,000-$300,000 per case.1 It is estimated that in some countries, the loss of productivity attributed to TB is 4-7% of a country’s GDP.2 However, significant progress has been achieved: from 1995-2011, 51 million TB patients were treated successfully through TB control programs – saving up to 20 million lives. Globally, deaths due to TB have fallen by more than one-third since 1990.3 With continued and sustained funds, by 2014, the United States will have: • Successfully treated at least 85% of TB cases detected in countries with established U.S. government programs; • Diagnosed and treated at least 57,200 new multidrug-resistant TB cases; and • Contributed to a 50% reduction in TB deaths and disease burden since 1990. Congress authorized $4 billion in funding over five years in 2008, an authorization level that congressional appropriations have never reached. InterAction therefore believes $400 million – a number with strong congressional support – is a reasonable down payment on that commitment, which will hopefully allow for further deployment of updated diagnostics and drug regimens as well as increased development and introduction of new tools.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

23

Success Story: Local Leader Encourages TB Testing
Grace Tsawe runs a prayer camp in the Lower Manya Krobo District of Ghana where, on clinic days, she sees over 100 patients, many of whom suffer from tuberculosis (TB). Until recently, Tsawe did not refer her patients to health facilities, because she believed only prayer could heal them. However, last year, she developed a persistent cough and began losing weight. When months of prayer did not alleviate her symptoms, Tsawe finally visited a hospital where she was diagnosed with TB. Six months of TB treatment cured her of all TB symptoms. Having learned of Tsawe’s role in the community as a prayer leader, the hospital’s TB coordinator asked to teach her about TB screening. She agreed and, with support from the USAID-funded TB CARE project, the TB coordinator trained Tsawe to identify patients with TB symptoms and refer them to the hospital for testing. In 2010, approximately 21,000 Ghanaians developed TB, and, of these, 34% of the cases were never detected. One possible explanation for the nation’s poor TB control is that many Ghanaians believe TB is a spiritual illness and rely on prayer for healing, rather than medical care. For those who eventually do seek treatment, it is often too late to avert death. To address these challenges, TB CARE has been implementing new standard operating procedures for TB screening at health facilities in Ghana for over two years. The project is also training health teams to educate community leaders, such as Tsawe, to identify TB symptoms and make timely referrals. Tsawe’s recovery from TB has inspired her to train other prayer camp owners in TB screening and referrals. She is also now using radio and TV interviews to encourage TB testing in her community.

References
1 US House of Representatives TB Elimination Caucus letter. 2012. 2 R.Laxminarayan, et. al. “Economic Benefit of TB Control,” Policy Research Working Paper 4295. World Bank. 2007. 3 “Global Facts on Tuberculosis, 2012,” World Health Organization. http://www.who.int/tb/publications/factsheet_global.pdf.

Neglected Tropical Diseases
FY2014 Recommendation:

Funding History

$125 million
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Each year, 400,000 people die from NTDs.1 But as little as 50 cents per person per year can provide prevention treatment against the most common NTDs. Over the past five years, the U.S. government has leveraged taxpayer dollars and $3.1 billion in donated medicines to provide 584.6 million safe and effective NTD treatments to approximately 257.9 million people.2 The World Health Organization estimates that in addition to industry contributions – such as pharmaceutical drugs – it would only cost $2 billion to prevent and treat all individuals at risk of contracting an NTD from 2012 to 2015.3 It is critical that the ongoing NTD control programs be supported and continued in order to reach all those afflicted, in addition to supporting research for new tools to fight NTDs. Currently, NTD research and development (R&D) programs are underfunded. R&D for new tools is essential to ultimately combating NTDs; however, USAID – which plays a unique and critical role in product development for new NTD technologies – does not fund NTD R&D. Unfortunately, many current NTD medications have severe side effects. Research into these diseases could lead to new vaccines, better drugs and improved diagnostic tools. Strong support for successful control and elimination programs, combined with robust funding for NTD R&D is the key to success against NTDs.

Funding for Neglected Tropical Diseases (NTDs) helps to prevent, control, eliminate and eradicate 17 diseases that infect 1 billion of the world’s poorest people. One in six people worldwide suffer from NTDs such as dengue, rabies, river blindness, leprosy, trachoma and hookworm. These diseases are deadly, debilitating and can cause blindness, disfigurement, disability, cognitive developmental delays and social stigma.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

25

Success Story: Education Campaigns Help Stop Neglected Tropical Diseases
Maroua, the bustling capital of the Far North Region of Cameroon, is an extremely hot, dry and dusty city with a population of approximately 250,000 people. Recently, the city has struggled to achieve high coverage rates for various public health initiatives. Launched in 2010 and continuing today, a campaign by the Neglected Tropical Disease Control Program to combat onchocerciasis and lymphatic filariasis reaches Maroua and all 28 health districts of the Far North Region. Knowing that social mobilization strategies would be essential to achieve high coverage rates, Helen Keller International and the Ministry of Health use a variety of innovative channels to communicate the need for everyone to participate in drug distribution events. Ministry leaders appear on popular radio programs, traditional storytellers spread the word, and engaging posters catch people’s attention on nearly every street corner.

One poster used during the campaign pictures a man with a very swollen leg, one of the symptoms of lymphatic filariasis. A man who was suffering unknowingly, from lymphatic filariasis saw the poster and noticed that his leg looked just like that of the man in the poster. Armed with this new information, he immediately visited his health center and was happy to learn that drugs to alleviate the symptoms of his disease would be distributed to him for free. Thanks to the public awareness campaign, not only did this man seek and receive treatment, but now he also is an active community health educator who travels house-to-house and mobilizes his neighbors to participate in the campaign against lymphatic filariasis and onchocerciasis so that others do not suffer like he has. Due to social mobilization strategies, significant progress has been made in reaching vulnerable populations in Maroua. As a result, 84% of the people at risk of lymphatic filariasis have received essential treatment in 2011. These results would not be possible without crucial funding from USAID.

References
1 U.S. Department of State (2011) Foreign Operations Congressional Budget Justification Fiscal Year 2011: Vol. 2. 2 “USAID’s Neglected Tropical Diseases Program,” USAID. http://www.neglecteddiseases.gov/about/index.html. 3 “Accelerating work to overcome the global impact of Neglected Tropical Diseases: A Roadmap for Implementation,” World Health Organization. http://whqlibdoc.who.int/hq/2012/WHO_HTM_NTD_2012.1_eng.pdf.

Helen Keller International

HIV/AIDS, PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria
FY2014 Recommendation:
for USAID’s HIV/AIDS programs

Funding History

$350 million $4.49 billion
for PEPFAR

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
PEPFAR combats HIV/AIDS through prevention, treatment, care and the strengthening of health systems through bilateral and multilateral programs. As of September 30, 2012, PEPFAR had directly supported antiretroviral treatment to almost 5.1 million people. In FY2012 alone, PEPFAR directly supported HIV testing and counseling for more than 49 million people and provided care and support for nearly 15 million people – including more than 4.5 million orphans and vulnerable children. By reaching nearly 750,000 HIV-positive pregnant women in FY2012 with drugs to prevent transmission of HIV from mother to child, PEPFAR helped avert 230,000 HIV infections in newborn children.1 Global Fund: As of December 2012, the Global Fund had provided HIV/AIDS treatment to 4.2 million people, as well as service to 1.7 million pregnant women to prevent transmission of HIV to their children. In addition, the Global Fund has distributed 310 million insecticide-treated bed nets, detected and treated 9.7 million cases of tuberculosis, and treated 290 million cases of malaria. On average, the Global Fund saves 100,000 lives each month.2 The Global Fund works in close partnership with PEPFAR and the President’s Malaria Initiative to create highly successful collaboration around the world. The U.S. is the Global Fund’s largest donor; however, by law, the U.S. contribution is capped at one-third of total contributions. This means that for every $1 contributed by the U.S., at least $2 must come from the international community. Funding for the Global Fund is critical to ensuring that we build on the successes of the past decade and that we can provide care to the millions around the globe waiting for access to antiretroviral therapies, tuberculosis treatments and insecticide-treated nets. USAID’s HIV/AIDS programs scale up proven interventions, while promoting newly-developed innovations and best practices.
27

$1.65 billion
for the Global Fund

Purpose
Funding for State and USAID for HIV/AIDS programs supports the President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other multicountry initiatives. This funding is used to prevent, treat and care for those infected with HIV/AIDS and to build country-level capacity to transfer operation of HIV/AIDS programs to implementing countries.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

Funding for two essential partnerships – the Commodity Fund and the International AIDS Vaccine Initiative – help increase condom availability and promote the development of an effective HIV vaccine. The global fight against HIV/AIDS is at a critical juncture. The knowledge and innovations acquired over the last 10 years have brought the end of the HIV/AIDS epidemic within reach. The United States must not let current budgetary constraints undo the success of the past few years. If we do not act, we may lose our best chance to end this epidemic.

Success Story: Living Long, Full Lives With HIV/AIDS
All her life, Laurence, who is 70 and HIV-positive, has struggled to care for herself and her family. Then in 2010 she joined an Internal Savings and Lending Group (ISLG) and started taking nutrition classes through the Higa Ubeho program in Rwanda, implemented by Global Communities/CHF International. With the loan she obtained through the ISLG and the skills she learned in nutrition training, she was able to make her farm a source of fresh, healthy vegetables for herself and her family. She began generating a sustainable income from the extra crops she grew. She now has access to treatment, health insurance and electricity in her home. Laurence also shares her training with people in her village who are replicating her methods. Laurence said that because of the program, “I am no longer sick all the time. And though I have health insurance, I hardly ever have to go to hospital anymore. Not only am I not a burden to anyone, I also am supporting others by teaching them the importance of improved nutrition. I am proud that I have gained knowledge and skills that I can use the rest of my life.” The Higa Ubeho program, which is funded by USAID and PEPFAR, works with people in Rwanda living with HIV/AIDS, orphans and other vulnerable children to reduce the impact of the disease on their lives, and works with local institutions to increase their access to education, psychosocial support, medicine and food. It serves more than 70,000 families in 20 districts to develop sustainable ways of coping with the health and economic challenges that affect the most vulnerable communities in Rwanda.

References
1 “World AIDS Day 2012 Update: Latest PEPFAR Results,” PEPFAR. http://www.pepfar.gov/funding/results/index.htm. 2 “Fighting AIDS,” The Global Fund. http://www.theglobalfund.org/en/about/diseases/hivaids/.

Laura Gingerich

Funding History

NIH Global Health
FY2014 Recommendation:

$605.7 million
Purpose
National Institutes of Health (NIH) Global Health funding supports basic and applied scientific research to identify new interventions and more effective ways to improve health and combat disease. These research activities are complemented by programs that train new researchers and scientists in partner countries so they can better undertake future global health research.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
As a premier research institution, NIH conducts and supports a range of biomedical and behavioral research activities, as well as training for young scientists. Continued investments in medical scientific research help lead to new, innovative, and life-saving technologies and medicines that improve health and combat disease both in the United States and around the world. Global health research at NIH spans 27 institutes and centers, including the National Institute of Allergy and Infectious Diseases, which continues to lead in global breakthroughs to combat HIV/ AIDS, malaria, tuberculosis and neglected tropical diseases. NIH funding also supports the Fogarty International Center, which supports approximately 400 research and training projects with more than 100 U.S. universities that partner with other research institutions around the world. NIH-supported research, which led to the codiscovery of HIV, has saved an estimated 14.4 million years of life since 1995 through AIDS therapies alone.1 NIH research has also led to other medical breakthroughs, such as treatments for HIV-associated coinfections, the development of the first microbicide gel effective for preventing HIV/AIDS, strategies to prevent mother-to-child transmission of the HIV/AIDS virus and steps to developing a malaria vaccine.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

Sustained funding for NIH’s global health research and training activities is critical to identifying new cures, finding more efficient and effective interventions to combat disease, and facilitating the training of new researchers, all while supporting U.S. universities and research jobs.

29

Success Story: NIH Discovery Turning the Tide Against River Blindness
Onchocerciasis, commonly known as river blindness, affects 37 million people with an estimated 180 million people in Africa at risk. Transmitted to humans through bites of blackflies, individuals who become infected experience intense itching, severe skin disfiguration, and – with years of repeated exposure – permanent blindness. In addition to its health effects, the disease leads to massive economic losses when productive agricultural lands are abandoned for fear of infection. Although a treatment exists, it needs to be taken for up to 20 years by the entire affected community through mass drug administration. Once free from the disease, communities must be closely monitored to prevent reintroduction of the disease and the need for additional mass drug administration. Scientists at the National Institutes of Health (NIH) discovered an antigen to river blindness that could lead to easier testing. However, there was little interest from potential commercial partners in pursuing its production because companies did not see much potential profit in manufacturing a test for a disease rampant in poor countries. Utilizing the discovery of NIH scientists, PATH, a nonprofit global health organization, developed a simple, rapid test that could accurately diagnose river blindness and partnered with the NIH to evaluate the technology. PATH identified Standard Diagnostics, Inc., as a partner for manufacture and distribution, and the two organizations are working to develop a commercially viable test for use in affected countries. Because of a discovery made in NIH labs, people living in remote areas can get tested in their own communities. This will improve their lives and help eliminate river blindness in Africa. Funding for NIH’s global health program allows for research that provides valuable innovations in our collective response to river blindness and other diseases. Ultimately, U.S. investment enables communities to overcome tremendous health challenges that limit economic productivity and perpetuate poverty.

References
1 “Estimating the impact of antiretroviral therapy: regional and global estimates of life-years gained among adults,” NIH, National Center for Biotechnology Information. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173805/.

PATH/Allison Golden

Funding History

CDC Global Health
FY2014 Recommendation:

$362.9 million
Purpose
Centers for Disease Control and Prevention (CDC) global health funding helps track diseases, provides public health leadership, assists foreign ministries of health in strengthening their research and laboratory infrastructure, and trains new health professionals. This type of collaboration draws on the CDC’s technical expertise and improves the ability of partner countries to lead in the future.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
As one of the premier public health agencies in the world, the CDC works in partnership with ministries of health, international organizations and other partners to strengthen global health capacity, increase security and support evidence-based global health programs. It makes significant contributions to global health research and development, monitors and tracks infectious diseases worldwide, alerts researchers when new disease strains emerge, and provides critical intelligence for the control and prevention of diseases. With over 60 years of experience, CDC works alongside foreign ministries of health to prevent the spread of disease worldwide. CDC is a key partner in the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in over 75 countries and provides technical assistance on how to implement the latest science, such as scaling up HIV treatment and preventing mother-to-child transmission. CDC is also a leader in global immunization and disease eradication efforts. For example, CDC programs helped reduce the number of new polio cases globally by more than 99% between 1988 and 2010,1 and the CDC-led global campaign to eradicate Guinea worm disease has helped reduce the disease burden from 3.5 million cases per year in 1986 to near eradication today.2 The CDC also continuously investigates and responds to disease outbreaks, such as the measles outbreak in 2010 in four African countries. The CDC’s efforts address critical global issues while also protecting the health of Americans. Continued, sustained funding for CDC programs is crucial.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

31

Success Story: Saving Lives Through Cervical Cancer Screenings and Treatments
During her annual exam at a health clinic, Mariam Cissé, a 41-year-old mother of three who is HIV positive, was screened for cervical cancer using a technique called visual inspection with acetic acid (VIA). This technique is a cost-effective alternative to the Pap smear. During a VIA screening, a doctor or nurse swabs the cervix with acetic acid, the main component of vinegar. If there are precancerous cells, the cervix turns white. Cissé’s cervix showed a large white lesion. She was stunned – a screening a year earlier had been negative. But as an HIV positive woman, Cissé was at greater risk to develop aggressive precancerous lesions. Her lesion was too large for the routine treatment. Normally, doctors use a freezing technique known as cryotherapy to destroy abnormal tissue. This would not help Cissé and she was worried. Hope arrived in the form of a phone call. A midwife told Cissé that the University Hospital Centre could treat large cervical lesions using loop electrical excision procedure (LEEP), which uses a thin wire heated by electric current to cut away the cells. Not only was the treatment available, but it was also free. Cissé was successfully treated. Greater access to screening and treatment drastically reduces the number of deaths from cervical cancer. Jhpiego – an affiliate of Johns Hopkins University – is working with the U.S. Centers for Disease Control, the President’s Emergency Plan for AIDS Relief, and National HIV/AIDS Care and Treatment Program to make screening and treatment available to the women in Côte d’Ivoire. Since 2009, the number of screening and treatment sites has grown to 20. To date, 7,343 HIV-positive women have been screened with VIA. Of these women, 429 women – including Cissé – have been treated for precancerous lesions. These are important strides in a country where only 5.8% of women are screened for cervical cancer every three years, and where almost 70% of the 1,600 women who are diagnosed annually with cervical cancer die from the disease, according to the World Health Organization. “I am a living testimony to the success of this approach,” said Cissé. “Other women could have the same chance.”

References
1 “Post-Polio Syndrome Face Sheet,” National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/post_polio/detail_ post_polio.htm. 2 “Guinea Worm Frequently Asked Questions,” CDC. http://www.cdc.gov/parasites/guineaworm/gen_info/faqs.html.

Toure Oumar/Jhpiego

Funding History

Development Assistance
FY2014 Recommendation:

$3.175 billion
Purpose
The Development Assistance (DA) account is the bedrock of U.S. investments to help the world’s poorest obtain access to education and clean water, grow nutritious food, protect the environment, promote economic development, support good governance, respond to climate change and create more sustainable, self-sufficient democratic societies.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Despite the fact that the Development Assistance (DA) account is at the core of U.S. investments in creating sustainable, self-sufficient societies, funding for the account has remained flat since FY2010. This is even more concerning given increasing food prices, threats to development from climate events, expanded engagement by geopolitical competitors and historic opportunities to advance democracy in the Arab world. The recommended $3.175 billion is the minimum level necessary to cover the challenges and opportunities in each major sector (including food security and agriculture, microfinance, basic education, climate change, biodiversity and water), without squeezing out other equally worthwhile programming, such as democracy funding, economic growth, trade capacity-building, technology, innovation and evaluation. The $3.175 billion level reflects the Senate FY2013 funding level plus an increase in $125 million over the Senate FY2013 funding levels for basic education. For more details, see the sectoral justifications on the following pages.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

33

Food Security and Agriculture
FY2014 Recommendation:
across all bilateral accounts

Funding History

$1.445 billion
Purpose
The recommended $1.445 billion funding level for Food Security and Agriculture includes support for Feed the Future programs and food security programs in frontline states: $1.2 billion would fund Feed the Future at the Senate FY2013 level, while an additional $245 million, based on the President’s FY2013 budget request, is needed to ensure food security in frontline states.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Globally, 870 million people suffer from malnutrition and hunger,1 while some 2.5 million children under 5 die each year from malnutrition.2 Hunger and malnutrition rob poor people of healthy, productive lives and stunt the mental and physical development of future generations. Food price volatility and extreme weather patterns, such as those that caused the droughts in the Horn of Africa and the Sahel, are pushing more and more people into extreme hunger and malnutrition. After decades of declining support for farmers in developing countries, renewed U.S. leadership has sparked a global commitment to helping people feed themselves. Feed the Future takes a comprehensive and sustainable approach to agricultural development. Investments focus on country-owned plans developed through engagement with local government and civil society, and emphasize the importance of gender, nutrition, climate change and natural resource management. Drawing upon resources and expertise of agencies across the U.S. government, this initiative is helping countries, including 19 focus countries, transform their agriculture sectors to sustainably grow enough food to feed their people. In FY2011, U.S. agricultural assistance helped 1.8 million farmers adopt improved technologies or management practices, and reached nearly 9 million children through nutrition programs such as micronutrient supplementation and food fortification.3 Additionally, with food prices remaining volatile and weather patterns threatening water availability and agricultural productivity, it is critical that we maintain or increase the level of funding for Feed the Future and agricultural development in the frontline states of Afghanistan, Pakistan and Iraq, in order to help promote stability in these areas.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

35

Success Story: “Passing On the Gift” for Sustainability
The Yaajeende Agricultural Development Program in Senegal’s eastern regions is transforming the lives of one million individuals in 100,000 households, and is part of USAID’s Feed the Future project. Yaajeende means “abundance” or “prosperity” in the local Pulaar language, and reflects the goals of the project: to improve the nutrition and income of one million people across 60 regional communities. The project brings together five organizations: Counterpart International, Heifer International, Manobi Inc., The National Cooperative Business Association, and Sheladia Associates Inc. For its part, Heifer is placing livestock (poultry, sheep and goats) among 5,500 households. Using the “passing on the gift” model, families who receive one of the 12,000 sheep and goats or 12,500 poultry will then pass on the offspring to their neighbors. Through this process the program will reach 19,500 households over five years. “When you are poor, you will never neglect the sheep because they are a way to move forward,” said Kumba Daranjay, president of a farmers association. “You know how bad poverty is, and you don’t want to go back. The sheep will help feed our children and take care of their health.” Heifer International estimates the increased economic activity resulting from the project will double the household incomes of farmer participants, which in turn will substantially reduce the number of underweight children and allow them to grow and reach their full potential. The livestock will not only allow families to better feed themselves, it will also give them money so that they can send their children to school.

References
1 “The State of Food Insecurity in the World,” Food and Agriculture Organization. http://www.fao.org/docrep/016/i3027e/i3027e.pdf. 2 “Committing to Child Survival: A Promise Renewed – Progress Report 2012,” UNICEF. 3 “Feed the Future Progress Report 2012,” Feed the Future. http://feedthefuture.gov/resource/feed-future-progress-report-2012.

Oliver Asselin/Heifer International

Funding History

Microfinance
FY2014 Recommendation:

$265 million
Purpose
Microfinance provides access to financial services like credit or savings for the world’s poor and marginalized people, enabling poor families to start businesses or meet health, education, or emergency needs, thus helping them lift themselves out of poverty.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
An estimated 2.5 billion people have no access to formal financial services.1 Microfinance began as a way to finance self-employment ventures by poor people who had few employment or incomegenerating opportunities or who could not obtain credit. It has since expanded to include poor households’ management of their finances through savings, credit and insurance for such things as enterprise, education, housing and health care. U.S. microfinance assistance focuses on improving access to these financial services for the very poor (those living on less than $1.25 a day) and the people most marginalized by the societies in which they live. Public funding is critical for reaching these populations because very little private foreign investment capital in microfinance goes to the countries with the greatest need – or to the most marginalized populations within these countries. For instance, in sub-Saharan Africa, which has the highest percentage of people living in extreme poverty of any region, 640 of the 800 million of the people in the region have no access to any financial institution – microfinance or otherwise.2 USAID microenterprise funding plays a critical role in expanding financial opportunities for the underserved in these highneed countries. Strong congressional support has demonstrated U.S. leadership in microfinance and microenterprise development, recognizing these tools as a cost-effective and successful way to reduce poverty and promote economic growth. In FY2011, U.S. microenterprise development assistance helped provide approximately 3 million people in 50 countries with the financial means to start or grow a business and help lift themselves out of poverty.3

For more information, contact: Jeremy Kadden Senior Legislative Manager InterAction jkadden@interaction.org

37

Success Story: Supporting Entrepreneurs with Microloans
Two years ago, Hemmin Omar Ali opened a chewing gum factory in Iraq with a $5,000 loan from Relief International. Hemmin had decided he could be more competitive by selling trading cards with the gum. So he used the loan to purchase machinery to print the cards and seal them in foil packets. His vision worked. His chewing gum business became very successful and he paid off his loan. At the height of his business, monthly revenue exceeded $200,000 and Hemmin employed 83 people, but foreign competitors from Turkey drove down price and profit. It was time for a change. Hemmin came up with a new plan, once again finding his niche in the market. His plan was simple: make potato chips that are cheaper, better and local. (Currently most potato chips sold in the region are imported from Iran.) With a stellar repayment record, Hemmin was able to reach out to Relief International’s microfinance program. Because he had already demonstrated his creditworthiness by repaying his first loan, and because he had developed a solid business plan, Hemmin secured a larger $10,000 SME loan to launch the new venture. Entrepreneurs in the developing world often lack access to basic financial services. The doors of traditional banks often remain closed to entrepreneurs with high aspirations but limited means. Relief International’s program, which received its startup funding from a $2.9 million USAID grant, is designed to fill this gap. By providing initial capital to entrepreneurs like Hemmin, these micro and small business loans support the dreams of local entrepreneurs and promote economic development.
Relief International

References
1 “Measuring Financial Inclusion: The Global Findex Database,” The World Bank Development Research Group. http://www-wds.worldbank.org/ external/default/WDSContentServer/IW3P/IB/2012/04/19/000158349_20120419083611/Rendered/PDF/WPS6025.pdf. 2 “2011 Microfinance in Africa: State of the Sector Report: Closing the Gap,” CARE. http://www.care.org/getinvolved/advocacy/access-africa/pdf/ CARE-Access-Africa-Closing-the-Gap-2011.pdf. 3 Based on a cost per beneficiary of $85 as determined from 107 projects that provided information on borrowers, savers, microenterprises or total number of employees from USAID. “Microenterprise Results Reporting [in 2011],” USAID. http://pdf.usaid.gov/pdf_docs/PDACT959.pdf.

Funding History

Basic Education
FY2014 Recommendation:
across all accounts

$925 million
Purpose
U.S. support for basic education furthers the alleviation of global poverty, strengthens societies, fosters stability and security, spurs domestic economic growth, reinforces gains in global health, and enhances U.S. global leadership and influence. Education is a cost effective and sustainable way to equip millions with the tools they need to better their lives and forge a path to self-sufficiency.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Today, 61 million children1 and 71 million adolescents2 worldwide are not in school. Roughly half of these out-of-school children live in areas affected by conflict and/or fragility.3 And these numbers continue to grow. Moreover, many millions of children receive an education of such poor quality that they leave school lacking basic literacy and numeracy skills.4 Basic education programs help alleviate poverty through economic growth. No country has achieved rapid economic growth without investing in education.5 Every $1 spent on education generates as much as $10 to $15 in economic growth.6 Educating the world’s poor also is essential for growing the stable trading partners that U.S. export markets require and enhancing security worldwide. Population rates are rising in countries with the highest illiteracy rates.7 Education has a stabilizing effect on youth populations, with each additional year of formal schooling for males reducing their risk of becoming involved in conflict by 20%.8 The recommended funding level is $125 million over the FY2012 level, a modest increase that would extend quality primary school education to approximately 1.25 million more children.9 Over the last 10 years, great strides have been made, with the number of out of school children dropping by 47 million.10 Strong investment in education will help maintain this progress and help achieve the goals of the USAID Education Strategy, which aims to improve reading skills for 100 million learners and increase equitable access for 15 million learners in conflict and crisis areas by 2015.

For more information, contact: Jeremy Kadden Senior Legislative Manager InterAction jkadden@interaction.org

39

Success Story: Increasing School Enrollment in Kenya
Mary Andrew Kopulo grew up in a poor family in rural Kenya, the fourth of 11 children. As a girl, she struggled to get an education. This experience inspired her to start a preschool so her students would have a chance at a better life. “Simply getting girls to attend school is an achievement here where many girls get married very young,” Kopulo said. She started Vilwakwe Children Centre in Mombasa’s squatter settlements where there is no public school. From seven students, enrollment grew in five years to 395, nearly half of them girls. She started a nutrition program and a girls’ forum with activities that boost girls’ skills and confidence. When the landlord locked the school for inadequate washroom facilities, Kopulo applied for a grant from Aga Khan Foundation and the Education for Marginalized Children in Kenya (EMACK) program. Funded by USAID, EMACK improves early childhood development facilities, learning methods, and tools for reaching girls and other underserved groups. In helping Kenyan schools scale-up a robust education for everyone, EMACK trains hundreds of teachers and provides small grants to informal schools like Kopulo’s to improve the classroom environment. It has supported 767 preprimary, primary and secondary schools with efforts tailored to gaps in the education system. To strengthen teaching skills for working with students from marginalized groups, EMACK has trained over 6,900 teachers (over half of them women). More profoundly, it fosters transparency in education by involving communities in school management, engaging 4,436 members of committees and boards of governors from 860 schools in training sessions. In remote areas, enrollment has increased by 74.1%. “My greatest hope is that my students believe in education to achieve their dreams,” explained Kopulo. “Education is the only thing that will break the poverty cycle for their families.”

References
1 “EFA Global Monitoring Report 2012: Youth and Skills: Putting Education to Work,” UNESCO, 2012. (Hereinafter “UNESCO GMR 2012.”) 2 Ibid. 3 “Last in Line, Last in School 2009: Donor Trends in Meeting Education Needs in Countries Affected by Conflict and Emergencies,” Save the Children, 2009. 4 “EFA Global Monitoring Report 2009: Overcoming Inequality: Why Governance Matters,” UNESCO, 2009. 5 “Education and the Developing World,” Center for Global Development, 2004. 6 UNESCO GMR 2012. 7 Ibid. 8 “Doing Well out of War,” The World Bank. http://www.uio.no/studier/emner/sv/statsvitenskap/PECOS4010/h12/undervisningsmateriale/war.pdf. 9 “EFA Global Monitoring Report 2010: Reaching the Marginalized,” UNESCO, 2010. 10 UNESCO GMR 2012.

Aga Khan Foundation U.S.A.

Climate Change Response (Bilateral)
FY2014 Recommendation:
across all bilateral accounts1

Funding History

$468 million
Purpose
Through the U.S. Global Climate Change Initiative (GCCI), USAID bilateral climate funds target the most vulnerable countries to support adaptation to climate impacts and countries with significant opportunities to mitigate greenhouse gases through clean energy development and sustainable landscape management. USAID integrates its climate work into food security, global health, democracy, and other development priorities, as well as multilateral efforts.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Bilateral investments concerning climate change and extreme weather are essential to meet the basic needs of poor people and protect critical forest areas and biodiversity. Climate change could reduce agricultural productivity in many developing countries by up to 50% by 2020.2 Every dollar invested in adaptation can generate returns of $1.45-$3.03 for communities.3 Investments in adaptation, clean energy and sustainable landscapes promote global security, minimize instability, reduce the cost of disasters, address global hunger and health, protect long-standing U.S. investments in global development and conservation, and increase economic opportunities for U.S. businesses and workers. In fact, the United States could create 280,000-850,000 new jobs by garnering just 14% of the clean technology market in the developing world.4 Since GCCI started in 2010, examples of USAID’s accomplishments include helping six countries develop and implement strategies for increasing economic growth with lower emissions, and providing 23 countries with early warning systems and other tools to improve water management, agriculture, health and postdisaster recovery.5 Based on FY2013 Senate funding levels, InterAction recommends $468 million for GCCI bilateral assistance, including $190 million for adaptation, $165 million for clean energy and $113 million for sustainable landscapes programs.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

41

Success Story: Reclaiming Degraded Land Reduces Malnutrition
Ibarogan was a parched, dusty village nestled upslope from a small ephemeral waterway in the Tahoua Region of Niger. With little rainfall and poor soil, farmers relied on subsistence crops such as millet and cowpeas, and barely harvested enough food to feed their families. The region also had limited access to other food sources and malnutrition was widespread. Recently, however, Ibarogan’s famers began to see significant improvement in their ability to produce more and better-quality crops as a result of joining the USAID-funded Arziki Project implemented by CLUSA International. The project promoted climate change adaptation (CCA), which helped farmers reclaim degraded land so they had access to more fertile land and can grow more nutritious crops. Ibarogan’s community built stone check dams along the village’s stream. Each check dam was buttressed at the water’s peak flow point to reduce powerful stream flows during high-intensity storms. Along the streambed, the villagers built rock walls to reduce soil erosion and improve water infiltration. On the improved, moisture-laden land, farmers now plant dolique, a legume eaten by humans and livestock and worth $1,000 per hectare. Ibarogan has long struggled to overcome droughts, malnutrition and an almost complete lack of natural resources. With the help of CLUSA International, in partnership with USAID, the village tackled these challenges. The farmers’ crops improved, and villagers reclaimed land and created fertile garden plots, reducing malnutrition and raising the standard of living.
NCBA CLUSA International

References
1 Does not include funding provided through the ESF account for the Least Developed Countries Fund (LDCF) and Special Climate Change Fund (SCCF). 2 “Climate Change Adaptation and Mitigation in the Food and Agriculture Sector,” United Nations Food and Agriculture Organization. ftp://ftp.fao. org/docrep/fao/meeting/013/ai782e.pdf. 3 “Policy Brief: Climate Change – Why Community Based Adaptation Makes Economic Sense,” CARE. http://www.careclimatechange.org/files/ adaptation/PolicyBrief_Why_CBA_Makes_Economic_Sense_July12.pdf. 4 “Getting Back in the Game: U.S. Job Growth Potential from Expanding Clean Technology Markets in Developing Countries,” World Wildlife Fund, 2010. 5 “Global Climate Change,” USAID. http://www.usaid.gov/climate/.

Climate Change Response (Multilateral)
FY2014 Recommendation:
across all multilateral accounts1

Funding History

$455 million
Purpose
USAID multilateral climate investments such as the Least Developed Countries Fund (LDCF), Strategic Climate Change Fund (SCCF), Climate Investment Funds (CIFs) and Green Climate Fund (GCF) complement and leverage U.S. bilateral investments to address the frequency and intensity of very costly extreme weather events that are likely to worsen with climate change, as temperatures continue to rise and affect weather patterns.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation
*Includes funding for the Least Developed Countries Fund and Special Climate Change Fund, the Green Climate Fund, the Strategic Climate Fund and the Clean Technology Fund.

Justification
Extreme weather is raging across the world, with Australia suffering massive forest fires from a record-shattering heat wave, Pakistan enduring unanticipated flooding, and more than 3,500 extreme weather events in the U.S.2,3 Addressing climate change requires U.S. action to help secure strong international response. InterAction recommends $50 million for the LDCF and SCCF. The LDCF helps least-developed countries prepare and implement country-driven National Adaptation Programs of Action that identify and prioritize urgent adaptation needs. The SCCF supports country-driven adaptation and technology transfer programs that are integrated into national development and poverty-reduction strategies, and catalyzes funding from other bilateral and multilateral donors. Based on FY2013 Senate funding levels, InterAction recommends $400 million for the CIFs: $300 million for the Clean Technology Fund (CTF), and $100 million for the Strategic Climate Fund (SCF). The CTF promotes scaled-up financing for transformational lowcarbon technology deployment that demonstrates significant reductions in greenhouse gas emissions. The STF includes programs that integrate climate risk and resilience, increase energy access through renewable energy use, and support efforts to reduce deforestation and forest degradation.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

InterAction recommends $5 million to support start-up costs for the Green Climate Fund (GCF). Launched in 2011 with broad international support, the GCF is intended as the primary financial mechanism through which developed countries will support developing country efforts to address climate change.

43

Success Story: Better Irrigation Techniques Ensure Food for All
Burkina Faso and its citizens constantly struggle with food security issues due to dwindling water resources and deteriorating pastures. This lack of access to reliable sources of nutritious food has led to more disease and child malnutrition. The Least Developed Countries Fund put $2.9 million into the Strengthening Adaptation Capacities and Reducing the Vulnerability to Climate Change project in 2008, which focused on the local level, working in six villages to develop strategies to adapt to climate change and thereby increase economic prospects and food security. This project successfully established climateresilient irrigation techniques, developed livestock feed storage facilities, new wells, and training for farmers in climate-resilient agricultural management with the objective of increasing food security and promoting sustainable agricultural development. Women and children are particularly vulnerable to negative effects of climate change, partly because of gender roles and their lack of control over assets. To address these challenges, the project provides women goat and sheep farmers with credit for stock and inputs. Women are also in charge of stocking and managing the stores of drought-resilient seeds.

References
1 Does not include multilateral assistance of $13 million in the International Operations and Programs account to support the Intergovernmental Panel on Climate Change and the United Nations Framework Convention on Climate Change. Note that funding is provided through the ESF account for the Least Developed Countries Fund and Special Climate Change Fund. 2 Lyall, Sarah. “Heat, Flood or Icy Cold, Extreme Weather Rages Worldwide,” The New York Times, January 13, 2013. http://www.nytimes. com/2013/01/11/science/earth/extreme-weather-grows-in-frequency-and-intensity-around-world.html?pagewanted=all. 3 For a tally of the extreme weather events in the U.S., see http://www.nrdc.org/health/extremeweather/.

Funding History

Biodiversity
FY2014 Recommendation:
across all accounts

$200 million
Purpose
U.S. biodiversity programs protect some of the most at-risk natural landscapes by improving natural resource management. This conserves species and ecosystems while also ensuring clean water, promoting rural stability, boosting health, securing environmental resources and reducing poverty for millions of people. Funding of $200 million is consistent with the FY2012 enacted level and the Senate FY2013 recommended level.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Sustainable development depends on healthy ecosystems. Yet according to experts, less than one-fifth of the world’s forests are intact, over half of global fish stocks are overexploited, and by the end of the century up to two-thirds of all species will be on the brink of extinction.1 People living in poverty, especially in rural areas, feel the most immediate impact when these systems are at risk, as they often draw their livelihoods directly from forests, fields, rivers and oceans. For three decades, USAID has helped boost ecological, economic and environmental sustainability. In 2010 alone, USAID helped at least 930,000 people increase their incomes through sustainable natural resource management and conservation activities.2 The recommended funding level would help improve natural resource management of approximately 70 million hectares of biologically significant areas – places around the world critical to survival of unique, rare and endemic species.3 Conserving just 25% of the world’s highest biodiversity areas would secure 56% of the value of the benefits provided by ecosystems to humankind (e.g., clean water) on which 1.1 billion of the world’s poorest people rely.4

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

45

Success Story: Sustainable Fishing Through Private-Public Partnerships
When the fishermen in her village began to struggle to catch anything from Lake Niassa, Jerusa wondered what her family would do to survive. Her father and husband were both fishermen, and she worried what her children would do with an empty lake. The creation of the Lake Niassa Aquatic Reserve in 2011 assured Jerusa that her children would not go hungry and that a host of new opportunities would provide them with a brighter future than before. Lake Niassa in Mozambique is one of the richest aquatic ecosystems on the planet, and the main source of food and income for hundreds of local communities. For years, it suffered as illegal fishing, mining and piracy depleted fish stocks and destroyed livelihoods for villagers like Jersua who live off the lake. USAID funding brought international organizations and local communities together to create a new future.

The private-public partnerships between international and local groups produced new policies that promote sustainable fishing, new economic opportunities in tourism, and a team of community rangers to protect the rich biodiversity of Lake Niassa. Local people have also received training about wildlife, natural resource management, and sustainable fishing practices, building local capacity for a sustainable future for Jerusa, her children and their lake.

References
1 “The Nature of Development,” InterAction. http://www.interaction.org/document/nature-development-full-report. 2 “Conserving Biodiversity and Forests,” USAID. http://www.usaid.gov/what-we-do/environment-and-global-climate-change/conserving-biodiversityand-forests. 3 “Biodiversity Conservation and Forestry Programs: 2011 Report,” USAID. http://transition.usaid.gov/our_work/environment/biodiversity/pdf/ biodiversity_report_2011.pdf. 4 “Global Biodiversity Conservation and the Alleviation of Poverty,” Conservation International. http://www.conservation.org/publications/Pages/WillTurner_Global-Biodiversity-Conservation-Alleviation-of-Poverty.aspx.

Helena Telkänranta/WWF-Canon

Funding History

Water
FY2014 Recommendation:
across all accounts

$400 million
Purpose
U.S. funding for water programs provides access to safe drinking water and proper sanitation to millions of people in poverty across the world. This funding improves water and sanitation in schools, clinics, hospitals and households; and helps local communities operate and maintain lasting water and sanitation projects.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Water, sanitation and hygiene (WASH) affects virtually every aspect of development: education, food security and agriculture, nutrition, health, women’s empowerment and environmental protection. • Annually, $260 billion in economic losses are associated with inadequate water and sanitation services.1 • Each year, children miss 443 million school days due to waterrelated illness.2 In FY2011, U.S. funding improved water access for more than 3.8 million people and sanitation facilities access for 1.9 million. Every dollar spent on WASH generates an estimated $4.30 in increased productivity and decreased health care costs.3 The $400 million request ($85 million above FY2012) would provide 8 million people with access to sustainable water and sanitation services – 850,000 more than in FY2012.4 Private sector contributions from NGOs, religious organizations and corporations would multiply the impact of this investment. Ongoing U.S. investment has paid off: 87% of the world’s population now has access to safe drinking water and 61% to improved sanitation.5 However, with 783 million people lacking access to safe drinking water and 2.5 billion lacking access to sanitation,6 much work remains.

For more information, contact: Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

47

Success Story: Restoring Rainwater Collection Equipment Restores Hope
Aiqire Mire was in trouble. Devastating drought in northwest Somalia left him with only eight goats to support his family, including six children. As a herdsman, this was his only source of income. His wife was forced to herd neighbors’ animals, and his older children scraped for work to help the family. Like most families in this region, they also lacked access to clean water. World Concern met with village elders and worked with them to rehabilitate Mire’s berkad, a semiunderground water reservoir. A few days of heavy rainfall filled the berkad, allowing Mire to support his family by selling water. Ongoing drought conditions in Somalia have left more than 2 million people in need of emergency aid. Many people rely on seasonal rains, which are sporadic and unreliable. Less than 30% of the population in northwest Somalia has access to drinking water, and no permanent surface water sources are available. Berkads provide a simple, sustainable means of capturing rainwater that would otherwise be lost.

With support from the Office of U.S. Foreign Disaster Assistance, World Concern partners with villagers in hard-hit rural areas of Somalia to build and rehabilitate berkads, supplying life-giving water and much-needed income in this devastated region.

References
1 “Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage,” World Health Organization. http://www.who.int/water_sanitation_health/publications/2012/global_costs/en/index.html. 2 “Human Development Report 2006: Beyond scarcity: Power, poverty and the global water crisis,” UN Development Programme, 2006. 3 “Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage,” World Health Organization, 2012. 4 Estimate of $100 per person. 5 “Progress on Sanitation and Drinking-Water: 2010 Update,” World Health Organization. http://www.unicef.org/eapro/JMP-2010Final.pdf. 6 “Progress on Drinking Water and Sanitation: Joint Monitoring Programme Report 2012,” WHO/UNICEF, 2012.

World Concern

Millennium Challenge Account
FY2014 Recommendation:

Funding History

$900 million
Purpose
The Millennium Challenge Corporation (MCC) was created by Congress in 2004 with bipartisan support as an innovative international assistance agency charged with reducing global poverty through enhancing economic growth. Using a compactbased model, the MCC forms program-oriented partnerships with developing countries committed to good governance, economic freedom and investing in their citizens.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
The MCC signs compacts with countries that are competitively selected based on independent and transparent policy indicators. Selected countries then identify their priorities for achieving sustainable economic growth. MCC compacts can include projects in agriculture, water/sanitation, transportation (roads, bridges, etc.), finance, anticorruption, and health and education. For example, a compact in Ghana has helped build a critical section of highway, while a compact in Indonesia is working to prevent childhood growth stunting and malnourishment. With five compacts coming to completion in 2013 and the possibility of new eligible candidates in 2014, the MCC is well positioned to sign several modestly sized agreements in FY2014, as well as to continue building on its existing programs. Allocating $900 million should provide sufficient funding for the MCC to continue to engage in important partnerships that increase economic growth and good governance in developing countries. The MCC’s work has produced constructive and sustainable policy changes in countries implementing compacts and in those seeking to qualify for MCC candidacy. It is also a leader in pioneering many best development practices including transparency, gender integration and country ownership.

For more information, contact: Melissa Kaplan Advocacy Manager for Aid Reform and Effectiveness InterAction mkaplan@interaction.org

49

Success Story: Fighting Food Insecurity and Famine in Mali
“The problem of water is very serious during the dry season,” said Boury Barrie, a farmer in the village of Beldinadji in Mali, “but for the first time this year, people are staying where they are for the harvest.” From 2009-2012, ACDI/VOCA, as part of a project funded by the Millennium Challenge Corporation, helped train Barrie and 10,000 other seminomadic herders to farm rice. The project established a modern farm irrigation system in the droughtand famine-prone plains of northern Mali, bringing a measure of food security to this fragile area. The former herders learned to grow irrigated rice using careful water management techniques and best practices in soil conservation and fertility. They then grew and sold $7,744,000 worth of rice over the last two seasons. By the end of the project, the newly-minted rice producers were earning an average of $1,000 per hectare in a country where the average annual income is $700 per year. Severe droughts have hit Mali’s long stretches of desert plains three times in the last 10 years, and rainfall patterns are expected to grow even less predictable. The low rainfall in 2011 had particularly disastrous consequences for the growing season: the poor harvest spiraled into food insecurity and famine in the greater Sahel region, leaving 19 million people without enough food. However, even in that time of scarcity, these farmers produced a surplus. “Everybody thought herders were incapable of successfully developing the land that the project has given us,” Demba Diallo, a chief of one of the resettled villages, remarked. “With all the positive impacts we are seeing, we are organizing ourselves to better overcome defeats.”

Leigh Hartless/ACDI/VOCA

International Organizations and Programs
FY2014 Recommendation:

Funding History

$385 million
Purpose
This account funds U.S. voluntary contributions to various international organizations. This funding allows the United States to work with other countries to address problems that benefit from international coordination and cooperation. Funding these agencies supports global health, democracy and governance, human rights, humanitarian response and other areas of concern to Americans.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
This account supports organizations that reduce poverty across the developing world: • UN Children’s Fund – UNICEF ensures the survival and wellbeing of children worldwide, focusing on immunization, early childhood development, education, HIV/AIDS and child protection. • UN Office for the Coordination of Humanitarian Affairs – UN OCHA coordinates the international response to humanitarian crises to better provide assistance to disaster victims. • UN Development Program – The UN’s primary development agency, UNDP’s programs combat poverty, promote democracy and rule of law, protect the environment, and support crisis prevention and recovery. • UN Women – UN Women helps meet the most urgent needs of women and girls by supporting women’s full participation in a country’s political, economic and social life. • Office of the United Nations High Commissioner for Human Rights – OHCHR works to ensure the enforcement of universally recognized human rights norms, including by promoting both the ratification and implementation of major human rights treaties and respect for the rule of law.

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

• Intergovernmental Panel on Climate Change/UN Framework Convention on Climate Change – Supporting the IPCC generates state-of-the art assessments and technology to better prepare for climate impacts. Investing in the UNFCCC helps generate a global response to climate change. • UN Population Fund – UNFPA is the largest multilateral provider of reproductive health services in the world. Its programs help reduce maternal and child mortality.
51

Success Story: Connecting Rural Ugandans to Innovative Technology
“What is taking place in the world, what’s happening in Libya. I can see what is happening there – the political instability,” said 12-yearold Simon Wokorach from Gulu, Uganda. Simon wants to be a journalist when he grows up, a goal that has been made much more tangible thanks to the installation of one of UNICEF’s “Digital Drums” at a youth center near his town. Simon’s interest in and knowledge of the problems that face the rest of the world serve as a strong testament to the importance of access to information – especially among youth as they form their opinions of the world and seek the skills, knowledge and independence they need to become successful, healthy adults. In Uganda, only about 10% of people have access to the Internet. The majority of Ugandans live in rural settings with little to no access to information about health, education and job training. The most isolated and vulnerable children and youth are hit the hardest by this lack of access, as they cannot benefit from the services and resources that could empower them, improving their health, safety and future. The Digital Drum, a simple, solar-powered computer made from two low-cost oil drums welded together, was created and built by UNICEF and its partners to respond to lack of access to information. These sustainable, sturdy and low-cost computers are preloaded with dynamic multimedia content on health, education, employment training and other services; and they offer Internet connections. They provide rural Ugandan communities, and children like Simon, with access to vital information and services they need. UNICEF’s Digital Drum was recognized as one of Time Magazine’s 50 Best Inventions of 2011. The International Organizations and Programs account supports the United States government’s voluntary contribution to UNICEF, which in turn supports UNICEF’s programs to save children’s lives, as well as successful investments in innovation and technology such as the Digital Drum.

Yannick Tylle/UNICEF

International Development Association
FY2014 Recommendation:

Funding History

$1.41 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
The IDA, known as the World Bank’s “Fund for the Poorest,” is one of the largest development financiers in the world’s least developed countries. Since its inception, IDA has distributed $255 billion in grants and interest-free, long-term loans, averaging $15 billion annually in recent years and directing approximately half of those funds to Africa.1 IDA plays a critical role as facilitator and financier of development projects in areas such as infrastructure, institutional development and technical support. Between 2000 and 2010, IDA built or rehabilitated over 73,000 miles of roads, enough to circle the globe nearly three times, and maintained another 84,000 miles.2 IDA financing leverages the efforts of other donors, helping developing countries create the systems and capacity they need to use donors’ funds. IDA is funded in three-year replenishment cycles. In 2010, 51 countries contributed $49.3 billion for July 2011 through June 2014. By 2015 with these funds, IDA estimates it can:

Funding for the International Development Association (IDA), an international financial institution that is part of the World Bank, leverages U.S. foreign assistance dollars and supports antipoverty programs in the poorest developing countries with long-term, no interest loans.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org Erin Jeffery Advocacy and International Development Coordinator InterAction ejeffery@interaction.org

• Immunize 200 million children; • Extend health services to over 30 million people; • Give 80 million more people access to improved water sources; • Help build more than 49,500 miles of roads; and • Train and recruit over 2 million teachers.3 Funding IDA at $1.4085 billion would fulfill the second installment of the United States’ IDA current cycle commitment of $1.3585 billion and cover $50 million to fund the Multilateral Debt Relief Initiative, which provides a group of low-income countries with 100% relief on eligible debt from three multilateral institutions.

53

Success Story: Dramatically Reducing Bolivian Infant Mortality Rates
In 1999, Bolivia struggled with some of the highest maternal and infant mortality rates in Latin America. The Bolivian government looked to the International Development Association (IDA) for help. Together, they worked to create the Health Sector Reform Program to deliver better health care to poor families across the country. In just two years, the number of births attended by trained health workers increased by 81%, and the number of children treated for pneumonia rose by 65%. Immunization coverage also jumped by 15% and the Bolivian government ramped up its spending on vaccines from $500,000 to $3 million. To build on these successes, IDA funded a project in 2001 to further reduce the infant mortality rate and to expand health coverage to an additional 2 million people by sending additional health teams with indigenous community support to the poorest regions of Bolivia. This program contributed to an overall 29% decrease in the infant mortality rate across the country.

References
1 “IDA History,” World Bank. http://www.worldbank.org/ida/ida-history.html. 2 “The World Bank’s Fund for the Poorest,” World Bank. http://www.worldbank.org/ida/what-is-ida/fund-for-the-poorest.pdf. 3 “World Bank’s Fund for the Poorest Receives Almost $50 Billion in Record Funding,” World Bank. http://go.worldbank.org/F5A0QOJ8K0.

Sara Sywulka

Global Agriculture and Food Security Program
FY2014 Recommendation:

Funding History

$158.3 million
Purpose
Funding for the Global Agriculture and Food Security Program (GAFSP), a multidonor trust fund managed by the World Bank, provides predictable, transparent, long-term investments in country and regional strategic agriculture and food security plans to increase agricultural production, link farmers to markets, reduce risk and vulnerability, improve rural livelihoods and provide technical assistance to governments.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

*Program originated in FY11

Justification
Most of the world’s poor and hungry people live in rural areas and depend on agriculture to support themselves and their families. U.S. investments in GAFSP, a critical part of Feed the Future, are on target to meet the $475 million the U.S. originally pledged through FY2013 and have mobilized funding from eight other government and private sector donors. Last October, the U.S. pledged up to $475 million over the next three years (FY2014-16) with the intention that for each dollar the U.S. contributes, other donors will contribute two. The recommended funding level of $158.3 million is one-third of the new U.S. three-year commitment to the program. GAFSP improves coordination of donor support for strategic, country-led agricultural and food security plans to produce better development results on the ground. Launched in April 2010, so far nine donors have pledged more than $1.2 billion to its operations. The United States should continue its investment in the Public Sector Window, which supports strategic country-led or regional programs and has allocated over $650 million for grants in 18 countries. GAFSP estimates that these 18 projects will help more than 7 million people become more self-sufficient.1

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

55

Success Story: Boosting Rwandan Smallholder Agriculture
Esther Nyiramanywa’s land was once barren, which was unsurprising given that – like most of the land in Rwanda – it was on the side of a steep hill. Rain ran down the hill taking the soil’s nutrients with it. Nyiramanywa fed her family from that land with difficulty. Today is a different story. Today Nyiramanywa’s farm produces more food than she ever imagined and she is making 10 times the amount of money she made last year from her farm. She and her husband are doing so well that they have been able to build a new house, grow a wider variety of fruits and vegetables and send their children to school. What was it that made such a quick and lasting difference for Nyiramanywa? It was terraces, built by her community and funded by a government of Rwanda initiative partially funded by the Global Agriculture and Food Security Program (GAFSP), a multilateral trust fund with support from the United States. These terraces have created flat farmland on the steep hills for Nyiramanywa’s entire community. With an initial investment of $6 million from the government of Rwanda, GAFSP support has allowed the program to expand by providing another $50 million in funding, enough to reach 6,000 farmers just like Nyiramanywa. GAFSP is an innovative trust fund that invests in country-owned plans and helps governments to fill gaps or test new advances in sustainable smallholder agriculture with medium- to long-term investments. U.S. leadership on the GAFSP Public Sector Window has garnered a total of almost $1 billion from 10 donors including nontraditional donors like South Korea. This funding is helping to improve the lives and livelihoods of more than 8 million people in 18 countries across Africa, Asia and Latin America.

References
1 “GAFSP Fact Sheet,” GAFSP. http://www.gafspfund.org/gafsp/sites/gafspfund.org/files/Documents/GAFSP_Combined_2Page1_Sept2012.pdf.

Katie Campbell/ActionAid

International Fund for Agricultural Development
FY2014 Recommendation:

Funding History

$32.2 million
Purpose
The International Fund for Agricultural Development (IFAD) is dedicated to enabling poor, rural people in developing countries to overcome hunger and poverty. IFAD supports smallholder farmers and poor rural producers, especially women, as well as focusing on food security and agricultural development to help reduce poverty.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
IFAD is the leading multilateral investor in the livelihoods of poor, rural agricultural producers and plays a critical leadership role in positioning small-holder farmers at the center of global efforts to strengthen food security. IFAD has over 35 years of experience in working with small-holder farmers’ organizations, and has a sharp focus on gender equality and women’s empowerment. Food and fuel price volatility, the global economic recession and extreme weather events threaten to increase hunger, poverty and political instability in many developing countries. Recent gains in the fight against hunger and poverty are at risk, and the world’s 500 million small-holder farmers face complex challenges in a rapidly transforming rural economy. IFAD’s approach to these challenges recognizes that with strategic support and investments, smallholder farmers – particularly women – have enormous potential to help achieve global food security. Funding of $32.2 million in FY2014 represents the second installment of the U.S.-pledged contribution of $90 million to IFAD’s ninth replenishment period (2013-15). It also begins to address arrears the United States has accrued in recent years. This funding is critical to increasing global food security, supporting small-holder agriculture, and building the resilience of rural communities in developing countries.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

In recent years, IFAD’s robust and far-reaching institutional reforms have significantly improved in its overall effectiveness and impact, as confirmed by several recent independent assessments.1 This improved effectiveness and efficiency will support IFAD’s effort to help 80 million poor people in rural areas pull themselves out of poverty between 2013 and 2015.2

57

Success Story: Strengthening Civil Society to Tackle Poverty
At the heart of every human experience is the desire to survive and prosper: to imagine how your life could be better and then have the means to change it yourself. Yet, every day, nearly 870 million people – one in eight of the world’s inhabitants – suffer from chronic undernourishment and cannot fulfill their most basic needs, let alone attain their dreams or desires. They represent the largest segment of the world’s poor: the almost 900 million poor women, children and men who live in rural areas. They are the small-holder farmers, poor rural producers, herders, fisherfolk and migrant workers, the artisans and indigenous peoples whose daily struggles seldom capture world attention. Yet they are at the center of everything that the International Fund for Agricultural Development (IFAD) does. In addition to providing loans and grants to developing country governments for projects to eliminate poverty, hunger and malnutrition, IFAD also provides grants to key partner institutions. One such example is a grant IFAD made to the Alliance to End Hunger for its National Alliance Partnership Program. With this funding, the project works with similar alliances in Ghana, Kenya and Uganda to help them strengthen the capacity of civil society to participate, in a sustainable way, in the development, implementation, and monitoring and evaluation of countryled agricultural development, food security and nutrition policies and activities. It has also helped them to build their organizational and financial capacity; diversify their coalitions, with particular emphasis on engaging farmers’ and producers’ organizations; and increase their capacity to engage in policy and advocacy at the national level.

References
1 “Report on the Consultations on the Ninth Replenishments of IFAD’s Resources,” IFAD. http://www.ifad.org/gbdocs/repl/9/iv/e/REPL-IX-4-R-2Rev-2.pdf. 2 “IFAD’s 2013 Results-Based Programme of Work and Regular Capital Budgets,” IFAD. https://webapps.ifad.org/members/eb/107/docs/EB-2012107-R-2-Rev-1.pdf.

Joseph Luna

McGovern-Dole International Food for Education and Child Nutrition
FY2014 Recommendation:

Funding History

$209.5 million
Purpose
Funding for the McGovern-Dole International Food for Education and Child Nutrition Program provides donations of U.S. agricultural products, as well as financial and technical assistance, for school feeding and maternal and child nutrition projects in low income, food-deficit countries that are committed to universal education. InterAction recommends $209.5 million for FY2014, consistent with the FY2010 enacted level.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Every year, some 2.5 million children die from an entirely preventable condition: malnutrition.1 According to the World Food Programme, 66 million children go to school hungry every day.2 UNICEF reports an estimated 130 million school-age children in the world’s poorest countries are undernourished and would be eligible for school feeding programs.3 The McGovern-Dole program provides school-age children in poverty-stricken countries with what is often their only full meal of the day — at an average cost of $40 per student per year — and is a cost-effective means of supporting education, child development and food security.4 Currently, the U.S. Department of Agriculture (USDA) funds 36 active agreements with 17 cooperating sponsors in 28 countries, assisting more than 4.3 million women and children through programs such as McGovern-Dole.5 Since 2000, when the predecessor to the McGovern-Dole food program was established, USDA has provided nutritious meals to more than 22 million children in 41 countries and boosted school attendance by an estimated 14% overall and by 17% for girls.6 Additionally, over the last 45 years, more than 37 national governments have successfully taken over school meal programs launched by donor countries, NGOs and international organizations, including Brazil and India, which now operate two of the largest school meal programs in the world.7

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org

59

Success Story: Giving Families Tools to Feed Themselves
When her husband lost his job, Bibi Hur feared that she would have no choice but to watch her young daughter be sold off to a 60-year-old man with two wives. Hur has seven children – three girls and four boys – and her family is extremely poor. In Afghanistan, particularly in Badghis province where Hur lives, people are grappling with widespread poverty and high unemployment rates. Even when there is work, it often doesn’t generate enough income to meet a family’s basic needs. Through the Food for Education (FFE) program funded by U.S. Department of Agriculture’s (USDA) McGovern-Dole Program, World Vision is working with the communities in Badghis and Ghor provinces to change this.

By engaging with USDA/FFE, Hur was not only able to ensure that her daughter would not be sold off in marriage, but also that her children could return to school. In 2004 she was identified as a very poor but respected woman by the village elders, and was subsequently hired as a cleaner at a USDA/FFE target school. This provided her and her family with desperately needed income. But this was just the beginning. Hur also enrolled in the adult literacy classes provided through the program. She continued to night school, graduating in 2010 with a high score, and then became a rural teacher for the local girls’ school. This position allowed her to earn enough money to properly feed her children and send them back to the school. For Hur and the many others involved in the program the positive impact of McGovern-Dole cannot be overstated. “My life has experienced a remarkable change for the better,” Hur said.

References
1 “Committing to Child Survival: A Promise Renewed – Progress Report 2012,” UNICEF, 2012. 2 “Two Minutes to Learn About: School Meals,” World Food Programme. http://documents.wfp.org/stellent/groups/public/documents/ communications/wfp249632.pdf. 3 Tracking Progress on Child and Maternal Nutrition,” UNICEF. http://www.unicef.org/publications/files/Tracking_Progress_on_Child_and_Maternal_ Nutrition_EN_110309.pdf. 4 Determined by dividing beneficiaries and funding levels from FY2008-2011. Figures taken from annual U.S. International Food Assistance Reports. 5 “U.S. International Food Assistance Report 2010,” USDA and USAID. http://transition.usaid.gov/our_work/humanitarian_assistance/ffp/fy2010. ifarreport.pdf. 6 UNICEF, “Tracking Progress” supra. 7 “Roadmap to End Hunger,” The Roadmap Group, including 1,000 Days, Alliance to End Hunger, Bread for the World, CARE, Catholic Relief Services, Congressional Hunger Center, Mercy Corps, Oxfam America, Save the Children, Women Thrive Worldwide, and World Food Program USA. http://usa.wfp.org/sites/default/files/u-6876/FINAL-roadmap_layout_web.pdf.

World Vision

International Disaster Assistance
FY2014 Recommendation:

Funding History

$1.6 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Robust funding for the International Disaster Assistance (IDA) account helps OFDA provide life-saving assistance following natural and man-made disasters, including conflicts, floods, earthquakes and droughts. This funding must be provided at the start of the fiscal year so the United States can respond quickly and effectively to unpredictable disasters, such as the humanitarian emergency in Syria, without reducing U.S. assistance to ongoing crises such as those in South Sudan and the Democratic Republic of the Congo. Global needs are mounting, with crises around the world driving global IDP numbers to over 27 million – nearly double the world refugee population. Despite facing similar challenges, IDPs receive far less international support than refugees. U.S. assistance for someone forced from their home should not hinge on whether he or she has crossed a national border. IDA also funds disaster risk reduction (DRR) activities, which build the ability of communities to prepare for and recover from disasters. DRR is chronically underfunded, yet it is invaluable. World Bank research has found that DRR investments can yield a 7-to-1 ratio of savings to investment.1 The recommended funding level includes $366 million for cash-based emergency food assistance for critical voucher programs, local and regional purchase of food, and related cash-based emergency assistance efforts that enable rapid delivery of assistance. The remaining $1.234 billion is the recommended base for IDA.

These funds enable USAID’s Office for U.S. Foreign Disaster Assistance (OFDA) to respond to international emergencies. It meets the needs of conflict- and disaster-affected people; addresses protracted emergencies; and supports disaster risk reduction activities (programs that help people prepare for and mitigate the impacts of disasters). This is also the primary account for addressing the needs of internally displaced persons (IDPs).

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

61

Success Story: Creating a Sustainable Future for South Sudanese Families
Achok Deng Agok, 45, has a story similar to nearly an entire generation of South Sudanese. She lost her husband in the civil war and fled with her children to the north where she lived and worked for nearly half her life. It was not until July 2011, when the Republic of South Sudan claimed independence, that Deng made the journey back to her home country with her family. “We came here with nothing but the clothes we were wearing,” says Deng. “We had no land, no home and no money; and we have been relying on the goodwill of my husband’s family to survive.” Concern Worldwide is helping returnees like Deng build a sustainable future in South Sudan by partnering with community-based organizations like Aweil Project Agriculture Development (APAD). “The first thing we need to do is help them earn a sustainable living,” explained Michael Piol, executive director of APAD. “Food aid was for the war time. Now we must stand on our own feet; only then can we truly develop to greater things.”

Concern and APAD secured a minimum of two acres of land each for 500 vulnerable families living in the area. With support from the Office of U.S. Foreign Disaster Assistance, Concern gave the farmers quality-assured seeds. “With one acre of land each family can grow eight or nine sacks of sorghum (198 pounds each),” Piol noted. “This is enough to feed their family all year and also gives them seeds to plant for next year’s harvest.” Another woman farmer, Adut Atak Atak, believes that 2013 will be different than any other before it. “Until now we have been surviving only with the help of others,” she predicted. “This year we will be able to feed ourselves. I know it.”

References
1 U.S. Geological Survey and the World Bank estimated that an investment of $40 billion would have prevented losses of $280 billion in the 1990s. “Natural Disaster and Disaster Risk Reduction Measures: A Desk Review of Costs and Benefits,” U.K. Department for International Development. http://www.unisdr.org/files/1071_disasterriskreductionstudy.pdf.

Concern Worldwide

Migration and Refugee Assistance
FY2014 Recommendation:

Funding History

$2.8 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Armed conflicts in countries like Syria, Mali, Somalia, Iraq and Afghanistan forced people to flee across borders at a faster rate in 2012 than in any other year this century.1 This account helps meet the needs of these refugees, whose survival depends heavily on the international humanitarian system. Robust funding for this account is also critical to assist the growing number of displaced people in protracted crisis situations and to support innovative, long-term, sustainable policies that can reduce the costs of responding to emergencies. Most refugees live in precarious conditions; reductions in assistance mean they will lack access to the most basic elements of survival: health care, safe shelter, clean water and education. Refugees often cannot safely return home, and 80% of the world’s refugees are hosted in developing countries with little capacity to support them. U.S. investment shows host nations that we support their efforts to shelter and provide for the most vulnerable. The recommended funding level would advance the protection of women and girls, internally displaced persons, victims of sexual and gender-based violence, and stateless persons. It would also support more effective implementation of the U.S. government’s urban refugee principles and its protracted refugee initiative; and improve access to traditionally underfunded solutions-oriented programs such as education and livelihoods for these vulnerable groups. Investing in these important activities lays the groundwork for refugees to become more self-sufficient and less aid-dependent in the long run.

This account enables the State Department’s Bureau of Population, Refugees, and Migration (PRM) to provide basic lifesaving assistance for refugees and to maintain the U.S. commitment to a strong refugee resettlement program. This funding supports the United Nations High Commissioner for Refugees, the International Committee of the Red Cross, and other international humanitarian agencies and nongovernmental organizations.

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

63

Success Story: Vulnerable Conflict-Displaced People Supporting Themselves
Abdul Rahman sustained injuries that left him permanently disabled when a car bomb blew up near his home. Two brothers, sadly, were both killed in the explosion. After the accident, Rahman stayed inside to avoid the discrimination against people with disabilities that is common in Iraq. However, the continuing conflict forced Rahman to join the ranks of Iraq’s internally displaced persons (IDPs) and move to Baquba. Displaced from his home region, with only an elementary-school education and limited mobility, Rahman’s future looked bleak. When Mercy Corps started a vocational training program in Baquba, local community leaders nominated Rahman to participate. He attended daily trainings for a month to learn about computer maintenance. When he was selected as one of 13 trainees to receive an internship, Rahman used his first monthly stipend to buy a second-hand computer to practice his new skills. His hard work earned him a full-time job after his internship. Rahman’s training and internship were part of a Mercy Corps program to build relationships between host communities and IDPs and refugees so that they can thrive in their new communities. Funded by the State Department’s Bureau for Population, Refugees, and Migration, the program helped build permanent solutions for extremely vulnerable groups, such as women and people with disabilities, by giving them the skills to resolve conflicts and secure employment. Rahman was one of over 480 IDPs and refugees from six conflict-affected regions in Iraq who received training. He cannot believe the transformation: “I’m working and receiving my own salary without depending on anyone else. I have skills that enabled me to find a new job … I’m so excited that I finally have a chance to become independent.”

References
1 “UNHCR Global Trends 2011,” United Nations High Commissioner for Refugees. http://www.unhcr.org/4fd6f87f9.html.

Tupungato/Shutterstock.com

Emergency Refugee and Migration Assistance
FY2014 Recommendation:

Funding History

$100 million
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
This emergency account provides a critical source of funding during unanticipated crises, and therefore should be fully funded in FY2014 up to its authorized ceiling of $100 million. In 2012, these funds were used to support PRM’s response to the needs of refugees who fled the crisis in Sudan’s South Kordofan and Blue Niles states, as well as to provide protection and support for the hundreds of thousands of Malian refugees in the Sahel. To enhance our country’s capacity to respond quickly and effectively to unanticipated crises, two structural changes to this account should be undertaken. First, the funding ceiling should be doubled to $200 million, as this ceiling has remained stagnant over the last decade and recent years have put significant stress on regular funding. Second, the Secretary of State, rather than the President, should be given the power to authorize the use of funds from the ERMA fund to speed up the response to emergencies. The current requirement of a presidential certification is cumbersome and too often results in unnecessary and costly delays in delivering critical assistance.

The Emergency Refugee and Migration Assistance fund is a drawdown account designed to ensure that the U.S. government has sufficient resources for refugee assistance in unanticipated and urgent humanitarian crises. The Department of State’s Bureau of Population, Refugees, and Migration (PRM) uses this funding to meet unexpected and urgent refugee and migration needs.

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

65

Funding History

Food for Peace Title II
FY2014 Recommendation:

$1.84 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
A core source for funding humanitarian assistance, each year Food for Peace Title II (FFP) uses donated agricultural commodities to meet the emergency food needs of up to 100 million people facing acute hunger due to conflicts or natural disasters.1 Through the United States Department of Agriculture (USDA) appropriations, FFP also provides multiyear funding for development programs that increase resilience of communities and reduce the need for emergency assistance. Since FFP began in 1954, more than 3 billion people in 150 countries have benefited from U.S. food aid,2 and the prevalence of stunting among children under 5 has been reduced by an average of 2.4% per year.3 Yet 870 million people still suffer from malnutrition and hunger,4 while some 2.5 million children die each year from malnutrition.5 Over the past two years, according to the World Food Programme, the annual global food assistance need has been roughly $6.5 billion; it will likely remain similar in 2014. Due to global food price volatility, increasingly frequent weather-related food security crises, and continuing conflict in many parts of the world, these needs are not expected to decline. Despite these issues, the FFP appropriation has declined steadily: from a total (including supplemental) appropriation of $2.32 billion in FY2009 to $1.47 billion in FY2012. Supporting FFP at $1.84 billion would maintain U.S. leadership in providing emergency food assistance, while also acknowledging increased U.S. contributions to food security in other accounts.

Food for Peace Title II programs provide emergency food assistance to people affected by natural disasters, food security crises and conflict. Its programs also promote resilience and long-term food security through multiyear investments in nutrition, agricultural productivity and diversifying household incomes of smallholder farmers and vulnerable populations. The recommended $1.84 billion matches the FY2010 enacted level.

For more information, contact: Katie Lee Advocacy and Policy Coordinator for International Development InterAction klee@interaction.org Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

67

Success Story: Helping Children to Grow Up Strong in Guatemala
For Lucia, joining a food program with her 16-monthold baby, Maria, was a life-changing decision. Maria was often sick, underdeveloped and inactive, which worried her mother. By attending monthly educational sessions, which were taught in the local language, Q’eqchi, Lucia gained the knowledge she needed to make healthier choices for her children. Using this new knowledge, Lucia has seen the health of each family member – especially Maria – noticeably improve. In the northern highlands of Guatemala, the signs and symptoms of malnutrition are a common sight: stunted growth, underweight bodies and visible fatigue. According to a study by the World Food Programme, Guatemala has the highest rate of malnutrition in Latin America. Common misconceptions about nutrition (such as the belief that breast milk is insufficient to quench a baby’s thirst) make it difficult for mothers to incorporate healthy practices into their cooking. But Mercy Corps is empowering women to change. The Mother-Child Community Food Diversification Program (PROCOMIDA in Spanish) is a six-year program funded by USAID’s Office of Food for Peace that strives to prevent malnutrition before it starts. Through the program, Mercy Corps distributes food rations to impoverished families and educates mothers and caregivers on their children’s nutritional needs, as well as proper food handling and household sanitation. They participate in monthly cooking demonstrations, learning how to best use their food rations with local produce to prepare nutritious meals. PROCOMIDA also connects mothers with local health services, so they are better able to seek professional help when it is needed – ensuring that their children stay healthy.

References
1 “A Roadmap for Continued U.S. Leadership to End Global Hunger.” http://womenthrive.org/sites/default/files/docs/resources/final-roadmap_ layout_web.pdf. (hereinafter “Roadmap”) 2 “What is Food for Peace?” USAID. http://transition.usaid.gov/our_work/humanitarian_assistance/ffp/ . 3 Roadmap, supra. 4 “The State of Food Insecurity in the World,” Food and Agriculture Organization. http://www.fao.org/docrep/016/i3027e/i3027e.pdf. 5 “Committing to Child Survival: A Promise Renewed – Progress Report 2012,” UNICEF. http://www.unicef.org/videoaudio/PDFs/APR_Progress_ Report_2012_final.pdf.

Maria Kasparian/Mercy Corps

Contributions to International Peacekeeping Activities
FY2014 Recommendation:

Funding History

$2.179 billion
Purpose
This account funds the United States’ assessed obligations to UN peacekeeping missions. These peacekeeping missions support and implement the terms of ceasefires and peace agreements; enhance the protection of civilian populations during armed conflict; protect and promote human rights; support the organization of elections; assist in restoring the rule of law; and build government capacity.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
Roughly 120,000 UN peacekeepers are deployed in 15 missions on four continents, a nearly three-fold increase over the last 10 years. These operations all originate with the UN Security Council and are managed by the UN Department of Peacekeeping Operations. UN peacekeeping missions advance U.S. interests by resolving conflicts, restoring peace and enhancing regional stability. Strong U.S. financial support plays a critical role in ensuring these missions are successful and have the resources needed to address complex conflict situations and advance peace around the world. Overall, peacekeeping has proven to be a successful, cost-efficient way to promote international peace and security. A RAND study found multinational UN forces far better suited than unilateral U.S. forces to perform peacekeeping responsibilities.1 The Government Accountability Office concluded UN peacekeeping is eight times less expensive than funding a U.S. force2 and the Office of Management and Budget (OMB) gave the CIPA account its highest grade under its Program Assessment Rating Tool, a diagnostic tool that measures the effectiveness of federal programs. Another study found that in the first three years after a conflict, UN peacekeeping missions have a substantial effect on economic growth. National economies in post-conflict countries with peacekeeping missions grow at nearly a 2.5% faster rate than the economies of postconflict countries without UN missions.3

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

69

Success Story: A Peaceful Future for Timor-Leste
With the last United Nations peacekeepers brought in to restore peace and stability in Timor-Leste (East Timor) boarding a plane home in December 2012, the Southeast Asian nation is emerging from decades of violence. A positive future for Timor-Leste was not always in the cards. The Indonesian army’s quarter-century grasp on the island claimed the lives of more than 200,000 through violence, hunger and illness. However, today Timor-Leste is a functioning democracy with two free and fair presidential and parliamentary elections facilitated by the UN under its belt. The UN leaves a democratically-elected legislature that is 38% female – the highest representation of women in parliament in the entire Asia-Pacific region. The UN Peacekeeping mission in Timor-Leste (UNMIT) has left behind a fully self-sufficient Timorese national police force. UNMIT strengthened Timorese police by helping to recruit, vet and train police officers; support relationships between the police and judiciary; and promote human rights and address gender-based violence. And Timor-Leste and Indonesia have built a new relationship, while Indonesia has also waged its own efforts to end government corruption and elect accountable leaders. The nation’s path to recovery – including a steady investment from the United Nations – has been a long one. But it is a model that saved lives, enabled an operational democracy, and created huge potential for economic growth.
United Nations

References
1 “The UN’s Role in Nation-Building,” RAND Corporation. http://www.rand.org/content/dam/rand/pubs/monographs/2005/RAND_MG304.sum.pdf. 2 “Peacekeeping: Cost Comparison of Actual UN and Hypothetical U.S. Operations in Haiti,” U.S. House Subcommittee on Oversight and Investigations, Committee on International Relations. http://www.gao.gov/new.items/d06331.pdf. 3 “World Development Report 2011 Background Paper: Post-Conflict Recovery and Peacebuilding,” World Bank. https://openknowledge.worldbank. org/bitstream/handle/10986/9184/WDR2011_0010.pdf?sequence=1.

Funding History

Peacekeeping Operations
FY2014 Recommendation:

$257 million
Purpose
This account funds multilateral UN and regional peacekeeping and security forces, as well as training programs that increase the capacity of relevant countries to participate in such forces.

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
U.S.-funded programs that train, equip and support the deployment of foreign security forces for international peacekeeping operations are essential to improving international security, sustaining and consolidating peace settlements, promoting institutions that preserve the rule of law, and enhancing the protection of civilians in conflict areas. Professional, well-equipped international peacekeepers reduce the burden on the United States by mitigating protracted armed conflict and consolidating peace at a fraction of the cost of U.S. intervention – a mere 12 cents to the dollar according to the Government Accountability Office.1 Funding at this level will ensure continued U.S. investments for these critical programs, which enable the United States to enhance the capabilities of our partner nations, expand the pool of properly trained peacekeepers and promote international security.

For more information, contact: Kari Fuglesten Legislative Coordinator for Humanitarian Affairs InterAction kfuglesten@interaction.org

71

Success Story: Seeding Stability in a Fragile State
Somalia has witnessed dramatic changes in the past year. After more than 20 years without a stable, central government, the Federal Government of Somalia was established in 2012. A new president, Hassan Sheikh Mohamud, has taken office as part of the transition to a permanent Somali government. And in January 2013, Somalia and the United States reestablished diplomatic relations after more than two decades. The African Union Mission in Somalia (AMISOM) and its United Nations partner, the UN Support Office for AMISOM (UNSOA), have played a major role in this transformation. AMISOM forces have consolidated control over the capital region, thereby expanding opportunities to address humanitarian need in Mogadishu and establish basic governmental functions.  In turn, this has enabled the government to attract much-needed foreign investment, and lay the groundwork for meaningful reform of the Somali security forces. As the mission seeks to operate in more parts of Somalia, the effective integration and equipping of new units should be prioritized. All AMISOM forces must continue to be trained in human rights and international humanitarian law, and their compliance ensured through practical support. This will enhance AMISOM’s ability to protect Somali civilians, while also serving as a positive example for Somalia’s nascent army and police. Continued U.S. support through the Peacekeeping Operations is critical to maintain the nascent progress in this fragile and critical country – just as it is essential to efforts to respond to other crises around the world.

References
1 “Peacekeeping: Cost Comparison of Actual UN and Hypothetical U.S. Operations in Haiti,” U.S. House Subcommittee on Oversight and Investigations, Committee on International Relations. http://www.gao.gov/new.items/d06331.pdf.

pavalena/Shutterstock.com

USAID Operating Expenses
FY2014 Recommendation:

Funding History

$1.4 billion
Purpose

Enacted FY13 CR Post-Sequestration (estimated) FY14 InterAction Recommendation

Justification
U.S. foreign policy objectives – both short- and long-term – require USAID engagement around the world. Cuts to the USAID operating budget do not reduce those requirements; they stretch the agency ever thinner, leading to reduced efficiency, effectiveness and oversight. After years of counterproductive cuts in staffing, the Development Leadership Initiative, initiated by the Bush administration and continued by the Obama administration, has allowed USAID to hire additional staff. These recent staffing increases have given USAID the capacity to implement programs and capitalize on technological innovations that foster solutions to complex development problems. Staffing levels must be sustained for USAID to carry out humanitarian and development assistance programs effectively and to have the technical capacity to assess what is working and what is not. They are also needed to uphold USAID’s part of the three-legged national security stool: defense, diplomacy and development. Full operational funding for USAID also supports USAID Forward, a package of reforms designed to strengthen, streamline and optimize the way USAID does business. Fully funding USAID’s Capital Investment Fund enables USAID to modernize and improve information technology (IT) systems. Importantly, this fund also allows USAID to work with the State Department to construct facilities that will keep our civilian representatives serving their country abroad safe. As USAID strives to increase accountability, transparency and efficiency, up-to-date information management systems are vital. This funding will support continued modernization of such systems, as well as consolidation of USAID and State Department IT platforms as prescribed by the Quadrennial Diplomacy and Development Review (QDDR).

USAID Operating Expenses improve efficiency and ensure U.S. taxpayer dollars are spent properly and in a manner ensuring the greatest maximum benefit for our nation’s investment while meeting the needs of the world’s most vulnerable populations.

For more information, contact: Jeremy Kadden Senior Legislative Manager InterAction jkadden@interaction.org

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Success Story: Making USAID More Effective and Accountable
Given tight budget constraints, USAID has recently focused on better policy planning, program design, and monitoring and evaluation to increase its effectiveness in delivering aid. While still a work in progress, a signature effort of the agency entitled USAID Forward has already led to several key improvements. USAID Forward brings a focus on results-based outcomes by: 1. better aligning resources with the priorities of local civil society organizations and partner countries; 2. promoting sustainable development through building local capacity; and 3. identifying new innovations that can be scaled up to achieve better results. Notable progress includes the completion of 186 high-quality evaluations designed to translate lessons from the field into new program designs, which will increase efficiency and effectiveness. In addition, USAID used its strategic planning process to reprioritize program focus, phasing out 38 food security and global health programs too small to have a meaningful impact. Under USAID Forward, the agency has doubled the amount of mission funding invested in local governments, increasing countries’ capacities to lead their own development. At the same time, the agency carries out risk assessments of governments to protect against potential corruption in the aid process. As USAID Administrator Rajiv Shah stresses, “country ownership doesn’t mean blank checks for governments.” The USAID Forward initiative has made this progress possible. It is an investment that clearly pays off, for our government, American taxpayers and our international development partners around the globe.

Other Key Development and Humanitarian Accounts
InterAction also supports funding for the following accounts, which help reduce poverty and respond to disasters and crises around the globe.

Other Key Long-term Development Accounts Inter-American Foundation African Development Foundation Enterprise for the Americas Multilateral Investment Fund Asian Development Fund African Development Fund Debt Restructuring Global Environment Facility Economic Support Fund – Poverty-focused Project Funding Other Key Humanitarian Accounts Refugee Resettlement Complex Crises Fund Other Key Transition Accounts Conflict Stabilization Operations Transition Initiatives Economic Support Fund – Transition Funding Other Key USAID Operating Accounts USAID Capital Investment Fund USAID Inspector General Operating Expenses Other Key Development-Enabling Accounts Contributions to International Organizations Economic Support Fund – Democracy and Governance Middle East and North Africa Incentive Fund Democracy Fund National Endowment for Democracy Peace Corps Development Credit Authority Overseas Private Investment Corporation Treasury Technical Assistance Inter-American Development Bank/Investment Corporation Asian Development Bank African Development Bank European Bank for Reconstruction and Development

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InterAction FY2014 Recommendations for International Development and Humanitarian Assistance Accounts InterAction FY2014 Recommendations for International Development and Humanitarian Assistance Accounts

($ in thousands)

FY10 Total Enacted (including supp) 58,593,103 56,605,700 8,315,000 2,645,000 680,000 534,000 95,000 13,000 330,000 50,196,872 48,203,400 54,939,307 53,343,000 53,167,000 50,455,483 51,958,966 9,410,860 3,268,000 750,000 750,000 200,000 23,000 350,000

FY11 Final Enacted (w/ 0.2% across-theboard cut) FY14 InterAction Recommendation

FY13 FY13 CR Continuing FY12 Enacted PostResolution (including Sequestration including OCO OCO) including OCO (Estimated)* (Estimated)* FY 14 Presidential Request Total (Enduring + OCO)

International Affairs Total (Function 150) State, Foreign Operations Total

77
1,169,833 265,000 925,000 507,200 205,000 315,000 1,105,000 394,000 1,334,500 90,000 209,500 50,000 75,000 300,000 1,305,000 1,850,000 45,000 1,840,000 2,221,500 331,500 1,388,800 898,200 354,290 1,232,530 99,800 29,440 199,101 35,000 49,900 184,630 863,270 1,686,620 49,900 1,497,000 1,883,931 304,390 1,347,300 898,200 348,705 1,325,000 135,000 30,000 184,000 35,000 49,900 184,630 975,000 1,875,100 27,200 1,466,000 1,828,182 383,818 1,347,300 1,167,493 264,470 923,150 522,900 204,590 314,370 1,170,000 265,000 800,000 481,500 200,000 315,000 1,287,815 291,685 880,557 529,985 220,139 346,719 898,200 348,700 1,358,500 135,000 30,000 184,000 35,000 49,900 184,630 1,599,661 2,798,950 27,200 1,435,000 2,006,000 383,000 1,347,045

Global Health Initiative (GHP - USAID & State) Global Health Programs - USAID Maternal and Child Health Family Planning in all accounts Nutrition Vulnerable Children HIV/AIDS Other Infectious Diseases, total Malaria TB Neglected Tropical Diseases Global Health - State (PEPFAR Only) Global Fund to Fight AIDS, TB & Malaria NIH Global Health CDC Global Health Development Assistance 670,000 191,000 85,000 4,020,000 1,650,000 625,264 393,024 2,837,812 (FtF only) 1,060,000 1,222,136 276,809 835,649 502,956 208,912 329,037 852,392 327,000 1,289,217 128,115 28,470 174,616 33,215 47,355 175,214 1,518,078 2,656,204 25,813 1,361,815 1,886,000 366,000 1,278,346 68,000 215,700 2,045,000 1,760,960 250,000 0 2,094,661 347,000 1,399,200 468,000

7,874,000 2,515,000 549,000 648,500 75,000 15,000 350,000 981,000 585,000 225,000 65,000 4,609,000 750,000 587,610 354,403 2,520,000

7,829,310 2,495,000 548,900 613,770 90,000 15,000 349,300 968,100 618,800 224,600 76,800 4,585,810 748,500 619,300 340,265 2,518,950

8,167,860 2,625,000 605,550 610,000 95,000 17,500 350,000 1,033,000 650,000 236,000 89,000 4,242,860 1,300,000 581,000 347,600 2,519,950

8,470,000 2,750,000 626,085 630,686 98,222 18,093 361,869 1,068,031 672,043 244,003 92,018 4,070,000 1,650,000 581,000 347,600 2,845,350

8,038,030 2,609,750 594,155 598,521 93,212 17,171 343,414 1,013,561 637,768 231,559 87,325 3,862,430 1,565,850 551,369 329,872 2,700,237

670,000 400,000 125,000 4,492,860 1,650,000 605,700 362,900 3,175,000

898,200 320,645 1,503,800 135,000 30,000 185,126

1,445,000 265,000 925,000 468,000 200,000 400,000 1,650,000 900,000 385,000 1,408,500 158,330 32,243 209,500 50,000 5,000 100,000 300,000 1,600,000 2,800,000 100,000 1,840,000 2,179,000 257,000 1,400,000

Food Security & Agriculture in all bilateral accounts Microfinance in all accounts Basic Education in all accounts Climate Change in all Bilateral accounts Biodiversity in all accounts Water in all accounts Gender in all accounts Millennium Challenge Corporation International Organizations and Programs International Development Association Global Agriculture and Food Security Program International Fund for Agricultural Development McGovern-Dole International Food For Education & Child Nutrition Least Developed Countries Fund & Special Climate Change Fund Green Climate Fund Strategic Climate Fund Clean Technology Fund

International Disaster Assistance Migration and Refugee Assistance Emergency Refugee and Migration Assistance Food for Peace Title II Contributions to International Peacekeeping Activities Peacekeeping Operations

*The FY13 CR did not specify exact funding levels for some accounts. For the Global Health (USAID) and Development Assistance (DA) subaccounts, FY13 funding levels are estimated based on a proportional distribution of the additional funding for FY13 for Global Health (USAID) ($125 million) and DA ($325.4 million) overall.  First, each subaccount’s proportion of the total Global Health (USAID) or DA funding level in FY12 was calculated. This proportion was multiplied by the additional funding provided and added to FY12 subaccount level of funding to create the estimate.

USAID Operating Expenses

InterAction Also Supports Strong Funding for These Key Accounts in FY2013 InterAction Also Supports Strong Funding for These Key Accounts in FY2014

($ in thousands)

FY10 Total Enacted (including supp)

FY11 Final Enacted (w/ 0.2% across-theboard cut)

FY13 FY13 CR Continuing FY12 Enacted PostResolution (including Sequestration including OCO OCO) including OCO (Estimated)* (Estimated)* FY 14 Presidential Request Total (Enduring + OCO)

Other Key Poverty Accounts Inter-American Foundation African Development Foundation Enterprise for the Americas Multilateral Investment Fund Asian Development Fund African Development Fund Debt Restructuring Global Environment Facility (GEF) ESF - Poverty-focused Project Funding 23,000 30,000 25,000 105,000 155,000 60,000 86,500 22,454 29,441 24,950 0 109,780 49,900 89,820 22,500 30,000 25,000 100,000 172,500 12,000 89,820 22,500 30,000 15,000 100,000 172,500 12,000 129,400 21,353 28,470 14,235 94,900 163,703 11,388 122,801

18,100 24,000 6,298 115,250 195,000 0 143,750

Other Key Humanitarian Accounts Refugee Resettlement - HHS Complex Crises Fund 50,000 150,000 55,000 39,920 43,500 56,695 39,920 769,789 40,000

769,789 40,000 43,500 56,695

730,530 37,960 41,282 53,804

40,000 45,207 57,600

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185,000 54,400 1,682,500 120,000 138,000 400,000 25,000 29,000 32,100 74,670 0 0 1,578,651 114,770 117,764 374,250 29,940 18,079 25,448 20,958 106,373 0 129,740 44,910

Other Key Transition Accounts Conflict Stabilization Operations (State and AID) Transition Intitiatives ESF - Transition Project Funding

Other Key USAID Operating Accounts USAID Capital Investment Fund USAID IG Operating Expenses

129,700 51,000 1,551,000 114,770 117,764 375,000 40,000 25,000 27,000 79,670 106,586 32,418

129,700 51,000 1,560,000 114,770 117,764 375,000 40,000 25,000 27,000 111,153 106,586 32,418

123,085 48,399 1,480,440 108,917 111,758 355,875 37,960 23,725 25,623 105,484 101,150 30,765

117,940 54,200 1,573,454 580,000 103,450 378,800 40,000 23,500 102,020 106,586 32,418

Other Key Development-Enabling Accounts Contributions to International Organizations ESF - Democracy and Governance Project Funding Middle East and North Africa Incentive Fund Democracy Fund National Endowment for Democracy (NED) Peace Corps Development Credit Authority (Program Account only) [By transfer, not direct appropriations] OPIC (Credit Subsidy only) Treasury Technical Assistance Inter-American Development Bank/Investment Corporation Asian Development Bank African Development Bank