The U.S. House of Representatives Foreign Affairs Committee recently issued a concept paper on foreign aid reform. The paper asserts that existing U.S. foreign assistance laws are outdated and inadequate for responding to 21st century global challenges. To address this problem, the paper suggests 11 changes that would help make the U.S. system of applying foreign assistance more practical and effective.
In order to highlight some of the concerns raised by the concept paper, the Infectious Diseases Society of America, along with at least two dozen other organizations, issued this response. While acknowledging that the concept paper "has a valuable focus on performance-based and needs-based foreign aid," the response identifies seven areas of concern related to U.S. global health policy, including policy specific to HIV/AIDS and other conditions:
1. Global health must continue to be the foundation of foreign aid.
2. Prevention, care, and treatment of HIV/AIDS, TB, malaria, and other infectious diseases must be a stand-alone goal, and not simply a subset of health care.
3. Authorization levels and policy provisions of PEPFAR must be preserved.
4. Aid must be consistent with the priorities of the countries and communities that receive it and must be flexible enough to make use of local capacity.
5. Use of funds and evaluation of performance must be transparent.
6. Changes in administrative reporting structure must not undermine what currently works well, specifically related to the Office of the Global AIDS Coordinator.
7. Existing authorization levels for aids related to HIV/AIDS, TB, and malaria must be maintained.