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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 2019

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.

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2019_Congress Budget

A+
A+

HIV & AIDS

 

Congress received a 97 (A+) with transparency and a 97 (A+) without transparency due to Congress appropriating high levels of funding for the Global Fund and President’s Emergency Plan for AIDS Relief (PEPFAR) and high levels of transparency within policy and funding. This grade was further raised by the passage of the Global Health Innovation Act which instituted a Congressional reporting requirement regarding HIV and AIDS-related global health technologies by USAID.

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
2019_Global Health Innovation Act of 2017 (H.R.1660)
This law instituted a new requirement for the Administrator of USAID to issue a report to Congress about USAID’s investment in and development of global health technologies. The passage of this bill indicated Congressional interest in global health technologies and implemented a mechanism to hold USAID accountable to continuous innovation of such technologies. HIV and AIDS technologies, unlike family planning technologies, were explicitly mentioned in the Act which provided an accountability mechanism for these specific technologies. This law was responsive to need and evidence-based, as it emphasized the importance of global health technologies and innovation in achieving global health goals. The Act did not reference human rights principles or the need for more women and girl-centered technologies, such as multi-purpose prevention. Overall, this law promoted SRHR within the HIV and AIDS domain because it encouraged the development of technologies to support HIV and AIDS programming.
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.
B
B

Maternal and Child Health (MCH)

 

Congress received an 86 (B) with transparency and an 86 (B) without transparency because it appropriated adequate levels of funding for UNICEF and USAID’s maternal and child health programs but inadequate funding for UNIFEM (now UN Women). The Global Health Innovation Act neither hindered nor raised the grade within this domain. Congress scored high on transparency due to available policy and budget 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
2019_Global Health Innovation Act of 2017 (H.R.1660)
This law instituted a new requirement for the Administrator of USAID to report to Congress on USAID’s investment in and development of global health technologies. The passage of this bill indicated Congressional interest in global health technologies and implemented a mechanism to hold USAID accountable to continuous innovation of such technologies. While HIV and AIDS technologies were explicitly mentioned, this Act did not include a request for details about other technologies that USAID could have been developing, such as maternal and child health technologies or multi-purpose family planning and/or HIV and AIDS technologies. It is possible that without explicit mention of these technologies, they may be omitted from reporting. This law was responsive to need and evidence-based, as it emphasized the importance of global health technologies and innovation in achieving global health goals. The Act did not reference human rights principles or the need for more women and girl-centered technologies. Overall, this law neither promoted nor harmed SRHR with regard to maternal and child health.
C-
C-

Family Planning (FP)

 

Congress received a 71 (C-) with transparency and a 71 (C-) without transparency due to inadequate funding appropriated for Family Planning and high levels of transparency within policy and funding. These budgetary determinations hindered the ability of U.S. global health assistance to support comprehensive family planning programs that promoted SRHR. The Global Health Innovation Act neither hindered nor raised the grade within 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
2019_Global Health Innovation Act of 2017 (H.R.1660)
This law instituted a new requirement for the Administrator of USAID to issue a report to Congress about USAID’s investment in and development of global health technologies. The passage of this bill indicated Congressional interest in global health technologies and implemented a mechanism to hold USAID accountable to continuous innovation of such technologies. While HIV and AIDS technologies were explicitly mentioned, this Act did not require USAID report on other technologies that USAID may have been developing, such as multi-purpose prevention technologies that prevent both pregnancy and HIV acquisition. It is possible that without explicit mention of these technologies, they may be omitted from reporting. This law was responsive to need and evidence-based, as it emphasized the importance of global health technologies and innovation in achieving global health goals. The Act did not reference human rights principles or the need for more women and girls centered technologies, such as multi-purpose prevention. Overall, this law neither promoted nor harmed SRHR with regard to family planning.