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With help of private industry, USAID review finds $2.9 billion for maternal, child health

Faced with the daunting task of starting an ambitious program in global child and maternal health during a depressed funding climate in Washington, Rajiv Shah knew just where to turn for advice: private industry.

In an unusual move last year, Shah, head of the U.S. Agency for International Development, convened an external panel that included corporate executives and millionaire philanthropists to review every dollar the agency spent and hunt for inefficiencies.

On Wednesday, Shah plans to announce the results of that effort: The group found $2.9 billion — or nearly 15 percent of the agency’s $20 billion annual budget — that could be “realigned” to child and maternal health over the next three years. He said the money will help save 500,000 lives.

“They came up with a lot of things we didn’t think about,” Shah said in an interview.

Although the U.S. government has turned to business for help on countless occasions throughout its history, the scope and the structure of the collaborations have become more ambitious and inventive under the Obama administration. The impact has been most visible in health care, which has been a priority for the president and a popular cause for corporate philanthropists.

U.S Agency for International Development Administrator Rajiv Shah speaks to journalists and staff members, at Mbagathi District Hospital in Nairobi, Kenya. (Khalil Senosi/AP)

In February, National Institutes of Health Director Francis Collins announced that the NIH had formed a pact with 10 drug companies to share scientists, tissue and blood samples, and data with one another and with the government to accelerate the search for treatments for Alzheimer’s, Type 2 diabetes, rheumatoid arthritis and lupus.

And in mid-October, when was repeatedly crashing, the White House called in reinforcements from Google and other leading tech companies. The Web site was revived faster than anyone expected.

Although the involvement of big business or big philanthropy in government affairs may make some people uncomfortable and raise concerns that participants could be using taxpayer programs to further their own interests, advocates of the approach argue that the government is simply tapping the corporate world for new ideas, and at no cost.

Ray Chambers, who chaired the USAID advisory panel and is a former private equity investor, said the corporate world’s most valuable asset is its quantitative approach to assessing the impact of initiatives.

“If we can’t measure results, then we are not sure we’ve accomplished anything,” said Chambers, who is the United Nations special envoy for financing the Health Millennium Development Goals.

Since Shah left the Bill & Melinda Gates Foundation to join USAID in 2009, he has shaken up the bureaucracy of the Kennedy-era agency by trying experimental approaches to fulfilling the agency’s goal of alleviating poverty.

“When I came here 41 / 2 years ago, I knew my focus had to be on making sure USAID was fully adapting to a new model of development that requires a much greater focus on making sure every taxpayer dollar brings maximum value for money and results,” Shah said.

One of the agency’s priorities has been on preventing maternal and child deaths worldwide. Because of new drugs and diagnostics, the number of deaths has fallen nearly 50 percent from 1990 to 2012, to 6.6 million, and Shah and his counterparts around the world think they can get the number down to nearly zero.

Jeffrey Walker, a former JP Morgan vice chairman who helped develop a course at Harvard University on social enterprise, was a member of the panel that worked on child and maternal health. He said the team started out by reviewing 60 large contracts and found that some of them had functions that could be consolidated, such as duplicate supply chains for malaria drugs and vaccines.

Additionally, the panel recommended reducing programs to the middle class to focus on the poor and cutting the budget for technical-support consultations that involve a lot of travel for staff members.

On Wednesday, USAID plans to announce that it is using some of those savings to fund $500 million in new awards that will support high-impact interventions — including efforts to collect more data about what programs are working. USAID also will partner with Coca-Cola and other groups to invest more than $21 million in a program that will expand the use of the beverage maker’s delivery system to transport critical medicine and supplies such as oral rehydration packets, zinc and malaria treatments to rural communities in Africa.

“In too many villages, you can get a Coca-Cola but you can’t get a simple amoxicillin,” Shah said.

Ariana Eunjung Cha is a national reporter. She has previously served as the Post's bureau chief in Shanghai and San Francisco, and as a correspondent in Baghdad.



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