What GAO Discovered
The U.S. Company for Worldwide Growth’s (USAID) Bureau for World Well being’s (Bureau) staffing will not be aligned with its mission and priorities. Greater than half of the Bureau’s workforce consists of contractors who USAID has decided can’t carry out inherently governmental features. These features embrace overseeing the Bureau’s contracts and grants—its main mechanisms for implementing its programming. As well as, the distribution of the Bureau’s workers is inconsistent with its program funding ranges. Particularly, the Bureau has the best variety of workers engaged on HIV/AIDS programming, however receives much less funding for this programming in contrast with its different strategic priorities—stopping youngster and maternal deaths and combating infectious ailments. Regardless of these challenges, the Bureau lacks a workforce plan, leaving it with restricted skill to deal with its present and future staffing wants.
Bureau efficiency assessments have gaps on the Bureau and program ranges. The Bureau doesn’t have indicators for bureau-wide efficiency that measure progress for every of its strategic priorities, or throughout them. Speaking the Bureau’s total efficiency can also be difficult on account of variations in its information. Whereas the Bureau assesses program degree efficiency for its well being program areas, its experiences to Congress in a few of these areas don’t all the time embrace key info. For instance, experiences on maternal and youngster well being don’t comprise outcomes for 18 nations that acquired greater than $200 million between fiscal years 2019 and 2021. By assessing its bureau-wide efficiency, harmonizing its information, and enhancing its experiences, the Bureau can higher consider and talk its outcomes and improve the standard of the knowledge it’s offering to Congress.
Examples of Programming Funded by the Bureau for World Well being
The Bureau has just lately confronted a number of challenges to its skill to execute its mission and priorities. These have included challenges posed by the COVID-19 pandemic, together with disruptions to current well being companies. The Bureau took steps to deal with COVID-related challenges, resembling by offering lengthier provides of medicines throughout lockdowns. Nonetheless, whereas some USAID missions have documented classes realized from the pandemic, the Bureau has not. Doing so may assist the Bureau higher reply to future world well being emergencies. Lastly, although the Bureau has recognized unfavorable behaviors that have an effect on its tradition, it has not but institutionalized its efforts to deal with them.
Why GAO Did This Research
The Bureau helps U.S. efforts to avoid wasting lives, defend the folks most weak to illness, and promote the steadiness of communities and nations all through the world. From fiscal years 2019 by way of 2022, the Bureau had an annual finances between $1 billion and $1.4 billion. The COVID-19 pandemic has highlighted the significance of the Bureau’s work to U.S. international coverage. To answer illness outbreaks and assist current well being programming, the Bureau requires a workforce with quite a lot of ability units. Its skill to evaluate its efficiency is vital to its preparation for future well being crises.
GAO was requested to assessment the Bureau’s operations. This report examines (1) the Bureau’s staffing and its workforce plans; (2) its efficiency assessments; and (3) key components that have an effect on the Bureau’s skill to execute its mission and priorities, and the steps it has taken to deal with them. GAO analyzed USAID staffing information and world well being experiences. GAO additionally interviewed USAID officers in Washington, D.C., and at 5 abroad missions, chosen based mostly on components resembling geography, quantity of funding, and variety of well being program areas.