Child Survival and Disease Programs Fund Accounts, Guidance, and Coding March 12, 2001

PAY ATTENTION!

Agenda 1. Take Home Message 2. Congressional Requirements and Agency Policy 3. What’s New 4. Discussion

4 Commandments of CSD Follow the CSD Guidance Use Earmarked Funds for Their Intended Purpose – No substitution Document Decisions Integrated programs Coding is Important

Congressional Interest Increased Funding Annual Reporting Strong Interest Groups Frequent Inquiries Including: Expanding Definition of CSD Integrated Programs (e.g., CSD and Pop) GAO/IG Audits Details of Activities Congressional Requirements

FY 2001 HACFO Report Language HACFO Section: “Preserving the integrity of the Child Survival and Disease Program’s Fund” Language noted: USAID “… should not combine... activities funded from the account with... activities funded from other accounts, except with the prior agreement of the Committee” Programs combining CSD and DA/Pop funds Requires special notification and justification or establishment of a series of separate programs.

Agency Policy on CSD Funds Direct Impact Measurable results of a specific Agency PHN objective e.g., Enhancing positive behavior change among HIV high-risk populations can reduce the transmission of HIV/AIDS. Optimal Use of Funds Priority for most effective and efficient activities Produce the greatest impact on the objective

What’s New? Account Structure and Directives Guidance Coding

Child Survival and Maternal Health Vulnerable Children HIV/AIDS Infectious Diseases Basic Education for Children New Budget Categories Child Survival HIV/AIDS Other Infectious Diseases Other Health Basic Education for Children OLD NEW

Child Survival and Maternal Health Including Line Items: Primary causes of mortality and morbidity Polio Micronutrients Global Alliance for Vaccines and Immunizations Tagged and Tracked Separately

Special Considerations: Prohibition on purchase of contraceptives Co-programming with FFP Title II Can use CSD funds for health system strengthening Child Survival and Maternal Health

Vulnerable Children Includes: Displaced Children and Orphans Fund (DCOF) Blind children (BHR/PVO managed) HIV/AIDS affected children, including orphans Designed to Address: Children affected by war Children affected by HIV/AIDS Street children Trafficking

HIV/AIDS C ore HIV/AIDS Funds: Prevention Care and Support Surveillance 2001 Directives: Vulnerable children Mother-to-child transmission Use of NGOs Microbicides Research International AIDS Trust Fund IAVI

HIV/AIDS Special Considerations Co-Programming and Multisectoral Programs Commodities Addressing HIV/AIDS in Military Agencies only if:  Part of a larger public health initiative;  Same as that for civilian groups; and  Can not be readily adaptable for military purposes.

Infectious Diseases Includes: Tuberculosis Malaria Other Infectious Diseases  AMR  Surveillance  Other infectious diseases Funds for TB and Malaria Tagged & Tracked Malaria Programs

Mixing CSD and Pop Funds Cannot use child survival funds for purchase of contraceptives. However, can use HIV/AIDS funds to purchase condoms for HIV/AIDS programs. Cannot use CSD Funds to make up for shortfalls in Population Funding or in any other program. Can mix CSD and Pop Funds in a single program, but Must Ensure that the balance of funds matches appropriate kinds of activities.

Mixing CSD and Pop Funds Can use child survival funds for birth spacing - where spacing efforts part of a predominantly child survival program and part of objective to reduce infant/child mortality. Can use CSD/CSMH funds for maternal health interventions, including maternal survival. Can use DA/Pop funding for reproductive health interventions related to maternal health within context of larger FP program. Can use either DA/Pop or CSD/CSMH funding for breastfeeding programs.

USAID Policy - Use of CSD Funds Allows Activities Included in the CSD Guidance Allows Funding to Be Used in Other Sectors IF the Activity contributes Directly to CSD Objectives, has a Measurable Impact, and is the Optimal Use of CSD Funds (Review Procedure Required) Any Use of CSD Funds Requires Justification in CSD Terms

Budget Constraints

Outside the CSD Guidance Prior Approval from PPC and G/PHN Concurrence by Regional Bureau Technical Staff Clearance from GC

Directives and Coding Example; not up-to-date

How EA Coding is Used Telling the story of USAID’s programs Congress Other partners Reveals implications of funding cuts Answers frequent questions without special field reporting, how much for immunization? How much for maternal health funding? Inaccuracies undermine USAID’s credibility

Inaccurate Coding: The Immunization Story

Take Home Message Follow the CSD Guidance Use Earmarked Funds for Their Intended Purpose – A void substitution Document Decisions Integrated programs Coding is Important