Two Steps Forward for Development—and for Global Security
The Bush administration has added two major new programs to the U.S. development assistance portfolio: The Millennium Challenge Account (MCA) and the President’s Emergency Plan for AIDS Relief (PEPFAR). These came in the wake of 9/11 and reflect the administration’s heightened awareness about the interconnectedness of poverty and global security.
In launching the MCA, the president explicitly made the connection between poverty and fighting terrorism: “We also work for prosperity and opportunity because they help defeat terror. Yet persistent poverty and oppression can lead to hopelessness and despair. And when governments fail to meet the most basic needs of the people, these failed states can become havens for terror.”18
Through PEPFAR, the United States has helped more than two million people, most of them in Africa, to get on lifesaving anti-retroviral medication. In Africa, neither the burden of HIV/AIDS nor the threat the disease poses to the stability of the continent can be overstated. The establishment of PEPFAR reflects the U.S. government’s recognition of the transnational threat posed by global pandemics. “The surest long-term strategy for addressing transnational threats is to promote the health, stability, and economic well-being of developing nations, and confronting HIV/AIDS is at the heart of this strategy,” explained Mark Dybul, U.S. Global AIDS Coordinator, in 2007 congressional testimony.19
The Millennium Challenge Account (MCA) is an innovative program and a pronounced break from the way the United States has traditionally provided development assistance. It is designed to respond to good governance, promote country “ownership” of projects, and ensure a reliable stream of funding for three to five years. The MCA meets most of the components of effective development assistance as discussed in Chapter 2, and which are so often lacking from other U.S. development programs. At a time when the MDGs and numerous independent studies of aid effectiveness call for greater country and local level “ownership” of foreign assistance, with the exception of the MCA, the U.S. government has been moving in the opposite direction.
Countries that receive MCA funding are selected based on a set of independently established social, economic and governance indicators. Those that meet the criteria are invited to submit proposals for major grants, or “compacts,” that are designed to have a transformative effect on reducing poverty. So far 16 countries have signed compacts and funding has averaged roughly $1.5 billion per year over the past four years.
A new organization, the Millennium Challenge Corporation (MCC), was established to run the program. MCC procedures call for proposals to be developed in consultation with civil society, including non-governmental organizations and the private sector. Upon approval, the recipient countries are then responsible for implementation. In return, the MCC demands greater accountability for achieving results.
This innovative program got off to a slow start, and the process of putting developing countries in the driver’s seat in planning and implementation is taking longer than originally anticipated. Despite delays, the MCA is being closely watched for its potential relevance as a new model for development assistance.
The President’s Emergency Plan for AIDS Relief (PEPFAR) was announced in the President’s 2003 State of the Union Address and enacted later that year. The initiative resulted in an increase in U.S. funding for international HIV/AIDS from $5 billion to $15 billion over five years, with a focus on 15 countries suffering high-infection rates. Most of the countries are in sub-Saharan Africa, but also includes programs in Haiti and Vietnam. PEPFAR, unlike other development assistance programs, is highly focused, with reliable funding, clear objectives and verifiable indicators of effectiveness (e.g., number of people receiving anti-retroviral therapy). PEPFAR is administered by a special Office of the Global AIDS Coordinator in the State Department.
The concern with PEPFAR is that its approach is overly narrow, and that in the Washington budget battles it has served to “crowd out” funding for other complementary programs, for example, economic development, water and sanitation (the absence of which claim many more lives each year than HIV/AIDS) or governance.
