Trade-induced economic expansion is the catalyst for improved living standards, poverty reduction, and sustained growth and political stability in the LAC region. Efforts under this strategic objective pave the way for increased trade and greater economic integration in Latin America by addressing key issues regarding the creation of the Free Trade Area of Americas, and by addressing the basic social and economic adjustments associated with entrance into a free trade arrangement.

Smaller economies face substantial obstacles in joining a hemispheric free trade arrangement. USAID efforts are directed to assist target countries resolve basic trade and economic integration issues and implement legal reform measures. A few of the mechanisms that will be operational in FY 1997, as a result of assistance under the LAC Regional program, are: (1) a regional training center to train agricultural quarantine and inspection officers in Latin America, (2) a rules of origin system to simplify customs procedures in target LAC countries, and (3) food safety regulatory procedures to ensure consistent production of food products that meet regulatory requirements of importing countries, based on accepted World Health Organization standards.

Small-scale businesses and entrepreneurs are currently limited from fully participating in regional markets due to technological inefficiencies, lack of access to trade-facilitating infrastructure and high transaction costs. USAID efforts will lead to development of integrated communications network technologies and use of personal computers to globally link small- and medium-sized businesses with traders and to carry out international trade transactions.

The segments of society that are currently the most disadvantaged and marginalized in the marketplace -- women, the poor, and indigenous groups -- will need access to information and outreach systems to allow them to take advantage of the benefits of free trade and economic growth. USAID efforts will strengthen key regional market institutions and networks to reach the disadvantaged and provide opportunities, particularly for small-scale agricultural producers, for participation in trade expansion. These institutions and networks include private property systems, agricultural technology development systems, and links between commercial capital markets and microenterprise institutions.

As economic growth and trade expand, pressures on natural resources and the potential for increased pollution, environmental contamination, and associated health risks will mount in the region. In FY 1997, the program will assist LAC countries to modify their policies to provide incentives for more sustainable natural resource use and for industries to adopt pollution prevention practices. Programs will be launched by LAC governments and industries to reduce health risks from key environmental contaminants. Targeted industries will begin to adopt the use of industrial audits for assessing environmental management needs.

Current labor standards and practices in the region are generally not at a level that can support efficient production necessary for companies to effectively participate in an increasingly competitive and interdependent global economy. USAID efforts will support democratic free labor movements, modern labor-management relations, and worker health and safety standards to ensure efficient and stable production capabilities.

Equally true for the United States and LAC countries, education is the foundation of democracy and the key to reducing poverty and income inequality. Education reform is a timely issue on the hemispheric agenda, illustrated by the commitment of the Summit of the Americas to an initiative to ensure universal access to high-quality basic education. With the shift in most of the LAC region to open economies, countries have come to recognize that political stability and success in world trade are dependent on increasing human capacity.

Most children in the region, male and female, attend primary school. Access to primary school increased from 60% in the 1960s to over 90% today. Participation rates in secondary and higher education also increased, although at a slower rate. While LAC countries have made good progress in providing access to basic education, the failings of existing systems to prevent students from repeating grades or dropping out, the particular issue of access by indigenous groups to basic education, and the small proportions of GDP dedicated by governments to education, point to a continuing need for deep reforms in education policies.

In an effort to increase awareness and understanding of education policy and program options, the LAC Regional program established, and will continue in FY 1997 to strengthen, a consultative forum of governments, the private sector, NGOs, and donors, to develop a broader and more active constituency for education policy reform hemisphere-wide, as well as within selected LAC countries. This sustainable, hemispheric "partnership for educational reform in the Americas" will strongly promote educational policy reform at all levels of society.

Agency Goal: Stabilizing World Population and Protecting Human Health

All funding requested for population and health is planned for health activities. Despite impressive gains in the hemisphere, limited access to and poor quality of health services have resulted in persistently high child and maternal mortality, particularly among rural poor and indigenous groups. The Summit of the Americas' plan of action provides that governments: (1) endorse child and maternal health objectives, including reducing child mortality by one-third and maternal mortality by half (from 1990 levels), reflecting the objectives of the 1990 World Summit for Children, the 1994 Narino Accord, and the 1994 International Conference on Population and Development, (2) endorse a basic package of child and reproductive health interventions; and (3) develop or update country action plans or programs to focus on reforms to achieve equitable, universal access to the basic package. Health reforms, which virtually all LAC countries are to some degree in the process of undertaking, include decentralization, alternative financing schemes, quality assurance, and greater use of NGOs and community-based services for the poor. Summit governments further agreed to use a network to share expertise, information, and experience on health reform efforts in the region. In FY 1997, USAID's contribution through the LAC Regional program will continue the United State's role in the hemisphere as a leader in public health and development, by helping LAC countries design, implement, and monitor such reforms.

Support for health management and financial reforms to increase equity of access to basic health services is also in the U.S. national interest for humanitarian, political (the United States is committed to implement the plan of action of the Summit of the Americas), and developmental reasons (improved health systems will be more sustainable, and will enable countries to provide full coverage of basic health services to their populations without having to depend upon donor resources). If resources were to diminish significantly for FY 1997, regional efforts to improve care for children sick with diarrhea and acute respiratory infections (the two primary causes of mortality among infants and children), would have to be cut back.

Infant, child and maternal mortality remain high, especially among disadvantaged populations in the LAC region. Currently, target countries do not dedicate enough health resources to priority needs in controlling diarrheal disease and acute respiratory infections, nor to maternal mortality reduction. The quality and effectiveness of these programs need improvement. Despite the drop in infant mortality, close to 600,000 infants die each year before their first birthday, most of them from causes that could be prevented with simple, low-cost technologies. While vaccination coverage levels generally are excellent, there are pockets of low coverage and programs not yet sustainable. Furthermore, the region has recently adopted an ambitious measles-elimination goal.

The proximity of the LAC region to the United States presents special challenges, especially in view of current migration and travel patterns. Communicable diseases such as cholera, polio and measles can cause problems in our own country if they are not addressed throughout the region. U.S. interests are also served by intensifying efforts to reduce maternal mortality, not only from a humanitarian perspective, but also to reduce the uncertainties of reproduction, leading to better family planning and, ultimately, to slower population growth and reduced pressures for migration to the United States.

In FY 1997, the LAC Regional program will use the same successful approaches as those employed in accelerated immunization projects (developing regional standards for program implementation and surveillance, providing technical advisors who work with country program managers and Interagency Coordinating Committees, and creating effective surveillance systems), which resulted over the past years in a high level of political attention and emphasis on immunization programs in target^1/ countries, and in the effective dedication of substantial national resources for this high priority program. In FY 1997, LAC regional program resources are intended to leverage other modest USAID resources to focus the attention of LAC countries and other assistance organizations on basic health interventions that are successful. Advancing basic health in selected areas of USAID's priority health goals (those relating to child survival and maternal health, which are amenable to regional action and which need additional program resources beyond other USAID bilateral and global assistance programs), will help the hemisphere, make progress towards its ambitious population and health goals.

Agency Goal: Protecting the Environment

The LAC Region contains nearly half of the world's biodiversity. However, population pressures, rapid urbanization and industrialization, increased demands for agricultural and grazing land, and other factors, are resulting in extensive degradation of key ecosystems. Conservation of the region's biodiversity is critical in view of its long-term potential for providing significant industrial, pharmaceutical, and agricultural uses. As a result of ongoing USAID assistance under the LAC Regional Parks in Peril (PiP) program, LAC governments are now committed to taking measures to protect, conserve and utilize their resources, including maintaining a system of parks and reserves of representative ecosystems.

The PiP program, implemented by The Nature Conservancy in collaboration with national and local governments, NGOs and indigenous communities, directly supports the Summit of the America's initiative to establish "a partnership for biodiversity" in key ecosystems in selected LAC countries. Through FY 1996, protection activities are ongoing in 28 parks covering 18 million acres in 12 countries participating in the program. The activities undertaken are against a target of 28 to 35 parks over the life of the program (subject to the availability of overall funding). Non- USAID funding was identified for 6 PiP sites, and they are well on their way to graduating from the PiP program. In FY 1997, increased emphasis will be placed on: (1) sharing lessons learned from the PiP program and on utilizing PiP sites as demonstration and training areas to advance conservation in other endangered ecosystems, (2) expanding the involvement of local communities in the conservation and management of the parks and reserves, (3) increasing scientific knowledge of the biodiversity in PiP sites and the impact of management interventions, and (4) promoting policy reform and sustainable financing for conservation of key ecosystems.

While rapid economic growth in the LAC region offers many opportunities for the United States, environmental degradation in the region contributes to global climate change, deterioration of the natural resource base, and political instability. The PiP program maximizes political, economic and social returns for the region as a whole and for all its participating countries, including the United States, when it prevents these phenomena from occurring.

Agency Goal: Building Democracy

While the 1980s and early 1990s witnessed dramatic advances in Latin American efforts to establish democracy, a new democratic order has yet to be consolidated. Still fragile Latin American democracies face difficult challenges from growing crime and drug trafficking, endemic corruption, uneven access to justice, and continuing human rights abuses. Internally, many democratic institutions are weak and remain unrepresentative, and the legacy of authoritarian rule has been a highly-centalized and unresponsive government. The poor remain unrepresented and unable to participate effectively in political life.

Despite these difficulties, the democratic transition that has taken place throughout the region offers a strong foundation for further progress in building sustainable democratic systems. Over the past few years, Latin American politics have been marked by important positive trends including: (1) growing pluralism and increasing citizen participation, (2) a rising popular demand for judicial reform, (3) a movement to decentralize political and financial decisionmaking, and (4) repeated calls for government institutions to become more accountable and responsive to citizens. Underlying each of these trends is the principle that a new democratic order in Latin America needs to promote the rights of citizens and the rule of law.

In FY 1997, the LAC Regional program will help consolidate democracy by supporting regional institutions, networks, and exchanges that serve as catalysts and innovators in the democratization effort. The program will identify broad trends that encourage or threaten democracy in the region and will work with USAID and regional institutions (both in Latin America and in the United States) to develop and disseminate new approaches which focus on these trends. The Regional program supports activities that help deepen democracy, as agreed to at the Summit of the Americas

The LAC Regional program has contributed to important achievements through promoting human rights and rule of law, promoting transparent elections, strengthening civil society, and decentralization of power to legislatures, local governments and municipalities. Nearly all countries have implemented judicial reforms and initiated human rights activities, partly as a result of technical assistance and other support provided under the regional program. The ability of election tribunals to carry out free, fair and transparent elections has improved dramatically. Civil society groups are expanding and multiplying rapidly throughout the region, helped along by U.S. assistance for an NGO network which has professionalized several organizations and which plans to assist 80 others in the region over the next five years. Accountability and anti-corruption are now the subject of public discourse in most countries of the region. USAID has been the most active donor in follow-up to the Summit of the Americas' "no to corruption" initiative. Much of the LAC Regional program's work is based upon, and strengthens, regional treaties, agreements and protocols.

The Inter-American Institute for Human Rights (IIDH) and its Center for the Promotion of Electoral Assistance (CAPEL) have received core funding through the regional program to carry out regional human rights education, and provide training, publications, and technical assistance to countries for human rights promotion and implementation of free and fair elections. The Latin American journalism project recently opened the Latin American Journalism Center in Panama. This regional center is close to becoming self-sustaining and will train media professionals in technical skills and ethical norms basic to independent media in functioning democracies.

A hallmark of the LAC Regional program is its ability to stimulate participation of other development assistance donors and numerous U.S. NGOs, institutions of higher education, other U.S. Government agencies (U.S. Departments of State and Justice, and the U.S. Information Agency), drawn into this essential work either as active collaborators with USAID or regional institutions supported by USAID, or first-time funding sources for LAC countries. For example, the Regional Financial Management Improvement project has leveraged over $130 million in World Bank and IDB resources to promote accountability and tranparency in various LAC countries.

Special Objective

Training

The Cooperative Association of States for Scholarships (CASS) and the National Association of the Partners of the Americas (NAPA) are U.S. NGOs that receive USAID grants to enable their existing programs to provide training forLAC participants. The training helps achieve USAID goals and strategic objectives across sectors and is useful in encouraging greater civic and voluntary participation in community-level development activities throughout the region.

While the CASS project, implemented by Georgetown University since 1989, was designed prior to the adoption of USAID's current strategic objectives, Georgetown University has redirected the training focus accordingly and continues to meet human resource development needs of LAC countries. For example, of the 283 participants entering the CASS training program in 1995, a total of 101 students began training in either agribusiness, small business management or industrial maintenance administration. Fifty participants entered ecotourism and environmental management. Forty-nine began programs of study in health care administration and food science technology. Thirty participants are enrolled in an education administration program. A growing number of participants throughout the LAC region are engaged in civic education and democratic initiatives at the grass-roots level of communities. Graduates of CASS and NAPA programs will contribute to the economic growth of their respective countries with new skills and by exercising leadership as individuals. Beneficiaries of these programs also will work to strengthen the democratic role of NGOs in community, national, and regional affairs.

	Encouraging Economic Growth	Stabilizing Population Growth and Protecting Human Health	Protecting the Environment	Building Democracy	Providing Humanitarian Assistance	Total
USAID Strategic Objectives
1. Resolution of Key Market Issues Impeding Environmentally Sound and Equitable Free Trade in the Hemisphere Dev. Assistance	$1,875		$1,000			$2,875
2. Improved Human Resource Policies Adopted in Selected LAC Countries Dev. Assistance	$1,225					$1,225
3. Implementation of Country Health Reform Plans/Programs that Increase Equitable Access to Basic Health Services Dev. Assistance		$1,000				$1,000
4. More Effective Delivery of Selected Health Services Dev. Assistancee		$3,800				$3,800
5. Protection of Selected Parks and Reserves Important to Conserve the Hemisphere's Biological Diversity Dev. Assistance			$4,300			$4,300
6. Strengthened Regional Trends that Deepen Democracy in Latin America and the Caribbean Dev. Assistance ESF				$5,400 $35,000		$5,400 $35,000
Special Objective:
Training Dev. Assistance	$13,750					$13,750
Total Dev. Assistance ESF	$16,850	$4,800	$5,300	$5,400 $35,000		$32,350 $35,000

Office of Regional Sustainable Development Director: Twig Johnson

PROGRAM: LAC REGIONAL
TITLE AND NUMBER: Key Market Issues Impeding Environmentally-Sound and Equitable-Free Trade in the Hemisphere Resolved, 598-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1997: $2,875,000 DA
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2000

Purpose: To resolve key market issues impeding environmentally-sound and equitable-free trade in the hemisphere.

Background: In 1994, at the Summit of the Americas, countries of the Western Hemisphere outlined the proposal for the Free Trade Agreement of the Americas (FTAA), which will increase trade and economic integration in the region. The Summit recognized that, as economic growth and trade expand, pressures on natural resources and the potential for increased pollution, environmental contamination and associated health risks mount, and require compatible trade and environment initiatives. Moreover, since education and health are essential social investments which are fundamental building blocks to produce broad-based economic growth, education and health activities, designed to expand human capacity, significantly contribute to attainment of this objective.

USAID Role and Achievements to Date: The LAC Regional program's Hemispheric Free Trade Expansion activity, which was implemented at the end of FY 1995, supports trade-induced economic expansion as a significant catalyst for improved living standards, reducing poverty, and sustaining growth and political stability in the developing world. USAID collaborates closely with the Office of thel U.S. Trade Representative to participate in the international working groups meeting on the FTAA and works with U.S. and LAC partners to carry out trade liberalization initiatives in support of the creation of the FTAA. Major activities include: (1) establishing an electronic agribusiness network, (2) improving the response capacity of technology institutions to changes and impacts of agricultural free trade in the LAC region, (3) increasing the participation of indigenous groups in natural resource markets, (4) promoting improved occupational health and safety conditions, (5) introducing labor and management relations practices and processes in the LAC region, (6) creating a repository of spatial data to support trade expansion, and (7) developing an information database system linking partners, customers, and beneficiaries through the Internet.

Description: In FY 1997, USAID will continue to focus on the following five distinct areas through the Hemispheric Free Trade Expansion (HFTE) and sustainable micro-finance activities under the LAC Regional program: (1) increasing the capability of target LAC countries to implement legal reforms in tariff and non-tariff areas required for countries' entries into the World Trade Organization (WTO), and the FTAA, (2) increasing the adoption of integrated network technologies and the use of personal computers to globally link traders and carry out international trade transactions more efficiently and at a lower transaction cost; (3) assisting countries with trade-induced structural adjustments by developing and strengthening a variety of local and regional social institutions and networks through which the public and private sectors can engage in dialogue and create a catalyst for social change, (4) increasing the adoption of improved environmental and natural resource management practices related to free trade to ensure that expanded trade and hemispheric economic integration does not contribute to the degradation of the environment, and (5) increasing the adoption of improved labor and management relations and practices related to free trade through support for democratic free labor movements and for modern labor-management relations.

Host Country and Other Donors: The LAC Regional program is already working with the Inter-American Development Bank (IDB) to support economic growth and trade initiatives, and with the World Bank and the World Research Institute to support environmental initiatives adopted at the 1994 Summit of the Americas. Donor coordination will expand further in FY 1997. USAID is working jointly in these activities with Ecuador, Honduras, Brazil, and El Salvador.

Beneficiaries: The LAC Regional program will focus economic growth and trade activities on smaller countries with less-developed economies in order to accomplish this objective. It also will focus on increasing trade opportunities for the poor, particularly small entrepreneurs and small farmers, by incorporating them in the economic process.

Principal Contractors, Grantees or Agencies: USAID is working closely with other U.S. government agencies andinternational organizations to support the initiatives adopted at the Summit of the Americas. The following U.S. organizations and agencies are some of the key partners involved in developing and implementing hemispheric free trade expansion and environment activities: the Office of the U.S. Trade Representative, Food and Drug Administration, U.S. Customs, the Inter-American Institute for Agricultural Cooperation, National Center for Food and Agricultural Policy, Geological Survey, the Environmental Protection Agency, and the Departments of Labor, Energy, Interior, and Agriculture.

Major Results Indicators:
Baseline Target

Number of FTAA-related trade Baseline assessment Catalytic reforms in
liberalizatioin reforms enacted and underway 4-5 countries
implemented.
Number of trade-facilitating systems 0 3 systems in 9
in key countries. countries
Number of market institutions 0 5 new market
strengthened and number of trade institutions tested in
disciplines advanced. 8 countries
Establishing enabling conditions for Baseline 4 conditions in 10-12
environmentally sustainable increased assessment countries
trade. underway
Number of new institutions established 0 3 institutions
to address workers rights and labor and established
management relations.

Purpose: To establish a sustainable hemispheric partnership to promote a better understanding of education policy issues and develop a broader and more active constituency for educational policy reform within the LAC region and selected countries.

Background: Education reform is a timely issue on the hemispheric agenda. With the shift toward open economies in most of the region, countries are increasingly concluding that success in world trade and political stability depends more on human resources than on natural resources. Large segments of society, particularly women, minorities and indigenous groups, have not been equipped to participate fully in economic life. Nearly one-half of the hemisphere's population lives in ignorance and poverty. The low level of primary school attainment is a major constraint to economic development. No country with low levels of human capital has developed successfully in a self-sustained manner in the latter half of the twentieth century. Considerable evidence suggests that policies change only when local policy thinkers and persuaders become intellectually convinced of the merit of an argument.

USAID Role and Achievements to Date: With only modest investments in educational policy reform in LAC countries, USAID can have a direct effect on developing influential constituencies to support policy reform and on the delivery of quality primary education. In FY 1996, First Lady Hillary Rodham Clinton launched USAID's Partnership for Education Revitalization in the Americas activity which, in FY 1997, will use policy dialogue to encourage selected governments in the region to make policy changes to improve the quality of primary education. While it is still too early to enumerate achievements, the partnership is off to a fast start with active participation from most LAC countries and major educational organizations in the region.

Description: The essence of USAID's approach in the region is to effect policy change through the development of a network of hemispheric "change agents," who will work to reform their own governments' considerable investment in education. USAID, in cooperation with other donors, will support a consultative forum for governments, nongovernmental organizations (NGOs), the business community, donors, and international organizations to review exemplary educational programs and policies and to focus resources for reform more effectively. The forum will establish the framework, process, and mechanism for identifying, showcasing and replicating best educational policies and practices in the hemisphere, leading to country-level reform in a variety of areas, including educational quality, finance, equity, and decentralization. The approach is very cost-effective because, for relatively small investments, USAID can effect large changes in manner in which national governments invest their massive expenditures in education, and because those changes will result in dramatic efficiencies and savings.

Host Country and Other Donors: USAID's effort to improve the quality and efficiency of education in the LAC region is a partnership between USAID, host countries, other donors, and LAC education organizations. Partners will be asked to provide financial and other support for the effort. The Inter-American Development Bank has already provided limited support for the effort, and expects to provide additional funds. The World Bank also is interested in becoming a partner in the effort. On hemispheric educational policy, the LAC Regional program works with the Inter- American Dialogue and LAC regional institutions, such as the Center for research and Development of Education. LAC regional activities also maintain contact with the U.S. Department of Education.

Beneficiaries: The ultimate beneficiaries of the effort will be all school-age children in the LAC region, especially those in the primary grades. Other beneficiaries will include the host country governments which will provide more cost-effective services, the private sector which will draw on a better educated, more productive labor force, and people at large who will gain more equitable and politically stable societies.

Principal Contractor, Grantees, or Agencies: The Partnership for Educational Revitalization in the Americas will be implemented through a cooperative agreement with a U.S.-based NGO (Inter-American Dialogue).

Major Results Indicators:
Baseline Target
Policies formulated and adopted
to improve educational quality,
finance, equity and governance. 5 (FY 1996) 25 (1000)
Working groups formed to showcase
and replicate successful practices
and policies. 0 30 (2000)
Increased percentage of primary
school completers. 55% 65%^2/ (2000)

Purpose: To assist in the development, approval and implementation of country health-reform plans and programs that increase equitable access to basic health services through supportive regional programs.

Background: Despite impressive gains in the hemisphere, limited access and quality of services have resulted in persistently high child and maternal mortality, particularly among the rural poor and indigenous groups. The action plan of the 1994 Summit of the Americas proposes that governments endorse child and maternal health objectives, including reducing child mortality by one-third and maternal mortality by one-half (from 1990 levels), reflecting the objectives of the 1990 World Summit for Children, the 1994 Nariño accord, and the 1994 International Conference on Population and Development, endorsing a basic package of child and reproductive health interventions and developing or updating country action plans or programs for reforms to achieve equitable, universal access to the basic package. The innovation is to support these objectives through health reforms, such as decentralization, alternative financing schemes, quality assurance, greater use of nongovernmental organizations and community- based services for the poor. It was further agreed to use a network to share expertise, information, and experience on health reform efforts in the region. Virtually all nations in the region are to some degree in the process of undertaking such health reforms.

Although reform efforts must be country-specific, there is much to be gained by LAC Regional program support for country reforms. Managers need easy access to information on those which have succeeded, and those which have not. Regional collection and dissemination of such information is needed. Countries need technical assistance from the various donors that is consistent and coordinated. Both regional and country coordination must be done. In some cases, the best way to provide such technical assistance is multi-country workshops or training programs. In addition, there is a need for operations research to try out new ideas, and for overview studies to assist countries in selecting reform efforts that they will implement. Monitoring of reform efforts in the region as a whole also is needed.

USAID Role and Achievements to Date: A meeting on health reform was held as part of the Pan American Health Organization's (PAHO's) governing council in September 1995. It was developed by an interagency steering committee, comprised of USAID, U.S. Department of Health and Human Services, and other donors, with PAHO as the secretariat. The intent of the meeting was to plan the strengthening of the network and to define PAHO's role in monitoring the country plans. During the meeting, which was attended by all LAC ministers of health, discussion was wide-ranging and lively, and the ministers left better-informed of the potential of health reform efforts for achieving equity of access to health services. In the declaration which resulted from this meeting, the governing council charged PAHO to do follow-up actions with other international organizations.

Description: To support health-reform efforts, governments agreed at the Summit to form a network that will focus on health reform through analyses, training and technical cooperation. The network will support country health reforms by means of technical assistance to foster hemisphere-wide (north-south and south-south) cooperation on reforms and support for analyses, training and other capacity-building activities. The LAC Regional program will strengthen the network and support PAHO in its role of monitoring country plans. In addition, the Partnerships for Health Reform and other USAID activities will carry out information dissemination, training, technical assistance, focused regional studies, and operations research.

Related Activities: Through bilateral assistance programs in LAC countries, USAID will support country-level efforts to endorse a basic package of services and assist in developing and implementing health-reform programs to make such services universally accessible, in order to achieve maternal and child health objectives.

Host Country and Other Donors: LAC regional program staff have met with the World Bank and PAHO to share information on program plans and possible actions, as a prelude to joint action to fulfill the networking and monitoringfunctions envisioned at the Summit. Meetings with the Inter-American Development Bank (IDB) will soon take place. USAID also works at the country level with these and other donors.

Beneficiaries: Ultimate beneficiaries of this program are people in countries where USAID has population and health programs, such as Bolivia, Ecuador, Paraguay, Peru, El Salvador, Guatemala, Honduras, Nicaragua, Dominican Republic, Haiti, Jamaica, Brazil and Mexico. Access to basic health services will be improved by reforms in health care organization and financing.

Principal Contractors, Grantees, or Agencies: PAHO, Abt Associates (and subcontractors), Harvard University, Center for Development and Population Activities and Johns Hopkins University are the principal implementors.

Major Results Indicators:
Baseline (1994) Target (2000)

Target countries with reforms
implemented as planned 0 13
Target countries with basic services packages
implemented as planned 0 13
Target countries with increased use of
USAID resources to support
reform efforts 0 13
Target countries with approved reform
plans/programs 0 13
Target countries with approved basic
services packages 0 13

Purpose: To improve the effective delivery of selected health services by strengthening quality and sustainability of services.

Background: Infant, child and maternal mortality remain high in the LAC region, especially among disadvantaged populations. Currently, target countries in the region do not dedicate sufficient health resources to priority needs in controlling diarrheal disease and acute respiratory infections, or reducing maternal mortality reduction. Quality and effectiveness of the programs also need improvement. Despite the drop in infant mortality in the region, close to 600,000 infants die each year before their first birthday, most of them from causes that could be prevented with simple, low-cost technologies. While vaccination coverage levels generally are excellent, there are pockets of low coverage, and programs are not yet sustainable. Furthermore, the region has recently adopted an ambitious measles-erradication goal.

In FY 1997, the LAC Regional program will use the same successful approaches as in previous accelerated immunization projects (developing regional standards for program implementation and surveillance, providing technical advisors who worked with country program managers and Interagency Coordinating Committees, and creating effective surveillance systems). These projects resulted in a much higher level of political attention and emphasis to immunization programs in target^3/ countries, and to the effective dedication of substantial national resources for this high-priority program. It is intended to leverage the LAC Regional program's modest resources to produce focused programmatic attention on the interventions considered to be most important in affecting health status.

USAID Role and Achievements to Date: This objective builds on the success of two successive regional grants to the Pan American Health Organization's (PAHO's) supporting vaccination programs in the Americas. Coverage, with final doses of each vaccination by age one, has reached at least 78% of the population in all target countries. Between 1986 and 1996, USAID provided about half of donor funding for vaccination efforts in the region. As a result of USAID's country and regional efforts with PAHO and other donors, the Americas have been declared free of indigenous transmission of wildpolio virus, and measles cases decreased by 99% from levels in the early 1990s.

Description: In target countries, regional service delivery improvement efforts will be expanded to provide highly- focused assistance to country programs to strengthen the quality and availability of selected health interventions (diarrheal disease control, acute respiratory infection control, vaccinations and maternal mortality reduction), which are among the specfic priority interventions defined in USAID's population, health, and nutrition strategy. These key health interventions will be strengthened in target countries by: (1) establishing and disseminating improved norms for service delivery and surveillance, (2) targeting resources to sub-national areas where help is needed most, and (3) increasing the sustainability of service delivery and surveillance by refining the roles for public and private actors, increasing health care financing, and increasing efficient management of services. Health services on which the activities will focus (such as vaccinations, acute respiratory infection control, diarrheal disease control, and emergency obstetric care), were selected based on their importance to USAID's overall population and health strategy, the likelihood of positive impact through a regional mechanism, and relevance to the agenda of the First Ladies' symposium in follow-up to the Summit of the Americas.

Host Country and Other Donors: The objective will use PAHO's unique capabilities to influence LAC governments insetting agendas, policies and standards. Since PAHO often is the lead agency among the health donors in LAC countries, and LAC country health authorities rely heavily on PAHO's advice regarding setting priorities, such an activity could have a substantial effect in promoting the interventions and system changes which are key to improving health in the hemisphere, regardless of source of donor funding. The use of the interagency coordinating committee mechanism will foster collaboration among all health donors in each target country. For the vaccination components of this strategic objective, USAID plans to contribute up to $8 million, the PAHO budget will provide $7 million; and PAHO has pledges of $1 million from Spain and $2.2 million from the Inter-American Development Bank. Approximately $7 million in USAID funds would support the other components, with PAHO providing a similar amount. USAID bilateral missions also funds country-specific programs which assist target countries in working toward the purpose of this strategic objective, and both USAID missions and LAC governments coordinate with other donors at the country level.

Beneficiaries: This objective is designed to directly benefit the service delivery and surveillance programs of the target countries in the LAC region. Ultimately, children less than five years of age and women of childbearing age in target LAC countries will be the major beneficiaries.

Principal Contractor, Grantees, or Agencies: The activities will be implemented, using an international organizations grant to PAHO. Inputs would include technical advisors and other regional support for national programs, such as technical materials or improved surveillance and information systems.

Major Results Indicators:

The number and proportion of target countries with:
Baseline Target

More than 80% of pneumonia in children over 5 years old TBD^4/ 6 (2000)
treated with appropriate case management
More than 80% of diarrhea in children over 5 years old TBD 6 (2000)
treated with oral rehydration therapy (ORT) and continued
feeding
Extended program immunization coverage of at least 90%
among children under one year of age 3 (1995) 8 (2000)
More than 50% of deliveries with serious obstetric TBD 6 (2000)
complications receive emergency
obstetric care

PROGRAM: LAC REGIONAL
TITLE AND NUMBER: Selected LAC Parks and Reserves Important to Conserve the Hemisphere's Biological Diversity Protected, 598-SO05
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 1997: $4,300,000 DA
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2000

Purpose: To ensure adequate on-site protection for 28-35 critically-threatened LAC national parks and reserves of global, biological significance.

Background: The LAC region contains approximately 50% of the world's biological diversity. However, extensive habitat and whole ecosystem destruction is causing the extinction of many species and with them the loss of genetic resources valuable for future advances in medicine, agriculture, and industry. To address this problem, many LAC countries have set aside parks and reserves. Unfortunately, countries often lack funds, expertise, and effective policies required to protect these areas. Since FY 1990, USAID has supported the Parks in Peril (PIP) program.

USAID Role and Achievements to Date: With USAID funding of approximately $19 million to date, The Nature Conservancy (TNC), PiP's implementing organization, has improved on-site protection in 28 sites, encompassing over 18 million acres. Significant lessons learned have led to replicable management practices in the region for biodiversity conservation, including innovative financing approaches. As a result of this effort, many local conservation nongovernmental organizations (NGOs) and indigenous community groups have been strengthened.

Description: With USAID, TNC provides direct grant support for NGOs and agencies to assist in the management of 28-35 parks or protected areas. The parks will be protected by: (1) establishing a permanent management presence in each park through training park staff and providing basic infrastructure, (2) expanding each park's community outreach and promoting economic activities compatible with park protection in communities near the protected areas, (3) initiating on-site environmental studies and monitoring, (4) developing long-term mechanisms for financial sustainability, (5) increasing dissemination through the hemisphere of lessons learned at PiP sites, and (6) increasing the capacity of TNC to manage and implement the PiP program.

Host Country and Other Donors: To date, host country and NGO sources have matched USAID funds with approximately $6 million. The PiP program complements funding from other bilateral donors (Germany), and from multilateral sources, such as the World Bank's Global Environment Facility. PIP also leverages funds from other bilateral donors (e.g., Japan, Denmark) and private foundations (MacArthur and Mellon).

Beneficiaries: Local communities benefit from the maintenance of the local natural resource base, and employment opportunities are created as a result of park development, maintenance and tourism. At the national and global levels, the conservation of biodiversity protects significant economic and scientific opportunities.

Principal Contractor, Grantees, or Agencies: USAID implements the PiP program through TNC. TNC works closely in target countries with local NGOs (including The Friends of Nature Foundation, Chile; National Association for the Conservation of Nature, Panama; Defenders of Nature, Guatemala; and Integrated Fund for Nature, Dominican Republic and Mexico), LAC governments, and communities, in program implementation.

Major Results Indicators:
Baseline Target

Parks and reserves with adequate management
Number: 0 (1990) 28 (1999)
Area (millions of hectares): 0 (1990) 19 (1999)
Number of parks and reserves with
sufficiently trained personnel 0 (1990) 28 (1999)
Number of NGOs with adequate
management capacity 0 (1990) 19 (1999)
Annual government contributions for
park protection at PIP sites $179,000 (1991) $2,730,000 (1998)

PROGRAM: LAC REGIONAL
TITLE AND NUMBER: Strengthened Regional Trends that Deepen Democracy, 598-SO06
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 1997: $5,400,000 DA; $35,000,000 ESF
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2000

Purpose: To help consolidate and deepen democracy in Latin America and the Caribbean by funding institutions, networks and exchanges that are essential to emerging regional democratic trends.

Background: In almost all countries since the mid-1980s, the LAC region has seen the transition from military dictatorships to democracies. Recently, in the areas of democracy and human rights, several dynamic, integrative trends have emerged, including growing citizen participation in nation-building, the demand for reform of judicial structures, political parties and legislatures, decentralization of political and financial decision-making, and a widespread call for improved accountability and responsiveness of public sector institutions. The protection of basic human rights is the core value of these trends. At the same time, democracies are challenged by rising crime rates, drug trafficking, and societal inequalities and poverty.

USAID Role and Achievements to Date: USAID works with LAC regional institutions and countries, and USAID bilateral missions and USAID offices, to: (1) promote human rights and the rule of law, (2) strengthen civil society, and (3) improve the legitimacy of key public sector institutions critical to a functioning democracy. As a result, civil society groups involved in democratic activities are growing in influence throughout the region, aided by regional funding of a nongovernmental organization (NGO) network. Accountability and anti-corruption are now the subject of public discourse in most LAC countries and judicial reforms and human rights activities are underway.

Description: The central focus of the program is to protect and expand human rights by using regional institutions, programs, and mechanisms to carry out activities that complement bilateral USAID programs. Consolidating democracy in Latin America requires functioning institutions that provide protection of basic rights, secure and expand opportunities to exercise those rights, and assure real potential for participation in decisionmaking. The LAC Rregional program focuses on:

Expansion of Inter-American Institute for Human Rights (IIDH) activities promoting human rights monitoring. Continued core funding for IIDH will further promote human rights education and training activities, dissemination of publications, and technical assistance for high-priority LAC countries.

Information exchanges promoting judicial reform. To complement bilateral USAID efforts to protect human rights by improving the rule of law, the regional administration of justice project has contributed to sharing of information about ongoing judicial reform efforts throughout the region.

Establishment of regional programs to share experiences and provide assistance to NGOs important to building pluralism and political participation. The regional civic education activity with Partners of the Americas helps dynamic Latin American civil society NGOs provide training and technical assistance to other NGOs. The regional program will also begin activities to address the critical role of competitive and representative political parties in pluralistic societies.

Improved training opportunities for Latin American journalists. In Panama, the Latin American journalism activity will help build self-sufficiency in the Latin American Journalism Center, which trains media professionals in the technical skills and ethical norms required by independent media.

Expansion of Center for the Promotion of Electoral Assistance (CAPEL) activities to promote free, fair, and transparent elections. Core funding for CAPEL in FY 1997 will allow it to continue providing technical assistance to countries in the region to carry out elections professionally and transparently.
Expansion of opportunities to share experiences in decentralization. Within this program area in FY 1997, the LAC regional program will support dissemination of information and exchanges that help inform and build support for efforts to decentralize governmental power. These efforts will largely be oriented toward devolution of budget and decisionmaking authority local levels, building capacity in local governments, and enhancing public participation in local decisionmaking.

Expansion of opportunities to share experiences in legislative strengthening. LAC regional activities may also include activities to broaden the locus of decisionmaking within the central government by strengthening the role of legislatures in relation to traditionally strong executives.

Expansion of programs to promote government accountability. The regional accountability and financial management improvement activity funds follow-up actions to the "No to Corruption" initiative of the Summit of the Americas. With FY 1997 funding, it will continue to work closely with the World Bank, the Inter-American Development Fund (IDB), and U.S. NGOs in planning anti-corruption activities.

Host Country and Other Donors: Major donors in the region finance democracy activities, which are closely coordinated with USAID democracy and human rights efforts at the field level (and in Washington, at the policy level). Other organizations that play key leadership or funding roles include the United Nations, Organization of American States, the IDB, the European Union, and World Bank, and bilateral donors (Canada, Holland, and Scandinavia).

Beneficiaries: As human rights practices improve and democracies are strengthened, direct beneficiaries are the citizens of LAC countries. The United States indirectly benefits as U.S. national security interests are closely tied with improved regional stability and democracy.

Principal Contractors, Grantees, or Agencies: Partners in USAID's regional democracy efforts include bilateral and multilateral donors (Netherlands, Canada, the European Union, the World Bank, and the IDB), IIDH, CAPEL, the Partners of the Americas, the Carter Center, a U.S. contractor (Casals & Co.),

and the LAC countries themselves. LAC NGOs participating in these activities include PARTICIPA (Chile), Conciencia (Argentina), Poder Ciudadano (Argentina), Institute for Investigation and Political Self-Formation (INIAP), and the University of the Andes (Colombia).

Major Results Indicators:
Baseline (1995) Target (2000)

Number of strengthened national and regional electoral bodies 5 11
Number of countries adopting integrated financial mgmt systems 2 6
Number of multilateral donor-supported accountability projects 0 15
Public confidence level in media in targeted LAC countries 38% 50%
Number of LAC NGOs participating in regional network 5 80