Policy Updates

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In US senate hearings, experts say best path forward is reform of, not departure from, WHO

Amid threats by President Trump to withdraw from the World Health Organization (WHO), the US Senate Foreign Relations Committee heard from experts on how to best respond to the COVID-19 pandemic. Although different views were expressed on details, the experts had a common message: work with the WHO towards reform.

Although a number of proposals for new entities to address global health security have been made, the experts warned against the creation of new structures that would work in parallel to WHO. Instead, the testimony stressed that reforming and improving the WHO was the best way forward. More funding is needed, they say, and WHO also needs stronger inspection rights so that it can better hold countries accountable. Internal US reforms are also needed, such a reinstating senior leadership in the National Security Council to coordinate global health security.  

News article - Devex

Donor Tracker to host webinar on donors’ international COVID-19 response following Global Goal Summit pledges

On July 2, 2020, from 16:00-17:00 (CEST), Donor Tracker will host a second webinar on donor countries’ international COVID-19 responses following the Global Goal Summit. The Summit, held on June 27, raised US$6.9 billion for developing globally accessible COVID-19 vaccines, diagnostics, and treatments.

The Donor Tracker's expert team will analyze the Summit's outcomes and discuss implications for donor countries’ further international responses to the pandemic.

Registration - Zoom 

US Supreme Court upholds law requiring prostitution and sex trafficking policy for HIV/AIDS funding

In a major loss for HIV/AIDS advocates, the United States Supreme Court upheld a provision in a 2003 law that required foreign entities receiving US funds for HIV/AIDS programming to have an explicit policy opposing prostitution and sex trafficking.

Although a 2013 decision found the same provision as applied to US-based NGOs to be a violation of their First Amendment rights, the Supreme Court, found that foreign affiliates of US organizations did not have the same protections. The decision, U.S. Agency for International Development v. Alliance for Open Society International, was decided by 5-3 vote.

News article - SCOTUSblog

US DFC to release impact measurement tool for public comment

The United States Development Finance Corporation (DFC) plans to publicly release its new tool for measuring the development impact of its investments and allow for a public comment period.

The new tool, called the Impact Quotient (IQ), has been in development for at least a year. According to the DFC's CEO, the IQ will develop objectives for each project, take into account country context, and look at potential negative risks, including environmental and social aspects. The IQ will have three main pillars: innovation, economic growth, and inclusion. Within each of those pillars, there will be sub-objectives, such as job growth and new financing mechanisms.

In the lead up to the final IQ, DFC's predecessor, the Overseas Private Investment Corporation, engaged in a robust consultation with the development stakeholder community, and now the DFC will open the IQ for public comment.

News article - Devex

US Senate debates COVID-19 response, WHO withdrawal decision

The US Senate Foreign Relations Committee held an, at times contentious, committee hearing on June 19, 2020, covering topics including the delay in spending of the supplemental appropriations passed by Congress in March and the US decision to withdraw from the World Health Organization (WHO). Both the State Department and the US Agency for International Development (USAID) appeared before the committee to answer questions about the administration's budget proposal. Secretary of State Mike Pompeo did not appear, a move which was criticized by Senator Bob Menendez, the ranking member of the committee.

Some of the debate focused on the administration's global health security proposal, which aims to move most global health programs out of USAID and into the State Department. Senator Menendez was sharply critical of the idea, expressing concern about the impact on USAID's ability to effectively do its work.

Chairman Risch diverted from the usual Republican criticism of the WHO to offer support for the work of the UN agency. Although the WHO needs some reforms, he said, the WHO does "some great work" and noted that he had talked directly to the WHO leadership to encourage changes to pandemic responses.

Senator Menendez asked the Health and Human Services (HHS) representative why the WHO should listen to the US, given its decision to withdraw. According to HHS, the US is still a member of WHO and is coordinating with other G7 ministers on the COVID-19 response.

News article - Devex

Bill and Melinda Gates criticize US' lack of leadership on COVID-19 response

Speaking before a group of over 200 philanthropists, both Bill and Melinda Gates criticized the US' global response to COVID-19. In particular, they called out the US for its decision to withdraw funding from the World Health Organization (WHO) and for stepping away from its traditional leadership role in helping to find global solutions to the world's largest problems.

One of their chief concerns was ensuring that after a COVID-19 vaccine is developed it does not go to the highest-bidder countries. They emphasized the importance of ensuring that any newly developed vaccine goes first to those most in need, including health care workers and vulnerable populations. 

It is estimated that the world will need 10 billion doses to innoculate 80% of the world's population through a two-shot vaccine. The Gates Foundation will work with both the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as Gavi, the Vaccine Alliance, to try to ensure equitable distribution of any vaccine.

News article - Forbes

Two former USAID heads criticize administration's plan to move pandemic response to the State Department

Two former Administrators of the United States Agency for International Development (USAID), one a Democrat and the other a Republican, strongly criticized a recent proposal by the Trump administration to move control of pandemic responses to the US Department of State (State).

Brian Atwood, who served under President Clinton, and Andrew Natsios, who served under President G.W. Bush, called the idea "counterproductive" and one that would both add costs and delay a US response during a pandemic.

The restructuring, dubbed the Pompeo Proposal, would move most of USAID's global health program to State. This would detach health from other development programs, such as food and nutrition programs, which are often critical to avoiding deaths. Further, while State has the political skills to respond to political crises, it does not have the capacity to manage large scale development programs or emergency responses.

The Pompeo Proposal would require Congressional approval.

Op-ed - Politico 

USAID gives long-awaited clarification on rules for purchase of PPE by relief workers

The United States Agency for International Development (USAID) has clarified the guidance regarding implementing partners' ability to purchase personal protective equipment (PPE) using USAID funds. The long-awaited guidance laid out broad restrictions against USAID implementing partners using any funds for PPE without prior written approval.

There are two exceptions to the restrictions -- one is for use by staff under any USAID grant or contract. The other is to allow the purchase of PPE for beneficiaries if the materials are manufactured in the area where assistance is provided, but only if the PPE is not intended for the US market. The guidance, which has been held up for months, has meant that relief groups have only received a portion of the US$1.6 billion that Congress approved in March as part of the global COVID-19 response. It will remain in effect until there is a surplus of PPE available in the US. 

News article - The New York Times

Guidance - USAID

US claims to lead global COVID-19 response efforts, but only fraction of promised assistance has been delivered

Although the US Trump administration claims to have led in the global response to COVID-19, over 75% of the assistance that Congress approved in March of 2020 has yet to be spent. Two supplemental appropriations containing foreign assistance funding have passed in Congress since that time, totaling US$1.6 billion, most of which was to be spent through the US Department of State ('State') and the United States Agency for International Development (USAID).

Although State and USAID have so far committed to spending US$1 billion on pandemic assistance to more than 100 countries, only US$386 million has actually been released to the countries in need and, of that total, only US$11 million has been provided to private relief organizations. Relief groups on the front lines, to whom where the money was supposed to be transferred quickly, expressed alarm that the funds are unspent, hurting prevention efforts.

The delay is attributed to slow decisionmaking and micromanagement as well as the lack of a ruling on whether funds can be spent on personal protective equipment (PPE). USAID had earlier put a restriction on the use of grant money for PPE until the White House had clarified its position.

The delays are likely to affect future funding decisions in Congress about additional money for the global response. 

News article - The New York Times

US pledges US$1.2 billion at Gavi's Global Vaccine Summit: 16% increase from 2015 pledge

At the Global Vaccine Summit, convened by Gavi, the Vaccine Alliance in London on June 4, 2020, the US reiterated its US$1.2 billion pledge for fiscal years (FY) 2020-2023, representing a 16% increase from the US pledge in 2015.

All pledges must be approved by Congress, which has already provided US$290 million for FY2020. The president's budget for FY2021, which Congress has not yet considered, includes US$290 million in support of Gavi.

Press release - USAID

Video - USAID

At Gavi's Global Vaccine Summit, world leaders exceed funding target with historic US$8.8 billion

Representatives of 52 countries, including 35 heads of state, joined the June 5, 2020, Global Vaccine Summit, convened by Gavi, the Vaccine Alliance, to raise a total of US$8.8 billion in financing for childhood immunizations and vaccine infrastructure. World leaders, meeting with representatives of 12 organizations and corporations for the London-based pledging moment, hoped to reach a US$7.4 billion funding target. By the time the pledging ended, the target had been overshot by US$1.4 billion.

Against the backdrop of a still-raging COVID-19 pandemic which has claimed the lives of hundreds of thousands and laid waste to the global economy, attendees of the summit spoke passionately about the need for global cooperation and solidarity in ensuring that a vaccine against the novel coronavirus, once developed, be accessible to all.

The US$8.8 billion will support Gavi's campaign to vaccinate 300 million children in the world's poorest countries against diseases including diphtheria, polio, and measles by 2025. Disruptions to Gavi's regular immunization activities, caused by COVID-19, have endangered an estimated 80 million children under one year old. The funding will also bolster Gavi's efforts in strengthening health systems in low-income states which have been ravaged by the pandemic and will help build out infrastructure to support the eventual provision of a vaccine against the virus.

A further US$567 million was also raised for 'Gavi Advance Market Commitment for COVID-19 Vaccines' (Gavi Covax AMC), a new financing instrument designed to provide access to the eventual COVID-19 vaccine specifically in low- and middle-income countries.

“To beat the COVID-19 pandemic, the world needs more than breakthrough science. It needs breakthrough generosity,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation. “...When COVID-19 vaccines are ready, this funding and global coordination will ensure that people all over the world will be able to access them.”

Press release - Gavi, the Vaccine Alliance

Trump signs executive order directing US agencies to protect religious freedom

US President Donald Trump signed an executive order, 'Advancing International Religious Freedom', requiring both the US Department of State ('State') and the US Agency for International Development (USAID) to fund projects and programs that protect religious freedoms globally.

The order, signed without fanfare, directs State and USAID to spend US$50 million in countries that have been found to violate religious freedoms. Diplomats must also increase their efforts to raise issues of concern with partner countries where religious discrimination was an issue. In April of 2020, the US Commission on International Religious Freedom (USCIRF) issued its annual report, designating certain countries as "Countries of Particular Concern." Designated countries include India, Nigeria, Russia, Syria, Vietnam, Burma, China, Eritrea, Iran, North Kora, Pakistan, Saudi Arabia, Tajikistan, and Turkmenistan. The USCIRF is an independent, bipartisan US government advisory board. 

News article - The Hill

Trump's decision to withdraw from the WHO sparks lots of criticism in US

US President Donald Trump announced his decision to withdraw from the World Health Organization (WHO) following an earlier move to freeze all funding to the organization while the US undertook a 60-day review. Criticism was swift and widespread, including from US medical groups such as the American Academy of Pediatrics, whose CEO said the move could endanger children, cause a surge in polio cases, an increase in deaths from malaria, and undermine vaccination campaigns. The president of the American Medical Association said the decision was illogical and will hurt the response to COVID-19. The former head of the US Centers for Disease Control also condemned the decision, saying that it will make both the US and the world less safe.

Trump reportedly cut ties with the WHO because it had allowed China to mislead the world about COVID-19.

News article - CNN

US development experts scratch heads as Trump grants DFC domestic supply chain investment powers

In a move that surprised development experts, US President Trump gave the new Development Finance Corporation (DFC) the power to invest in domestic supply chains. The agency, which just opened its doors in January 2020, is supposed to focus a significant amount of its investments in low- and lower-middle-income countries. Under the new executive order, the DFC will now have a separate unit to provide loans and make purchases to improve the US supply chain related to COVID-19. 

The executive order invoked the Defense Production Act and will expire in two years. Development experts questioned why this new agency, which is still not fully operational, would be tapped with this domestic function.    

News articles - Devex 

US State Department makes play for new health security powers

In a move that could shift much of the US COVID-19 pandemic response from the United States Agency for International Development (USAID) to the US Department of State (State), the US has issued a proposal to restructure the response through a new office at State.

The proposal would create a new coordinator role and appears largely to be modeled after the President's Emergency Response for AIDS Relief (PEPFAR), which is also part of State. This whole-of-government approach would be run by a unit called America's Response to Outbreaks (ARO) and would coordinate the pandemic response across all agencies. Although the proposal is short on details, government sources raised concerns about the impact such a new office would have on USAID's role and its ability to provide an integrated response.

Congressional approval to create the new offices and make the appropriations will be necessary.  There are several different bills that have been introduced in the US House and US Senate to address health care security and pandemic response. The latest bill was introduced by the Chair of the Foreign Relations Committee, Senator James Risch, and co-sponsored by Senate Democrats Chris Murphy and Ben Cardin. The legislation would reorganize the US global health security leadership and would provide US$3 billion in funding for fiscal years 2021-2025. 

News article - Devex

News article - Politico

News article - Devex

Following US accusations, UN denies using COVID-19 funds to "promote abortion"

The UN firmly denied an accusation by the acting administrator of the United States Agency for International Development (USAID) that the UN was using the COVID-19 response to "promote" abortion.

A letter sent by USAID claimed that sexual and reproductive health was given the same level of importance as other essential services, such as food insecurity and essential healthcare, in order to advance abortion. The UN spokesperson denied the claim, stating that while the UN supports "healthcare that prevents millions of women from dying during pregnancy and childbirth and protects people from sexually transmitted infections, including HIV, we do not seek to override any national laws."

News article - The New York Times

Renewing attacks on WHO, Trump threatens to permanently cut funding and membership

In a renewal of his attacks on the World Health Organization (WHO), US President Trump sent a letter to the organization demanding that substantive changes be made within thirty days. Failure to do so might result in the US permanently cutting funding and membership to the WHO.

Trump didn't specify the changes that were needed but had earlier tweeted a letter sent to the head of the WHO, claiming mismanagement of the pandemic and charging that the WHO was weak in responding to China. Previously, Trump had frozen US funding to the WHO, a move criticized by many as simply an attempt to deflect attention away from his own mishandling of the US COVID-19 response. 

News article - The Washington Post

Leading foreign policy voice in US Senate says there is bipartisan support for signficant international COVID-19 funding

One of the leading voices for US foreign policy in the US Congress said that the US is "fundamentally misresourced" to respond to global health threats.

Senator Chris Murphy has joined a call by US development stakeholders to have US$12 billion in international funding added to the next supplemental COVID-19 response bill. The US House of Representatives is due to vote on a US$3 trillion bill this week; no international funding is included in the legislation.

Last week, a group of US Democratic senators introduced a US$9 billion bill for international spending. Murphy stated that there is "enormous" bipartisan support in the US Senate for significant international funding in the next emergency COVID-19 supplemental appropriations.

News article - Devex

Statement - InterAction


US senate Democrats introduce legislation for US$9 billion in international COVID-19 assistance

Nine US Democratic senators introduced legislation to authorize US$9 billion in funding to help with the international COVID-19 response. The bill, 'COVID-19 International Response and Recovery Act', known as CIRRA, calls upon the US to assert strong leadership at the global level and to work with the multilateral fora to help ensure a "comprehensive and coordinated response." CIRRA also included: 

  • The immediate restoration of funding to the World Health Organization, including payment of arrears;
  • US$2.8 billion for the United Nations, including US$500 million for the COVID-19 Global Humanitarian Response Plan;
  • US$4.4 billion for humanitarian relief;
  • US$1 billion in funding to the Global Fund for AIDS, Tuberculosis and Malaria; and 
  • US$200 million for the Coalition for Epidemic Preparedness Innovations (CEPI).

CIRRA will also restore funding to the United Nations Population Fund (UNFPA), which the Trump administration had stopped, and called for global health security functions to be restored in accordance with the Global Health Security Act.  The bill singled out the role of the new US Development Finance Corporation (DFC), calling upon it to take on riskier investments that could have a greater development impact and providing for a new surge financing authority for the DFC to speed decision making in the COVID-19 response.  

The development stakeholder community had pushed for a slightly larger response package of US$12 billion. Passage of this legislation in its entirety is not viewed as likely, especially given the UNFPA mandate, but parts of it could be added to any further relief bills that Congress considers. 

News article - Devex

As US Supreme Court hears arguments on PEPFAR's anti-prostituton pledge, experts worry pro-Trump ruling could mean more conditioning of US assistance

For the second time in seven years, the United States Supreme Court heard arguments as to whether foreign organizations can be subject to an anti-prostitution pledge as a condition of receiving funds under the President's Emergency Plan for AIDS Relief (PEPFAR).

In a ruling in 2013, the Supreme Court held that such a pledge restricted the constitutional rights of US organizations. In the current case, the Trump administration attempted to prohibit PEPFAR funds from going to foreign affiliates of US organizations unless they denounced prostitution. The Court, which heard arguments by phone due to the COVID-19 pandemic, appeared skeptical that there was any difference between US- and foreign-based organizations. The case was brought on behalf of a number of US NGOs, including InterAction, Save the Children, and World Vision. During the argument, some justices raised concerns that such restrictions could have broader implications for attaching other conditions to US foreign assistance.

News article - Aljazeera