THE BLOG
07/15/2014 12:01 pm ET Updated Sep 14, 2014

USAID 2.0: Improving Impact and Outcomes

At the Case Foundation, we've had the privilege of working on numerous public-private partnerships with every Administration since our founding 17 years ago. We've been a part of collaborative initiatives that have included the White House, federal agencies, members of Congress, governors, state governments, local municipalities and foreign governments.

Through this work, and in my 30 plus years in Washington, it's been my experience that leaders who accept roles in government agencies genuinely want to make an impact and have a heartfelt desire to be in service of others. Yet I have witnessed that, many times, great people who come into these roles with a significant passion to make a difference grow disillusioned or paralyzed by a culture that doesn't want a change from the status quo.

So it was more than heartening to see a new approach taking shape at one large federal agency -- USAID -- under the purview of its young, innovative leader, Dr. Rajiv Shah. At USAID, 10,000 professionals work in more than 100 countries to end extreme poverty and promote resilient, democratic societies.

USAID has worked to provide quality programs at scale while its budgets have come under pressure. With this challenge in mind, recently Administrator Shah invited a group of leaders from the private sector to help the agency better evaluate outcomes and to determine more efficient paths to achieving results -- a move that was unprecedented for this agency.

I've had the true privilege of serving with this group to advise USAID on the most high-impact use of its resources to save the lives of more women and children. The Award Cost Efficiency Study (ACES) Blue Ribbon Panel of Advisors, under renowned business leader and UN Special Envoy Ray Chambers, and with funding from the Bill and Melinda Gates Foundation, was chartered to perform a wide-ranging exploration of internal challenges to USAID's efficiency and effectiveness.

The task at hand for the Panel was fearless and ambitious: Analyze and make recommendations to improve the way USAID operates toward the goal of increasing the number of mothers and children whose lives are saved through the interventions of USAID's maternal and child health programs. A true "dream team" in global development and the private sector was tapped to lead this work, including eminent experts and leaders in their fields from Paul Farmer of Partners in Health, to Helene Gayle at CARE, to former Senator Majority Leader (and doctor) Bill Frist, to other deeply respected leaders from across sectors.

Administrator Shah and his team worked tirelessly with members of the Panel in a remarkable spirit of openness and transparency, and he and his team embraced the animating principle that saving a greater number of lives depends on fundamental revisions to existing practices at USAID.

As a result of the Panel's recommendations, USAID unveiled an action plan and has piloted a new strategy in five countries. Based on the results of this pilot, USAID will expand changes to the 24 countries that today represent 70 percent of all maternal and child deaths. USAID is projecting that, with the reprogramming of $2.9 billion in these 24 countries, it can save an additional 500,000 lives by the end of 2015.

The Panel also recommended that USAID establish a central coordinator position, similar to structures used for HIV/AIDS and malaria initiatives, to fully enable these changes to be taken forward across USAID and its country missions. As with the Global Malaria Coordinator for the President's Malaria Initiative, it will be critical that this Coordinator has broad budget authority and responsibility to review and make decisions around key maternal and child survival grants.

The Panel agreed to continue working with USAID and Administrator Shah to ensure the recommendations are implemented and to monitor the resulting efficiencies and lives saved. A select number of Panel members were in Washington to release the findings in late June, alongside Administrator Shah, at a high level, daylong forum -- Acting on the Call: Ending Preventable Child and Maternal Deaths. At the Forum, it was widely acknowledged that the recommendations are only the start, and that the real hard work of implementation and monitoring results was yet to come.

This important public-private effort holds great promise for demonstrating a new path forward as our Federal agencies are challenged to deliver improved results in an era of tight budgets and increased demand. Administrator Shah should be commended for inviting the private sector in as partners in the work of making USAID a more effective and impactful agency. Recognizing that change is hard, especially in large, established organizations, the team at USAID deserves credit for embracing the recommendations in the ACES study.

The private sector has always understood the need to constantly revisit what is working and what is not, and to pivot or move investments and activities to those areas that hold the greatest potential for successful outcomes. Too often, government agencies don't embrace this approach. Leaders in government need more than encouragement to change and adapt programs and budgets to drive efficiencies and effectiveness. Congress and the White House should consider how to provide guidance to agencies to ensure these efforts are undertaken and that they endure. When outcomes and impacts improve, stakeholders are better served and taxpayers enjoy a better "return" on the dollars they contribute -- making it a "win-win" for all.

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