"Many observers have acknowledged that one of the potential flaws of major U.S. aid programs was that they were open-ended. There wasn't an emphasis on sustainability, on national financial contributions and on training enough national and local leaders to be able to take over the management of the programs. These aspects of transition, of sustainability, of self-reliance, are now the policy of the U.S. government."
"Those transitions have to be careful. In many cases, they have to be more gradual because the capacity of national institutions to pay for what donors have been supplying varies greatly from country to country. There are countries that are ready now to absorb the responsibility and cost. There are going to be others that are poor, more complicated, beset by conflict, where"
U.S. global health policy now emphasizes accelerating transitions toward national self-reliance by prioritizing sustainability, domestic financing, and local leadership capacity. Major aid programs historically lacked clear exit plans and did not sufficiently train national or local leaders to assume program management. Transition policies recognize wide variation in national institutional capacity to absorb donor-supplied services and funding. Some countries are ready to assume responsibility and costs immediately, while poorer, more complex, or conflict-affected countries will require slower, more careful transitions and continued donor support during capacity development. Leadership in malaria elimination is moving from government roles to nonprofit stewardship.
Read at www.npr.org
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