Christopher Flavelle
By Christopher Flavelle
President Barack Obama is asking Congress for $6bn in emergency funds to fight Ebola, including $2bn for the US Agency for International Development to spend on health care in West Africa. But an analysis of federal spending shows that in the five years leading up to the Ebola outbreak, his administration struggled to spend the money Congress had already made available.
From 2009 through 2013, Congress appropriated $243m for health-related spending in Liberia, the bulk of it through USAID, according to ForeignAssistance.gov. (Guinea and Sierra Leone, the other countries affected by the outbreak, got a fraction of that amount.) Yet the US government managed to spend just $152m over that same period, or 63 percent.
When I asked USAID for comment on that spending, the agency said it was more reasonable to look only at a more restrictive category of money — what’s called the Global Health Program. Using that criteria, the US government spent $99m on health aid to Liberia over the same period, out of $135m Congress appropriated. That’s a spend rate of 73 percent.
Money for healthcare aid can often be rolled over to the next budget year. And according to USAID, the groups that spend aid money have up to five years to submit their invoices. But the data show that low spending on health care in one year didn’t necessarily lead to a surge later. In the five-year period, only once did disbursements come close to matching appropriations.
In the five years leading up to the Ebola outbreak, the US was able to spend more than 83 percent of the $67m Congress made available for fighting malaria, and 87 percent of the $19m appropriated for HIV/AIDS. By contrast, it spent just 63 percent of the $39m appropriated for maternal and child health, and 56 percent of the $32m appropriated for family planning and reproductive health.
What explains USAID leaving so much of its healthcare budget for Liberia unspent? One possible explanation is that health care in Liberia wasn’t the priority that, in hindsight, it should have been.
It may have seemed reasonable for USAID to focus on other priorities. Ben Leo, former global policy director for Bono’s ONE campaign and now a senior fellow at the Washington-based Center for Global Development, told me that after Liberia emerged from civil war in 2003, it made sense for foreign aid to focus on security and basic infrastructure.
A more charitable explanation is that spending development money responsibly in West Africa is just really, really hard. So when the White House says that preventing the next outbreak of Ebola means getting more money from Congress, that’s only part of the problem.
WP-BLOOMBERG
By Christopher Flavelle
President Barack Obama is asking Congress for $6bn in emergency funds to fight Ebola, including $2bn for the US Agency for International Development to spend on health care in West Africa. But an analysis of federal spending shows that in the five years leading up to the Ebola outbreak, his administration struggled to spend the money Congress had already made available.
From 2009 through 2013, Congress appropriated $243m for health-related spending in Liberia, the bulk of it through USAID, according to ForeignAssistance.gov. (Guinea and Sierra Leone, the other countries affected by the outbreak, got a fraction of that amount.) Yet the US government managed to spend just $152m over that same period, or 63 percent.
When I asked USAID for comment on that spending, the agency said it was more reasonable to look only at a more restrictive category of money — what’s called the Global Health Program. Using that criteria, the US government spent $99m on health aid to Liberia over the same period, out of $135m Congress appropriated. That’s a spend rate of 73 percent.
Money for healthcare aid can often be rolled over to the next budget year. And according to USAID, the groups that spend aid money have up to five years to submit their invoices. But the data show that low spending on health care in one year didn’t necessarily lead to a surge later. In the five-year period, only once did disbursements come close to matching appropriations.
In the five years leading up to the Ebola outbreak, the US was able to spend more than 83 percent of the $67m Congress made available for fighting malaria, and 87 percent of the $19m appropriated for HIV/AIDS. By contrast, it spent just 63 percent of the $39m appropriated for maternal and child health, and 56 percent of the $32m appropriated for family planning and reproductive health.
What explains USAID leaving so much of its healthcare budget for Liberia unspent? One possible explanation is that health care in Liberia wasn’t the priority that, in hindsight, it should have been.
It may have seemed reasonable for USAID to focus on other priorities. Ben Leo, former global policy director for Bono’s ONE campaign and now a senior fellow at the Washington-based Center for Global Development, told me that after Liberia emerged from civil war in 2003, it made sense for foreign aid to focus on security and basic infrastructure.
A more charitable explanation is that spending development money responsibly in West Africa is just really, really hard. So when the White House says that preventing the next outbreak of Ebola means getting more money from Congress, that’s only part of the problem.
WP-BLOOMBERG
