Leadership changes at USAID
Authors: Susan Jaffe
Journal: The Lancet (2020)

Mark Green, the respected head of the US Agency for International Development, has resigned. Susan Jaffe reports from Washington. Mark Green, administrator of the US Agency for International Development (USAID), is a rarity in Washington, DC—an appointee of President Donald Trump's administration who is respected by both Republicans and Democrats. He also has earned high marks from global health advocates. But last week he announced he we leave his post on April 10. His departure has raised some concerns about the agency's role as coronavirus disease 2019 (COVID-19) takes hold in more corners of the world. Green is expected to become president of the McCain Institute for International Leadership, established by the family of the late Senator John McCain at Arizona State University. When Green was president of the International Republican Institute, before joining USAID in 2017, he worked with McCain. Green was recruited by McCain's widow when the institute began looking for a new president. During his USAID tenure, Green became known for his efforts to shift the agency's focus. “We believe the purpose of foreign assistance must be ending its need to exist”, he told reporters at a meeting in Munich, Germany, in February. But, he added, that does not mean “walking away” from its partners. “Instead… where we have partners who are willing to do the difficult things that are necessary to get to self-reliance, we feel an obligation to walk with them along the way.” Green will be “sorely missed”, said Senator Bob Menendez of New Jersey, the senior Democrat on the Senate Committee on Foreign Relations, in a statement. “Faced by an administration that has relentlessly sought to cut foreign development and humanitarian relief programs it incorrectly views as charity, I sincerely appreciated Administrator Green's commitment to defending programs and funds that are proven to advance U.S. national security, help lift up the world's most impoverished, and build resilient and prosperous communities…” “The timing is unfortunate”, said Jen Kates, senior vice president and director for global health and HIV policy at the Kaiser Family Foundation. “The agency is going to be significantly challenged by the COVID-19 pandemic, potentially at a level that it has not seen before.” USAID has received up to US$100 million to battle COVID-19 in developing countries. The agency also supports various global health programmes, including the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Malaria Initiative, and maternal and child health, family planning and reproductive health, nutrition, and environmental health programmes. As a Republican member of Congress representing a Wisconsin district, Green worked on the PEPFAR legislation during the George W Bush administration. In 2007, he was named ambassador to Tanzania. His background in international development and diplomacy along with his Washington experience made him “a natural” for the job, said Liz Schrayer, president and chief executive officer of the US Global Leadership Coalition. “He was able to preserve bipartisan support in Congress for [global health] programmes that were under siege from the White House”, said Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies. “He was able to navigate the realities of the Trump administration and defend the notion of bipartisanship for the mission of doing good in the world through foreign assistance.” A day after Green's announcement that he was leaving, Trump named his replacement: USAID's assistant administrator for Latin America and the Caribbean, John Barsa. Before joining USAID 9 months ago, Barsa had been working in various leadership positions at the Department of Homeland Security since 2017, including as acting assistant secretary. Barsa takes over as USAID confronts COVID-19, an increasing refugee crisis as millions of Venezuelans flee their country, and growing food insecurity around the world. During a congressional hearing earlier this month, Green faced questions about these challenges, as well as the administration's proposed global health budget cuts. He was also asked about the Trump administration's controversial policy denying health care funding overseas to providers who also offer family planning or abortion services or information about how to obtain these services. Barsa is largely unknown in the global health community, among whom there are worries that he might be more closely aligned with Trump than Green was, and might support the administration's proposed funding cuts for the agency. The concerns of the global health community are unlikely to get a public hearing since Barsa is among several Trump appointees serving in an acting or temporary capacity that sidesteps the Senate confirmation process.