Introduction
Governments and several International Non Government Organizations (NGOs) have over the years, channeled a lot of funds to national and international programs. Through funding of these programs, governments and donor agencies have an overall aim of improving people’s living standards globally.
The donors or governments attempt to make rational and reliable funding arrangements for these programs (Amor, 2007). This paper compares and contrasts the utilization of these programs in both national and international levels. Two programs are discussed in this essay. These are:
- PEPFAR – International utilization.
- Medicaid(US) – National utilization
This paper will also outline the political ideologies in relation to the two programs and their levels of utilization. In addition, it will outline how the programs are and describe the different funding arrangements.
PEPFAR
President of the US asked the country in 2003, to commit $15 billion to combat the AIDS epidemic internationally. Later in 2007, the President called for the formation of the President’s Emergency Plan for AIDS Relief (PEPFAR). He further requested Congress to authorize an additional $30 billion for the program.
PEPFAR funded programs have saved millions of lives worldwide (Ketler, 2008). Distribution of funds for this program began in the first year of it launch after connections to groups mainly in Africa, were established. The breakdown of U.S. contribution to combat international AIDS between 2004 and 2007 was; $2.3 billion in 2004, $2.6 billion in 2005, $3.2 billion in 2006, and $4.5 billion in 2007 (Amor, 2007).
800,000 people worldwide have accessed antiretroviral treatment. Prevention of mother to-child- HIV transmission programs have helped avoid approximately 150,00 infant infections. An example of a country utilizing PEPFAR funds is South Africa. The country’s population constitutes only 0.7% of the world’s population.
However, it has the largest HIV burden with 17% of global cases, and 17.8% national adult prevalence (Amor, 2007). The South African government and PEPFAR team are actively engaged in a strategically planned transition of clinical service provision and support from PEPFAR to the South African Government.
Political Context
The presidential announcement in 2003 surprised many people. The surprise was preceded by excitement, then criticisms. The excitement stemmed from the knowledge that the extent of the AIDS epidemic and its possible effects on the U.S and global interests, were finally being taken seriously.
Some viewed the move as a strategy by a super power to go beyond normal national interests and deal with global humanitarian problems (Amor, 2007). Criticism resulted from the fear that the program was a short-term effort aimed at enhancing America’s image.
Spectators were concerned that moral programs would shape the agenda choices, and not the medical best-practice procedures. The President himself, cabinet members, and top government officials, saw the program as a moral issue and supported it for more funding but were afraid that the money would not be spent well.
Medicaid
Medicaid is the United State’s biggest health program, serving 60 million users. The program was initiated in 1964 and gives medical service to the poor and the less privileged. It is also caters for the elderly in nursing homes. In 2010, the Congressional Budget Office stated that 75% of people registered for Medicaid included families and children, whereas 20% were old. However, 63% of Medicaid spending was for older citizens and the disabled, while 36% went to families and children (Ketler, 2008).
Political Context
The program has recently been the focus of several policy arguments between Republicans and Democrats. Congress managed to pass President Barrack Obama’s new health care law recently, which takes care of the citizens who are not insured. Led by Representative Paul D. Ryan, house Republicans voted in favor of substituting Medicaid with block grants that would trim down expenditure by a third, over ten years.
This move allows states alter lowest eligibility, care standards, and regulations at the state which shields 14 year olds from expenses from the Medicaid bill of their guardians or parents. Some Democrats opposed the idea. The U.S faced an economic crunch in 2009 (Ketler, 2008). However, the Obama administration managed to inject billions of dollars into the program although the money was planned to last only until the end of the first half of 2011.
Conclusion
Several challenges exist in the operations of funded programs and the utilization of their funds. One significant limitation is poor insight and planning for these programs. Another challenge is the over dependence on consultants or agents, a majority of whom do not have adequate skills to effectively advise and assist governments and donors (Amor, 2007). So as to reinforce the capacity of programs to assist the poorest people, donor/government agencies should clearly state what percentage of funds should be utilized on this group.
To ensure that funds benefit the less privileged, patent policies and strategies should be formulated. Moreover, funding agencies should create effective monitoring and evaluation mechanisms. Initiatives must be taken to build government and non-governmental funded programs that are sustainable, with clear operation and implementation plans.
References
Amor, J. S. (2007). PEPFAR Implementation: Progress and Promise. London: National Academies Press.
Ketler, S. R. (2008). Medicaid: Services, Costs and Future. New York: Nova Science Publishers Inc.