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YEAR 2019

Actor Score Overview

The U.S. government, including the White House, Congress, and relevant federal agencies, should engage in global health assistance in ways that are evidence-informed, responsive to need, consistent with internationally-recognized human rights principles, and gender transformative. Data and documentation supporting these actions should be reasonably accessible to the public.

D

This is an average of the three domain scores.

White House

The White House received a 65 (D) with transparency and a 69 (D+) without transparency in 2019. These grades were the result of the White House’s low proposed budget for Family Planning and for Maternal and Child Health, including the zeroing out of funding for the United Nations Population Fund (UNFPA), UNIFEM (now UN Women), and UNICEF. The policies issued or signed by the White House either did not impact sexual reproductive health and rights (SRHR), such as the Global Health Security Strategy, or harmed SRHR by omitting health altogether, as seen in the United States Strategy on Women, Peace and Security. Related policy information was difficult to find, which led to low transparency grades across all domains.

Selecting a document will download the file
2019_President’s-Budget-Request.pdf

B
HIV & AIDS
D-
Maternal and Child Health
F
Family Planning
View White House Score Card
B

This is an average of the three domain scores.

Congress

Congress received an 85 (B) with transparency and an 85 (B) without transparency because it appropriated adequate funding for Family Planning and Maternal and Child Health as well as full funding for HIV and AIDS in 2019. Congress passed one policy in 2019 that did not significantly impact sexual reproductive health and rights (SRHR) within the Maternal and Child Health and Family Planning domains but did promote SRHR within the HIV and AIDS domain. Congress scored high on transparency due to available policy and budget information.

Selecting a document will download the file
2019_Congress Budget

A+
HIV & AIDS
B
Maternal and Child Health
C-
Family Planning
View Congress Score Card
D-

This is an average of the three domain scores.

Department of State

The Department of State received a 61 (D-) with transparency and a 66 (D) without transparency in 2019. The Family Planning and Maternal and Child Health domain grades were lower due to the release of guidance for the implementation of the Protecting Life in Global Health Assistance (PLGHA) policy through the 2019 PLGHA FAQs as well as the neglect of both family planning and maternal and child health in issued guidance and reports such as the President’s Emergency Plan For AIDS Relief (PEPFAR) Annual Report to Congress. The Department of State’s HIV and AIDS grade was high due to activities that were evidence-based and highly responsive to need, as described in PEPFAR’s Monitoring, Evaluation, and Reporting (MER) Indicator Reference Guide and the 2019 Country Operational Plan (COP) Guidance. The Department of State’s actor-level grade was lowered by a lack of policy transparency within the Family Planning and Maternal and Child Health domains. The Department of State’s grade was raised by high budget scores, which indicated that family planning and maternal and child health funds were mostly responsive to need, and HIV funds were highly responsive to need.

A
HIV & AIDS
F
Maternal and Child Health
F
Family Planning
View State Dept. Score Card
C+

This is an average of the three domain scores.

US Agency for International Development

The United States Agency for International Development (USAID) received a 77 (C+) with transparency and an 81 (B-) without transparency. In 2019, the Agency released a number of policy and guidance documents that negatively impacted SRHR, including an updated version of the Protecting Life in Global Health Assistance (PLGHA) FAQs. The majority of policy documents released by USAID in 2019 hindered the Agency’s ability to support global health programs that promote SRHR, including the expansion of the implementation of pre-existing statutory requirements regarding abortion activities through Automated Directive System (ADS) Chapter 308, which impacts programs in all domains. USAID’s grade also decreased across domains due to low transparency because the 2018 version of ADS Chapter 308 was not updated to the USAID website before additional revisions were released in 2019.

Additionally, family planning and maternal and child health funds were not spent according to need, which further reduced USAID’s grades in these domains. Following a consultation with USAID in 2020, we have made minor adjustments to the methodology for the budget calculation for USAID’s Family Planning and Maternal and Child Health domains to most accurately reflect the appropriation of these funds. This change is reflected in the 2019 grades.

B
HIV & AIDS
D
Maternal and Child Health
C
Family Planning
View USAID Score Card
D-

This is an average of the three domain scores.

Department of Health and Human Services

The Department of Health and Human Services (HHS) received a 60 (D-) with transparency and a 68 (D+) without transparency. This grade was based on the release of the Center for Disease Control and Prevention (CDC) Global Health Strategy as well as four statements related to the U.S. government’s regressive stance on sexual and reproductive health and rights (SRHR) shared by Alex Azar, the U.S. Secretary of Health and Human Services, at various international fora in 2019. The transparency grades for HHS were low across domains because the information on the disbursement of HHS’s funding remains unavailable online.

D-
HIV & AIDS
F
Maternal and Child Health
NA
Family Planning
View HHS Score Card
C-

This is an average of the three domain scores.

Department of Defense

The Department of Defense (DoD) received a 71 (C-) with transparency and an 81 (B-) without transparency due to the unavailability of policy and budget information related to sexual and reproductive health and rights (SRHR) and low transparency of funding data related to HIV and AIDS. The Maternal and Child Health and Family Planning domains do not factor into the DoD grade because the DoD does not work in international maternal and child health or family planning.

C-
HIV & AIDS
NA
Maternal and Child Health
NA
Family Planning
View DoD Score Card

C-

Overall SRHR Score

The U.S. Government received a 72 (C-) with transparency and a 75 (C) without transparency for Sexual and Reproductive Health and Rights (SRHR) overall in 2019. This grade stems from documents and guidance related to the Protecting Life in Global Health Assistance (PLGHA) policy, including the PLGHA FAQ and the updated Standard Provisions for relevant USAID agreements within the Automated Directive System (ADS), as well as publicly issued statements by the U.S. Secretary of Health and Human Services regarding the U.S. government’s regressive stance on SRHR in numerous international fora. The grade was also negatively impacted by low funding amounts across domains in the President’s proposed budget, a lack of gender transformative policies, and low transparency of data across actors in key SRHR domains.