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                BlogSearch < WatchBlog: Following the Federal Dollar
    For World Health Day (April 7), We Look At U.S. Efforts to Promote Global Wellness Posted on April 04, 2024
                    When it comes to communicable diseases, it turns out, it *is* a small world after all. Serious diseases like COVID-19, AIDS, and mpox (previously known as monkeypox) can move quickly around the globe—threatening lives and livelihoods. The U.S. plays an important role in working with global partners to prevent the spread of diseases like these.Today, for World Health Day (April 7), the WatchBlog looks at our recent work on key U.S. agencies’ efforts to prevent the spread of diseases and the challenges these efforts face.**USAID supported COVID-19 vaccinations in indigenous communities in Guatemala**Image
              Photo showing a medical worker injecting a COVID vaccine into a woman's arm with others standing by awaiting vaccinations.**USAID’s Efforts to Increase COVID-19 Vaccination Rates**In response to the COVID-19 pandemic, the U.S. government pledged to help reach a global goal of vaccinating 70% of the world’s population against this disease. The U.S. Agency for International Development (USAID) obligated an estimated $904 million, as of March 2023, to help 125 countries prepare for and deliver vaccines.For example, in Malawi, USAID assistance helped provide “cold chain” equipment needed to store vaccines at required temperatures. In South Africa, a USAID implementing partner created an app to show users the closest vaccination centers and the brands of vaccines offered there.But, despite these efforts, as of July 2023 vaccination rates had not reached 50% in almost two-thirds of the countries where USAID provided assistance. USAID officials and those in countries assisted highlighted a number of challenges that contributed to not meeting the 70% goal. Some reported challenges such as misinformation and vaccine hesitancy. Others said there were shortages of trained health care workers to administer vaccines. And in some cases, it was difficult to reach remote locations to provide vaccines.Our video below discusses some of these challenges and lessons learned. USAID officialstold usthey plan to share lessons learned from these issues to help its partners prepare for future pandemics.Video URL
              Lessons Learned from Efforts to Meet Global Vaccination Goal
      Transcript
              Transcript**Staffing challenges pre-date COVID-19 response. They were seen in global HIV/AIDS program**Even before COVID-19, there have been persistent staffing challenges in response to other global health crises—for example, HIV/AIDS.Over the past two decades, the U.S. government has provided more than $100 billion through the President’s Emergency Plan for AIDS Relief (PEPFAR) program toward combating HIV infections and AIDS worldwide. The PEPFAR program has prevented millions of new HIV infections and saved more than 20 million lives in over 50 countries.However, in ourDecember 2022 reportabout the Department of State’s (State’s) management of this program, we found staff vacancies may hamper efforts.  For example, 70% of PEPFAR headquarters positions are vacant and 89% of key overseas positions are vacant. This has led to workload and morale issues among PEPFAR staff. We also found longstanding coordination challenges between State’s headquarters and overseas officials. This too could hamper implementation of PEPFAR’s life-saving activities.While State has taken actions to improve coordination, it has not identified and addressed the underlying causes of PEPFAR staffing vacancies. To learn more about State’s challenges in managing the PEPFAR program and our recommendations, read ourreport.**The President's Emergency Plan For AIDS Relief funded activities to combat HIV/AIDS in these countries in FY 2022**Image
              Global map showing countries that received funding through PEPFAR in FY 2022.**The bigger picture******To meet the challenges of future global health crises, U.S. government agencies need the right number of staff with the right skills and leadership. This helps to foster a positive organizational culture and better positions U.S. efforts to respond quickly. USAID’s Bureau for Global Health manages crisis response and other efforts. Butwe foundsome similar challenges (to those discussed above) in the Bureau’s management.**Aligning resources with need.** Of the Bureau’s three strategic priorities, the two receiving the most funding—preventing child and maternal deaths and combating infectious diseases—have far fewer staff working on them than the third, HIV/AIDS. We think the Bureau needs a workforce plan to better align staffing with funding and evaluate future staffing needs.******Leadership.** Negative leadership behaviors without accountability have also been a persistent problem, according to Bureau officials. The Bureau has taken some initial steps to address these issues. But we think it needs a more comprehensive approach.**Learning from the past.** We also found that the Bureau has not documented its lessons learned from COVID-19 and does not assess its performance at a bureau-wide level. Doing so is key to improving the response to global health emergencies.**Examples of Programming Funded by the Bureau for Global Health******Image
              Photos showing a medical worker taking the blood pressure of a child, medical supplies, and a lap technician looking through a microscope.Learn more about our work on****USAID’s Bureau for Global Health by readingour report.GAO’s fact-based, nonpartisan information helps Congress and federal agencies improve government. The WatchBlog lets us contextualize GAO’s work a little more for the public. Check out more of our posts atGAO.gov/blog.
TopicsHealth Care
              International Affairs
                        Department of State
              U.S. Agency for International Development
                        Global health
              Epidemics
              Pandemic
              Coronavirus
              AIDS prevention
                        International Affairs and Trade
GAO Contacts
    
      Chelsa L. Kenney
      
              Chelsa L. Kenney
            
            Director
      
            kenneyc@gao.gov
      
            (202) 512-2964
    Latesha Love
      
              Latesha Love-Grayer
            
            Director
      
            lovegrayerl@gao.gov
      
            (202) 512-4409
		
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Related Products
					President's Emergency Plan For AIDS Relief: State Has Taken Actions to Address Coordination Challenges, but Staffing Challenges PersistProduct Number
              GAO-23-105347

	Published:  Dec 12, 2022


	Publicly Released: Dec 12, 2022
							USAID: Management Improvements Needed to Better Meet Global Health MissionProduct Number
              GAO-23-105178

	Published:  Jun 09, 2023


	Publicly Released: Jul 10, 2023
							COVID-19: USAID Plans to Share Lessons Learned from Efforts to Meet Global Vaccination GoalProduct Number
              GAO-23-105579

	Published:  Sep 27, 2023


	Publicly Released: Sep 27, 2023
About WatchblogGAO's mission is to provide Congress with fact-based, nonpartisan information that can help improve federal government performance and ensure accountability for the benefit of the American people. GAO launched its WatchBlog in January, 2014, as part of its continuing effort to reach its audiences—Congress and the American people—where they are currently looking for information.

The blog format allows GAO to provide a little more context about its work than it can offer on its other social media platforms. Posts will tie GAO work to current events and the news; show how GAO’s work is affecting agencies or legislation; highlight reports, testimonies, and issue areas where GAO does work; and provide information about GAO itself, among other things.

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