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USAID helped spark the Green Revolution when research, development, and technology transfer initiatives combined to boost agriculture production in India and around the world. As part of the principals agreed upon at the 2009 G8 Summit in L’Aquila, we are building on this history of success through:

f _{Country-led process:} In December 2009, the Government of Rwanda

became the first country to submit an Agriculture Sector Investment Plan for technical review under the auspices of the Comprehensive Africa Agriculture Development Program (CAADP). The Investment Plan was reviewed by a broad group of stakeholders including donor countries, the private sector, civil society, and multilateral institutions.

f _{Private sector engagement:} In Tanzania, the World Economic Forum and

eight major companies are jointly developing agribusiness and infrastructure along the country’s southern trade corridor. They are also helping to provide fertilizer, sourcing sustainable products to foster demand, and providing technical assistance to local millers.

f _Partnering: In Ghana, we are working directly with the Government of

Ghana and other major donor states and organizations to chart a unified, ef- ficient path to food security. This effort builds directly on the agricultural work of the Millennium Challenge Corporation and USAID and has established an active role for the U.S. in donor coordination.

f _Research: USAID’s Collaborative Research Support Programs, or CRSPs,

harness the capabilities of U.S. land-grant universities. USAID recently awarded $1.1 million in funding to Oregon State University to research ways to increase profits for small aquaculture operations in Ghana, Kenya, and Tanzania.

Global Health and the GHI

The United States is committed to bringing life-saving prevention, treatment, and care to more people in more places. People cannot achieve their potential or contribute to eco- nomic growth when their health is poor and they lack access to health systems. We invest in global health to strengthen fragile and failing states, to promote social and economic progress, to protect America’s security, as tools of public diplomacy, and as an expression of our compassion.

While the U.S. recognizes that development is fundamental to health and vice versa, cer- tain public health functions are distinct from development and are critical to sustain healthy populations in America and globally. For instance, we would invest in global health to protect Americans from disease independent of our development interests. Similarly, the regulation of pharmaceuticals and vaccines produced globally can significantly impact Americans in many ways not necessarily linked to development.

The United States, already compelled to prioritize global public health for many reasons, has clear expertise in helping other countries improve health outcomes and develop their health systems. Our assistance programs have helped to save tens of millions of lives over the last 50 years by advancing public health through clean water delivery, vaccines, and health services for mothers and children, among others. But this success has come at a cost. As the largest funder of health programs in many countries, we have saved lives and improved livelihoods, but our as- sistance dollars have sometimes had the unintended effect of relieving our partner governments of their responsibility for funding this basic service. Too often, there is too little coordination between donors, too little integration of programs, and too little innovation in new technolo- gies and approaches.

Through the Global Health Initiative, we are drawing together the expertise of other govern- ment agencies such as Health and Human Services including the Centers for Disease Con- trol and Prevention. The GHI builds on the successful foundation of disease-specific health programs including the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by President Bush in 2003, the President’s Malaria Initiative, global health programs in maternal and child health, and many others. GHI seeks to achieve improved disease prevention and treat- ment, strengthened health systems, enhanced maternal and child health, improved outcomes for neglected tropical diseases, and increased research and development.

Success of GHI is predicated on building and leaving behind sustainable platforms through which to manage, oversee, and operate basic care and health services in partner countries. Ulti- mately handing these platforms over to host governments will require that we work with these countries from the outset—ensuring they lead in designing and implementing comprehensive, tailored health strategies with cost effective, evidence-based interventions that have the greatest potential for maximum global health impact; and that they grow their own capacities to operate health programs over the long term.

In building USAID as the premier development agency and recognizing the need to sustain critical momentum in achieving health outcomes, the Secretary will appoint an Executive Direc- tor for the Global Health Initiative at the State Department to facilitate: (1) the coordination

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of agency programs to meet the goals and objectives of GHI; and (2) the ultimate transition of leadership of GHI to USAID as below. The Executive Director will report to the Secretary of State and the GHI Operations Committee (the USAID Administrator, the Global Aids Coordinator, and the Director of the Centers for Disease Control and Prevention), which will continue to ensure inclusive interagency oversight and management of the Initiative.

We have established a target that at the end of FY 2012, pending the completion of a set of de- fined benchmarks (attached at Appendix 2), USAID will assume leadership of this interagency Initiative. The determination that USAID has met the benchmarks in Appendix 2 will be made by the Secretary of State, drawing on the assessment of the GHI Operations Committee. The responsibility for leading PEPFAR, following current practice and its governing statute, will re- main with the Office of the Global AIDS Coordinator (OGAC) at the State Department. The GHI Strategic Council will also continue to provide the Initiative with high-level interagency advice and guidance on meeting the goals and objectives of the Initiative.