Note: This document may not always reflect the actual appropriations determined by Congress. Final budget allocations for USAID's programs are not determined until after passage of an appropriations bill and preparation of the Operating Year Budget (OYB).
BRAZIL
FY 1997 FY 1998 FY 1999 Actuals Estimate Request Development Assistance.............. $9,610,000 $8,378,000 $8,117,000 Child Survival and Disease.......... $3,000,000 $2,500,000 $2,500,000
Introduction
Brazil is critically important to U.S. national interests because of its vast geographic size, 155 million population, rich natural resources, and $780 billion GDP. Brazil is a pivotal and predominant power in Latin America, a strategic ally of the United States, and a valuable trading partner with over $20 billion in bilateral trade. Long-term, sustainable development in Brazil is in the U.S. strategic interest because of the need to protect the United States and its citizens from the effects of environmental degradation in Brazilian forest, from the spread of infectious diseases, such as AIDS, and uncontrolled world population growth. These global issues are serious problems in Brazil and have a significant impact on the United States.
The Development Challenge
Brazil is the tenth largest economy in the world. However, due to past poor economic management and extremely uneven income distribution, Brazil also has high levels of income inequality and extreme poverty, particularly in the Northeast, which has 30 million people below the poverty line. Brazil's external debt is more than $170 billion dollars. Brazil and the United States expect to complete final debt rescheduling negotiations pursuant to the 1992 Paris Club agreement by March 1998. The USAID health program will graduate in 2003 and the environment and energy program will continue until global objectives are achieved. Given the scope of these global problems, graduation from U.S. assistance is not anticipated in the near future.
One of Brazil's challenges is to develop its tropical biodiversity for productive, sustainable use. Deforestation and burning in the Amazon basin and extensive habitat conversion for agricultural development in the savannas substantially contribute to Brazil's greenhouse gas emissions. In certain regions, severe deforestation and forest fragmentation threaten the viability of forest biodiversity and carbon exchange. USAID supports workable land use alternatives which replace harmful practices that rapidly degrade natural areas. Given Brazil's size and the magnitude of the threats to its natural ecosystems, USAID resources alone cannot significantly alter the loss of these natural areas. Thus, the Brazilian environment program leverages resources and involvement from NGOs, industry, multilateral banks, cooperatives, universities, and government agencies, allowing USAID to play a significant, catalytic role in protecting Brazil's ecosystems. USAID-funded actions have been successful in demonstrating the viability of low impact forest management for both timber and non-timber forest resources. Also, USAID supports the first-ever co-management plan for two national parks in the Amazon, involving shared responsibilities between NGO groups and federal park authorities.
Brazil is the world's fifth largest net greenhouse gas emitter and is one of ten key countries receiving priority for action in USAID's Climate Change Action Plan. With continued economic expansion of approximately four percent per year requiring energy resources to grow by 65% from 1996 to 2006, Brazil's energy future runs the risk of increased dependency on fossil fuels or hydropower dams that flood valuable tropical forests. USAID will target its resources on increasing Brazil's ability to detect and mitigate energy sector climate change impacts focusing on policy, regulation, and financing mechanisms critical to environmentally sustainable energy. USAID has already influenced the designof two major World Bank loans directed to energy efficiency ($150 million) and renewable energy ($200 million). USAID helped the Brazilian government agency PROCEL to write the Brazilian strategy in the area, and helped the World Bank to write their project. USAID is also assisting in the design of an Inter-American Development Bank (IDB) loan intended to assure access to clean electric power in poor rural areas in Northeastern Brazil.
Approximately 52% of the reported AIDS cases in Latin America/Caribbean are in Brazil and an estimated 560,000 to 850,000 persons are infected with HIV, making Brazil second only to the United States in reported cases in the Americas. Transmission of HIV in Brazil is predominantly sexual and increasingly heterosexual; transmission through other means accounted for only 26% of all infections during 1996. Transmission is also increasing among young people and those with the lowest levels of education. Thus, the HIV/AIDS epidemic in Brazil is concentrated among the poorest and most marginalized populations. USAID's strategic objective is designed to increase sustainable and effective programs to prevent sexual transmission of HIV among major target groups, focusing on women, adolescents, and low income populations. The USAID-supported AIDS prevention program developed in the city of Santos is considered a model prevention program by the Ministry of Health (MOH) who has taken over support for the program and replicated it to other locales. The condom social marketing program has achieved 14% market share in Brazil and fostered increased competition in the condom market. The program identifies and disseminates the most effective interventions, increases the management capacity of selected institutions to provide sexual transmitted infection and HIV prevention and education services, and supports condom social marketing (the use of marketing to change a social behavior). This program will receive decreasing emphasis over the next five years.
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. The USAID program in this area, planned for closeout in FY 2000, is focused on the development of reproductive health services in two Northeastern States and actions designed to expand the range of contraceptive options in the public and private sectors. The governments of these states have signed agreements to support the program when USAID phases out. A major agreement was concluded with Pharmacia Upjohn for the introduction of a three-month injectable for lower income groups as a social marketing product.
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 $110 monthly minimum wage. The pressures of poverty and scarcity of basic services lead to a breakdown in family structure, which contributes to the problems of sexual exploitation of youth and violence. USAID-funded at-risk youth activities emphasize expanded NGO and government capacity and innovative approaches to provide formal schooling, vocational training, health programs for youth, and promotion of children and adolescents' rights. A program subgrantee was awarded the Brazilian Bar Association's Human Rights prize for USAID-funded activities, and with USAID support the Brazilian government launched a national campaign to prevent sexual exploitation of children and youth.
Other Donors
USAID works closely with the UN Population Fund, UN Children's Fund, the World Bank, the IDB, Germany, Japan and Canada. In FY 1997, the U.S. provided $14.8 million of development assistance to Brazil, about 25% of the amount provided by Japan and 30% of that provided by Germany. The top five donors are Japan, Germany, Canada, United States and United Kingdom. Japan works in the areas of environment, agriculture, fishing, health, and industry. Germany works in the areas of environment, low income communities, and medium, small, and microenterprises. Canada works in the area of environment, gender issues, but most of the resources go to support a partnership between Canadian and Brazilian institutions. The United Kingdom works in the areas of environment and governance.
The World Bank has $7.7 billion dollars in projects in the areas of agriculture ($1.6 billion), education ($1.14 billion), energy ($490 million), environment ($1.8 billion), health ($740 million), public sector reform ($440 million) and transportation ($1.49 billion). The IDB has $7 billion dollars in projects in the areas of infrastructure, environment, health, public sector reform, poverty, civil society, street kids and at-risk youth.
FY 1999 Program
In summary, the funding level requested will allow the USG through USAID to engage Brazil collaboratively on vital foreign policy issues: the global issues which were the focus of President and Mrs. Clinton's highly successful visit to Brazil in October, the President's recently announced $1 billion Climate Change initiative, the U.S./Brazil Common Agenda Agreement, USAID's global agenda, and three of the seven bilateral agreements signed during the presidential visit. The AIDS program will work with the MOH to evaluate existing prevention activities and design training curricula to strengthen program management. The Reproductive Health program will continue the process of phasing over the program to the State Secretaries of Health, building upon their political commitment and continue activities to improve the quality of family planning services in rural clinics. The program will also sponsor national seminars with the MOH on contraceptive methods, and continue support for social marketing programs. The At-Risk Youth program will concentrate on capacity building in management and income-generation for local NGOs, strengthen regional networks, and continue education and training programs for disadvantaged youth.
The environment program will work with World Bank and Brazilian coordinators of the G-7 Pilot Program to Conserve the Brazilian Rain Forest to establish a scientific basis for sustainable resource use in the Amazon utilizing the new U.S. contribution of $10 million (over five years) to this program. The program will continue efforts to establish reduced impact forest management practices in timber operations to reduce deforestation pressure through expanded training for both industry technicians and enforcement officials. Energy actions will focus on collaboration with the new Brazilian energy regulatory agency, ANEEL, to assure private sector access for clean energy technologies to meet Brazil's growing energy needs. The energy program will also further define planned World Bank loans in energy efficiency and renewable energy.
BRAZIL FY 1999 PROGRAM SUMMARY
($000s)
USAID
Strategic and Special
ObjectivesEconomic Growth and Agriculture Population and Health Environ-ment Democracy Human Capacity Develop-ment Human-itarian Assistance
TotalS.O. 1
Environment-ally and socio-economically sustainable alternatives for sound land use adopted
- DA
795
795
S.O. 2
Reduce rate of growth in greenhouse gas emissions from energy sources
- DA
5,322
5,322
S.O. 3
Programs to prevent sexual transmission of HIV
- CSD
2,000
2,000
S.O. 4
Access to contraceptive methods and integrated family planning services
- DA
2,000
2,000
Sp.O. 1
Improved quality of life for at-risk youth
- CSD
500
500
Totals
- DA
- CSD
2,000
2,500
6,117
8,117
2,500
USAID Mission Director: Edward L. Kadunc
ACTIVITY DATA SHEET
PROGRAM: BRAZIL
TITLE AND NUMBER: Environmentally and socioeconomically sustainable alternatives for sound land use adopted beyond target areas - 512-SO1
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $795,000 - DA
INITIAL OBLIGATION: FY 1996; ESTIMATED COMPLETION DATE: FY 2003
Purpose: To increase protection and sustainable use of natural resources in Brazil's critical regions for biodiversity, including the Amazon, Atlantic Forest and Cerrado (savanna) regions, and to reduce greenhouse gas emissions from deforestation.
Background: Brazil is considered a major potential contributor to greenhouse gas emissions because of deforestation and burning that take place extensively in the Amazon basin and extensive habitat conversion for agricultural development in the Cerrado(savannas) zone. By disseminating sustainable development alternatives throughout the Amazon region and reducing the frequency of burning in the savannas, CO2 emissions are reduced and biodiversity is conserved, while encouraging stable economic growth through a participatory, democratic local-level approach. In the Atlantic Forest region of Brazil and to a lesser extent in the Amazon, severe forest fragmentation threatens the viability of tropical forest biodiversity. USAID has taken the lead in Brazil in attacking these problems through innovative partnerships between U.S. and Brazilian NGOs.
USAID Role and Achievements to Date: USAID--through support to local NGO efforts and training of key individuals--continues to play a model role reconciling development and conservation in the Amazon, and more recently in the Atlantic Forest and Cerrado regions. Participatory workshops were held with representatives of partner NGOs, community leaders, and the federal environmental agency (IBAMA) to discuss 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),and Serra do Divisor National Park (840,000 hectares). Management plans developed by partner NGOs (World Wildlife Fund and Vitória Amazônica Foundation for Jaú and The Nature Conservancy and SOS Amazônia for Serra do Divisor) are being finalized after extensive participatory research and field work. After approval by IBAMA, IBAMA has proposed to use these plans as models for future management plans in other protected areas throughout Brazil.
After several years of planning, preparatory studies, and community organizational assistance, the first community-owned, operated and managed palm heart factory in the Amazon was inaugurated in an extractive reserve in the eastern Amazon state of Amapá. By ensuring carefully planned and monitored extraction procedures, the over-harvesting, palm devastation, and resource depletion typical of commercial palm heart exploitation have been replaced by a sustainable harvest system. The project provides a secure market for the producers, generating local employment in palm heart processing, and commercializing a value-added product. The major weak point of extractive reserves, that of economic viability, is now being addressed by this activity and is ready for replication to other areas of the Amazon.
USAID/Brazil continues to support model reduced-impact forest management practices in the Amazon, guiding the timber industry and government enforcement officials to workable solutions that assure industry viability and forest permanence. Engagement of USAID partners World Wildlife Fund (WWF), the Institute of Man and the Amazon Environment (IMAZON), and Tropical Forest Foundation (TFF) was key to design of an $18 million World Bank activity in forest management under the G-7 Pilot Program to Conserve the Brazilian Rain Forest.
Severe El Niño-aggravated burning conditions in the Amazon in 1997 highlighted the importance of developing effective local measures to control fire. Woods Hole Research Center scientists and
collaborating partners at Amazon Environmental Research Institute (IPAM) used radio spots to disseminate community-developed fire control guidelines throughout the Amazon. The U.S. Forest Service and Woods Hole/IPAM continue to quantify the effects of burning on Amazon forest and Cerrado savanna ecosystems while surveying the extent of fire damage on private land from ground surveys and with satellite/GIS mapping.
Description: Incorporating the lessons learned from the original USAID Global Climate Change (GCC) Project, this program is supporting adoption of sound land use practices in the Amazon, Atlantic Forest and Cerrado regions. It is implemented by a number of U.S. agencies and NGOs through agreements with in-country partners. 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 the Eastern Amazon; 3) fire science and management to reduce the effects of uncontrolled burning on local biodiversity and global warming; 4) agroforestry alternatives for restoring productivity to degraded cleared areas, developed in a participatory approach with small holders; 5) natural resource policy and environmental education, with federal, state, and local officials and land managers; and 6) building local capacity and strengthening NGOs.
In addition, USAID is responsible for a new U.S. contribution to the science and technology component of the G-7 Pilot Program to Conserve the Brazilian Rain Forest (PPG-7). During his visit to Brazil in October 1997, President Clinton announced a $10 million commitment to the PPG-7 over a five-year period. This activity complements USAID/Brazil's other bilateral activities by contributing to science-based solutions for sound forest use.
Host Country and Other Donors: USAID works in close consultation with Brazilian Government programs as an integral part of the U.S./Brazil Common Agenda on the Environment. However, assistance is provided directly to U.S. NGOs who have a presence in the country working with Brazilian partners. USAID also coordinates its program with other U.S. Government agencies. Activities under the USAID environmental program leverage those of other multilateral donors, especially the G-7-funded, World Bank-implemented Pilot Program to Conserve the Brazilian Rain Forest, the Global Environment Facility, and the Brazilian Fund for Biodiversity (FUNBIO).
Beneficiaries: Rural communities and especially small holders who frequently have only traditional rights to their land are the focus of USAID activities. USAID-supported actions benefit Brazilian society at large by assuring that the resource base is maintained for future generations. Benefits will also result at the international level from protecting tropical forests and biodiversity, and reducing greenhouse gas emissions.
Principal Contractors, Grantees, or Agencies: USAID implements activities through U.S. PVOs (World Wildlife Fund, The Nature Conservancy, Conservation International, Woods Hole Research Center, and Tropical Forest Foundation), U.S. Government agencies such as the USDA Forest Service and the Smithsonian Institution, and several U.S. academic institutions (University of Florida and the State University of New York).
Major Results Indicators: Baseline (1991) Target (1999) Families adopting sustainable management systems 0 350 Hectares in protected areas using improved management systems 0 5,500,000 Low impact logging systems developed and validated 0 3 Trained environmental professionals 0 (1991) 4,000 (1999)
ACTIVITY DATA SHEET PROGRAM: BRAZIL
TITLE AND NUMBER: Reduce rate of growth in greenhouse gas emissions from energy sources - 512-SO2
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $5,322,000 DA
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2003
Purpose: To reduce greenhouse gas emissions from wasteful energy use through strengthening in-country capability for investment promotion in renewable energy and energy efficiency.
Background: In September 1995, as a result of agreements signed at the Summit of the Americas, USAID launched a comprehensive Brazil Energy Program (BEP). The Environmental Initiative for the Americas (EIA) funded $3.3. million in activities under BEP in FY 1995 over a two-year period. In FY 1996 the USAID environmental program funded part of the program and will provide funds to BEP through 1999 as these activities complement the Mission's environmental strategic objective by addressing the emission of greenhouse gases from the power sector. The Brazil energy program includes activities in renewable energy, energy efficiency, private sector participation, and energy sector regulatory reform.
USAID Role and Achievements to Date: A Renewable Energy Project Support Office (REPSO) opened in Brazil during early 1996 in Salvador, Bahia as part of the overall goal of BEP. REPSO, staffed by Winrock International, works with cooperatives, NGOs, private companies, and development banks to provide technical and financial assistance necessary to help identify and develop renewable energy projects. Winrock prepared an initial study as groundwork for a possible World Bank renewable energy loan to Brazil. The proposed project is comprised of a technical assistance program to assist state governments in the Northeast with restructuring and privatization of the electrical energy sector coupled with the supply of rural energy by means of renewable sources. Winrock's report provides an overview of renewable and rural energy projects in the Northeast of Brazil. The results of this report, a World Bank Idea Paper, and an identification mission formed the basis for a formal project concept paper for the proposed $200 million World Bank loan entitled, "Integrated Commercial-Social Power."
USAID is also assisting the Government of Brazil (GOB) with the design of a large World Bank energy efficiency loan to Brazil, which is expected to direct $150 million towards improving the efficiency of electricity supply and end use, with provision of major financing mechanisms for energy efficiency activities. Funds will also go toward technical assistance for efficiency program design and management and power sector regulation formulation. USAID/Brazil is also engaged with the IDB in developing an action plan on Sustainable Markets for Sustainable Energy (SMSE) through Brazil's National Energy Development Program for States and Municipalities (PRODEEM). USAID interventions assure a level playing field for energy investments by assisting in regulatory reform.
As part of a comprehensive energy training program, USAID invested in building capacity among Brazilian energy professionals and high-level decision makers in key aspects of private power, efficiency, and renewable energy. Training courses have been completed in resource assessment, renewable energy systems design and installation, integrated resources planning, demand-side management, and co-generation.
In the policy area, USAID was active instituting a regulatory partnership between Brazil and U.S. state-level public utility commissions with a targeted high level agenda directed to advocacy for support of energy efficiency and renewable energy, through seminars, executive exchanges, round tables and open forums on policies, regulations, and procedures. USAID also supported policies and standards and appliance labeling for energy efficiency.
Description: USAID focuses its energy activities in Brazil in the following areas: (1) Renewable energy: increasing the use of on-grid and off-grid renewable energy sources, through support of sustainable markets; (2) Energy Efficiency: encourage and support increased efficiency in energy production, supply, and consumption; (3) Power Sector Regulation: encourage and support the implementation of policy, regulatory, and procedural agendas supportive of the development of sustainable markets for energy efficiency and renewable energy; and (4) Financing: facilitate increase in the amounts of and access to financing for energy efficiency and renewable energy initiatives.
Host Country and Other Donors: Activities in Brazil are cooperative efforts of USAID, the Government of Brazil, and many NGOs and private organizations. USAID also provides assistance to and leverages funds from the World Bank and IDB, which are also active in Brazil's energy sector.
Beneficiaries: Electric energy consumers in Brazil both in grid-connected and off-grid locations, with special attention to poor rural communities in Northeastern Brazil.
Principal Contractors, Grantees, or Agencies: USAID implements activities through U.S. contractors, including Winrock International, Hagler Bailly Consulting, U.S. Energy Association (USEA), U.S. Export Council for Renewable Energy (US/ECRE), and Environmental Enterprises Assistance Fund (EEAF).
Major Results Indicators: Baseline Target (1999) New capacity installed and operating, on and off the grid, which is powered by renewable energy or other clean energy technology. 600Kw (1996) 6,500Kw Number of people using renewable energy, energy efficiency, or other clean energy system. 40,500 (1996) 450,000 Electric power and energy saved, attributable to energy efficiency programs which USAID has 397MW (1995) 1,100MW created or influenced.
ACTIVITY DATA SHEET
PROGRAM: BRAZIL
TITLE AND NUMBER: Increased sustainable and effective programs to prevent sexual transmission of HIV among major target groups - 512-SO3
STATUS: New
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $ 2,000,000 CSD
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2002
Purpose: Increased use of improved, effective and sustainable responses to the HIV/AIDS epidemic
Background: Approximately 52% of cases of AIDS in Latin America and the Caribbean are in Brazil. This amounts to 116,389 reported cases, making Brazil second only to the U.S. in reported cases in the Americas. Given the delay between infection and the appearance of disease symptoms, it is estimated that there are currently between 560,000 and 850,000 persons infected with HIV in Brazil. With borders on most of the countries in South America, Brazil's location at the center of the continent places it as a potential focus to spread the disease. Following national program guidelines, USAID has been emphasizing women, adolescents and low income groups taking into consideration that the prevalence of sexual HIV transmission in Brazil has increased risks among those groups.
USAID's role and achievements to date: Building on successful experiences and lessons learned from the AIDSCAP project, USAID has developed a new strategy to implement this strategic objective. USAID's proposed five-year strategy is closely linked with and complementary to the programs of the World Bank, MOH and other smaller donors. The proposed 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 sector and to implement HIV/AIDS prevention interventions. The areas of particular need where USAID has excellent resources to offer include program evaluation, operations research, management improvement, and social marketing. The new 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.
Description: This program will concentrate on three areas: (1) Most effective program interventions identified and disseminated; (2) management capacity of selected HIV/STI/family planning institutions increased; and (3) sustainable condom marketing. USAID will carry out an operations research-supported assessment of existing HIV prevention program interventions in Brazil in order to identify the most effective interventions for each major target population. Selected interventions will be disseminated to institutions which are implementing, or will implement HIV prevention activities. USAID will provide technical assistance to those institutions as needed. USAID will replicate the model for increasing management skills that has been successfully implemented in USAID's family planning program. Activities will also include continued initiatives to expand the existing condom social marketing program and achieve financial sustainability. USAID has also developed strategies to ensure a smooth phase-out of USAID's assistance at the completion of this strategy. The program's exit strategy is based on developing and leaving behind HIV/AIDS prevention models that can be phased over to the Ministry of Health (MOH)/World Bank.
Host country and other donors: USAID is working closely with the MOH and other international donors. The World Bank is presently negotiating a second $165 million loan with the GOB for HIV/AIDS prevention and control for implementation beginning in July 98. USAID will provide technical assistance to the MOH during program design. USAID's program funding time frame coincides with the time frame of the WB program, allowing for USAID to rely on the World Bank program to finance and replicate the best practices which are identified and developed via the USAID program. Other partners are the UNAIDS theme group, JICA and the European Union, which plans to continue its program during 1998-2000 at about $4 million for the period.
Beneficiaries: Low-income women and their partners; adolescents; at-risk youth; STD patients.
Principal Contractors, Grantees, or Agencies: USAID will implement activities through three U.S. PVOs: the Population Council, Family Health International, and Population Services International. In Brazil, the Pathfinder Fund local office will play an important role in expanding activities to the Northeastern region.
Major results indicators: Baseline (1997) Target (1999) Number of the four target states with an annual increase in expenditures for HIV prevention equal to/greater than 5% N/A 2 Percent of financial sustainability achieved by condom social marketing programs DKT 78% 86% (DKT do Brasil and BEMFAM) BEMFAM 74% 97% Number of identified interventions 0 10 which are disseminated Percentage change in sales of male 30 million sold 10% male/female condoms female 360,000 sold 100%
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 1999: $2,000,000 DA
INITIAL OBLIGATION: FY 1992; ESTIMATED COMPLETION DATE: FY 2000
Purpose: The USAID objective is 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.
Background: Brazil has the largest population in Latin America, with 155 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 59/1000. Family planning prevalence is 70% for Brazil as a whole, although wide regional disparities persist. Due to limited access to contraceptive methods, contraceptive use is still heavily concentrated on female sterilization and oral contraceptives. In the Northeast, a heavily populated and extremely poor region of 40 million people, where USAID assistance is targeted, health services for women and children remain of relative poor quality. Although USAID assistance has had 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, a proportion almost double that of their urban counterparts. USAID assistance allows for the development and implementation of service delivery systems, public and private, for low-income groups, that emphasizes preventive services, especially in maternal and child health.
USAID Role and Achievements to Date: USAID assistance is channeled through U.S. organizations which work in conjunction with the state health departments and national NGOs in the two Northeast states of Ceara and Bahia. With USAID assistance, the availability of 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 the registration of Depo Provera has been made with its addition to the list of methods purchasable by public funds. More recently, sterilization has been legalized. Progress is evident at the service delivery level as well. The proportion of municipalities in the two target states providing family planning increased substantially between 1993 and 1996, from 20% to 26% in Ceara and from 12% to 27% in Bahia.
Description: The USAID assistance program will concentrate on the two target states of Ceara and Bahia until the planned phaseout by FY 2000. Emphasis will be placed on consolidation of achievements through emphasis on 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 diminished over time, with the gradual assumption of this responsibility by other organizations and the Government of Brazil (GOB). In this regard, USAID has negotiated significant contributions from Pharmacia and 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 population assistance.
Host Country and Other Donors: The only other major donor in reproductive health in Brazil is UNFPA whose programs complement and are coordinated with USAID's activities. USAID/Brazil will continue to streamline its efforts with other international donors, particularly with respect to the integration of family planning and STD/AIDS prevention programs. Because of USAID expertise, other donors have been willing to “cost-share” contributions.
Beneficiaries: USAID-supported activities are targeted to low-income women in the areas of Bahia and Ceara, which have an estimated population of 20 million persons.
Principal Contractors, Grantees, or Agencies: USAID implements its activities through U.S. private voluntary organizations and U.S. firms such as Pathfinder Fund, International Planned Parenthood Federation, Futures Group, Population Council, Johns Hopkins University, Management Sciences for Health and Family Health International.
Major Results Indicators: Baseline Target % of Births Declared as Unwanted 24% (1996) 20% (1999) - Ceara State Couple Years of Protection 173,034 (1996) 185,600 (1999) - Bahia State Units of Depo-provera sold to the 222,000 (1998) 456,000 (2000) public sector and through pharmacies.
ACTIVITY DATA SHEET PROGRAM: BRAZIL
TITLE AND NUMBER: Improved quality of life for at-risk youth in target areas - 512-SpO1 (512-0616)
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $500,000 CSD
INITIAL OBLIGATION: FY 1994; ESTIMATED COMPLETION DATE: FY 2002
Purpose: To improve living conditions of at-risk youth by expanding local capacity to provide services to children and youth living in especially difficult circumstances.
Background: The situation of children and youth in Brazil is particularly precarious. Recent changes in the country's economic picture have not been effective in addressing 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, model legislation which has not yet been enforced.
USAID Role and Achievements to Date: The USAID program has demonstrated the capacity to develop programs that make a difference and to leverage and direct the resources of other donors. In 1997 an activity extension through FY 2000 was approved, allowing for an increase in the number of beneficiaries to 50,000 through the life of activity. Education and health have become a major focus, 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 1997 USAID has promoted the creation of important coalitions of Northeastern institutions to more effectively address issues that directly affect the lives of at-risk youth, such as advocacy of rights and prevention of child and adolescent prostitution. Emphasis has been given to institutional strengthening through development of local capabilities in the areas of fund raising, NGO efficiency and strategic planning. In Fortaleza, USAID's support has been critical to promote improvements in the living conditions of nearly 500 at-risk girls through arts and dance. In Salvador, low income youth have been trained in car mechanics, electricity, production of neonatal medical equipment, music and performing arts. In Recife, a children's rights advocacy center has been assisting families to formalize spontaneous adoptions at the community level, thus helping to implement the provisions of the Brazilian Children and Adolescents' Act. In Brasília, the replication of a successful USAID-funded pilot activity to assemble and sell computer equipment will provide vocational training and employment opportunities to approximately 100 low-income youth. In 1997, USAID also worked closely with the Brazilian government at the state and local levels, managing to increase to nearly 60% the level of governmental participation in USAID-supported activities.
Description: The focus of USAID's At-Risk Youth activity is improving the quality of life of at-risk youth in three large, poor capitals in Northeast Brazil, and in Brasília, the country's capital. In seeking to achieve this objective, USAID develops activities capable of promoting changes in three fundamental areas in the youth's surrounding environment: family ties, schooling and employment. USAID's strategy involves leveraging Government of Brazil (GOB), other donor, NGO and/or private sector resources toward replication of successful and innovative models. Today, 51 indigenous organizations receive USAID financial and technical assistance. The activity supports existing, successful initiatives in the areas of education, vocational training, prevention of child and adolescent prostitution, and promotion of children and youth rights, besides addressing the critical issues of AIDS/STI infection and prevention of early pregnancy. The recent strategic planning exercise details a five-year phase-out plan to be completed in September 2003. The extended program will prioritize the problem of adolescent
prostitution through proven education interventions that USAID has developed. In the process, coalitions between public and private organizations at the state and local level will be strengthened aiming at the creation of a regional safety network, and the sustainability of NGOs will be systematically addressed. These activities will ensure that effective, sustainable implementing agencies exist and supportive policies are in place when USAID assistance ends, thereby assuring continued capacity to provide services.
Host Country and Other Donors: USAID collaborates with UNICEF for complementary support to successful initiatives. Phase I of the IDB's program will be closed out in December 1997, posing a problem to some institutions supported jointly by USAID and the IDB, which generally provided the largest amount of funding. USAID has been playing an important role in strengthening sustainability efforts of such institutions. The actual implementation of the EU's program, started in 1997, included the replication and expansion of innovative activities developed under USAID's support. Recent GOB budget cuts in the areas of health and education further limit the central government's performance in social areas. USAID will continue to work with state and local governments to expand services and strengthen partnerships with civil society.
Beneficiaries: USAID activities are targeted to assist low-income children and youth aged 7-17 in the cities of Fortaleza, Recife, Salvador and, on a smaller scale, Brasília. Approximately 80,000 children, youth and their families should benefit from USAID's support.
Principal Contractor: USAID implements activities through the U.S. private voluntary organization, Partners of the Americas.
Major Results Indicators: Baseline Target (1999) Number of at-risk youth receiving services 1994 - 0 45,000 % of children completing the school year 1994 - 49% 65% % of at-risk youth trained and able to engage in income-generating activities 1996 - N/A 65% Number of youth services strengthened 1995 - 6 65 Public sector involvement in provision of ade- quate services to target population (% of program interventions receiving public sector support 1995 - 16% 55%
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