Foreign NGO Engagement in U.S. Global Health Efforts: Foreign NGOs Receiving USG Support Through USAID

Non-governmental organizations (NGOs) are key partners in U.S. global health efforts. A recent Kaiser report shed light on the role of U.S.-based NGOs in these efforts, finding that a significant share of U.S. government (USG) funding for global health is channeled to these NGOs, who often act as program implementers and conduct research and development efforts.¹ To date, however, little information has been available about the extent of foreign NGOs’ role in carrying out U.S. global health programs. To help fill this gap, this report provides an analysis of foreign (non-U.S.-based) NGOs that received global health funding from the USG during FY 2013. The report focuses on funding provided to NGOs by the U.S. Agency for International Development (USAID), the largest implementer of global health activities among USG agencies and departments. The focus on USAID spending is due both to the availability of data from this agency and the fact that USAID spending represents the majority of bilateral U.S. global health spending.² Key findings include (also see Table 1 below):

• Total Number of NGOs: In FY 2013, 157 foreign NGOs received USG global health funding through USAID to implement global health activities. They include NGOs working on a single global health issue, those working on multiple health issues, and those working on global health within a broader development scope. About 15% (24 NGOs) are faith-based organizations.
• Total Funding: Collectively, these NGOs received approximately $355 million (more than 5%) of USAID global health disbursements in FY 2013. The majority of this funding (75%) was concentrated among 20 NGOs. Funding amounts ranged from more than $10 million per NGO (6 NGOs) to less than $1 million (104 NGOs).
• Program Areas: NGOs carried out activities in nearly all major U.S. global health program areas. The greatest number of foreign NGOs worked on HIV. Additionally, the highest amount of funding was for HIV-related activities. Tuberculosis received the second highest amount of funding, followed by family planning/reproductive health.
• Geographic Presence: Foreign NGOs received USG global health funding through USAID for efforts carried out in 42 countries and across multiple regions, including Africa, Asia, Latin America and the Caribbean, and the Middle East. Some NGOs (15) implement efforts that are “worldwide” in scope, but most (146) are engaged in regional and/or country-specific programs. Nearly all funding to NGOs ($329.3 million) supports regional and country-specific efforts, while the remainder ($25.7 million) is directed to “worldwide” efforts. Among the 141 NGOs engaged in country-specific efforts, nearly all (136) received funding for efforts in a single country, while the remainder (5) received funding for efforts in two or more countries. Most countries (30 of 42) host activities by more than one NGO. Overall, more NGOs operate in Africa than in all other regions combined.

Table 1: Summary of Foreign NGO Engagement in USG Global Health Efforts, FY 20133
# of NGOs
157
of which, 24 are faith-based organizations
USG Global Health Funding Provided by USAID
$355,004,250
to foreign NGOs
# of NGOs by Program Area
HIV	97
Water Supply and Sanitation	28
Maternal and Child Health	24
Family Planning/Reproductive Health	22
Tuberculosis	16
Malaria	10
Nutrition	9
Pandemic Influenza and Other Emerging Threats4	3
Other Public Health Threats, including NTDs+5	0
Countries Reached
42*
NOTES: Reflects foreign (non-U.S.-based) NGOs that received funding disbursed by USAID in FY 2013 for USG global health activities. + NTDs are neglected tropical diseases. * Other countries may have been reached through regional programs or “worldwide” efforts.