USAID plays a key role in responding to global health emergencies. According to the World Health Organization (WHO), in 2019 there were an unprecedented 55 active health emergencies around the world. However, just 4 years later, the number of health emergencies increased to 72. Thus, it is imperative that USAID remains prepared to simultaneously respond to multiple global health emergencies. USAID’s three main units responsible for global health emergency responses have developed plans that largely align with best practices, though some critical gaps remain.
The audit assessed the three units that respond to health emergencies against best practice benchmarks. The audit found:
- Bureau for Humanitarian Assistance (BHA): Strongest alignment – met 12 of 14 best practices
- Global Health Bureau (GH): Good alignment – met 10 of 14 best practices
- Agency task force-led plans: Moderate alignment – met 7 of 11 applicable best practices
Key Gaps Identified
- Staffing Issues: Plans lack updated rosters of staff with crucial skillsets
- Contingency Planning: No provisions for scenarios with insufficient task force staffing
- Deployment Procedures: Global Health’s plan mentions capacity to deploy 30 full-time staff to the field but lacks specific implementation details
- Testing and Learning: GH and Agency-led task force plans don’t include provisions for periodic testing or documenting lessons learned
These gaps significantly impact USAID’s ability to respond effectively to future global health emergencies, as evidenced by staffing challenges experienced during the COVID-19 response. Clearly the demise of USAID will further debilitate responsiveness to global health emergencies.
The Inspector General recommended that the Bureau for Global Health take the following actions:
- Establish procedures to facilitate the deployment of staff to the field when needed during a health emergency.
- Develop a timeline for finalizing all aspects of its Global Health Emergency Management System, including provisions for periodic testing of plans and for documenting and incorporating bureau-specific lessons learned.
For the Bureau for Management take the following actions:
- Develop a plan for the identification, recruitment and retention of skilled personnel to task forces in the event of a global health emergency, including contingency planning for a lack of available staff.
- Develop a plan to periodically test procedures in ADS 112 through proactive exercises and evaluation activities and integrate lessons learned into the chapter.
Given the pending demise of USAID as a separate agency, it is unclear if State will retain capacity to respond to global health emergencies or be responsive to the recommendations.
Read the audit report here.
