Effective Foreign Assistance: Successes and Asks

The ONE Campaign urges Congress to:

• Sustain funding for high-impact programs like the President’s Emergency Plan for AIDS Relief (PEPFAR), Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Millennium Challenge Corporation (MCC), the Development Finance Corporation (DFC), and the International Development Association (IDA). These proven investments save millions of lives, build stable partners, and keep Americans safe.
• Require details about what programs the administration proposes to cancel or keep, and why.
• Assert Congress’s essential role in advancing effective and innovative foreign assistance.

Saving Lives

Key U.S. global health investments save millions of lives, promote stability worldwide, and protect Americans by reducing the threat of emerging diseases reaching our shores.

The President’s Emergency Plan for AIDS Relief (PEPFAR)

• In addition to saving 26 million lives, PEPFAR’s phenomenally successful global fight against HIV/AIDS promotes long-term growth. Per capita GDP growth in PEPFAR countries was nearly 50% higher than it would have been without PEPFAR, and children’s out-of-school rates have been nearly reduced by nearly 10%.
• The U.S. is laying the groundwork for country self-sufficiency. Over half of PEPFAR’s funds go to local partners, and its latest five-year strategy focuses on strengthening local health systems and sustainability.
• Without U.S. PEPFAR support global progress would reverse, with a potential sixfold increase in HIV infections and tenfold increase in AIDS-related deaths (to 6.3 million, orphaning 3.4 million children) by 2029.

Gavi, the Vaccine Alliance

• Gavi is a public-private partnership that gives millions of children access to vaccines. Children in Gavi-supported countries are 70% less likely to die from a preventable disease before their fifth birthday than when the program began in 2000. Increasing life expectancy by just one year can lead to a 4-5% increase in GDP, and every $1 invested in immunization returns an estimated $54 in wider economic benefits, including savings in health care costs and lost wages and productivity.
• Gavi drives self-sufficiency and savings: 19 countries have graduated from Gavi support and are self-financing. By 2030, over 25% of the original lower-income countries supported by Gavi will be fully funding their own programs. Gavi’s success in reducing vaccine costs has generated more than $300 million in savings.

The Global Fund to Fight AIDS, Tuberculosis, and Malaria (The Global Fund)

• Created in 2002 as a global public-private partnership to coordinate investments to fight HIV, TB, and malaria, the Global Fund has helped save 65 million lives – nearly the population of Texas and California combined. The Global Fund has reduced TB deaths by 36% and malaria deaths by 28%.
• Every $1 invested in the Global Fund generates estimated returns of $31 in health and economic benefits.
• Between 2002 and 2023, the Global Fund’s investments have generated an estimated $400 billion in direct economic gains due to improvements in workforce productivity.
• The Global Fund requires recipient governments to pay for a portion of the program, encouraging countries to increase their own domestic health spending and move away from reliance on external aid.

Economic Development and Poverty Alleviation

U.S. investments in economic development have helped lift hundreds of millions of people out of extreme poverty, contributed to economic growth, and significantly expanded peace and prosperity. In 2000, more than 1 in 4 people lived in extreme poverty. Today that number is fewer than 1 in 10, thanks in large part to U.S.-led economic development programs.

• The African Growth and Opportunity Act (AGOA) is the cornerstone of U.S. economic engagement in Africa, which is home to 9 of the world’s 20 fastest growing economies. AGOA has helped U.S. companies gain access to key African markets and diversify their supply chains. It supports nearly 120,000 American jobs here at home and has helped create hundreds of thousands of new jobs in Africa. Two-way goods trade with sub-Saharan Africa has increased by nearly 30% since 2015.
• The Millennium Challenge Corporation (MCC) is a U.S. government international assistance agency established in 2004 that works to reduce poverty through sustainable economic growth by partnering with countries that demonstrate a commitment to good governance and economic freedom. The MCC stands out for its commitment to transparency, competitive selection process, and focus on country-led solutions.

The U.S. does not work alone. Partnerships with the private sector and multilateral development banks unlock development finance and maximize the impact of U.S. investments.

• By mobilizing private capital, the U.S. International Development Finance Corporation (DFC) committed a record $12 billion last year to projects driving economic growth and advancing U.S. strategic interests. With a $50 billion portfolio of active investments in 114 countries (with Africa being its largest market), the DFC is competing with the People’s Republic of China (PRC), whose predatory lending practices are seeking to expand China’s influence around the world.
• The World Bank’s International Development Association (IDA) serves the world’s poorest countries with low-interest loans and grants, assisting their development toward self-sufficiency. Every $1 the U.S. contributes catalyzes approximately $27 in additional IDA resources. Between 2012 and 2023 IDA support provided 1.18 billion people with essential health services, 117 million people with improved access to water, and 92 million people with new or improved electricity services. Since 1960, 36 countries have graduated from being supported by IDA to becoming IDA donors.

ONE’s Government Relations Team