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TRANSPARENCY SCORE
The transparency grade represents the expectation that the federal government should make data about U.S. global health assistance available, accessible, and informative. To see the transparency grade, toggle below.

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TRANSPARENCY SCORE
The transparency grade represents the expectation that the federal government should make data about U.S. global health assistance available, accessible, and informative. To see the transparency grade, toggle below.

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B

This is an average of the three domain scores below.

YEAR 2018

HIV & AIDS

The U.S. Government received an 86 (B) with transparency and a 90 (A-) without transparency for HIV and AIDS across all actors. This grade reflects the negative impact of the PLGHA FAQ and Six Month Review and the gender accommodating nature of issued guidance. This domain also had a low funding transparency score for some actors which led to a decrease in its grade. However, in spite of these negative actions, the domain grade for HIV and AIDS-related government work remains higher than the grades of the other domains.

B+
A-

White House

 

The White House received an 87 (B+) with transparency and a 92 (A-) without transparency for HIV and AIDS because it signed into law two HIV and AIDS-related pieces of legislation in 2018. Neither policy hindered the ability of U.S. global health assistance to support comprehensive HIV and AIDS programs globally that are based in evidence and human rights principles. However, both policies had the potential to include gender transformative language, but did not. The White House budget within this domain received a high score because the budget request included adequate funding for PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Similar to other domains, the transparency score for the White House under HIV and AIDS was low due to difficulty accessing budgetary information and the inability to search White House policies by criteria that had been previously available.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_Asia Reassurance Initiative Act of 2018 (S. 2736)
The Asia Reassurance Initiative Act discussed U.S. efforts to improve relations with countries in Asia and promote democracy and human rights within the region. These efforts were responsive to need and based in human rights principles, particularly related to reducing poverty and violations of human rights that have occurred within the region. However, the law was not gender transformative or strongly evidence-based in HIV and AIDS prevention and treatment efforts. It mentions "reducing the HIV and AIDS infection rate” through the Lower Mekong Initiative (LMI), but provided no programmatic guidance on how to accomplish this. The LMI was launched in 2009 and is a multinational partnership among Cambodia, Laos, Myanmar, Thailand, Vietnam, and the U.S. to create integrated sub-regional cooperation among the five Lower Mekong countries. The LMI could serve as a promising platform for HIV and AIDS prevention and treatment efforts, but this could only be implemented if additional policy and technical guidance are released. The law also briefly mentioned supporting women’s equality, but did not discuss the importance of addressing gender-based violence (GBV) and sexual and reproductive health and rights (SRHR) in promoting democracy and human rights. Given the prevalence of GBV against ethnic and religious minorities in the region, this was a missed opportunity by the White House to address this issue. For these reasons, this law will likely only have minimal direct effect on the ability of U.S. global health assistance to support HIV and AIDS programs in the region.
2018_PEPFAR Extension Act of 2018 (H.R. 6651)
The PEPFAR Extension Act amended the PEPFAR Stewardship and Oversight Act of 2013 by extending the authorization of PEPFAR through FY 2023. The legislation allows PEPFAR to continue its programming, which is largely evidence-based, responsive to need, and based in human rights norms. However, it also maintained previous authorization language that is not gender transformative and continued clauses that cause harm to key populations, such as the Anti-Prostitution Loyalty Oath and the refusal clause. With the reauthorization, Congress had the opportunity to revise these harmful aspects of the authorization of PEPFAR and chose not to do so. As a result, this legislation moderately promoted the ability of U.S. global health assistance to support HIV and AIDS programs that are evidence-informed, responsive to need, consistent with human rights principles, and gender transformative.
2017_Presidential Memorandum of January 23, 2017_The Mexico City Policy (Expanded Global Gag Rule)
President Trump reinstated and expanded the Mexico City Policy, often known as the Global Gag Rule, and renamed it the Protecting Life in Global Health Assistance (PLGHA) policy. When in place under previous administrations, the policy applied only to international family planning assistance, whereas Trump’s version of the policy "extend(s) the requirements... to global health assistance furnished by all departments or agencies." Research has documented the harms of this policy in previous administrations when the policy was in effect, and the expansion of this policy via this 2017 Presidential Memorandum demonstrated a disregard for evidence and international human rights norms. This policy spurred a chain of events that significantly reduced community and government engagement in HIV prevention, care, and treatment programs and prohibits beneficiaries from accessing key services in many countries that receive U.S. global health assistance. The expansion of the PLGHA policy was against evidence, need, and human rights principles and was not gender transformative; this policy was gender blind, as it did not discuss the role of gender norms on the promotion of SRHR through U.S. global health assistance programs.
2016_The United States National Action Plan on Women, Peace, and Security
The United States National Action Plan on Women, Peace, and Security described what the U.S. continues to do to empower women as equal partners in preventing conflict and building peace in countries threatened and affected by war, violence, and insecurity. The Plan moderately promoted SRHR by calling for better access to "clinical care and reproductive health services such as family planning, HIV testing, counseling, and treatment…" though HIV testing, counseling, and care was not discussed in further detail. The Plan did not explain the impact of access to HIV and AIDS prevention and treatment services on conflict prevention and country stability nor did it acknowledge the relationship between gender-based violence (GBV) in conflict and the prevalence of HIV and AIDS among women and girls. In fact, there was little discussion on any structural, cultural, and safety barriers that prevented women in conflict-ridden areas from accessing the HIV and AIDS care they wanted and needed. However, the Plan did discuss the intersections of HIV and AIDS with other sexual and reproductive health (SRH) issues, such as maternal mortality. Additionally, this plan is moderately gender transformative as it called for more gender equality and inclusivity in all initiatives, especially regarding “members of marginalized groups, including youth, ethnic, racial or religious minorities, persons with disabilities, displaced persons and indigenous peoples, lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals, and people from all socioeconomic strata.” The Plan also discussed the distinct needs of ex-combatants and former violent extremists who are female, specifically stating that these women have a difficult time adhering to traditional gender norms upon their return from combat. However, it did not explicitly mention the disproportionate impact of HIV and AIDS on former combatant populations or other key populations such as female sex workers or people who inject drugs (PWID). This National Action Plan supported the U.S. government's ability to promote SRHR with regard to HIV and AIDS programs and funding.
A
A

Congress

 

Congress received a 93 (A) with transparency and a 95 (A) without transparency for HIV and AIDS because it passed two pieces of legislation related to HIV and AIDS in 2018. Neither piece of legislation hindered the ability of U.S. global health assistance to support comprehensive HIV and AIDS programs globally that are based in evidence and human rights principles. However, both pieces of legislation had the potential to include gender transformative language, but did not. The Congressional budget within this domain received a high score because the budget request included adequate funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Transparency for this domain was also high for both legislation and funding information.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_Asia Reassurance Initiative Act of 2018 (S. 2736)
The Asia Reassurance Initiative Act discussed U.S. efforts to improve relations with countries in Asia and promote democracy and human rights within the region. These efforts were responsive to need and based in human rights principles, particularly related to reducing poverty and violations of human rights that have occurred within the region. However, the legislation was not gender transformative or strongly evidence-based in HIV and AIDS prevention and treatment efforts. It mentioned "reducing the HIV and AIDS infection rate” through the Lower Mekong Initiative (LMI), but provided no programmatic guidance on how to accomplish this. The LMI was launched in 2009 and is a multinational partnership among Cambodia, Laos, Myanmar, Thailand, Vietnam, and the U.S. to create integrated sub-regional cooperation among the five Lower Mekong countries. The LMI could serve as a promising platform for HIV and AIDS prevention and treatment efforts, but this could only be implemented if additional policy and technical guidance are released. The legislation also briefly mentioned supporting women’s equality, but did not discuss the importance of addressing gender-based violence (GBV) and sexual and reproductive health and rights (SRHR) in promoting democracy and human rights. Given the prevalence of GBV against ethnic and religious minorities in the region, this was a missed opportunity by Congress to address this issue. For these reasons, this legislation will likely only have minimal direct effect on the ability of U.S. global health assistance to support comprehensive HIV and AIDS programs in the region.
2018_PEPFAR Extension Act of 2018 (H.R. 6651)
The PEPFAR Extension Act amended the PEPFAR Stewardship and Oversight Act of 2013 by extending the authorization of PEPFAR through FY 2023. The legislation allows PEPFAR to continue its programming, which is largely evidence-based, responsive to need, and based in human rights norms. However, it also maintained previous authorization language that is not gender transformative and continued clauses that cause harm to key populations, such as the Anti-Prostitution Loyalty Oath and the refusal clause. With the reauthorization, Congress had the opportunity to revise these harmful aspects of the authorization of PEPFAR and chose not to do so. As a result, this legislation moderately promoted the ability of U.S. global health assistance to support HIV and AIDS programs that are evidence-informed, responsive to need, consistent with human rights principles, and gender transformative.
A-
A

Department of State

 

The Department of State received a 90 (A-) with transparency and a 93 (A) without transparency for HIV and AIDS based on eight relevant guidance documents released in 2018. Aside from the guidance documents related to the implementation of PLGHA, the Department of State issued guidance documents and reports that were responsive to need, evidence-based, and grounded in human rights principles regarding HIV and AIDS. The Department of State released detailed technical guidance documents to guide country-level President’s Emergency Plan for AIDS Relief (PEPFAR) programs. The Department of State also released annual reports that documented programmatic progress and demonstrated areas for improvement. Overall, the guidance documents and annual reports did not include gender transformative language. The Department of State’s commitment to comprehensive HIV and AIDS programming was demonstrated in the disbursement of funds for HIV and AIDS programming according to country-level incidence.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_DREAMS Report: Dreaming of an AIDS-Free Future
The annual DREAMS report highlights the strengths, challenges, and future directions of the DREAMS program. The report was evidence-based and responsive to need, but lacked a clear gender transformative stance. The DREAMS program does have concrete gender transformative components, but they were not reflected in this report in a clear and substantial way. The report described harmful gender norms that affected HIV and AIDS prevention and treatment programs for adolescent girls and young women (AGYW), but did not mention how to address these barriers in a manner informed by human rights principles.
2018_PEPFAR 2018 Annual Report to Congress
The PEPFAR Annual Report to Congress provides an overview of the PEPFAR program to date and discusses future directions. The report was evidence-based, responsive to need, and included a description of how the Department of State will deliver on the mission of PEPFAR moving forward. The report also discussed factors that made HIV prevention and treatment complex for AGYW and for key populations; however, these programmatic concerns were framed within current constructed gender norms. The programming discussed in this report did not include gender transformative components as a means to provide comprehensive HIV and AIDS services.
2018_PEPFAR 2018 Progress Report
The PEPFAR Progress Report is issued annually to provide an overview of programs and illustrate PEPFAR priorities in the future. The report shared a program plan that was responsive to need and based in evidence and human rights principles. However, the document did not discuss gender norms or include a commitment to increase gender transformative programming.
2018_PEPFAR 2018 Country Operational Plan Guidance for Standard Process Countries
Released annually by the Office of the Global AIDS Coordinator, the Country Operational Plan (COP) Guidance outlines the plan for PEPFAR-funded global HIV and AIDS activities and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The 2018 COP guidance was comprehensive and provided updates that were evidence-informed, responsive to need, and based in human rights principles. The 2018 COP Guidance took a holistic approach to PEPFAR programs and discussed intersecting issues, such as: gender-based violence, post-abortion care, contraceptive access, and comprehensive HIV prevention programs. The COP Guidance illustrated gender as a cross-cutting issue within PEPFAR but should have included specific guidance to increase gender transformative programming across PEPFAR countries.
2018_PEPFAR Statement on Potential Safety Issue Affecting Women Living with HIV Using Dolutegravir at the Time of Conception
This press release contains PEPFAR's policy and technical guidance in response to data from a study in Botswana indicating a potential association between women of childbearing potential taking dolutegravir (DTG), an antiretroviral, at the time of conception and the risk of neural tube defects. The statement provided a nuanced overview of the data and concluded by issuing the guidance that all PEPFAR programs continue transitioning to a DTG-based regimen. The release recommended that "HIV-infected women who desire to become pregnant" should remain on efavirenz-based regimens until further data are available. The issuance of this statement was timely and provided an accurate explanation of the Botswana study preliminary findings; however, the Department of State's recommendation took away the choice of treatment from a population based solely on their ability or desire to become pregnant. This was in conflict with a human rights, individual-centered framework. It is also unclear from the press release if PEPFAR consulted with civil society or other relevant stakeholders before issuing this statement.
2018_Protecting Life in Global Health Assistance FAQs_September 2018
The PLGHA FAQs provided detailed guidance on the implementation of the expanded Global Gag Rule for implementing partners as of September 2018. The document was responsive to need in that it clarified areas of the policy that partners had expressed are vague or unclear, but the FAQs were not evidence-based or based in human rights principles. The FAQs included a PEPFAR-specific section that provided detailed guidance on the implementation and monitoring of the impact of PLGHA on PEPFAR programs, specifically within DREAMS. However, this discussion of PEPFAR, aside from the mention of DREAMS, did not discuss gender norms or include gender transformative language. This section emphasized the importance of minimizing disruption of HIV and AIDS care and treatment and therefore received a higher score within this domain compared to the other two domains, Family Planning and Maternal and Child Health.
2018_Protecting Life in Global Health Assistance Six Month Review
The PLGHA Six Month Review summarized the PLGHA policy and identified solutions to challenges that had arisen in the process of PLGHA implementation. The review was responsive to need in that it addressed concerns expressed by partners who are required to implement the policy, but it was not evidence-based, based in human rights principles, or gender transformative. The Six Month Review received a higher grade within the HIV and AIDS domain because it discussed the importance of addressing the impact of PLGHA on HIV and AIDS programs and assured that efforts are being made to track the impact of this policy through PEPFAR programming. Still, the Six Month Review substantially hindered the Department of State's ability to support comprehensive HIV and AIDS programs.
2018_State and USAID Agency Priority Goal Action Plan_HIV/AIDS
The Agency Priority Goals (APGs) for HIV and AIDS hold PEPFAR accountable through quarterly reporting that includes details around the goals, strategies, milestones, indicators, and progress made towards controlling the HIV epidemic. Released by both the Department of State and USAID, these reports are useful for government transparency and are responsive to need, and based in evidence and human rights. The 2018 APGs reported on challenges faced by HIV and AIDS programs, but did not provide clear strategies to address them. One such challenge was high HIV and AIDS rates among AGYW and key populations. The APGs mentioned the importance of promoting layered core packages of services for AGYW through the DREAMS program and increasing access to HIV and AIDS services for key populations. However, the APGs did not include indicators specific to either population or data disaggregated by gender as a means to highlight progress made in these areas. As a result, the APGs moderately promoted the ability of the Department of State to support comprehensive HIV and AIDS programs.
2017_PEPFAR Country/Regional Operational Plan (COP/ROP) Guidance 2017
The Country Operational Plan (COP) Guidance is an annual document released by the Office of the Global AIDS Coordinator. It outlines the plan for global HIV and AIDS activities funded by PEPFAR and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The 2017 COP Guidance was evidence-informed and ensured continued community and government engagement in PEPFAR programs. It also discussed the intersection of gender-based violence with HIV and AIDS and the importance of including contraception and counseling into HIV and AIDS programs. This guidance moderately promoted SRHR because it was responsive to need and addressed the disproportionate impact of HIV and AIDS on adolescent girls and young women, men who have sex with men (MSM), female sex workers, and transgender individuals. The plan was gender accommodating, as it did not seek to dismantle existing gender differences and inequalities. Such guidance should instead outline how to change inequitable gender norms and dynamics and promote gender equity.
2017_PEPFAR Evaluation Standards of Practice (Version 3.0)
The PEPFAR Evaluation Standards of Practice was released to increase the quality of evaluations conducted by all PEPFAR implementing agencies. These standards emphasized the importance of evidence-informed evaluation planning and provided a detailed explanation of the ethics and human rights principles that should be incorporated in all PEPFAR-funded evaluations, particularly for "children, prisoners, pregnant women, and other vulnerable groups." Additionally, these standards laid the groundwork for adaptive programming and the continued commitment of all key stakeholders, including community members and government personnel, in PEPFAR programs. Although the Standards of Practice acknowledged that evaluations should be “context-sensitive” and “culturally relevant,” they did not include a gender transformative component. There was no mention of the gendered power dynamics and cultural barriers that may prevent people living with HIV, sex workers, or lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) persons from participating in evaluations. Despite this, the Standards of Practice were responsive to need and were based in evidence. The Standards moderately supported the ability of PEPFAR programs to promote SRHR.
2017_PEPFAR Monitoring, Evaluation, and Reporting Indicator Reference Guide_MER 2.0 (Version 2.1)
The 2017 PEPFAR Monitoring, Evaluation, and Reporting (MER) Indicator Reference Guide provided guidance for monitoring and evaluating PEPFAR’s HIV and AIDS programs. The indicators were evidence-informed, based on human rights principles, and detailed the importance of sustained “district and community” engagement. The document included an extensive list of indicators for HIV and AIDS program evaluation, including the number of key and priority populations reached with specifically tailored HIV prevention programs, and the percentage of pregnant women living with HIV that receive antiretroviral therapy (ART) to reduce mother-to-child transmission. Though the Reference Guide listed sex workers, MSM, and transgender individuals as key populations, it did not address their distinctive needs when discussing how to evaluate interventions that were tailored for these populations. This lack of clarity can be harmful as evaluators may not understand how to meaningfully engage with these key populations during the evaluation, monitoring, and reporting processes. The indicators were somewhat gender transformative, as they included a limited discussion of gender norms and related stigma, though this element should be standardized throughout the Reference Guide. The updates within this version of the MER Reference Guide were responsive to need and based in human rights norms and evidence, including WHO and UNAIDS indicators.
2016_Department of State Implementation Plan for the U.S. Adolescent Girls Strategy
The Department of State Implementation Plan for the U.S. Adolescent Girls Strategy was launched in partnership with three other U.S. implementing agencies as part of the first U.S. Global Strategy to Empower Adolescent Girls in 2015. This Plan moderately promotes sexual and reproductive rights (SRHR) because it discussed the importance of incorporating HIV prevention in all adolescent girls' empowerment programs, especially those that address girls’ political, civic, and economic participation and programs that increase peace and security. This Plan specifically acknowledged the relationship between girls who have undergone female genital cutting (FGC) and their increased risk of acquiring HIV. The Plan also mentioned HIV as a barrier to girls’ education and provided examples of existing Department of State programs that are responsive to need and grounded in human rights, including the President’s Emergency Plan for Aids Relief (PEPFAR). However, this Plan did not disclose how to support the needs of adolescent girls and young women (AGYW) who are living with HIV. It only discussed preventing HIV transmission to AGYW. The Plan is gender accommodating, not gender transformative because it relied on existing gender norms and references unequal gender and age dynamics that put AGYW at a higher risk of HIV incidence.
2016_PEPFAR Country/Regional Operational Plan (COP/ROP) 2016 Guidance
The Country Operational Plan (COP) Guidance is an annual plan that outlines global HIV and AIDS activities funded by PEPFAR and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The fiscal year (FY) 2016 COP Guidance was responsive to need and addressed the disproportionate impact of HIV and AIDS on AGYW and other key populations such as men who have sex with men (MSM), female sex workers, pregnant women and infants living with HIV, and transgender individuals. The programming was evidence-informed and promoted community and government engagement. Although the Guidance discussed the intersection of gender-based violence (GBV) and HIV and AIDS, it failed to strongly incorporate the positive impact that comprehensive and integrated sexual and reproductive health (SRH) services can have on reducing HIV transmission amongst key populations.
B
B

US Agency for International Development

 

USAID received an 84 (B) with transparency and an 88 (B+) without transparency for HIV and AIDS based on four HIV and AIDS-related documents issued in 2018. These documents ranged from significantly hindering to moderately promoting sexual reproductive health and rights (SRHR) within the HIV and AIDS sector and all four documents neglected to discuss the role of gender norms in the implementation of relevant programming. USAID’s grade decreased in this domain since last year primarily due to the lack of HIV and AIDS-specific information in the 2018 Acting on the Call Report. USAID received a high budget score because disbursed funds were responsive to demonstrated HIV and AIDS programming needs. USAID’s commitment to HIV and AIDS programming was demonstrated in the disbursement of funds for HIV and AIDS programming according to country-level incidence.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_Acting on the Call
Acting on the Call is USAID's annual flagship report for reproductive, maternal, newborn, and child health services. Within the 2018 report, HIV and AIDS was discussed strictly in the context of child mortality despite the fact that HIV is a leading contributor of maternal mortality worldwide. Evidence suggests that HIV and AIDS are key factors in maternal mortality and wellness and in child health through the prevention of maternal to child transmission (PMTCT). By leaving out HIV and AIDS data herein, the framework of this report reinforced the silos between maternal and child health, family planning, and HIV and AIDS programming that challenged USAID's ability to support integrated SRHR programs in 2018.
2018_Acquisition and Assistance Strategy
As USAID’s first-ever Acquisition and Assistance (A&A) Strategy, this guidance document increased the accountability and transparency of USAID's procurement, partnering, and project management processes across the Agency. The goal of this Strategy was to streamline "approaches to design and procurement" and develop "new and innovative methods of collaboration" to advance USAID's Journey to Self-Reliance mandate. The Strategy was responsive to need and evidence-based because it cited the current make-up of USAID foreign assistance funding recipients and set specific goals to diversify this partner base. Many of the strategies and shifts put forward in the report incorporated feedback received from smaller and/or local partners. The Strategy also demonstrated a commitment to human rights norms, specifically to the right of self determination, by actively incorporating local partners in the design, procurement, and implementation of USAID's programming. Though the Strategy referenced the importance of "diverse" partners, it did not define who these partners were except for a specific mention of faith-based organizations. Women's rights and human rights groups should also be explicitly mentioned as underutilized partners because of their important role in advancing SRHR for all populations. This Strategy indicated a meaningful effort by USAID to ensure that local partners and recipient countries are included and supported throughout the Journey to Self-Reliance. However, this effort by USAID seemed to be in direct conflict with the Trump Administration's strategy of decreasing appropriated funds as a means to ‘motivate’ self-reliance and haphazardly decrease U.S. involvement in foreign assistance. It is unclear in this Strategy how USAID aims to reconcile this conflict.
2018_ADS Chapter 312sae_Condoms and Pharmaceuticals
The Automated Directives System (ADS) contains the operational policies that guide USAID's programs and operations. The Condoms and Pharmaceuticals ADS Help Document is an addendum to ADS Chapter 312 that was revised in 2018 to guide the procurement of condoms and pharmaceuticals by USAID’s Bureau for Global Health. The updated directive required that the procurement of all condoms (internal and external) be managed by the Office of HIV/AIDS. While this directive was detailed and informative and included the procurement of female (internal) condoms, it is unclear what prompted this update. As a result, it was challenging to gauge whether the guidance was responsive to need, evidence-based, human rights-based, or gender transformative. It was also unclear how the consolidation of procurement of all condoms under the Office of HIV/AIDS will impact USAID's HIV and AIDS programming and, therefore, SRHR overall, given that condoms are an important intervention in both family planning and maternal and child health.
2018_Protecting Life in Global Health Assistance FAQs_September 2018
The PLGHA FAQs provided detailed guidance on the implementation of Trump's expanded Global Gag Rule for implementing partners as of September 2018. The FAQs were responsive to need in that they clarified areas of the policy that partners had expressed were vague or unclear. The FAQs were neither based in human rights principles nor evidence. The FAQs were also not gender transformative and substantially hindered USAID's ability to implement comprehensive HIV and AIDS programs that were evidence-informed, responsive to need, consistent with internationally-recognized human rights principles, and gender transformative.
2018_State and USAID Agency Priority Goal Action Plan_HIV/AIDS
The Agency Priority Goals (APGs) for HIV and AIDS hold the President’s Emergency Plan for Aids Relief (PEPFAR) accountable through quarterly reporting that includes details around the goals, strategies, milestones, indicators, and progress made towards controlling the HIV epidemic. Released by both the Department of State and USAID, these reports are useful for government transparency and are responsive to need and based in evidence and human rights. However, the APGs did not explain the role of USAID, specifically, in HIV and AIDS programming and only discussed PEPFAR-level successes and challenges. As a result, the APGs did not hinder or promote USAID's ability to support comprehensive HIV and AIDS programs, so the APGs did not increase or decrease USAID's score in this domain in 2018.
2016_USAID Adolescent Girl Strategy Implementation Plan
The USAID Adolescent Girl Strategy Implementation Plan was launched in partnership with three other U.S. implementing agencies as part of the first U.S. Global Strategy to Empower Adolescent Girls in 2015. The Plan moderately promoted SRHR, noting the importance of using USAID’s “whole-of-girl” approach (which “encompasses the interconnected events that resonate across a girl’s life from birth to adulthood”) to reduce gender disparities and gender-based violence (GBV) and increase capacity of women and girls through USAID’s programs. Though it did not explicitly mention USAID’s HIV and AIDS programs through the President’s Emergency Plan for Aids Relief (PEPFAR), this Plan provided a high-level overview of the programs, best practices, and indicators that were used to measure USAID’s progress in implementing the Adolescent Girl Strategy across programs, including HIV and AIDS. The Plan was responsive to need and based in evidence. The Plan referenced USAID’s ongoing work on gender (e.g., implementing USAID’s 2012 Gender Equality and Female Empowerment Policy) and directly acknowledged the importance of incorporating activities that foster gender equity in all USAID programs. This plan supported the ability of USAID to implement HIV and AIDS programs that moderately promoted SRHR.
D+
C-

Department of Health and Human Services

 

HHS received a 67 (D+) with transparency and a 71 (C-) without transparency for for HIV and AIDS based on the release of two relevant documents in 2018. The disbursed funds for HIV and AIDS programs through HHS were not publicly available, which contributed to this actor’s low transparency grade in this domain.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_HHS Strategic Plan_Strategic Goal 2: Protect the Health of Americans Where They Live, Learn, Work, and Play
The HHS Strategic Plan provides an overview of the Agency's domestic and global strategy that is based on evidence and human rights norms. Strategic Objective 2.2 within the Strategic Plan states that the Centers for Disease Control and Prevention (CDC) will implement HIV programs "including prevention, testing, treatment, and retention interventions, provide technical assistance, and conduct research in support of PEPFAR." The Strategic Plan did not include any other specific information, so was determined to have little effect on the ability of HHS to implement HIV and AIDS programs that are evidence-based, responsive to need, consistent with internationally-recognized human rights principles, and gender transformative.
2018_Protecting Life in Global Health Assistance FAQs_August 2018
The Protecting Life in Global Health Assistance (PLGHA) FAQs provided detailed guidance on the implementation of the expanded Global Gag Rule for implementing partners as of September 2018. HHS was graded based on the "HHS Specific Information" section on page 17 that outlined how HHS administered grants according to the Code of Federal Regulations (CFR). The information offered in this section did not have an effect on the ability of HHS to implement HIV and AIDS programs that were evidence-based, responsive to need, consistent with internationally-recognized human rights principles, and gender transformative.
C-
B-

Department of Defense

 

The DoD received a 72 (C-) with transparency and an 81 (B-) without transparency based on the release of one directive that signified progress within this domain. The directive allowed the DoD to continue incorporating HIV and AIDS treatment and prevention into their work with foreign militaries. It is unclear whether the implementation of this directive was efficacious, but it was specific and nuanced. The disbursed funds for HIV and AIDS programs through DoD were not publicly available, which contributed to this actor’s low transparency grade in 2018.

The CHANGE data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.

Selecting a document will download the file
2018_Department of Defense Directive_DoD HIV/AIDS Prevention Program to Support Foreign Militaries
This directive discussed the DoD HIV and AIDS Prevention Program and its efforts to protect foreign armed forces from the threat of HIV and AIDS. The program provided funding for the development of programs and interventions to protect foreign nation armed forces from HIV and AIDS. This directive was originally written in 2013 and was revised in 2018 to extend it indefinitely. By doing so, this directive allows the DoD to continue minimizing the threat of HIV and AIDS among the U.S. and foreign militaries. This directive was responsive to need, evidence-based, and human rights based; however, it did not discuss gender norms which are particularly relevant in the armed forces.