When it involves communicable ailments, it seems, it is a small world in spite of everything. Serious ailments like COVID-19, AIDS, and mpox (beforehand often called monkeypox) can transfer rapidly across the globe—threatening lives and livelihoods. The U.S. performs an essential position in working with world companions to stop the unfold of ailments like these. 

Today, for World Health Day (April 7), the WatchBlog appears at our latest work on key U.S. companies’ efforts to stop the unfold of ailments and the challenges these efforts face. 

USAID supported COVID-19 vaccinations in indigenous communities in Guatemala

USAID’s Efforts to Increase COVID-19 Vaccination Rates 

In response to the COVID-19 pandemic, the U.S. authorities pledged to assist attain a worldwide objective of vaccinating 70% of the world’s inhabitants in opposition to this illness. The U.S. Agency for International Development (USAID) obligated an estimated $904 million, as of March 2023, to assist 125 international locations put together for and ship vaccines. 

For instance, in Malawi, USAID help helped present “cold chain” tools wanted to retailer vaccines at required temperatures. In South Africa, a USAID implementing companion created an app to indicate customers the closest vaccination facilities and the manufacturers of vaccines supplied there. 

But, regardless of these efforts, as of July 2023 vaccination charges had not reached 50% in virtually two-thirds of the international locations the place USAID supplied help. USAID officers and people in international locations assisted highlighted plenty of challenges that contributed to not assembly the 70% objective. Some reported challenges akin to misinformation and vaccine hesitancy. Others stated there have been shortages of educated well being care employees to manage vaccines. And in some instances, it was troublesome to achieve distant areas to supply vaccines. 

Our video under discusses a few of these challenges and classes realized. USAID officers told us they plan to share classes realized from these points to assist its companions put together for future pandemics. 

Staffing challenges pre-date COVID-19 response. They have been seen in world HIV/AIDS program

Even earlier than COVID-19, there have been persistent staffing challenges in response to different world well being crises—for instance, HIV/AIDS.

Over the previous twenty years, the U.S. authorities has supplied greater than $100 billion by the President’s Emergency Plan for AIDS Relief (PEPFAR) program towards combating HIV infections and AIDS worldwide. The PEPFAR program has prevented hundreds of thousands of latest HIV infections and saved greater than 20 million lives in over 50 international locations.

However, in our December 2022 report in regards to the Department of State’s (State’s) administration of this program, we discovered workers vacancies could hamper efforts.  For instance, 70% of PEPFAR headquarters positions are vacant and 89% of key abroad positions are vacant. This has led to workload and morale points amongst PEPFAR workers. We additionally discovered longstanding coordination challenges between State’s headquarters and abroad officers. This too may hamper implementation of PEPFAR’s life-saving actions.

While State has taken actions to enhance coordination, it has not recognized and addressed the underlying causes of PEPFAR staffing vacancies. To study extra about State’s challenges in managing the PEPFAR program and our suggestions, learn our report.

The President’s Emergency Plan For AIDS Relief funded actions to fight HIV/AIDS in these international locations in FY 2022

The larger image 

To meet the challenges of future world well being crises, U.S. authorities companies want the precise variety of workers with the precise abilities and management. This helps to foster a constructive organizational tradition and higher positions U.S. efforts to reply rapidly. USAID’s Bureau for Global Health manages disaster response and different efforts. But we found some related challenges (to these mentioned above) within the Bureau’s administration.  

Aligning sources with want. Of the Bureau’s three strategic priorities, the 2 receiving essentially the most funding—stopping little one and maternal deaths and combating infectious ailments—have far fewer workers engaged on them than the third, HIV/AIDS. We assume the Bureau wants a workforce plan to raised align staffing with funding and consider future staffing wants. 

Leadership. Negative management behaviors with out accountability have additionally been a persistent drawback, in response to Bureau officers. The Bureau has taken some preliminary steps to deal with these points. But we expect it wants a extra complete method. 

Learning from the previous. We additionally discovered that the Bureau has not documented its classes realized from COVID-19 and doesn’t assess its efficiency at a bureau-wide degree. Doing so is essential to bettering the response to world well being emergencies. 

Examples of Programming Funded by the Bureau for Global Health

Learn extra about our work on USAID’s Bureau for Global Health by studying our report. 

• GAO’s fact-based, nonpartisan info helps Congress and federal companies enhance authorities. The WatchBlog lets us contextualize GAO’s work a bit of extra for the general public. Check out extra of our posts at GAO.gov/blog.