Key Points
  1. At the time this project began, this was the most recent complete data available at the awardee level. Complete data from FY 2016 may now be available.

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Issue Brief
  1. Defined by USAID as “a for-profit or not-for-profit non-governmental organization that is not organized under the laws of the United States, any State of the United States, the District of Columbia, or the Commonwealth of Puerto Rico, or any other territory or possession of the United States.” USAID: “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303maa; “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303mab.

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  2. A prime recipient receives money directly from the U.S. government after signing a cooperative agreement, grant, contract, or other funding agreement with the U.S. government.

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  3. A sub-recipient receives money from a prime recipient (see above) to carry out the original agreement.

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  4. With some exceptions – see endnote #9 for exception about “grants under contracts.”

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  5. USAID, “Implementation of Protecting Life in Global Health Assistance (formerly known as the Mexico City Policy),” Executive Message to USAID/General Notice Distribution List, May 15, 2017. As of May 15, the policy applies to all new USAID grants and cooperative agreements that provide global health assistance, as well as to all existing grants and cooperative agreements that provide global health assistance when such agreements are amended to add new funding. As of March 2, the same holds true for USAID grants and cooperative agreements that provide family planning assistance. USAID: “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303maa; “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303mab.

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  6. KFF analysis of USAID FY 2013 – FY 2015 transaction data provided via personal communication with USAID staff of the U.S. Foreign Assistance Dashboard (ForeignAssistance.gov), Feb. 10, 2017.

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  7. At the time this project began, this was the most recent complete data available at the awardee level.

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  8. USAID, “Implementation of Protecting Life in Global Health Assistance (formerly known as the Mexico City Policy),” Executive Message to USAID/General Notice Distribution List, May 15, 2017. As of the date this brief was published, the policy is not in effect with regard to contracts. A rulemaking process is required to apply the policy to contracts, which may take some time. The exception to this is “grants under contracts,” which were previously subject to the policy when last in effect and are covered by the reinstated policy at this time; they are essentially grants made to sub-recipients by prime recipients of contracts.

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  9. Among the top 20 NGO prime recipients, as measured by funding that could have been subject to the MCP had it ultimately been directed to foreign NGOs, 14 reported providing global health funding to sub-recipients, but only 13 were included in this analysis (there was an apparent error in the funding amount reported by the one that was excluded); their sub-recipients that were NGOs were included in this analysis. KFF analysis of data downloaded from USAspending.gov, March 10, 2017.

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  10. See, for example, KFF, Key Implementers of U.S. Global Health Efforts, Sept. 6, 2016.

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  11. CDC, “Additional Requirement – 35: Protecting Life in Global Health Assistance,” webpage, updated July 13, 2017, https://www.cdc.gov/grants/additionalrequirements/ar-35.html; NIH, “Protecting Life in Global Health Assistance,” Notice Number: NOT-OD-17-083, June 23, 2017, https://grants.nih.gov/grants/guide/notice-files/NOT-OD-17-083.html.

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  12. Some prime recipients are also sub-recipients, so the total is less than the sum of prime and sub-recipients.

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  13. This $2.2 billion represented 17% of global health assistance that the policy might have applied to during this period if it had ultimately been provided entirely to foreign NGOs during this period (approximately $12.54 billion).

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  14. Of this, approximately $12 million was provided to other foreign NGOs (sub-recipients) by a foreign NGO prime recipient; this funding may or may not overlap to some degree with that prime recipient’s funding that was included in the foreign NGO prime recipient funding total.

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  15. This does not represent the entire amount of program funding that would have been subject to the policy. Most FP/RH funding was provided to U.S. NGO prime recipients, which may have provided funding to foreign NGO sub-recipients in turn; as with other global health funding provided to U.S. NGO prime recipients, funding provided indirectly to foreign NGOs would have been subject to the Mexico City policy.

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  16. NGOs that received funding through both cooperative agreements/grants and contracts were not considered to be newly impacted since they would already be subject to the policy; only 15 NGOs received both during this time period.

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  17. See State Department, “Subject: Protecting Life in Global Health Assistance,” Federal Assistance Management Advisory Number 2017-01; USAID, “USAID Notice: Implementation of Protecting Life in Global Health Assistance (formerly known as the Mexico City Policy),” Executive Message, May 15, 2017.

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  18. Additionally, some of the 70 U.S. NGOs that would have been required to ensure prior certification of their foreign NGO subawardees for FP/RH funding under prior policy would have also had their responsibilities expanded under the reinstated policy to include subawardees of their non-FP/RH funding via cooperative agreements and grants and/or any global health funding via contracts.

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Appendix
  1. KFF analysis of USAID FY 2013 – FY 2015 transaction data provided via personal communication with USAID staff of the U.S. Foreign Assistance Dashboard (ForeignAssistance.gov), Feb. 10, 2017.

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  2. At the time this project began, this was the most recent complete data available at the awardee level.

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  3. A foreign NGO is defined by USAID as an NGO “that is not organized under the laws of the United States, any State of the United States, the District of Columbia, or the Commonwealth of Puerto Rico, or any other territory or possession of the United States.” USAID: “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303maa; “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303mab.

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  4. Among the top 20 NGO prime recipients, as measured by funding that could have been subject to the MCP had it ultimately been directed to foreign NGOs, 14 reported providing global health funding to sub-recipients, but only 13 were included in this analysis (there was an apparent error in the funding amount reported by the one that was excluded); their sub-recipients that were NGOs were included in this analysis. KFF analysis of data downloaded from USAspending.gov, March 10, 2017.

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  5. See USAID, “Implementation of Protecting Life in Global Health Assistance (formerly known as the Mexico City Policy),” Executive Message to USAID/General Notice Distribution List, May 15, 2017; USAID, “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303maa; USAID, “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision May 22, 2017, https://www.usaid.gov/ads/policy/300/303mab.

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  6. PAI, What You Need to Know About the Protecting Life in Global Health Assistance Restrictions on U.S. Global Health Assistance, Oct. 5, 2017.

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  7. For the purchase of goods or services.

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  8. USAID, Glossary of ADS Terms, partial revision, April 30, 2017, https://www.usaid.gov/sites/default/files/documents/1868/glossary.pdf.

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  9. Foreign public educational institutions were excluded from our analysis, since they are exempt from the Mexico City Policy as government-operated institutions.

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  10. USAID, Grants and Cooperative Agreements to Non-Governmental Organizations, ADS Chapter 303, partial revision, April 3, 2017, https://www.usaid.gov/ads/policy/300/303.

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  11. Not subject to the Mexico City Policy are, among others: agreements with national and sub‐national governments, including foreign public universities; public international organizations; and other multilateral entities in which sovereign nations participate (such as the Global Fund to Fight AIDS, Malaria, and Tuberculosis, and Gavi, the Vaccine Alliance). USAID, “Implementation of Protecting Life in Global Health Assistance (formerly known as the Mexico City Policy),” Executive Message to USAID/General Notice Distribution List, May 15, 2017. A Department of State memo included a similar statement; see the Department of State, “Subject: Protecting Life in Global Health Assistance,” Federal Assistance Management Advisory Number 2017-01, May 15, 2017.

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