By Charlene Porter
Washington — Investments in global health and development are investments in global security, according to testimony presented to the U.S. Congress during consideration of the budget for the next fiscal year. Congress is weighing that calculation at the same time many U.S. citizens and lawmakers are worried about the nation spending beyond its means.
Though foreign assistance amounts to less than 1 percent of the federal budget, there is a widespread public perception that a much higher percentage of national spending goes to other countries. The political outcry to keep those funds in the United States grows to a clamor in difficult budget years.
In that context, the administrator of the U.S. Agency for International Development (USAID), Dr. Rajiv Shah, told the House Appropriations Subcommittee on Foreign Operations March 30 that the success of the United States in the world is closely linked to the success and progress of other nations.
“We will save lives, expand global freedom and opportunity and crucially strengthen America’s national and economic security,” Shah said. Through programs supporting democracy and the expansion of free markets, Shah said, USAID helps contribute to greater international stability and security overall.
With USAID programs supporting development assistance, or better health, or enhanced agricultural productivity, Shah says his agency is also representing the nation’s most important principles.
“USAID is proud to put American values in action — distributing anti-malarial bed nets donated by school children, supporting faith-based organizations that help ease suffering abroad and engaging all Americans in solving the greatest global challenges and generating results,” Shah said.
The President’s Emergency Plan for AIDS Relief (PEPFAR) is a relative newcomer to U.S. foreign assistance spending, initiated in 2003 in response to the global HIV/AIDS epidemic and renewed in 2008.
The Obama administration is seeking more than $7 billion in the upcoming fiscal year to provide anti-AIDS drugs and care for the infected, and to support campaigns that will prevent the virus spreading further. Ambassador Eric Goosby, U.S. global AIDS coordinator, told the committee March 31 that the numbers tell a story of success: 3.2 million people receiving treatment in 2010; prevention of virus transmission in 600,000 pregnant women; care and support for more than 11 million people, including almost 4 million orphans and vulnerable children.
“When I reflect that each of the numbers represents a real person — with a story, a family, a community,” Goosby said, “the impact of this work is too vast to comprehend through numbers alone.”
Goosby, who also is a medical doctor, pointed out that global health programs help stabilize societies where illnesses such as HIV, malaria and tuberculosis are so widespread that they have shattered families and communities, orphaned children and increased poverty by disabling young adults. In addition to easing suffering in these populations, Goosby said, PEPFAR contributions have helped build better health care infrastructure in countries where it has been lacking.
“By meeting the HIV challenge, we have naturally created significant health care system improvements that are important in the struggle against other threats, and we have done so without diluting our focus on our own mission of combating HIV/AIDS,” Goosby said.
While Shah and Goosby presented impressive statistics about the achievements of health and development programs, the nation is in a difficult budget environment, reminded Subcommittee Chairwoman Kay Granger of Texas.
The congressional debate over the budget for the fiscal year that begins October 1 is just getting started, so these officials likely will make their case for global health programs a few more times before a funding level is set.