BRAZIL

	FY 1998 Actuals	FY 1999 Estimate	FY 2000 Request
Development Assistance	$8,378,000	$10,532,000	$8,000,000
Child Survival & Disease Fund	$2,500,000	$2,000,000	$2,900,000

Introduction

Brazil, the fifth largest country in the world (over 160 million population) has increased in importance to the United States, the hemisphere and the global community. With the world's eighth largest economy, Brazil's significant trade relationships ($20 billion annually with the United States), and its current economic crisis, have made events there even more critical to the international community. As the hemispheric economic power, it has taken the leadership role in hemispheric matters, such as Mercosur -- a Free Trade Zone among Brazil, Paraguay, Argentina and Uruguay, and in the resolution of the Peru-Ecuador conflict. Brazil's emergence as a strong, dependable partner is important to broader U.S. foreign policy goals globally, as well as in the hemisphere. Long-term, sustainable development in Brazil is in the U.S. strategic interest and our targeted programs benefit both countries by advancing mutual goals of preventing environmental degradation in Brazilian forests, the spread of infectious diseases, such as the Acquired Immune-Deficiency Syndrome (HIV/AIDS), and from uncontrolled population growth.

The Development Challenge

Brazil has high levels of income inequality and areas of extreme poverty, particularly in the North and Northeastern regions. Brazil's external debt is more than $230 billion dollars, though completion of final debt rescheduling negotiations pursuant to the 1992 Paris Club agreement is expected in 1999. Given the scope of the global problems to be addressed in Brazil, such as those in the environment and energy area, U.S. assistance will continue to focus on two key problem areas: in the environment goal area, the protection of globally important biodiversity and the reduction of greenhouse gases associated with climate change; in the health goal area, support for HIV/AIDs prevention, women's reproductive health and services to at-risk children and youth. USAID's program fits under the 1998 Mission Performance Plan's (MPP) strategic goals of Broad-Based Growth, Democracy, Environment, Population and Health.

Brazil's main challenges in addressing global environmental priorities are reducing biodiversity loss and GCC. USAID activities focus on reducing deforestation in the Amazon, the Atlantic Coastal Rainforest and the Cerrado. Due to serious risk of accidental fires in these ecosystems, USAID has directed renewed attention to fire preparedness and prevention. In 1998, USAID provided $25,000 emergency support for one month of food supplies to 7,000 individuals of the Makuxi Indians in Northern Brazil to mitigate the effects of an eight-month drought and fire. Food distribution activities also provided the opportunity to deliver information on fire management and environmental education. Given the magnitude of the threats to Brazil's natural ecosystems, USAID resources alone cannot significantly alter the loss of these natural areas. Thus, the environment program seeks to leverage resources with those of non-governmental organizations (NGOs), industry, multilateral banks, cooperatives, universities, and government agencies, allowing USAID to play a catalytic role in protecting Brazil's ecosystems. USAID-funded actions have successfully demonstrated the viability of low-impact forest management for both timber and non-timber forest resources. On the energy side, USAID targets its resources on increasing Brazil's ability to detect and mitigate energy sector climate change impact, focusing on policy, regulation, and financing mechanisms critical to environmentally sustainable energy. Negotiations are in progress with the Government of Brazil (GOB) and the private sector to identify and support Clean Development Mechanism (CDM) initiatives, laying the ground for U.S. technology exchanges.

USAID's health program covers HIV/AIDS prevention, voluntary reproductive health and services to at-risk children and youth. Approximately 52% of reported AIDS cases in Latin America and the Caribbean are in Brazil and between 560,000 and 850,000 persons are infected with HIV. Following epidemiological trends, USAID's newly approved, follow-on strategic objective (SO) is designed to increase sustainable, effective programs to prevent sexual transmission of HIV among major target groups: women, adolescents, and low-income populations. Although contraceptive prevalence in Brazil continues to increase and fertility levels continue to decline, wide regional disparities still exist and access to a broad range of contraceptive methods remain problematic. USAID's program in reproductive health, planned for closeout in FY 2000, emphasizes increased access to family planning methods and improved quality and sustainability of family planning services. Street children and at-risk youth constitute a serious problem in Brazil, especially in large urban areas of the Northeast. Many of these children come from families with incomes of only half the $68 monthly minimum wage and are victimized by domestic violence, sexual exploitation and abuse. USAID-funded activities emphasize the promotion of children's rights and the provision of direct services, especially vocational training, education and health.

Other Donors

USAID's environment program leverages activities of multilateral donors, especially the World Bank's (IBRD) G-7 Program to Conserve the Brazilian Rainforest (PPG-7) and the Global Environment Facility (GEF) -- a multilateral fund managed jointly by the UNDP and World Bank. USAID's FY 1999 contribution to the IBRD's Rainforest Trust Fund will fund research proposals on relevant issues to natural resource development in the Brazilian Amazon in a fully participatory manner, engaging Brazilian scientists and stakeholders, the donor community and IBRD managers. The incipient energy program has started negotiations with the United Nations Development Program (UNDP), IBRD and the Inter-American Development Bank (IDB) for cost-shared activities and loans for energy efficiency and renewable energy technologies.

In reproductive health, USAID closely collaborates with the United Nations Population Fund (UNFPA), the Japanese International Cooperation Agency (JICA), UNDP and the United Nations Children's Fund (UNICEF). Support to the Ministry of Health (MOH) under the new HIV/AIDS strategy flows through USAID's participation in the UNAIDS Theme Group, composed of IBRD, UNDP, UNICEF, the United Nations Education, Scientific and Cultural Organization (UNESCO), the European Union (EU) and bilateral donors. Major donors in the at-risk youth area are UNICEF and the IDB. In the past year, USAID increased coordination with these and other donors, developing a significant cost-shared portfolio. Other active partners are the EU, France and Spain.

In 1998, the IBRD has provided long-term, continuing loans in energy ($1 billion in 1998), sanitation and environment ($1.8 billion), and health ($740 million), while the IDB has $7 billion dollars in projects in the areas of environment, health and at-risk youth. Other donor contributions for environment from 1994 through 1998 were (in US$ millions): Germany ($233); EU ($89.8); United Kingdom ($28); Japan ($10.7). The U.S contribution in the same period totalled $37 million. Japan alone conducts a multi-billion dollar assistance program directed to Brazil's savannah zone. In 1998, UNICEF's investment in health and at-risk youth amounted to $11.5 million, while the EU's technical cooperation totalled $2 million in AIDS and $1 million in at-risk youth activities. As compared to other donors' contributions, the United States ranks fifth in environment and second in reproductive health (a phase-out program). USAID is not among the five major donors in at-risk youth, AIDS prevention or energy.

FY 2000 Program

The requested funds are necessary to meet current commitments to the GOB, as well as Brazilian and U.S. NGOs. The request will allow the U.S. Government (USG), through USAID, to engage Brazil on vital foreign policy issues: pursuing achievement of Summit of the Americas' goals, addressing global issues, and accomplishing the objectives of the U.S./Brazil Common Agenda Agreement. The AIDS program will work with the MOH to evaluate existing prevention activities and design training curricula to strengthen program management and the reproductive health activities will continue the process of phase over to the State Secretaries of Health. At-Risk Youth activities will concentrate on education/training programs for disadvantaged youth, while environment efforts will continue with PPG-7 coordinators to establish a scientific basis for sustainable resource use in the Amazon. Energy actions will focus on collaboration with the new Brazilian energy regulatory agency to assure private sector access for clean energy technologies to meet Brazil's growing energy needs.

BRAZIL

FY 2000 PROGRAM SUMMARY
($000s)

USAID Mission Director: Janice M. Weber

USAID Strategic and Special Objectives	Economic Growth & Agriculture	Population & Health	Environment	Democracy	Human Capacity Developmnt	Humanitarian Assistance	TOTALS
S.O. 1 Environment-ally and socio-economically sustainable alternatives for sound land use adopted - DA	---	---	7,150	---	---	---	7,150
S.O. 2 Reduce rate of growth in greenhouse gas emissions from energy sources - DA	---	---	850	---	---	---	850
S.O. 3 Programs to prevent sexual transmission of HIV - CS	---	2,000	---	---	---	---	2000
S.O. 4 Access to contraceptive methods and integrated family planning services - DA	---	---	---	---	---	--	---
Sp.O. 1 Improved quality of life for at-risk youth - CS	---	900	---	---	---	---	900
Totals - DA - CS	--- ---	--- 2,900	8,000 ---	--- ---	--- ---	--- ---	8,000 2,900

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ACTIVITY DATA SHEET

PROGRAM: BRAZIL
TITLE AND NUMBER: Environmentally and socioeconomically sustainable alternatives for sound land use adopted beyond target areas - 512-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 2000: $ 7,150,000 DA
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2003

Summary: USAID's environment program addresses two global environmental priorities: biodiversity loss and GCC. Brazil is a "key" country in these areas because it has one of the greatest number of species in the world and produces approximately ten percent of the world's carbon dioxide emissions, the latter primarily from deforestation and habitat conversion and burning. Incorporating the lessons learned from USAID/Brazil's GCC Project, this strategic objective (SO) aims at reducing deforestation in the Amazon, the Atlantic Coastal Rainforest and the Cerrado (savannah). Due to serious risk of accidental fire in these ecosystems, renewed attention is being directed to fire preparedness and prevention. The purpose of this SO is to increase protection and sustainable use of natural resources in Brazil's critical regions for biodiversity, and to reduce greenhouse gas emissions from deforestation. The program focuses on: 1) protected area management in two major national Parks, one extractive reserve, one national forest, one state-protected area, and the buffer zone surrounding one biological reserve; 2) forest management alternatives for reduced-impact harvest of upland timber in the largest timber harvesting region in Eastern Amazon; 3) fire science and management to reduce the effects of uncontrolled burning on local biodiversity and global warming; 4) provision of information and training support for the preparedness and mobilization of rural dwellers to deal effectively with fires; 5) natural resource policy and environmental education with federal, state, and local officials and land managers; 6) capacity building of local organizations and NGOs; and 7) agroforestry alternatives for restoring productivity to degraded, cleared areas, developed by a participatory approach with small holders. As of the current presentation, USAID/Brazil is integrating the contribution to the World Bank-managed PPG-7 program under the same SO in order to achieve a more integrated means of reporting environment activities. Direct beneficiaries are rural communities, especially small holders, who frequently have only traditional rights to their land, as well as Brazilian research organizations. USAID-supported actions also benefit Brazilian society at large by assuring that the resource base is maintained for future generations. Benefits will ultimately be felt at the international level from protecting tropical forests and biodiversity, and reducing greenhouse gas emissions.

Key Results: Four key results will be achieved in the course of reaching this objective: (1) A total of 16 systems for sound land use will be identified, promoted and adopted in target areas; (2) Nine institutions and local capacity of 4,000 people will be strengthened; (3) Ten Targeted policies that support environmentally sound land use will be adopted and/or implemented; and (4) Sound land-use systems will be disseminated beyond target areas (71 dissemination tools reaching a total of 490,000 people).

Performance and Prospects: Performance over the past year has been very encouraging. USAID activities through support to local NGO efforts and training of key individuals continue to serve as models for reconciling development and conservation in the Amazon and, more recently, in the Atlantic Rainforest and Cerrado regions. Management plans for two important parks in the Amazon, Jaú National Park (the largest park in Brazil and the size of Massachusetts - 2,270,000 hectares (ha)), and Serra do Divisor National Park (840,000 ha) were completed and are under implementation. They were finalized as a result of a participatory process that included research activities, field work and workshops with representatives of partner NGOs, community leaders, and the federal environmental agency (IBAMA). IBAMA approved the plans and now proposes to use them as models for future management plans in other protected areas throughout Brazil. USAID support has helped establish the first community-owned, operated and managed palm heart factory in the Eastern Amazon state of Amapá. The World Wildlife Fund (WWF) Brazil office, in collaboration with IBAMA and the National Center for Development of Traditional Populations (CNPT), has developed a plan for producers to manage the palm forest located within the extractive reserve of Cajari. USAID is also supporting activities in fire prevention, suppression and control. Through PPG-7, the local partner NGO Amazon Working Group (GTA), has provided training to 11,200 rural community leaders. The U.S. Forest Service and the Woods Hole Research Center/Amazonian Institute for Environmental Research (IPAM) partnership continue to quantify the effects of burning on Amazon forest and Cerrado (savannah) ecosystems, while surveying the extent of fire damage on private land from ground surveys and with satellite/Geographic Information System (GIS) mapping. A new study, partly funded by USAID, carried out by Woods Hole/IPAM, and based on rainfall exclusion, is currently underway and aims to understand the effects of increasingly frequent and severe droughts in Amazonian forests. The GOB has made substantial progress in the environmental sector over the past year, with President Cardoso's pledge to set aside ten percent of tropical forests as protected areas. As a result, an ecological reserve was created near Jaú National Park, in an attempt to form an ecological corridor connecting different conservation areas. However, a decline in GOB environment resources is likely to result following recently implemented economic austerity programs, thus, affecting the short-term feasibility of new projects.

Possible Adjustments to Plans: A severe El Niño drought aggravated fire conditions in the Amazon in 1998, and highlighted the importance of developing effective local measures to control fire. Increasing risk of accidental fires in the Amazon, the Atlantic Coastal Rainforest and the Cerrado, will require renewed attention to fire awareness, preparedness and prevention. The Mission will be working with other donors, U.S. and Brazilian government agencies and U.S. and Brazilian NGOs to expand this SO to include a fire activity that will help prevent the devastation of Brazilian forests. USAID will be entering a new phase of the environment strategy in FY 2000 and new set of indicators will be developed to measure progress of this new phase.

Other Donor Programs: USAID works in close consultation with Brazilian Government programs as an integral part of the U.S./Brazil Common Agenda on environmental issues. Assistance is provided directly to U.S. NGOs that have a presence in the country and work with Brazilian partners in coordination with other USG agencies. Activities under the USAID environmental program leverage those of multilateral donors, especially the $300 million PPG-7 program, GEF, and the Brazilian Fund for Biodiversity (FUNBIO). USAID continues to support model reduced-impact forest management practices in the Amazon, guiding timber industry and government enforcement officials to workable solutions that assure industry viability and forest permanence. Engagement of USAID partners such as WWF, the Institute of the Man and the Amazon (IMAZON), and the Tropical Forest Foundation (TFF) was key to designing IBRD's $18 million activity in forest management under PPG-7.

Principal Contractors, Grantees or Agencies: USAID implements activities through U.S. private voluntary organizations (PVOs) such as WWF, The Nature Conservancy, Conservation International, Woods Hole Research Center, and TFF; USG agencies such as the USDA Forest Service and the Smithsonian Institution; and several U.S. academic institutions (e.g. University of Florida and the State University of New York).

Selected Performance Measures:

	Baseline	Target
Number of families adopting sustainable resource management systems	40 (1997)	310 (2000)
No. and proportion of protected areas (and their area in hectares) having management plans developed and validated on schedule	7/7 (1996) 5,277,000 (1996)	9/9 (1999) 5,450,000 (1999)
Low impact logging systems developed and validated Trained environment professionals	3 (1996) 2,450 (1991-96)	4 (1999) 4,000 (1999)
Note: End-of-Activity targets to be developed this year.

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ACTIVITY DATA SHEET

PROGRAM: Brazil
TITLE AND NUMBER: Brazil Energy Program (BEP), 512-SO02
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000: $850,000 DA
INITIAL OBLIGATION: FY 1999 ESTIMATED COMPLETION DATE: FY 2003

Summary: Brazil is currently the largest emitter of greenhouse gases (GHGs) in Latin America. In the 1991-1995 period, industrial carbon dioxide emissions increased by 20%. Given the continuing growth and structural changes in its economy, it is likely that Brazil's GHGs caused by energy production will continue to increase at a quick pace. In addition, Brazil is reshaping its existing energy industry and diversifying its energy sources. USAID has used this opportunity to provide assistance to Brazil in an attempt to ensure that energy is used efficiently and that energy demand is supplied by a mix of sources with the lowest greenhouse gas emitting potential. The purpose of this program is to reduce the threat of GCC through increased adoption by key actors of concepts, methods and technologies for clean and efficient energy production and use. The direct beneficiaries are Brazil's energy sector and economy, U.S. renewable energy and energy efficiency technology companies and, especially, a currently estimated group of 20 million people who are under-served by traditional sources and scattered in 60,000 rural communities.

Key Results: Four key results will be achieved in the course of reaching the objective of clean and efficient energy production and use: 1) three policy initiatives will be promoted, operational incentives to cogeneration, renewable energy and climate change; 2) eight training courses and workshops of key Brazilian institutions will be developed to facilitate access to markets and financing; 3) availability and use of financing will be increased, two IBRD loans and one DCA loan guarantee; and 4) one umbrella technology cooperation framework between U.S. and Brazilian firms will be implemented.

Performance and Prospects: Performance over the past year has met established targets. The GOB continues to show a clear commitment to restructuring and privatizing its energy industry in a competitive environment. Significant progress in privatization of state-owned utilities, and notable administrative and institutional reforms in the period were: 1) enactment of policies and regulations supportive of energy efficiency and clean energy production; 2) establishment of energy regulatory agencies and initial steps conducive to a legal framework for the energy industry; and 3) establishment of open access to energy transmission for power utilities and regional competition among energy producers.

The USAID-sponsored Renewable Energy Project Support Office (REPSO), staffed by Winrock International, has played a strong role in developing commercial renewable energy projects. Based on the concept of sustainability, those projects address the following issues: providing technical assistance on renewable energy systems installation, operation and maintenance to rural communities, a NGO network, power utilities and trade associations. REPSO is also providing local technical assistance for the development of the proposed IBRD "Integrated Commercial-Social Power" loan to the GOB, establishing the necessary institutional bridges to support deployment of clean energy sources in other USAID environmental activities, as well as in the PPG-7 program.

With support provided by USAID, the IDB initiative on Sustainable Markets for Sustainable Energy (SMSE) is assisting the National Program for Energy Development of States and Municipalities (PRODEEM), a program focused on infrastructure development, social equity and job generation, ranked as a top priority of the Cardoso Administration. The Secretary of Energy has formally approved PRODEEM's action plan, which is composed of a set of specific activities to foster the development of private sector sustainable markets for rural energy services in Brazil. A priority identified in PRODEEM’s action plan was the need for quality technical assistance to review PRODEEM's operations and to reshape its incentive program supportive of clean energy markets. Considering the excellent results obtained through a full time, USAID-financed technical advisor to the National Electricity Conservation Program in 1996-97, USAID used a similar mechanism and placed an advisor at PRODEEM. The initial elements of a new management structure that will result in more effective operations were further detailed by the Advisor and implementation is expected in fiscal years 1999-2000.

In the policy area, USAID instituted a regulatory partnership between the National Agency for Electric Power and three American state-level public utility commissions (Florida Public Service Commission, Iowa Utilities Board and Oregon Public Utilities Commission). The purpose of this partnership is to promote regulatory experience exchanges between American and Brazilian regulatory institutions in the areas of energy production, planning and market regulation.

USAID also played a critical liaison and local support role to the State Department and Department of Energy in developing the U.S.-Brazil Implementing Arrangement for Cooperation in the Area of Energy Technology. This foreign policy initiative was signed during President Clinton’s October 1997 visit to Brazil and it is expected that, due to its significance for U.S. business, the Arrangement will form a useful institutional umbrella to further leverage USAID results. USAID expects to provide technical assistance to institutions associated with the arrangement, targeted to developing a Work Plan for energy technology cooperation.

Possible Adjustments to Plans: In order to support the international consensus on GCC, that is the need for reducing GHG emissions, USAID intends to direct BEP's technical and training assistance to act locally on the energy and climate change agenda. It is expected that this will result in CDM project design activities in the private sector. Climate change awareness, focused technical training and private sector involvement, in turn, is expected to lead to the creation of knowledgeable constituencies to support policy decisions on international GHG trading mechanisms between the U.S. and developing nations, the latter of which generates fewer GHG.

Other Donor Programs: USAID has provided assistance to both GOB and the IBRD on the preparation of two major loan requests: one $150 million loan targets energy efficiency, and the other $200 million loan, entitled "Integrated Commercial-Social Power," targets 60,000 isolated rural communities. Once in place, both loans and their accompanying GEF grants, will target Brazil’s potential market in clean and efficient energy applications and maximize involvement of the private sector. USAID has also been successful in attracting, coordinating and assisting other major donors such as the IDB with its initiative on SMSE. USAID is currently in the process of coordinating with the UNDP local office on further assisting PRODEEM's Action Plan. In coordination with other donors, the Mission is also considering providing support to the National Renewable Energy Laboratory's initiative on the Technology Cooperation Agreement Pilot Project, whose aim is to attract international donor community assistance in fostering private investment in energy technologies that can reduce GHGs and initiate projects based on the United Nations Framework Convention on Climate Change and the Kyoto Protocol's mechanisms such as the Clean Development Mechanism (CDM).

Principal Contractors, Grantees or Agencies: Current grantees, cooperative agencies and contractors include Winrock International, Advanced Engineering Associates International (AEAI) and the United States Energy Association (USEA).

Selected Performance Measures:

	Baseline	Target (1998)
New capacity installed and operating, on and off the electric grid, powered by renewable energy or other clean energy technology	607 KW (1996)	6,500 KW
Electric power and energy saved, attributable to energy efficiency programs which USAID has created or influenced	900 MW (1997)	1,100 MW
Number of people using renewable energy, energy efficiency, or other clean energy systems	1,600,000 (1997)	2,300,000
Note: The above indicators were set for BEP's first phase, which ended in FY 1998. A new set of indicators and targets will be reflected in the FY2001 CP.

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ACTIVITY DATA SHEET

PROGRAM: BRAZIL
TITLE AND NUMBER: Increased sustainable and effective programs to prevent sexual transmission of HIV among major target groups, 512-SO03
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 2000: $ 2,000,000 CS
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2002

Purpose: Increased use of improved, effective and sustainable responses to the HIV/AIDS epidemic.

Summary: In the Western Hemisphere, Brazil is second only to the U.S. in the number of reported AIDS cases, totalling over 120,000 cases. Brazil also accounts for half of the cases in the Latin America and Caribbean region. Over 65% of HIV/AIDS infections are concentrated in the states of São Paulo and Rio de Janeiro, with about eight percent occurring in the Northeast, including the states of Bahia and Ceará, two of USAID's target areas. Estimates of HIV infection range from 560,000 to 850,000 individuals. Bordering most of the countries in South America, Brazil is a potential epicenter to spread the disease. Following the successful conclusion of the five-year AIDSCAP program, USAID started a new program to follow the epidemiological trend that shows increasing HIV incidence among women and adolescents and to integrate reproductive health and HIV/AIDS prevention programs.

Key results: The activity contemplates three intermediate results: (1) strengthened institutional capacity to plan and implement sexually transmitted infection (STI/HIV) programs; (2) strengthened technical capacity to plan and implement STI/HIV services; and (3) sustainable condom marketing.

Performance and prospects: In 1998, USAID started the implementation of its new five-year strategy to increase the use of improved responses to the HIV/AIDS epidemic. This strategy is closely linked with and complementary to the programs of the World Bank, MOH and other smaller donors. The pro-posed program emphasizes the provision of technical assistance, which is one of USAID's comparative advantages, but relies on World Bank financing to fund training programs for the public and private sectors and to replicate HIV/AIDS prevention interventions on a large scale. The areas of particular need where USAID has excellent resources to offer include program evaluation, operations research, management improvement and social marketing. The strategy also involves expansion of activities to reach the Northeastern region, where USAID will promote integration of AIDS/STI prevention activities with the ongoing reproductive health and at-risk youth programs. The relationship with the MOH has been intensified through the provision of hands-on technical assistance in monitoring and evaluation and through the MOH-supported introduction of the strategy to the four target geographical states.

While the strategy's key elements were being negotiated with the MOH and the UNAIDS Group, USAID provided bridge funding to the Pathfinder Fund to implement pilot activities in Northeastern Brazil, in preparation for the five-year program that has been expanded to include this region. Under the bridge grant, among other achievements, USAID support reached 2,295 private sector employees in 15 companies through awareness-raising activities; referred 400 female adolescents and their mothers to health services in Fortaleza; and engaged 50 radio stations in broadcasting HIV/AIDS information in 13 different municipalities.

Possible Adjustments to Plans: The major results indicators shown below refer to the bridging grant to the Pathfinder Fund. Illustrative indicators that will measure the progress of intermediate results under the newly started strategy are also included. Final indicators and respective baseline and targets will be established in FY 1999.

Host country and other donors: USAID has been working closely with other international donors to achieve the results under this SO. Coordination with the MOH is done through the United Nations AIDS Program (UNAIDS) theme group that, besides USAID, includes IBRD ($300 million for 1998-2002), UNDP ($13 million, 1998-1999), the World Health Organization/Pan-American Health Organization (WHO/PAHO), the United Nations Drug Control Program (UNDCP, $22 million, 1998-1999) UNICEF, UNFPA, UNESCO ($17.8 million, 1998-1999), the EU ($2.5 million for 1998-2000) and bilateral donors. USAID's program funding time frame coincides with the time frame of the IBRD program. Best practices which have been identified and implemented by the USAID program to date are being financed and replicated under that program.

Principal Contractors, Grantees, or Agencies: USAID implements activities through four U.S. PVOs: the Population Council, Family Health International, Population Services International and the Pathfinder Fund local office, in cooperation with Brazilian NGOs.

Selected Performance Measures (illustrative):

	Baseline	Target
Annual increase in expenditures for HIV/AIDS prevention in states	Under survey	TBD
% sustainability of Condom Social Marketing (CSM) programs	Under survey	TBD
Note: End-of-Activy targets to be developed this year.

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ACTIVITY DATA SHEET

PROGRAM: BRAZIL
TITLE AND NUMBER: Increase access to contraceptive methods and integrated family planning services to improve women's reproductive health, 512-SO04
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 2000: no new funding
INITIAL OBLIGATION: FY 1992 ESTIMATED COMPLETION DATE: FY 2000

Purpose: To improve the quality and sustainability of family planning services in the poorest regions of the country, through increased access to integrated reproductive health services.

Summary: Brazil has the largest population in Latin America, 160 million persons, and faces continued urbanization and a large disparity of income. Overall mortality is still considered high: maternal mortality is estimated at 200 deaths per 100,000 births, and infant mortality is 39 deaths per 1000 live births nationwide, elevated in the Northeast region to 106/1000 in the poorest areas. The total fertility rate is 2.5 while contraceptive prevalence is 70% for Brazil as a whole, although wide regional disparities persist. However, due to limited access to contraceptive methods, contraceptive use is still heavily concentrated in female sterilization and oral contraceptives. In the Northeast, a heavily populated and extremely poor region of 40 million people, one of the areas where USAID assistance is targeted, health services for women and children remain of relatively poor quality. Although USAID assistance has had a marked impact on overall health and fertility indicators in targeted states, distinct urban to rural disparities still exist. In the Northeast, some one-quarter of rural women declared a birth as "unwanted" in the past five years, (Demographic and Health Surveys-DHS, 1996), a proportion almost double their urban counterparts. USAID assistance allows for the development and implementation of public and private service delivery systems for low-income groups, that emphasize preventive services, especially in maternal and child health.

Key Results: The program contemplates two key intermediate results: (1) improved quality of family planning services, through increased access to contraceptive methods and adoption of key quality elements such as informed choice, trained providers and adequate supplies; and (2) improved sustainability of family planning delivery services, that focuses on the increased ability of state, NGO and private sector systems to provide services.

Performance and Prospects: USAID assistance is channeled through U.S. organizations that work in conjunction with the state health departments and Brazilian NGOs in the two Northeastern states of Ceará and Bahia. With USAID assistance, the availability of voluntary reproductive health services has been expanded, and the quality of services improved to the benefit of low-income women who utilize the public health system. As a direct result of USAID assistance, political support for family planning has increased. Brazil has conformed to international norms in the testing of condoms, has lifted non-tariff barriers on imported commodities, and has registered Depo-Provera, adding it to the list of methods purchasable by public funds. Furthermore, in 1998, UNFPA expanded USAID's model of improved RH and family planning services in rural clinics to the Northeastern State of Rio Grande do Norte.

The USAID assistance program will continue to concentrate on the two target states of Ceará and Bahia until the planned phaseout in FY 2000. Emphasis will be placed on consolidation of achievements through training, creation of demand for quality services and method choice, integration of family planning within overall reproductive health strategies, and assurance of sustainable delivery systems by FY 2000.

USAID's role in the provision of contraceptive commodities has purposefully diminished over time, with the gradual assumption of this responsibility by other donor and private organizations and the Government of Brazil. In this regard, USAID has negotiated significant contributions from Pharmacia & Upjohn for the introduction of an injectable contraceptive at an affordable price to the public sector and to low-income consumers. These and other organizations supported by USAID will remain involved in the provision of family planning services and/or the sale of contraceptive commodities after the phaseout of USAID family planning assistance.

Possible Adjustments to Plans: In preparation for the phaseout of USAID population assistance in 2000 and looking at a means to provide Brazilian institutions with ongoing access to technical information and support, USAID and its Cooperating Agencies (CA) working in Brazil will pursue the establishment of a virtual network utilizing existing resources of the CA community. This virtual link should facilitate the exchange of lessons learned between Brazil and other countries as reproductive health institutions work to achieve sustainability.

Host Country and Other Donors: The major donor in reproductive health in Brazil is UNFPA ($9 million in the 1998-2000 period) whose programs complement and are coordinated with USAID's activities. USAID will continue its efforts to leverage funds from other international donors such as UNDP and UNICEF, particularly with respect to the integration of family planning and STI/AIDS prevention programs. Because of USAID's expertise and proven track record in this area, other donors have been willing to cost-share activities. In spite of the lack of a U.S.-Brazil bilateral relationship in the population area, USAID has made great strides in developing an open and collaborative relationship with the GOB, that includes policy dialogue, standardization of family planning norms and introduction of new contraceptive methods, such as depo-provera.

Principal Contractors, Grantees or Agencies: USAID implements its activities through U.S. private voluntary organizations and U.S. firms. They include The Pathfinder Fund, Population Council, Johns Hopkins University, Management Sciences for Health and BEMFAM, the local International Planned Parenthood Federation's affiliate.

Major Results Indicators:

	Baseline	Target (2000)
% of Births Declared as Unwanted Ceará State Bahia State	24% (1996) 27% (1996)	20% 20%
Couple Years of Protection	Bahia State Ceará State	173,034 (1996) 64,165 (1996)	190,200 70,600
Units of Depo-Provera sold to the public sector and through pharmacies	284,000 (1998)	456,000

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ACTIVITY DATA SHEET

PROGRAM: Brazil
TITLE AND NUMBER: Improved ability of at-risk children and youth to become healthy, productive citizens, 512-SpO01
STATUS: New
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 2000: $900,000 CS
INITIAL OBLIGATION: FY 1999; ESTIMATED COMPLETION DATE: FY 2003

Purpose: To promote activities that can improve the ability of at-risk children and youth to become productive, healthy citizens, in selected cities in Northeastern and West-Central Brazil.

Summary: The situation of children and youth in Brazil is particularly precarious. The effects of the current economic crisis have further limited the GOB's capacity to effectively address the issues affecting the mass of children already living or at risk of living in the streets. Migration into large urban centers and the concentration of impoverished populations in the outskirts of capital cities force children into begging and looking for small informal jobs in central areas. Contributing and consequent problems are illiteracy, disease, delinquency, drug abuse, prostitution, and human rights violations. Street children and at-risk youth lack access to educational and health services, while the country still lacks safety networks capable of supporting the implementation of existing, excellent legislation, which provides for the delivery of model services but has not yet been enforced. Since 1994, USAID has been strengthening the capacity of local governments and NGOs to provide better services to this population by: (1) providing at-risk children and youth with access to vocational training and formal educational opportunities in order to augment their chances to find legitimate, income-generating alternatives; (2) mobilizing society to decrease violence against youth and to decrease the phenomenon of child and adolescent prostitution; (3) promoting the direct participation of children and youth in the country's political process through legitimate bodies; and (4) supporting educational activities to promote the healthy, responsible and safe sexual development of youth. A four-year extension to this objective was approved in 1998, with estimated completion in 2003.

Key results: The program includes four key intermediate results: (1) society will be engaged in decreasing violence against youth; (2) educational preparation of program-assisted youth will be increased; (3) program youth access to information on reproductive health and HIV/AIDS will be increased; and (4) lessons learned and successful, innovative approaches targeting replication will be disseminated and adopted.

Performance and Prospects: In the first phase of implementation of the At-Risk Youth program (1994-1998), USAID demonstrated the capacity to develop programs that make a difference and to leverage and direct the resources of other donors. Incorporating the lessons learned in that period, the four-year follow-on activity will focus on education and health with subgrants directed to promote access to formal schooling and vocational training, and to prevent early pregnancy and AIDS/STI infections among Brazilian disadvantaged youth.

In 1998, the target for children and youth completing the school year and being promoted to the next grade, established at 60%, was far exceeded, with an actual promotion rate of 87%, nearly twice the national average. Three new subgrants were signed to develop specific AIDS/STI prevention activities targeting adolescents from public schools and educators in Salvador and Fortaleza. In 1998, USAID also strengthened the work of coalitions of Northeastern institutions to more effectively address issues that directly affect the lives of at-risk youth, such as advocacy of human and civil rights, prevention of child and adolescent prostitution, and child labor eradication. USAID sponsored a four-day technical seminar to exchange lessons learned with Central American countries and to provide Central American Labor Ministers with an overview of USAID-supported activities to promote the labor rights of adolescents. USAID's support was also critical for two institutions assisting girls victimized by domestic violence and commercial sexual exploitation to leverage the Brazilian National Social and Economic Development Bank (BNDES) funds to expand services and increase the number of beneficiaries.

Approximately 40,000 people were reached by the activity as of December 1998. The target for 2003, the estimated activity completion date, is 80,000 beneficiaries. In 1998, new objectives and results were defined for the follow-on activity.

Possible Adjustments to Plans: Following the review of objectives and results, USAID and the grantee will work in 1999 to adjust the strategy designed in late 1997. The strategy focuses on the provision of hands-on assistance and training to implementing NGOs and coalitions; expansion of project monitoring and evaluation activities; and dissemination and replication of best practices from previous activities in this area.

Host Country and Other Donors: In 1998, UNICEF ($2 million), the IDB (approximately $4 million) and the EU ($1 million) were the major donors in the area of at-risk youth in Brazil. USAID works closely with these and other donors, such as the International Labor Organization (ILO, $1.1 million in the 1997-98 biennium) for complementary support to successful initiatives. Of the 16 local institutions supported by USAID in 1998, 15 subgrants were co-funded with other bilateral and multilateral donors. After a suspension of grant assistance in mid-1998, the IDB restored its grant program to BraziI, which favorably impacts the sustainability of some institutions that receive both USAID and IDB assistance. USAID's main role has been to provide small amounts of seed money to demonstrate the feasibility of programs that have subsequently been replicated and expanded by other donors. USAID has intensified its contacts with local foundations, the private sector and, particularly, BNDES, from which USAID leveraged funds of approximately $2,000,000 in 1998. The Bank, with a total budget of $42,000,000 for 1999, will become the major in-country resource to address at-risk youth issues. Since budget cuts in the health and educational sectors, driven by the effects of the global economic crisis, may further limit the GOB's ability to provide social services to its population, USAID plans to continue to work with state and local governments to expand services in target areas and strengthen partnerships with civil society.

Principal Contractors, Grantees or Agencies: USAID will continue to implement activities through a cooperative agreement with the U.S. PVO National Association of the Partners of the Americas, and local NGOs.

Major Results Indicators:

	Baseline	Target (2000)
% of program-assisted youth that find legitimate income-generating work	59% (1996)	70%
% of program-assisted youth promoted to the next grade	49% (1994)	90%
Number of grievance cases lodged and monitored by children and adolescent advocacy groups	300 (1997)	1,000
Note: End-of-Activy targets to be developed this year.

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