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Congress, against all odds, appears to be working again. While gridlock has been the norm since Republicans retook the House in 2011, last year legislators succeeded in permanently fixing Medicare doctor payments, passing a five-year highway funding bill, replacing No Child Left Behind, extending the solvency of the Social Security disability program, and making a whole raft of tax breaks for low-income families and corporations permanent.
As far as 2016 is concerned, the odds of progress are looking good on one topic where you'd never expect the parties to agree: foreign aid. Two bills that would modestly but significantly revamp US assistance programs are making their way through Congress. One has already passed the House, while the other has bipartisan backing in the Senate. Here's what they'd do, and what development experts think about them.
First up: the Foreign Aid Transparency and Accountability Act
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The first bill, the Foreign Aid Transparency and Accountability Act, has already gotten halfway to President Obama's desk. It passed the House in a voice vote on December 8. While that leaves us without a roll call showing where each member of Congress stood, the co-sponsor list is pretty bipartisan, with 16 Republicans (including lead sponsor Ted Poe of Texas) and nine Democrats ranging from relative moderates like Rep. Adam Smith (D-WA) to strident progressives like Rep. Earl Blumenauer (D-OR). The Republican co-sponsors included some of the House's most conservative members, like Rep. Ted Yoho (R-FL).
Meanwhile, the Senate companion bill is sponsored by Marco Rubio and co-sponsored by two liberal Democrats (Ben Cardin of Maryland and Chris Coons of Delaware) and one Republican (Johnny Isakson of Georgia).
The bill's broad appeal can be explained in part by the innocuousness of its goal. The bill doesn't try to start new transparency or evaluation initiatives; rather, it makes permanent many of the efforts to make foreign aid programs more evidence-based begun by Obama's former US Agency for International Development (USAID) administrator Raj Shah, a figure who is beloved on Capitol Hill by members of both parties (you can read a summary of a new book chapter he coauthored summarizing his views on this issue here).
Casey Dunning, a senior policy analyst at the Center for Global Development, explains that while the bill doesn't do a whole lot that agency administration can't already do on their own, it ensures that the Obama administration's push for evidence continues into the future.
The biggest potential, she argues, comes from the bill's focus on estimating the bang for the buck that each aid program is getting. "What it attempts to do is connect the dollar to the result of the dollar," Dunning says. "It's attempting to say, 'This input got this end result,' and show that in a transparent and publicly available way. … Actually being able to know what we can get dollar by dollar across the agencies could have huge potential in making sure our resources are going to places with the highest impact."
But the bill is short on specifics about how to actually generate that information, providing relatively little guidance on what kinds of evaluations should be done, or how to compare the effectiveness of programs with less quantitative goals, such as initiatives promoting democracy and the rule of law.
"It does have some requirements," Dunning explains. "Every program that is above the median of the agency's programs [in size] must have an evaluation. So the majority of programs in every agency must have at least one evaluation in the lifetime of the program."
It is also "quite heavy" on data reporting requirements, Dunning says, which, while good for transparency, doesn't do much to improve the quality of data being reported. In general, though, agencies get a lot of leeway on implementation, meaning evaluation-friendly administrators will still be needed if the bill is to meet its goals.
Dunning's biggest grievance is that the bill totally exempts US military and security aid to other countries, which makes up a huge fraction of total foreign aid budget. (Case in point: Israel, a rather rich country by any metric, is our top aid recipient.) There's no reason this kind of aid couldn't benefit from rigorous evaluations, too. "We know the dollars that are put into these programs, and in some cases the budgets are quite large," Dunning says. "But they have no idea of the output/outcome results of these investments."
All that said, Dunning's overall assessment is that the Foreign Aid Transparency and Accountability Act is a modest positive step. "It's nothing shocking to those of us in the development community, because these kinds of hallmarks of good aid practice have been happening for a while," she says. "But what the bill does is actually authorize them and legislate them, which I think is quite important."
That assessment is echoed by a number of aid experts, like Brookings's George Ingram, and advocacy groups like Oxfam and ONE. Their support hasn't been enough to get the bill through past Congresses, even though it passed the House once before in December 2012. But with Congress looking more active, its Senate prospects are looking slightly more promising this time around.
Next on the docket: the REACH Act
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Somewhat more ambitious is the Reach Every Mother and Child Act, or REACH Act. Introduced by Coons and Sen. Susan Collins (R-ME), it also features the support of Rubio, Minority Whip Dick Durbin (D-IL), Pat Roberts (R-KS), and Patty Murray (D-WA), among others, giving it a similar bipartisan base as the transparency bill.
And like that bill, the REACH Act is less about changing course than about entrenching reforms the Obama administration has already initiated. In this case, Collins and Coons are interested in making permanent Shah and his successor Gayle Smith's efforts to refocus USAID on reducing child and maternal mortality.
Many of the reforms derived from recommendations made by a Blue Ribbon Panel Shah appointed in 2013, including creating the position of child and maternal survival coordinator who can aggressively scale up programs with demonstrative effectiveness in reducing child and maternal death, while canceling less effective measures.
Given the number of disparate government agencies working on these topics — USAID, National Institutes of Health, Centers for Disease Control and Prevention, the President's Malaria Initiative, the President's Emergency Plan for AIDS Relief (PEPFAR) — ensuring the survival of the coordinator job could prove important.
"We made a tremendous amount of headway by bringing in a private panel of experts and redirected $2.9 billion of our portfolio towards concrete results-oriented efforts to save children's lives," Shah says. "It will result in hundreds of thousands of lives being saved per year. For that to persist beyond any legislation, the REACH Act is a great vehicle for ensuring those hard-fought gains."
While the bill does not specifically allocate new funding, it does expand the federal government's ability to reach outside its own coffers to fund aid initiatives. The bill directs the USAID and child and maternal health coordinator to "develop a financing framework to leverage public and private capital to expand delivery of high-impact, evidence-based interventions for maternal, newborn, and child health."
That funding can take the form of development impact bonds — a form of funding where private sector banks and other institutions fund programs and get paid back if the program achieves results — as well as loan guarantees, public-private partnerships, and other methods. The bill specifically authorizes agencies to grant loans, make equity investments in private companies, and otherwise do the kind of financial transactions you'd need to do to leverage new money.
Shah is optimistic that the act could lead to more federal financing of global health overall. "Frankly, when it comes to child and maternal survival we dramatically increased the budget, but it came at a cost to other effective and important programs in global health and in development," he says. "I hope that passing the REACH Act in Congress also serves as a first step in increasing US investment in child survival around the world."
Amanda Glassman, director of global health for the Center for Global Development, is broadly supportive but has some concerns. For one thing, the bill further divides the aid budget into silos, after malaria and AIDS have already been given their own separate locations in the federal government.
"It continues the trend toward silos and earmarks," she says. "I'm a little worried to see maternal and child health out on its own again." That can lead to an approach to aid that's fractured and duplicative, and harder rather than easier to coordinate. It can also be overwhelming for developing countries' governments, which have to work with several different US programs to get aid, even similar types of aid.
Glassman is also concerned that the child and maternal survival coordinator won't have enough power to manage programs outside of USAID. "It's not like the PEPFAR coordinator who has powers over the interagency process. The PEPFAR coordinator clears every dollar spent overseas on AIDS. That's a very different role," she says. "I don't know why this person would be different from the assistant administrator at USAID."
All that being said, she still backs the bill, as do some development advocacy groups. Advocates argue that even if the child and maternal survival coordinator doesn't have as much power as, say, the head of PEPFAR or the head of the President's Malaria Initiative, the success of those targeted programs suggests that a similar approach to child and maternal health in general, led by a single empowered individual, could do a lot of good.
