New Agreements for Funding Global HIV Program Miss the Mark 

Today, amfAR is releasing a report on the America First Global Health Strategy’s first set of seven publicly available Memoranda of Understanding (MOUs) with the countries of Ethiopia, Kenya, Liberia, Mozambique, Nigeria, Rwanda, and Uganda. The report, Unmeasurable and Unaccountable, dives into the metrics established in the MOUs to hold the PEPFAR program accountable to continued success in fighting the global HIV epidemic while gradually transitioning the program from U.S. taxpayer dollars to country-level ownership. 

While the MOUs provide an opportunity to potentially drive additional domestic resources toward health programming and an opportunity for establishing long-term sustainable programming, our analysis finds several key limitations, outlined below. 

• Flawed initial set of metrics: The metrics are incapable of providing any basis for reasonable and necessary oversight of U.S. global health assistance funds by Congress or any other external entity. 
• Ineffective set-up for useful future metrics: The MOUs have failed to set up the necessary transition to more meaningful metrics for the next phase of the HIV epidemic. 
• Lack of data transparency complicates accountability: The confidentiality provisions around data and transparency all but establish that no one outside the U.S. government and foreign Ministry of Health will have access to any information about how the health system is performing after the transition. 

“We are being put in the position that U.S. taxpayers, in order to do any oversight of the tens of billions of dollars being allocated to these MOUs, must go ask permission from a foreign government to do oversight of American dollars. That’s unacceptable,” Brian Honermann, Deputy Director of amfAR’s Andelson Office of Public Policy, and the primary author of the report, said. 

“PEPFAR is our country’s most successful global health program because of its transparency, ambitious target-setting, and organizational structure. Gutting what made the program impactful will squander millions of U.S. taxpayer dollars and may place just as many lives at risk,” Greg Millett, VP and Director of Policy at amfAR, said. 

Read the full report here.