THE CHILDREN AT RISK FOUNDATION
THE CHILDREN AT RISK FOUNDATION
THE CHILDREN AT RISK FOUNDATION 
USAID is helping 

people live longer, healthier,

more productive lives. 

AL GENEINA,WEST DARFUR, SUDAN 

USAID’s global health program focuses on the development and delivery of low-cost, 

high-impact interventions in poor countries to help prevent and treat leading killers, 

including tuberculosis, HIV/AIDS, pneumonia, diarrhea, malaria, avian influenza, and 

malnutrition. USAID’s multiple programs provide treatment, such as immunization of 

mothers and children, vitamin A and iron supplementation, insecticide-treated net 

distribution, and antenatal care. The Agency’s high-quality, voluntary family planning 

programs enable couples to better space child births, which then helps them better 

plan and provide for their children. Stronger families and improved environments 

for women’s education are two of the programs’ key results. 
USAID is helping 

people live longer, healthier,

more productive lives. 

USAID’s global health program focuses on the development and delivery of low-cost,

high-impact interventions in poor countries to help prevent and treat leading killers, 

including tuberculosis, HIV/AIDS, pneumonia, diarrhea, malaria, avian influenza, and

malnutrition. USAID’s multiple programs provide treatment, such as immunization of

mothers and children, vitamin A and iron supplementation, insecticide-treated net 

distribution, and antenatal care. The Agency’s high-quality, voluntary family planning

programs enable couples to better space child births, which then helps them better 

plan and provide for their children. Stronger families and improved environments 

for women’s education are two of the programs’ key results. 

AL GENEINA,WEST DARFUR, SUDAN
USAID is helping 

people live longer, healthier,

more productive lives. 

USAID’s global health program focuses on the development and delivery of low-cost,

high-impact interventions in poor countries to help prevent and treat leading killers, 

including tuberculosis, HIV/AIDS, pneumonia, diarrhea, malaria, avian influenza, and

malnutrition. USAID’s multiple programs provide treatment, such as immunization of

mothers and children, vitamin A and iron supplementation, insecticide-treated net 

distribution, and antenatal care. The Agency’s high-quality, voluntary family planning

programs enable couples to better space child births, which then helps them better 

plan and provide for their children. Stronger families and improved environments 

for women’s education are two of the programs’ key results. 

AL GENEINA,WEST DARFUR, SUDAN
USAID is helping 

people live longer, healthier,

more productive lives. 

USAID’s global health program focuses on the development and delivery of low-cost,

high-impact interventions in poor countries to help prevent and treat leading killers, 

including tuberculosis, HIV/AIDS, pneumonia, diarrhea, malaria, avian influenza, and

malnutrition. USAID’s multiple programs provide treatment, such as immunization of

mothers and children, vitamin A and iron supplementation, insecticide-treated net 

distribution, and antenatal care. The Agency’s high-quality, voluntary family planning

programs enable couples to better space child births, which then helps them better 

plan and provide for their children. Stronger families and improved environments 

for women’s education are two of the programs’ key results. 

AL GENEINA,WEST DARFUR, SUDAN
-

USAID Global Health 

ARMANDO WAAK/PAHO 

A child’s best hope for survival begins with the 

health of the mother. If a mother dies, is incapacitated by illness, or is weighed down by the needs 

of many children, the child’s life is at serious risk. 

Too often children are lost. Complications from 

hemorrhage, hypertension, infections, anemia, 

and prolonged labor account for two-thirds of maternal mortality. These major causes of maternal 

death are preventable and treatable with low-cost 

treatments and care, the targets of USAID efforts. 

Essential to maternal health is the care mothers receive during pregnancy and childbirth. 

Strengthening the capabilities and number of skilled birth attendants; promoting home-based, 

critical newborn care; and improving health information systems have helped reduce maternal 

deaths dramatically. In 15 USAID-supported countries, there has been an average 32 percent re 

duction in maternal deaths as a result of the promotion of family planning. Across all USAIDassisted countries, skilled attendance has increased from an average of 37 percent in 1990 to 51 

percent in 2005. The greatest increase is in the Asia and Near East region, from 21 to 48 percent. 

Globally, child death rates reached a record low in 2006, falling from 13 million in 1990 to 

9.7 million in 2007. This is the lowest level since record keeping began in 1960. Tragically, these 

deaths are mostly preventable. They occur largely in the developing world. 

Since 1990, USAID has spent more than $6 billion on child survival programs in about 80 

countries. Much of the progress is the result of the widespread adoption of basic health treatments, such as early and exclusive breastfeeding, measles immunization, Vitamin A supplementation, treatment of child illness, and use of insecticide-treated nets to prevent malaria. In 

collaboration with international, national, and private-sector partners, this effort has yielded 

public health successes on an unprecedented global scale. 
Almost 1 billion episodes of child diarrhea are treated successfully each year. Death from diarrheal disease has been reduced by more than 50 percent since 1990. With USAID assistance, 

more than 100 million children receive basic immunizations annually. Tens of millions more 

receive supplemental immunizations against polio, measles, and other diseases that kill. 

Trained health workers successfully treat more than 75 million cases of infant and child 

pneumonia annually. A 25 percent reduction – from one in three to one in four – in 

malnutrition among children under age 5 has been achieved. An estimated 5 million children 

have been saved from death or paralysis due to polio. 

Measles control efforts have saved more than 2 million children’s lives since 1999. In 2007 

alone, about a half a million more children survived as a result of micronutrient supplementation 

programs. 

USAID has worked to strengthen health systems and expand the capacities of developing country institutions to reduce preventable illnesses in mothers and children. The Agency supports 

provision of widespread, affordable, sustainable health services in its efforts to address the health 

needs of the most vulnerable populations in impoverished nations. 

Annually, 4 million newborns fail to survive even the first month of life, despite the improvements in maternal health and child survival. Each year, half a million mothers lose their lives in 

the process of giving birth. Millions more suffer complications that produce lifelong disability. 

Consequently, USAID Global Health continues its extensive efforts to provide an effective 

continuum of care essential for maternal and child well-being and longevity for impoverished 

families throughout the world. 

March 2009 

Web site 

http://www.usaid.gov/our_work/global_health/mch/index.html

E-mail queries 

GHCommunicationsTeam@usaid.gov
USAID Global Health 

© 2004 YESAYA BANDA, COURTESY OF PHOTOSHARE 

With more than 33 million people worldwide living 

with and affected by HIV/AIDS, addressing this global 

pandemic remains a chief objective for USAID. Close 

to 7,000 people become infected with HIV every day, 

especially women, who are twice as likely as men to 

contract HIV from a single sex act. About 5,700 people 

die daily from AIDS. Virtually unmatched in the field 

in the scope and depth of work, USAID’s foreign assistance mandate is an essential element in the global effort to prevent and eliminate the spread of HIV/AIDS. 

In 1986, USAID instituted a cutting-edge treatment and prevention program, just two years 

after the HIV virus was isolated and identified, and only five years after the first evidence of 

AIDS was reported in the United States. Agency leadership fighting HIV/AIDS throughout 

the developing world is demonstrated through a multidimensional portfolio of efforts, including 

direct provision of services, behavior change programs, strengthening of research, policy analysis, 

and vaccine research and development, to name a few. 

The Agency also works in partnership with the U.S. President’s Emergency Plan for AIDS Relief 

(PEPFAR), which, to date, has invested more than $18 billion in the global AIDS fight, and is 

also supporting important global efforts in tuberculosis and malaria. Announced in 2003 to 

stem the growing epidemic of HIV/AIDS, the plan is the largest such program in the world, 

touching millions of lives through essential HIV/AIDS prevention, care, and treatment programs. 

In 2008, the United States expanded this unprecedented HIV/AIDS commitment to $48 billion, 

to include $5 billion for malaria and $4 billion for tuberculosis treatment and care. A large 

portion of these resources will be administered through USAID in cooperation with other U.S. 

Government agencies, partner organizations, and host countries. It is through this venue that 
USAID provides invaluable technical support to the Global Fund to Fight AIDS, Tuberculosis 

and Malaria, and collaborates with an important network of international groups and 

indigenous partners. 

In PEPFAR’s 15 focus countries, the United States has supported care for more than 10.1 million 

people, including more than 4 million orphans and vulnerable children. Also, USAID supports 

essential HIV/AIDS programs in more than 60 countries, in addition to the 15 PEPFAR focus 

nations. In some of these countries, USAID is the only U.S. Government presence addressing 

the epidemic – a lifeline for men, women, and children infected and affected by the disease. 

USAID invests not only in the prevention and treatment of HIV/AIDS and other infectious 

diseases today, but also focuses on tomorrow’s needs by training people to manage, deliver, 

and support the distribution of health services, which are critical for sustained successes against 

infectious diseases. 

Improving the health of populations and reducing the spread and impact of diseases are important 

in their own right. In addition, they result in greater productivity and economic growth, and contribute to peace and political stability. Drawing on its nearly 50-year development history, USAID 

mobilizes its best resources and expertise to fight the HIV/AIDS pandemic in every geographic 

region of the world, continually ensuring the delivery of quality interventions. Agency efforts are 

rooted in sound development theory and practice, as well as deeply felt humanitarian concerns. 

March 2009 

Web site 

http://www.usaid.gov/our_work/global_health/aids/index.html

E-mail queries 

GHCommunicationsTeam@usaid.gov
USAID Global Health 

HELEN KUDRICH/WFP 

Not getting enough to eat and not getting nourishing food can kill. Malnutrition is one of the 

biggest contributors to child mortality around the 

world. Roughly half of the 852 million chronically 

hungry people in today’s world are children. About 

3.5 million of these children die each year. Many 

of these deaths could have been prevented through 

such simple activities as breastfeeding, fortification 

of food with vitamins and minerals, and the addition of zinc to diarrhea treatment. The impacts of 

malnutrition in the first two years of life cannot be reversed. Undernourished children who survive grow up impaired by worse health and lower educational and productivity capabilities. 

Since good nutrition can save lives and protect against infectious disease, USAID supports 

efforts to combat malnutrition and hunger in vulnerable populations. Annually, the Agency invests about $30 million in nutrition programs. USAID concentrates on six main areas: micronutrient supplementation and fortification, improved infant and young child feeding, and measures 

to improve household food supplies and security. Additionally, USAID supports communitybased approaches to monitoring and improving children’s nutritional health, as well as expanding 

research into supplementation and the development and dissemination of biofortified crops. 

More than 50 countries have received USAID assistance to establish vitamin (especially Vitamin 

A) programs. The Agency and its partners helped increase global Vitamin A coverage in children, 

aged 6 to 59 months, and support programs in 19 countries around the world that fortify staple 

foods with iron, iodine, Vitamin A, and other micronutrients. The cost of food fortification can 

be as low as a few cents per individual per year for adding iodine to salt, and up to 25 cents for 

adding more complex vitamins and minerals. 
The United States is the largest food aid donor in the world. Annually, it procures, ships, stores, 

distributes, monitors, and evaluates about 2.5 metric tons of food, which is worth more than 

$1 billion. The Agency addresses not only the quality of diets for vulnerable groups, but also 

works to improve the access, availability, and utilization of foods. For more than 30 years, 

USAID has supported programs that help prevent malnutrition, improve the health of millions, 

and lessen death rates. 

March 2009 

Web site 

http://www.usaid.gov/our_work/global_health/nut/index.html 

E-mail queries 

GHCommunicationsTeam@usaid.gov 
Infectious Diseases 

USAID Global Health 

© 2007 GILBERT AWEKOFUA, COURTESY OF PHOTOSHARE 

Infectious diseases disproportionately impact 

developing nations. USAID works with countries 

to halt these treatable, sometimes preventable, diseases through assistance that supports improved delivery of a full range of medical services. 

Tuberculosis (TB). One-third of the world’s 

population is infected with TB, with about 80 percent of all cases concentrated in 22 countries. TB 

kills about 5,000 people daily and between 

2 million and 3 million people annually, 98 percent 

of whom live in the developing world. One out of 

every three HIV/AIDS patients has TB. Since 

2002, the United States has treated 10 million people with this disease through programs that expand and ensure basic treatment, make lower-cost drugs available, address multidrug resistance, 

and support research for new TB drugs. Research shows that our efforts are causing TB rates to fall. 

Malaria causes 1 million to 3 million deaths annually, or one death every 30 seconds. More 

than half of the cases and 80 percent of the deaths occur in sub-Saharan Africa. USAID, the 

lead agency in the President’s Malaria Initiative, is targeting treatment for the most vulnerable 

populations – pregnant women and children under age 5. The five-year, $1.2 billion effort 

is working to reduce malaria-related deaths by 50 percent in 15 African countries through 

interventions that include spraying insecticides on home walls; distributing insecticide-treated 

nets to protect against malaria-carrying mosquitoes; and providing lifesaving drugs and 

preventive care for pregnant women. More than 25 million people have benefited. 

On Zanzibar, the percentage of children who tested positive for malaria has dropped from 

22 percent in 2005 to less than 1 percent, following the distribution of long-lasting nets and 

indoor spraying. In Malawi, where coverage with insecticide-treated nets has increased rapidly 

over the past several years, a 2007 survey in six districts showed a 43 percent decline in just two 

years in severe anemia among children aged 30 months to 6 years. 

Neglected Tropical Diseases (NTDs) have disabled more than 1 billion people, mostly in the 

developing world, contributing to childhood malnutrition and reduced mobility, and often 
leading to blindness and disfigurement. Five of the most virulent NTDs – lymphatic filariasis, 

schistosomiasis, trachoma, onchocerciasis, and soil-transmitted helminthes – can be controlled 

and even eliminated through targeted mass drug administration. The United States launched one 

of the first global efforts to integrate existing disease-specific treatment programs to expand care 

for millions of the world’s poorest. In its first full year, USAID distributed more than 36 million 

treatments to more than 14 million people in four countries in Africa. 

The Presidential Initiative for NTD Control, established in February 2008, increases the U.S. 

financial commitment to fighting these diseases from $15 million in 2008 to $350 million over 

five years. This will treat 300 million people in Latin America and the Caribbean, Asia, and 

Africa, and the number of countries receiving aid will rise from 10 in 2008 to about 30 in 2013. 

The speed with which emerging pandemic threats can spread presents enormous public health, 

economic, and development concerns. Launched in 2005, USAID’s avian and pandemic influenza preparedness and response program has increased the capacity of countries to limit the 

spread of H5N1 and its ability to develop into a human influenza pandemic. This program served 

as a platform for USAID’s response to 2009 H1N1 influenza outbreaks, when pandemic response 

plans were activated, existing public outreach messages were rapidly adapted and disseminated, 

and commodities were quickly deployed to affected areas from existing stockpiles via pre-established distribution channels. USAID is working with partners to implement longer-term interventions to mitigate the impact of the H1N1 influenza pandemic. 

Both the H5N1 and H1N1 viruses highlight the risks certain newly emergent diseases of animal 

origin can pose to human health. USAID’s Emerging Pandemic Threats (EPT) program represents a comprehensive approach to provide early warning about such diseases and respond before 

they have spread globally. The program involves early detection of dangerous pathogens, support 

for appropriate laboratory capacity to facilitate better surveillance, launch of timely and effective 

outbreak response, strengthening of national and local response capacities, and promotion of public awareness to reduce disease transmission. 

October 2009 

Web site 

http://www.usaid.gov/our_work/global_health/id/index.html 

E-mail queries 

GHCommunicationsTeam@usaid.gov 
USAID Global Health 

© 2000 LIZ GILBERT, COURTESY OF PHOTOSHARE 

Family planning assistance is crucial to saving the lives 

of women and children, helping countries stabilize their 

populations, protecting the environment, and promoting U.S. political and economic interests throughout 

the developing world. 

An estimated 200 million women in the developing 

world want to space or limit births, but are not using 

modern methods of contraception. The health consequences are grave: More than half a million women 

die each year from causes related to pregnancy. When a mother dies, her children are less likely 

to survive. 

Maternal and child mortality can be substantially reduced by family planning. Research by the 

United Nations shows that access to family planning alone would lessen global maternal deaths 

by 20 to 35 percent and child deaths by 20 percent. Other key researchers estimate that if mothers in developing countries could space their births three years apart, infant and under-5 mortality rates would decline by 24 percent and 35 percent, respectively. Family planning can eliminate 

at least one in three maternal deaths each year by helping women manage life-threatening births 

that occur too early or too late in life. It prevents unintended pregnancies that could result in 

abortion. Also, family planning can help alleviate the spread of HIV/AIDS, particularly motherto-child transmission. 

Women want family planning for the health benefits. They see it in broad terms, recognizing that 

having smaller families and spacing births are important steps not only in their efforts to improve 

their own lives and health, but also to ensure that their families are better fed, clothed, educated, 

and healthy. 

Additionally, most of the world’s nations recognize that family planning programs play an important role in human and economic development. Since 1967, USAID has been delivering family 
planning services and supplies. Currently, the Agency has a presence in 60 countries in Africa, 

Latin America and the Caribbean, Southeast Asia, Russia, and Eastern Europe at the request of 

the countries. USAID’s work is known worldwide as one of the most successful components of 

U.S. foreign assistance. 

The Agency’s support emphasizes choice among a wide range of contraceptives, improved quality 

of care, and client-centered services. Programs are frequently delivered with other communitybased efforts to improve maternal and child health, enhance women’s status, prevent HIV transmission, and blend agricultural and environmental protection with health. Counseling about 

nutrition and obstetric care are included, as well. Essential elements involve training health workers, providing services, designing innovative educational campaigns for mass media, and developing and marketing improved contraceptives. Contributing to these activities is support for 

research and data collection and evaluation, all of which are crucial to informed decisionmaking 

and more effective programs. 

Because of USAID’s work, more than 63 percent of married women worldwide are using family 

planning. Hundreds of thousands of women and children are alive today because of U.S. help. 

USAID’s contribution costs each U.S. taxpayer less than 3 cents a week, or $1.44 per year. 

With this investment, taxpayers are working in common cause with those living in lesser-developed nations, helping them improve their lives and health, reduce pressure on the environment, 

stop the extinction of plant and animal species, and lessen food and water shortages. A disaster 

across the globe can profoundly impact lives in the United States. USAID programs contribute 

greatly to the prevention of such problems. 

March 2009 

Web site 

http://www.usaid.gov/our_work/global_health/pop/index.html

E-mail queries 

GHCommunicationsTeam@usaid.gov
USAID Global Health 

© 2006 SCOTT HARRISON, COURTESY OF PHOTOSHARE 

Bad air and water can cause ill health and death, 

especially among young children. In countries already 

struggling with poverty, infectious diseases, and war 

and conflict, the toll from polluted air and water adds 

greatly to the national burden. 

Acute respiratory infections, primarily pneumonia, 

are leading causes of death among children under 

age 5 and are closely associated with exposure to 

indoor smoke from cooking with biomass fuels. Nearly 

1.6 million children under age 5 died in 2007 from diarrheal diseases caused by unsafe drinking water and poor sanitation. Millions more were 

exposed to waterborne infections, such as cholera, typhoid fever, and dysentery. The spread of 

malaria, which results in about 2.5 million deaths annually, is worsened by poor environmental 

conditions. Water shortages and poor water management can lead to increases in malnutrition 

and disease, loss of biodiversity and agricultural production, reduced economic growth, and 

social instability. 

Safe water and proper sanitation are great concerns for impoverished populations, for areas with 

heavy migration, and in the wake of disasters, such as earthquakes and hurricanes. Improving 

hygiene can markedly reduce the number of infections, parasites, and insults to immune systems. 

USAID focuses on such simple interventions as changing hygiene behavior by promoting 

handwashing with soap, proper storage and treatment of water, and safe disposal of feces. 

Each activity alone can reduce the prevalence of diarrheal disease by as much as 30 percent. 

Household water treatment and safe storage reduce waterborne disease, empower families and 

communities, and improve productivity. These measures compliment community and municipal 
water supply infrastructure programs by providing immediate access to safe water while 

construction of improved treatment facilities is planned or implemented. 

Additionally, USAID supports other health interventions that address not only environmental 

issues, but also focus directly on individual treatments. To deal with air quality, the Agency and 

its partners have created initiatives to reduce vehicle pollutants, launch retrofit technologies, 

encourage use of cleaner fuels, and support other science-based urban air pollution strategies 

and management. 

Rehydration therapy and treatment with zinc through USAID-sponsored projects reduce the 

severity and duration of diarrhea. The loss of these nutrients, along with dehydration and weight 

reduction, are the primary dangers of diarrhea. Broad outreach and information campaigns, 

which are designed to educate thousands of health care providers and families on proper techniques and best practices, are undertaken to help spread the word about the availability and utility of these and other lifesaving treatments. 

USAID considers the preservation and improvement of the environment to be a top priority of its 

global health program. Its environmental protection interventions help struggling nations establish 

self-sustaining programs of their own and improve the lives of millions throughout the world. 

March 2009 

Web site 

http://www.usaid.gov/our_work/global_health/eh/index.html

E-mail queries 

GHCommunicationsTeam@usaid.gov
THE CHILDREN AT RISK FOUNDATION