Gerson and Shah: What results-based development can do for global health

The Center for Global Development (CGD) recently hosted a discussion on the future of U.S. foreign assistance with Dr. Raj Shah, former Administrator of the U.S. Agency for International Development (USAID), and Michael Gerson, Washington Post columnist, policy fellow with the ONE campaign, and former speechwriter for President George W. Bush. In both of their discussions at CGD and online, Shah and Gerson focus on results-based development as the way to move U.S. foreign assistance forward.

“Results are about, in my view, using American assistance to create human opportunity and to end extreme poverty around the world,” said Shah. He argues that to be effective in development, you have to know what you’re trying to achieve, measure it, and adapt to findings to ensure the delivery of effective results.

Gerson highlighted the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) – both implemented by President Bush – as two examples of effective U.S. foreign assistance “that are designed for outcomes and are good for America in the long-term.” He described the steady bipartisan support these programs have experienced since their inception, focusing on PEPFAR champions such as Nancy Pelosi, Henry Hyde and John Kerry.

In addition to uniting political parties, foreign assistance reform has brought together different facets of government, from the Centers for Disease Control (CDC), to the State Department and USAID. Gerson described PEPFAR’s immediate impact: “The day after the drugs arrive, everyone was surviving. Children with opportunistic infections in their eyes had their sight restored. They called it the ‘Lazarus Effect.'” The “Lazarus Effect” refers to people who are HIV-positive and on the brink of death responding to treatment and later thriving.

PEPFAR’s results-based successes demonstrate the importance of data collection and serve as a model for current and future programs. Shah believes that budgeting for evaluation is critical. As an example, he suggested that aid programs “should spend 3 percent collecting data so you know what you’re doing with the other 97 percent. […] This is saving lives. This is letting you be smarter about saving lives.”

The Global Fund is also investing in data systems, particularly emphasizing the expansion of data collection. By expanding the types of data collected to include age and sex-disaggregated data, the Global Fund partnership will be better able to track epidemics and know where to most effectively funnel resources and investments. Data collection and analysis can help save lives by ensuring the right people are receiving treatment at the right time.

Including its contribution to the Global Fund, the U.S. government spends more than $8 billion each year on global health. Knowing the effectiveness of foreign assistance can help make the case to sustain lifesaving programs, including those that the Global Fund supports in more than 140 countries. Understanding the impact of such investments – and the positive results we’ve seen in the fight against HIV/AIDS, tuberculosis and malaria – is particularly important as the Global Fund makes plans to host its Fifth Voluntary Replenishment conference this fall.