Domain Score Overview

The U.S. Government received a 73 (C) with transparency and a 77 (C+) without transparency for the Family Planning (FP) domain across all actors in 2022. Global FP efforts were not meaningfully included in most whole-of-government actions or key agency-level actions for both the Department of State and United States Agency for International Development (USAID) in 2022. This omission reinforced the siloed nature of global health programs and did not support the implementation of integrated sexual and reproductive health (SRH) programming based in evidence and human rights. Most agency-level actions were gender accommodating as they reinforced a gender binary and did not use inclusive language such as “internal and external condoms.” An inadequate funding request from the White House, a low level of appropriated funding by the U.S. Congress for global FP programs, and the disbursement of FP funds by USAID that was not responsive to need affected the low grade in this domain. Actors received low to moderate transparency scores for actions graded in the FP domain which also impacted the overall score for 2022.

The U.S. Government received a 79 (C+) with transparency and an 83 (B) without transparency for the Maternal and Child Health (MCH) domain across all actors in 2022. Though global MCH efforts were meaningfully included in the National Strategy on Gender Equity and Equality, MCH was omitted from some whole-of-government actions as well as key agency-level actions from both the Department of State and the United States Agency for International Development (USAID). This omission reinforced the siloed nature of global health programs and did not support the implementation of integrated programming based in evidence and human rights. In most instances, agency-level actions were gender accommodating as they reinforced a gender binary and did not use inclusive language such as “pregnant and breastfeeding persons,” which excluded the experiences of all people who can become pregnant. All actors received low to moderate transparency scores for actions graded in the MCH domain. The continued lack of funding information for the Department of Health and Human Services (HHS) global MCH efforts and low scores for appropriate use of funds by USAID and the Department of State also negatively affected the overall MCH domain grade in 2022.

The U.S. Government (USG) received an 89 (B+) with transparency and a 94 (A-) without transparency in the HIV and AIDS domain across all actors in 2022. This grade reflected the continued commitment of the USG to support the President’s Emergency Plan for AIDS Relief (PEPFAR) to implement programs that were based in evidence, consistent with international human rights norms, and responsive to need. However, the majority of PEPFAR actions graded across actors in 2020 were gender accommodating and not gender transformative. All actors received low or moderate transparency scores for actions graded in the HIV and AIDS domain. Budget scores were relatively high across actors where budget data were available, and transparency of funding information was high for all actors except the Department of Defense (DoD). For the first time, funding information was available for the Department of Health and Human Services (HHS), which had a positive impact on overall scores. Consistent with previous years, the domain grade for HIV and AIDS was higher than the Maternal and Child Health and Family Planning domains across actors in 2022.