Mcc Compact Moldova Should Be Done Again

Key Facts

The Millennium Claiming Corporation (MCC) is an contained U.S. foreign aid agency that has the goal of reducing poverty in developing countries through supporting economic growth. Since its cosmos in 2004, MCC has supported development programs in 43 low- and lower-middle-income countries. MCC projects bridge many sectors of evolution, including global health.
MCC has a unique approach among U.S. foreign assistance agencies in that it works only with countries that are deemed "eligible" after coming together certain benchmark measures for expert governance, economic freedom, and investing in people, and it provides aid through formal bilateral agreements negotiated and adult in a "country-led" process.
Historically only a small proportion of MCC funding has been directed to global health. Between FY 2004 and FY 2018, xi% of MCC commitments were directed to wellness and/or h2o and sanitation projects, with water and sanitation receiving virtually of that funding.
In recent years MCC has maintained its partnerships with other U.S. agencies working in global health to improve coordination and share best practices.

MCC Overview

Based in the Executive Branch, MCC is an contained U.S. foreign assistance agency, specifically a U.South. government corporation established in January 2004 by the Millennium Challenge Act of 2003.^ane ^, ² Its purpose is to reduce poverty by promoting economic growth in low- and lower-eye-income countries through the evolution of state assistance agreements, which are meant to be driven past country-identified priorities for U.South. authorities support.³

Approach

MCC'southward approach is considered unique among U.S. development agencies for several reasons, including its use of quantitative benchmarks to make up one's mind eligibility, a heavy emphasis on country-led planning and implementation of help agreements, and a reliance on robust and transparent monitoring and evaluation of progress and impact of its assistance.^iv The agency has also been seen as early champion of gender dimensions of development, having adopted its starting time gender policy in 2006 and long recognizing gender inequality as "a significant constraint" to achieving its mission.^v ^, ⁶

Board of Directors

MCC is led by a chief executive officer (CEO) – a Presidential appointee requiring Senate confirmation – and overseen by a Board of Directors consisting of v members from the U.S. government and four members from the individual sector. U.S. government members include: the Secretary of State, the Secretary of the Treasury, the U.S. Trade Representative, the Ambassador of the U.S. Agency for International Development (USAID), and the CEO of MCC.

Private sector members are nominated by the President and confirmed past the U.Due south. Senate.^vii

Country Selection Process

The MCC Lath carries out a multi-tiered country pick process, by first identifying candidate countries and and so assessing their eligibility to apply for assist.^viii Candidate countries are identified based on per capita income. Only low- and lower-middle-income countries, according to World Bank income classifications, are considered candidates. Eligible countries are selected from these candidates based on their demonstrated commitment to policies related to MCC's three key areas:

"Ruling Justly," which includes expert governance and fighting corruption,
"Economic Freedom," and
"Investing in People," which incorporates several measures of population well-beingness including some related to wellness.

Eligibility Indicators and Land Scorecard

To determine eligibility and approximate country commitment to key principles, MCC relies on more than than twenty quantitative indicators of policy and performance. Iii of these eligibility indicators are wellness-focused:

public expenditure on wellness,
immunization rates, and
"child health" (a blended indicator that includes child mortality rate, percent with admission to water, and percent with admission to sanitation).⁹

How a country performs against all indicators (known every bit a "country scorecard") helps determine whether they are eligible for MCC assistance. The MCC Board can also consider ii other factors in its determination: the opportunity to reduce poverty and generate economic growth within a land, and the availability of MCC funds.¹⁰

Types of Assistance

Since its cosmos in 2004, MCC has supported evolution programs in 43 low- and lower-middle-income countries.^xi MCC assistance is provided through ii types of agreements: compacts and thresholds.¹²

Compacts are larger agreements that tin can span multiple sectors and which typically final v years. To be eligible for compact funding, a candidate country must score in a higher place the median compared to other countries in its income group (e.grand., other depression-income countries) with regard to at to the lowest degree 10 of the eligibility indicators, including two required indicators:

to a higher place median performance on "corruption" and
meeting a minimum standard for either the "civil liberties" or "political rights" indicators (or both).

Through August 2019, MCC has signed 36 compacts with 29 countries (some countries have signed a second compact after the first concluded), for amounts ranging from $66 million to $698 million.¹³ A legislative change enacted in April 2018 allows MCC to now pursue agreements with regional investments (i.east., with neighboring countries) in improver to its standard bilateral agreements; to date, no regional investments have been approved.¹⁴

Thresholds are smaller, targeted, shorter-term grants designed to help countries become compact-eligible. A candidate state not meeting the criteria for a compact but demonstrating delivery to improving its performance may be eligible for threshold funding. MCC has signed 29 threshold agreements with 27 countries (some countries signed a second threshold agreements later the first ended), for amounts ranging from $vi.vii million to $55 million.¹⁵ Ix countries have successfully moved from receiving threshold funding to subsequently signing a compact.¹⁶

U.S. Government Funding

Offset funded by Congress at $994 million in FY 2004, MCC appropriations reached a peak of $1.75 billion in FY 2006 and FY 2007. Since and so, appropriated funding for MCC fluctuated somewhat, though in recent years remained steady at around $900 million a yr (meet Figure 1). As in the prior two years, the current Administration has proposed reduced funding for MCC in FY 2020). Congress has thus far rejected proposed spending cuts.¹⁷

Figure i: Millennium Challenge Corporation (MCC) Funding, FY 2004-FY 2020 Request

Since 2004, MCC has committed over $14 billion in assist through its compact and threshold agreements. Most MCC funding has been provided through compacts (96%), with a smaller proportion provided through thresholds (4%).¹⁸

MCC Support for Global Health

The MCC portfolio of projects spans many sectors of development, including health. MCC recognizes health equally important to its poverty reduction mission and has supported a number of health projects in a range of countries.¹⁹ These have included support in areas such as HIV/AIDS, family planning and reproductive health, nutrition, and other public health efforts, as well as water and sanitation. Together, health and/or h2o and sanitation has been included in 12 compacts and v threshold agreements, spanning 16 countries. All simply one of these compacts and threshold agreements have been completed (the threshold program in Sierra Leone remains agile). From FY 2004 through FY 2018, MCC committed near $1.5 billion to 17 different projects focused on health and/or water and sanitation (under compacts and thresholds), an amount which equaled most 11% of total committed MCC funding. Around $310 million of this has been for wellness-specific projects, while $i.182 billion has been for water and sanitation.²⁰ See Tabular array 2.

Table ane: MCC Disbursements for Health, Water and Sanitation, and All Other Sectors, FY 2008 – FY 2018 (in $ millions)
Sector	FY08	FY09	FY10	FY11	FY12	FY13	FY14	FY15	FY16	FY17	FY18
Wellness	0.6	1.seven	11.8	44.4	43.0	68.four	19.three	6.1	5.9	13.eight	xiii.two
H2o and Sanitation	four.1	14.0	34.4	80.5	128.1	223.5	113.0	89.6	113.iii	127.6	78.2
All Other Sectors	346.half dozen	635.1	1039.six	1405.2	1253.iv	1270.7	950.0	630.three	597.vii	580.nine	588.7
Total	351.4	650.9	1085.ix	1530.one	1424.5	1562.6	1082.3	726.0	717.0	722.3	680.1
SOURCES: Kaiser Family Foundation analysis of data from the U.S. Foreign Assistance Dashboard, www.foreignassistance.gov

Looking at disbursements since FY 2008, MCC has directed a by and large increasing share to health/water and sanitation projects over time. In FY 2008, $iv.vii one thousand thousand (about 1% of all disbursements) was directed to wellness/water and sanitation, while in FY 2018, $91.4 million (about 13% of all disbursements) was directed to these sectors. See Table 1 and Figure 2.²¹

Effigy 2: MCC Disbursements for Health and Water/ Sanitation, and All Other Sectors, FY 2008-FY 2018

Health Projects

Wellness projects (other than water and sanitation) have been included in four compacts and four threshold agreements with 7 countries. Funding for these projects fabricated up varying proportions of each agreement's full funding, ranging from 0.four% of Namibia's compact funding to 36% of Indonesia'south threshold funding (see Tabular array two).²² Some examples of wellness projects supported by MCC are:

Lesotho's meaty (completed 2013) supported the renovation and expansion of HIV/AIDS treatment clinics, a new fundamental laboratory facility, and improvements to tuberculosis control and maternal and child health.²³
Mongolia's compact (completed 2013) included investments in prevention and direction of non-infectious disease.
Namibia's compact (completed 2014) included support for targeted HIV/AIDS didactics programs.
Threshold programs in Peru (completed 2010) and Timor-Fifty'este (completed in 2014) accept included efforts to improve childhood immunization, while Indonesia's compact (completed 2018) included funding for childhood nutrition.

Tabular array two: MCC Compacts/Thresholds with Health and Water & Sanitation Projects, FY 2004 – FY 2018
State	Blazon of Understanding	Year Signed-Completed	Project Focus	Project Funding in $ millions	Full Agreement Funding in $ millions	Project Funding every bit % of Total
Ongoing
Sierra Leone	Threshold	2015 – ongoing	Large arrangement; basic drinking h2o supply	16.0	44.four	36.0%
Completed
Cabo Verde II	Compact	2012 – 2017	H2o, sanitation and hygiene	$41.1	$66.two	62.ane%
El Salvador	Compact	2006 – 2012	Basic drinking h2o supply and sanitation	19.0	461.0	v.1%
Georgia	Meaty	2005 – 2011	Large systems*	53.0	395.3	13.4%
Ghana	Compact	2006 – 2012	Basic drinking water supply and sanitation	xiii.0	547.0	2.4%
Indonesia	Threshold	2006 – 2010	Kid health (immunization)	twenty.0	55.0	36.iv%
Republic of indonesia	Compact	2011 – 2018	Child health/nutrition	131.v	600.0	21.9%
Hashemite kingdom of jordan	Meaty	2010 – 2016	Large systems*; basic drinking water supply	253.8	275.1	92.2%
Republic of kenya	Threshold	2007 – 2010	Health care procurement and delivery	four.0	12.7	31.5%
Kingdom of lesotho	Compact	2007 – 2013	HIV/AIDS; maternal and kid health; TB	122.4	362.6	33.8%
Kingdom of lesotho	Compact	2007 – 2013	Water resources protection, policy	164.0	"	45.2%
Mongolia	Compact	2007 – 2013	Non-communicable diseases	17.0	285.0	6.0%
Mozambique	Compact	2007 – 2013	Large systems; basic drinking water supply	203.6	506.nine	xl.2%
Namibia	Compact	2008 – 2014	HIV/AIDS education	i.3	304.5	0.four%
Peru	Threshold	2008 – 2012	Child health (immunization)	11.5	35.6	32.3%
Tanzania	Meaty	2008 – 2013	Large systems*	63.iii	698.0	9.5%
Timor-Leste	Threshold	2011 – 2014	Child health (immunization)	2.half dozen	10.five	24.eight%
Zambia	Meaty	2012 – 2018	Water supply, sanitation, and drainage	354.8	354.8	100.0%
NOTES: Funding in millions. As of Baronial 2019. *Large systems refers to investments in water and sanitation infrastructure. " indicates full agreement funding is aforementioned as above, since projects are function of single agreement. SOURCES: KFF analysis of data from MCC Threshold and Meaty pages (https://www.mcc.gov/where-we-work); CRS, Millennium Challenge Corporation, RL32427, April 2018.

H2o & Sanitation Projects

Water and sanitation projects have been included in nine compacts and one threshold understanding with 10 countries. Equally a proportion of total state compact funding, back up for these projects ranged from 2% of Republic of ghana'due south compact funding to 100% of Zambia'due south compact funding (see Table ii). Some examples of water and sanitation projects supported past MCC are:

Hashemite kingdom of jordan's meaty (completed 2016) sought to rehabilitate the water supply and distribution network, ameliorate sewage systems, and expand wastewater handling.
Mozambique'due south compact (completed 2013) focused, in function, on investments in rehabilitation of urban water supply systems.
Tanzania's compact (completed 2013) supported improving potable water supply in ii urban areas.
Cabo Verde'southward compact (completed 2018) was largely focused on water infrastructure and regulation of the country'southward water sector, while Republic of zambia's compact (completed 2018) focused on improving h2o and sanitation infrastructure, management, and policy.

Coordination with Other U.S. Efforts

MCC has made efforts to coordinate with other U.S. foreign assistance agencies on health. For instance, through its compact with Lesotho focused on HIV/AIDS and other health issues, MCC coordinated with President's Emergency Plan for AIDS Relief (PEPFAR, the U.Due south. authorities'south response to global HIV/AIDS) programs in-country.²⁴ MCC and PEPFAR also jointly created a Data Collaboratives for Local Bear upon initiative in 2015 to help build the capacity communities to generate and use data effectively.²⁵ MCC has at times served as a resource for other agencies seeking to learn from its approach. For example, MCC has partnered with the State Department's Office of the Global AIDS Coordinator (OGAC), which administers PEPFAR, to promote mutual learning on country ownership and sustainability of foreign assistance.²⁶

Key Issues for the U.South.

MCC, once considered a novel approach to U.S. strange assistance, is now established and well into its second decade of functioning. Sustainability of funding for MCC is a claiming, with funding levels having been halved from their peak of over ten years ago. While MCC has stated it recognizes the value of wellness for development, simply a small-scale proportion of its disbursed funds have been directed to health/h2o and sanitation projects. Nearly of those funds were for h2o infrastructure projects, while only a small portion has gone to wellness-specific projects. Fifty-fifty so, the agency has demonstrated some commitment to coordinating activities with those of U.S. global wellness efforts such as PEPFAR.

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Source: https://www.kff.org/global-health-policy/fact-sheet/the-millennium-challenge-corporation-mcc-and-global-health/