I. Public Benefit
School health education activities
have been integrated into primary school training curriculum
covering topics from hygiene, water and sanitation,
infectious disease prevention, reproductive health,
and HIV/AIDS prevention. A teacher discusses malaria
prevention lesson with students at Phum Thom Primary
School of Sambo District, Kratie Province.
Photo: USAID/Cambodia
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Strengthening international cooperation to ensure stable,
prosperous societies is critical to U.S. national security.
Disease, poverty, displacement, lack of education, and environmental
degradation destroy lives, ravage societies, destabilize regions,
and cheat future generations of prosperity. By integrating
economic growth with social development and environmental
steward-ship in every corner of the globe, USAID is extending
to the international community the basic values American citizens
hold dear: prosperity in balance with sustainable management
of land-based and marine natural resources, healthy lifestyles,
knowledge-based society, and co-operation to advance research
frontiers and stimulate innovation.
U.S. health sector investments have improved health and
well being for women, men, and children worldwide. Results
include the rapid expansion of HIV/AIDS treatment, prevention,
and care services in high-priority countries and improved
quality of life for persons living with and affected by HIV/AIDS;
more couples being able to decide the number and spacing of
their children; more women having access to skilled care at
childbirth; more children being immunized and surviving common
childhood illnesses; expanded access to effective prevention
and treatment measures for infectious diseases like malaria
and tuberculosis; greater international engagement to address
Avian Influenza; better preparedness against the threat of
bioterrorism; and significant progress in eradicating polio
worldwide.
Investments in basic education have provided millions of
people with the literacy and numeracy skills that are needed
to live and work productively in today's world. Improvements
in higher education help to ensure a stable, highly skilled
work force, provide opportunity for economic betterment, and
create an informed society that will both demand and participate
constructively in democratic institutions.
Sound governance of natural resources not only protects
the planet, it is a key condition for sustainable growth and
a key attribute of democratic governance. By promoting access
to clean drinking water and clean, modern energy; by sustainable
management of fisheries, forests, and other flora and fauna;
by keeping dangerous chemicals and other pollutants out of
terrestrial and marine environments; by increasing resilience
to climate variability and change; and by improving the environmental
capacity of trade partners, USAID is promoting economic prosperity
in sustainable harmony with nature. These initiatives reduce
the strains on society that lead to conflict and even terrorism,
while inculcating democratic values of participatory decision-making,
rule of law, and transparency.
II. Resources Invested
III. Selected Performance Trends
IV. Illustrative Example of Significant Achievement
Access to Health in Africa
A driver in Senegal teaches fellow
truck drivers about the risks associated with HIV/AIDS.
Photo: USAID/Senegal
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One of the challenges of low-income people in Africa is to
access and pay for health care. The need for quality care
is especially acute in rural areas, where many people have
to walk miles to the nearest health center. To help face this
challenge, a USAID sponsored project in Uganda has supported
the design and implementation of a cooperative health system.
Partners built a health care system that is paid for and run
by the people it serves through cooperative. Plan members
include: schools, tea cooperatives, forestry cooperatives,
and self-help groups. Plan members make decisions as a group
about what services to buy, thereby determining the price
of their periodic dues. The concept of health cooperatives
was easily understood by Ugandans because of their familiarity
with cooperatives in the agricultural and commercial industries
in their country. Thus, the popularity of cooperative health
plans is growing. In 2003, insurance plans grew from 10 health
plans serving 1,500 members to 48 health plans serving 5,000
members. This year, the Church Mission Society has recruited
up to 15,000 new clients—mainly from schools and clergy—to
this program. Ugandan health officials recognize that the
country does not have enough money to support a central health
care system so they are now considering using the cooperatives'
plans and successes as a model for replication.
A program in Mali to distribute insecticide-treated nets
(ITN) to vulnerable populations appears to have had another
unexpected—and very positive—effect on USAID's
recently launched integrated family health program. Under
USAID's ITN initiative, pregnant women enrolling in antenatal
care at government of Mali health clinics in certain program
areas also receive a heavily subsidized family-size ITN. Parents
of children under five who are on track with their scheduled
childhood vaccinations also qualify for a highly-subsidized
net. All those receiving nets are urged to have their most
vulnerable family members, pregnant women and small children,
sleep under the nets to help prevent malaria—the number
one killer of young children in Mali. Preliminary tracking
of clinic health data already appears to show a decline in
incidence of malaria cases among targeted net recipients,
which clinic personnel attribute to increased use of ITNs.
But more unexpectedly, the net distribution activities themselves
seem to have had a dramatic impact on health service use with
more women signing up for and regularly attending antenatal
care and parents showing renewed efforts to fully vaccinate
their children. These indirect trends could mean a far greater
impact on overall family health than the nets themselves can
yield alone. Drawn by the incentive of the nets, many more
people are meeting their health care providers face-to-face.
HIV Campaign Reaches Out to Youth
A poster designed for USAID's HIV
awareness campaign tells youth to "Be Faithful
to Your Love."
Source: USAID/Russia
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Over the past decade, Russia has experienced one of the fastest
growing HIV/AIDS epidemics in the world. UNAIDS estimates
that a Russian is infected with HIV/AIDS every 12 minutes.
By April 2005, around 313,000 cases were officially registered,
though estimates put the number of actual cases between one
and 1.5 million — one percent of the total population.
The epidemic especially targets Russia's youth. Eighty percent
of HIV-positive Russians are between the ages of 15 and 29.
In May 2004, USAID, in coordination with the President's
Emergency Plan for AIDS Relief, supported the launch of a
new HIV education and prevention campaign targeted at Russian
youth. The "Be Faithful to Your Love" Internet campaign
was created to raise awareness about the risks of HIV infection
and to promote healthy sexual habits, including abstinence,
condom use, and monogamy among youth over 15 years of age.
Special features on the Web site include an interactive game
that determines the user's risk of contracting HIV and a series
of questions and answers about how the disease is transmitted.
During a special "Be Faithful to Your Love" promotion,
visitors with the best answers to the question, "Why
do you think you should be faithful to your loved one?"
were awarded prizes such as mountain bikes and rollerblades.
During its two-week promotional period, "Be Faithful
to Your Love" attracted more than 116,727 visitors. The
game was played 12,138 times, and 7,500 young people answered
questions. Users also asked more than 400 questions of Dr.
Pertsev—a virtual doctor who gives advice and answers
questions about HIV/AIDS and provides referrals for professional
help and testing facilities. Administrators continue to monitor
the Web site's chat rooms and review e-mail comments, using
this information to adapt USAID's other HIV education programs
so they effectively appeal to Russian youth.
Providing Ecological Livelihoods in Honduras
In the Taulabe, Comayagua region of Honduras, small sugar
processors make a product called rapadura, a hard brown sugar
that is sold in the local market. Traditionally, sugar cane
processors had burned firewood as their primary source of
fuel, however, firewood was becoming increasingly scarce.
Processors shifted to the burning of old tires for fuel, causing
environmental pollution, a low quality product, and serious
health hazards to those who tend the fires and nearby communities.
USAID's Farmer to Farmer program, working with Partners
of the Americas, linked Vermont maple sugar makers with the
Honduran sugar processors to find an appropriate technical
solution to a serious local problem. The Honduras Ecological
Sugar Project aims to improve sugar processing methods, reduce
contaminants, eliminate the need to use tires as fuel, and
improve the quality of the final product in an environmentally
sustainable way. Moreover, the project transfers marketing
concepts and techniques for increasing the return on sugar,
while diversifying into value-added sugar products.
Through an innovative adaptation of maple sugar technology,
Farmer to Farmer volunteers from Vermont constructed an improved
evaporator that replaces the flat bottom pans with a more
efficient flue pan. This new technology uses sugar cane fiber
as fuel. Since this is the organic waste from the plant itself,
it helps improve processing in an environmentally sustainable
way. Product quality was also improved by reducing the introduction
of contaminants though simple technologies that protected
cane juice from press lubricants. Between the flue pan and
an improved quality of the cane juice, a high quality sugar
cane product was produced without the need to burn tires.
Significant progress has been made for small-scale sugar
producers and the community in Taulabe. There is a decreased
demand for scarce firewood and a dramatic reduction in the
amount of rubber tires being burned for sugar processing.
More efficient and cost-effective sugar production methods,
and improving business practices have made the small producers
more competitive in local markets. Other economic impacts
include the identification of niche markets for ecologically-produced
sugar and the production of value-added products such as granulated
sugar, cane syrup, and hard candy, allowing for diversification
and broader market exposure. The community at large has greatly
benefited since the municipality of Taulabe approved an ordinance
banning tire burning, as evidence of the new system's economic
viability continues to grow.
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