Actor Score Overview

The Department of Defense (DoD) received a 65 (D) with transparency and a 74 (C) without transparency due to the lack of explicit details about the DoD’s global HIV and AIDS programs in the four actions that were released publicly in 2022. Most of the actions did not promote sexual and reproductive health and rights (SRHR) and lacked transparency. Funding information about the DoD’s global HIV and AIDS programming was unavailable at the time of grading, which also contributed to the actor’s low transparency score in 2022. The Maternal and Child Health (MCH) and Family Planning (FP) domains do not factor into the DoD’s grade because this actor does not work in international MCH or FP.

The Department of Health and Human Services (HHS) received a 69 (D+) with transparency and a 78 (C+) without transparency in 2022. This grade was based on the Centers for Disease Control and Prevention (CDC) new Health Equity Strategy, a revised strategy for the overall organization, and whole of government actions such as the National Strategy for Combating Multi-drug Resistant Tuberculosis. The transparency scores for HHS were low across domains because it was unclear whether most of the graded actions were relevant to their global health programs. Similarly, there was no indication of what information had been changed from previous versions of some actions and prior versions were not available on the website for comparison. While funding for HIV and AIDS programs were available during the grading period for the first time this year, funding data for the maternal and child health (MCH) programs within HHS were unavailable at the time of grading, which contributed to the low transparency grade in 2022.

The United States Agency for International Development (USAID) received a 79 (C+) with transparency and an 83 (B) without transparency in 2022. Most of the graded actions across HIV and AIDS, maternal and child health (MCH), and family planning (FP) moderately promoted sexual and reproductive health and rights (SRHR). The limited acknowledgement and lack of effort to address the connection between climate change and SRHR decreased the actor’s grade. The transparency of funding data was generally high across domains, but there were persistent transparency issues regarding ADS chapters, the Global Health eLearning courses, and the role of USAID global health programs in some whole-of-government actions. The HIV and AIDS grade was higher than the MCH and FP domain grades due to the disbursement of funding that was highly responsive to need in 2022.

The Department of State received a 62 (D-) with transparency and a 68 (D+) without transparency in 2022. The President’s Emergency Plan for AIDS Relief (PEPFAR) Five Year Plan, along with the updated Country and Regional Operating Plans raised this actor’s grade across all domains. However, subsequent updates to PEPFAR Five Year Strategy (e.g., definitional footnotes) significantly hindered sexual and reproductive health and rights (SRHR) across all domains, as they did not provide information based in evidence about the scope of SRHR within PEPFAR programming. On the whole, the graded actions were largely based in evidence, aligned with human rights principles, and responsive to need. Transparency was low across all domains for this actor. The Department of State grade was raised by high budget scores across domains. Maternal and child health (MCH) and family planning (FP) health funds were moderately responsive to need, and HIV and AIDS funds were highly responsive to need.

Congress received an 89 (B+) with transparency and a 92 (A-) without transparency in 2022. Congress appropriated full funding for HIV and AIDS, significant funding for maternal and child health (MCH), but inadequate funding for family planning (FP). Congress passed the Consolidated Appropriations Act – (H.R.2617) which enabled U.S. global health assistance to support efforts to address the impacts of the war in Ukraine, which could include the impacts of the pandemic on sexual and reproductive health and rights (SRHR). It also renewed funding to the United Nations Population Fund (UNFPA). In all three domains, Congress demonstrated moderate transparency across actions and high transparency across funding data.

The White House received an 85 (B) with transparency and an 88 (B+) without transparency in 2022. This grade was the result of multiple actions that moderately or significantly promoted sexual and reproductive health and rights (SRHR) globally across all three domains, including the Executive Order on Protecting Access to Reproductive Healthcare Services, the United States Strategy to Combat Gender Based Violence Globally, and the Memorandum on the Establishment of the White House Task Force to Address Online Harassment and Abuse. The White House requested an adequate funding amount for both global HIV and AIDS and maternal and child health (MCH) efforts, but the proposed budget for family planning (FP) continued to be low, which negatively affected the grade in this domain. Transparency was moderately high for all actions and budget data across the three domains in 2022.