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YEAR 2019

Domain Score Overview

The U.S. government, including the White House, Congress, and relevant federal agencies, should engage in global health assistance in the domains of HIV and AIDS, Maternal and Child Health, and Family Planning in ways that promote sexual and reproductive health and rights (SRHR) around the world. Data and documentation supporting these actions should be reasonably accessible to the public.

B

This is an average of the actor scores.

HIV & AIDS

The U.S. Government received an 86 (B) with transparency and an 89 (B+) without transparency for HIV and AIDS across all actors in 2019. This grade reflected the continued commitment of the President’s Emergency Plan for AIDS Relief (PEPFAR) to implement programs that are evidence-based, responsive to need, and gender accommodating and Congress’s commitment to appropriating adequate funding for HIV and AIDS. Similar to past years, the implementation of the PLGHA policy by relevant actors harmed SRHR within this domain. Furthermore, HIV and AIDS continued to be omitted from key reporting documents across actors, including USAID’s annual Acting on the Call report. Low transparency of policy documents from USAID in this domain also contributed to the overall lower grade. In spite of these negative actions, however, the domain grade for HIV and AIDS-related funding and policies remained higher than the grades of the other domains across actors.

B
White House
A+
Congress
A
Department of State
B
US Agency for International Development
D-
Department of Health and Human Services
C-
Department of Defense
D+

This is an average of the actor scores.

Maternal and Child Health

The U.S. Government received a 68 (D+) with transparency and a 71 (C-) without transparency for Maternal and Child Health across all actors in 2019. This grade stemmed from a low budget request by the White House and gender-blind language across policy documents that reinforced the traditional gender binary with regard to maternal and child health programs. The U.S. government also omitted specific references to maternal and child health programming in the PLGHA policy documents and guidance, which indicates that the U.S. government did not consider the unique impact of the implementation of the PLGHA policy on maternal and child health programs. The grade was positively impacted by the continued issuance of USAID’s reports like Acting on the Call and USAID’s revision of ADS Chapter 212 that are based in evidence. Low transparency regarding USAID’s maternal and child health policies and maternal and child health funding by HHS also contributed to this grade.

D-
White House
B
Congress
F
Department of State
D
US Agency for International Development
F
Department of Health and Human Services
NA
Department of Defense
D-

This is an average of the actor scores.

Family Planning

The U.S. Government received a 61 (D-) with transparency and a 64 (D) without transparency for Family Planning across all actors in 2019. This grade reflected the continued harm to SRHR by the implementation of the PLGHA policy and the harm to SRHR caused by omitting family planning from key global health documents concerning women and girls by various actors. Similar to 2018, this grade was also harmed by insufficient family planning funding, the defunding of the United Nations Population Fund (UNFPA) due to an unsubstantiated Kemp-Kasten amendment violation in FY 2019, low transparency of policies by USAID, and family planning spending by USAID that was not responsive to need.

F
White House
C-
Congress
F
Department of State
C
US Agency for International Development
NA
Department of Health and Human Services
NA
Department of Defense

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.