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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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D-

This is an average of the three domain scores below.

YEAR 2019

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-
D+

HIV & AIDS

 

HHS received a 60 (D-) with transparency and a 68 (D+) without transparency for HIV and AIDS in 2019. The four statements related to the U.S. government’s regressive stance on SRHR (including HIV and AIDS) shared by Alex Azar, the U.S. Secretary of Health and Human Services, significantly decreased the HHS’s grade in this domain. The amount of disbursed funds for HIV and AIDS programs through HHS was not publicly available which also contributed to the 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
2019_CDC Global Health Strategy_2019-2021
The CDC Global Health Strategy, 2019-2021 presented data to document the CDC’s progress to date with regard to HIV and AIDS activities. It provided evidence to support continued investment in CDC’s programs across the spectrum of HIV and AIDS prevention, care, and treatment through the President’s Emergency Plan for AIDS Relief (PEPFAR). This Strategy was based on programmatic and global evidence but did not include an international human rights component. The Strategy also did not include a gender transformative approach to the CDC’s HIV and AIDS programs. In fact, the word "gender" was not mentioned in the entire document, despite gender being a vital factor in HIV and AIDS programming. However, the Strategy advocated for the continued support of evidence-based HIV and AIDS programs carried out by the CDC and therefore moderately promoted SRHR.
2019_Joint Statement on the Nairobi Summit on the ICPD25
This Statement by the U.S. Secretary of Health and Human Services Alex Azar only affirmed the specific elements of the International Conference on Population and Development (ICPD) Programme of Action that aligned with the Trump Administration’s ideology. It asserted that any outcomes of the Nairobi Summit—including any discussions or decisions related to SRHR—were not to be considered reflective of Member State consensus. Though this Statement might not immediately impact the implementation of global health programs related to SRHR, including HIV and AIDS efforts, it reflects the U.S. government’s stance on SRHR generally and amplifies and emboldens anti-SRHR ideals globally. This Statement operated within traditional gender norms and was based on ideology, not evidence or international human rights norms. Furthermore, the Statement conflicts with comprehensive sexuality education "that fails to adequately engage parents" and mentioned the importance of "giving young people the skills to avoid sexual risk" which suggested support for abstinence-only programs. The language did not promote autonomy and agency of all people to engage in sexual experiences free of shame, coercion, and violence and substantially hindered SRHR.
2019_Joint Statement_Item 12.8: Global Strategy for Womens, Childrens, Adolescents Health (2016-2030)
This Statement denounced "ambiguous" terms such as "the right to sexual and reproductive health (and its derivatives)" at a World Health Assembly meeting to discuss the WHO Global Strategy for Women’s, Children’s, and Adolescents’ Health. This Statement highlighted the role of the family over the rights of the individual and omitted inclusive language regarding gender or the specific health needs of key populations. This Statement did not mention HIV and AIDS as a health issue that is relevant for women, adolescents, and children. This Statement was not based in evidence or international human rights norms and substantially hindered SRHR.
2019_U.S. Commitment Statement to the Nairobi Summit on ICPD25
This Commitment Statement undermined international human rights norms related to SRHR and their supporting processes, including the U.S. government’s own commitments under the International Conference on Population and Development Programme of Action. This Commitment Statement sought to excuse the U.S. government from its commitments to comprehensive SRHR included in the ICPD Programme of Action under the guise of protecting "the inherent value of every human life -- both born and unborn" and the role of "caring fathers" and faith-based organizations (FBOs) in supporting women and girls access to healthcare. This Statement included an account of some relevant U.S. global health or development initiatives that contributed to ICPD, including the HIV and AIDS programming administered by PEPFAR. This statement moderately hindered SRHR because it was not based in evidence or international human rights norms and was not gender transformative.
2019_U.S. Government Statement at the U.N. High Level Meeting on Universal Health Coverage
This Statement emphasized the U.S. government’s commitment to universal health coverage (UHC) but condemned the inclusion of SRHR language and sexual education that "diminishes the protective role of the family in improving health." This Statement also rejected that there is an international right to abortion. Though language included was possibly more immediately related to domestic U.S. health policy, it directly translates to the ideology being used to shape U.S. global health assistance through the Protecting Life in Global Health Assistance (PLGHA) policy and other mechanisms. This Statement substantially hindered SRHR because it did not discuss HIV and AIDS as a vital health issue, was not based in evidence or international human rights norms, and was not gender transformative.
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 .
F
D+

Maternal and Child Health (MCH)

 

HHS received a 59 (F) with transparency and a 68 (D+) without transparency for Maternal and Child Health in 2019. The four statements related to the U.S. government’s regressive stance on SRHR (including maternal and child health) shared by Alex Azar, U.S. Secretary of Health and Human Services, significantly decreased the HHS’s grade in this domain. The amount of disbursed funds for maternal and child health programs through HHS was not publicly available, which also contributed to the 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
2019_CDC Global Health Strategy_2019-2021
This Strategy included a brief description of maternal and child health programs carried out by the CDC and presented programmatic and global evidence that highlighted the importance of these programs as a broad contributor to global health. The Strategy discussed the strengthening of health systems through the Saving Mothers, Giving Life Initiative, and the CDC’s role in developing new tools and techniques to address maternal and child health needs. The integration of maternal and child health efforts with HIV and AIDS or family planning was not discussed in the Strategy, which reinforced the siloed nature of these programs. The information moderately promoted SRHR with regard to CDC's maternal and child health programming, though it did not include a gender transformative approach to maternal and child health.
2019_Joint Statement on the Nairobi Summit on the ICPD25
This Statement by the U.S. Secretary of Health and Human Services Alex Azar only affirmed the specific elements of the International Conference on Population and Development (ICPD) Programme of Action that aligned with the Trump Administration’s ideology. It asserted that any outcomes of the Nairobi Summit—including any discussions or decisions related to SRHR—were not to be considered reflective of Member State consensus. Though this Statement might not immediately impact the implementation of global health programs related to SRHR, including those related to maternal and child health, it reflects the U.S. government’s stance on SRHR generally and amplifies and emboldens anti-SRHR ideals globally. This Statement operated within traditional gender norms and was based on ideology, not evidence or international human rights norms. Furthermore, the Statement conflicted with comprehensive sexuality education "that fails to adequately engage parents" and mentioned the importance of "giving young people the skills to avoid sexual risk" which suggested support for abstinence-only programs. The language did not promote autonomy and agency of all people to engage in sexual experiences free of shame, coercion, and violence, and substantially hindered SRHR.
2019_Joint Statement_Item 12.8: Global Strategy for Womens, Childrens, Adolescents Health (2016-2030)
This Statement denounced "ambiguous" terms such as "the right to sexual and reproductive health (and its derivatives)" at a World Health Assembly meeting to discuss the WHO Global Strategy for Women’s, Children’s, and Adolescents’ Health. This Statement highlighted the role of the family over the rights of the individual and did not include inclusive language regarding gender or the specific health needs of key populations. The Statement did not mention maternal and child health as a relevant health issue for women, adolescents, and children. This Statement was not based in evidence or international human rights norms and substantially hindered SRHR.
2019_U.S. Commitment Statement to the Nairobi Summit on ICPD25
This Commitment Statement undermined international human rights norms related to SRHR and their supporting processes, including the U.S. government’s own commitments under the International Conference on Population and Development Programme of Action. This Commitment Statement sought to excuse the U.S. government from its commitments to comprehensive SRHR included in the International Conference on Population and Development Programme of Action under the guise of protecting "the inherent value of every human life -- both born and unborn". and the role of "caring fathers" and faith-based orgniazations in supporting women and girls’ access to healthcare. This Statement included an account of some relevant U.S. global health or development initiatives that contributed to ICPD, including the statement that the U.S. government is the largest bilateral funder for family planning and "that hasn't changed." This language assumed that only couples were using family planning to “either achieve or prevent pregnancy", however is not the only situation in which someone would want to use family planning. This statement moderately hindered SRHR because it was not based in evidence or international human rights norms and was not gender transformative.
2019_U.S. Government Statement at the U.N. High Level Meeting on Universal Health Coverage
This Statement emphasized the U.S. government’s commitment to universal health coverage (UHC) but condemned the inclusion of SRHR language and sexual education that "diminishes the protective role of the family in improving health." This Statement also rejected that there is an international right to abortion. Though language included here may be more immediately related to domestic U.S. health policy, it directly translates to the ideology being used to shape U.S. global health assistance through the Protecting Life in Global Health Assistance (PLGHA) policy and other mechanisms. This Statement substantially hindered SRHR because it did not discuss maternal and child health as a vital health issue, was not based in evidence or international human rights norms, and was not gender transformative.
2018_Protecting Life in Global Health Assistance FAQs_August 2018
The 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 maternal and child health programs that were evidence-based, responsive to need, consistent with internationally-recognized human rights principles, and gender transformative.
NA
NA

Family Planning (FP)

 

HHS does not receive a grade within the Family Planning domain because they do not work in international family planning.