Policy Updates

From July 7 through 19, 2024, Japanese Health Minister Keizo Takemi undertook key diplomatic missions to the US and China, highlighting Japan’s proactive stance in global health policy and international development cooperation.

From July 7 to 14, 2024, Takemi visited the US to engage with pharmaceutical R&D stakeholders in San Francisco and participate in health policy dialogues with Secretary Xavier Becerra in Washington, DC. He attended a reception by the Northern California Japan Society and visited the Japan Innovation Campus in Silicon Valley, focusing on advancing Japan’s drug discovery ecosystem and fostering collaborative health initiatives.

From July 17 to 19, Takemi traveled to Beijing to meet with senior Chinese officials, including the head of the National Health Commission. Discussions centered on bilateral cooperation in addressing aging populations and preparing for the upcoming Japan-China-Korea Health Ministers' Meeting. Takemi also participated in the Boao Forum’s Global Health Forum, where he emphasized Japan’s contributions to international health through initiatives such as the UHC Knowledge Hub and the establishment of the Japan Institute for Health Security(JIHS).

On July 18, 2024, the US announced additional humanitarian assistance to both Chad and Sudan to help alleviate urgent humanitarian needs, totaling US$203 million for the people of Sudan and US$69 million for the people of Chad.

The assistance in Chad is intended to help address the needs of crisis-affection populations that are facing severe food insecurity, in part because of the conflict in Sudan and the refugee crisis it has caused. In Sudan, populations are facing historic levels of food insecurity, including famine.

In both cases, the humanitarian assistance will include food, nutrition, health care, WASH services, shelter, and cash. The assistance funding comes through both the US State Department and USAID.

On July 10, 2024, the House Foreign Affairs Committee, largely on a bipartisan basis, advanced a reauthorization of the BUILD Act and modified a bill concerning the MCC.

The reauthorization of the BUILD Act, the legislation that created DFC, passed with bipartisan support, extended DFC for 7 years. The reauthorization included a committee markup with amendments that improved DFC's development mandate, included new leadership for a senior development role, strengthened transparency requirements, increased DFC's risk appetite, introduced changes to investment limits in HICs, and outlined requirements to increase private capital mobilization. The MFAN, a bipartisan coalition of international development and foreign policy practitioners, policy advocates, and experts, applauded both the reauthorization and the amendments.

The committee also marked up a bill concerning the MCC and modified some requirements on MCC compact eligibility.

On July 5, 2024, the US, in response to the continuing humanitarian crisis in South Sudan, announced an additional US$57 million to the people of South Sudan to address the compound effects of violence, mass migration, and climate events such as seasonal flooding.

The care provided by the US will include health, WASH services, shelter, and other protections for vulnerable populations.

The UN estimates that 73% of the local population will need humanitarian assistance in 2024. 1.6 million children are at risk of acute malnutrition.

The US has provided US$351 million in FY2024 and a total of US$7.3 billion to South Sudan since 2011, when the country gained its independence.

On July 4, 2024, it was reported that PEPFAR, which had already faced hurdles on reauthorization, appears set to be cut by more than 6% in FY2025.

The US' Biden administration is planning to cut the program by 6% in FY2025. PEPFAR was due to be reauthorized for an additional five-year term in 2023, but accusations of using funding for abortions, which is prohibited by US law, eventually led the program to be reauthorized for a single year.

Supporters of PEPFAR worry that the progress made since the turn of the century will be jeopardized. PEPFAR is viewed as one of the most effective US foreign assistance programs, but progress across countries has been uneven. HIV/AIDS advocates called for a strategic review of the program to ensure past gains are not lost.

On June 28, 2024, based on a new report from the IPC, USAID Administrator Samantha Power raised concerns about growing acute food security reported in April and May 2024 in Sudan, along with dire projections for June 2024 through February 2025.

Power noted that the food insecurity crisis is historically severe, with more than half of Sudan's population facing severe levels of hunger, which are the highest levels ever measured.

Power pointed to the conflict between the Sudanese Armed Forces and the Rapid Support Forces and the inability to get humanitarian assistance to the region. Although the US and other partners are continuing to support the people of Sudan with provisions of food, malnutrition treatment, health care, and other assistance, especially to vulnerable populations, more is needed to assist the cross border assistance relief effort.

Power also called upon the warring factions to negotiate an immediate ceasefire.

On June 27, 2024, USAID announced US$66 million to Zambia, which is designated by the US as a Feed the Future accelerator county, to mitigate worsening drought conditions, strengthen food security efforts, and build local resilience.

Zambia's crop loss has reached between 60-95% due to drought conditions, increasing food prices by 83%. USAID is providing emergency assistance to address the urgent nutritional crisis, as well as help farmers in Zambia strengthen longer-term resilience.

The US and Zambia are working together to help implement the Feed the Future program, including through implementation of the Feed the Future Accelerator effort.

On June 20, 2024, USAID issued its second progress report, finding that its direct funding percentage dropped from 10.2% in FY2022 to 9.6 % for FY2023, showing little progress towards its goal of 25% direct funding by 2025.

An independent report also found that the percentage had dropped, although it put direct funding lower at 5.2%.

USAID Administrator Samantha Power set an ambitious goal on localization in November 2021, pledging that by 2025, 25% of USAID's funding would go directly to local organizations and by 2030, 50% of program design, implementation, priorities, and metrics would be led through local partners.

Power stressed that the agency was committed to the localization agenda, but noted that shifting systems in an agency as large as USAID would take time. USAID has instituted changes to help reach its localization goal, including changes to the acquisition and assistance procedures, translating documents into other languages, and helping to reduce the barriers to local organizations' ability to participate.

The independent report, while praising Power's ambitious goal, outlined two major flaws in the way that USAID is measuring and implementing its 25% goal:

• The definition of "local" is too broad, creating opportunities for affiliates of international groups to be counted as local; and
• The envelope of funding, or the total amount considered when calculating the percentage of local funding, is much smaller than it should be. The report called for USAID to open up all financial flows to countries so that local organizations have more opportunities to compete. Currently, USAID only includes funding to NGOs, academia, and private companies.

On June 20, 2024, UK Foreign Secretary David Cameron attended the Gavi Investment Opportunity and AVMA launch in Paris, France, and pledged to reallocate GBP49 million (US$58 million) to Gavi’s newly launched AVMA through reallocated COVID-19 funding already committed to Gavi.

Co-hosted by Gavi, the African Union, and France, the event saw Gavi lay out its investment case for 2026 and 2030 and call for US$9 billion in new donor funding.

The UK did not make an early pledge to Gavi’s new replenishment, unlike the US, France, Spain, and some philanthropic providers, which committed a total of US$2.4 billion. Gavi is set to engage in an intense period of fundraising with a view to hosting a final pledging event in 7 to 12 months.

Since the creation of Gavi, the UK has invested GBP5.5 billion (US$7 billion) in the organization, helping to vaccinate over a billion children and save millions of lives.

The UK did not provide an early pledge to Gavi's 2026-2030 replenishment.

On June 15, 2024, during a peace summit in Ukraine with Ukrainian President Volodymyr Zelenskyy, US Vice President Kamala Harris announced a new US$1.5 billion package of support to the people of Ukraine through energy, humanitarian assistance, and civil society.

The assistance will come through both USAID and the State Department and includes US$500 million in new assistance for the energy sector. US$324 million in previously announced energy funding will be used to address emergency assistance aimed to repair damaged infrastructure, as well as to expand and protect other infrastructure.

US$379 million in humanitarian assistance will provide food, health, shelter, and WASH services to the people of Ukraine. The final part of the package will assist with civilian security assistance to help law enforcement and border guards operate on the front lines.