United States

   

Social Sustainability

#28
Key Findings
In the category of social sustainability, the United States falls into the sample’s bottom ranks (rank 28).

Education is largely managed by the states, with substantial inequalities in funding and resources across localities. Teacher shortages are chronic, in part due to low wages. Federal social safety nets are very limited, but are supplemented to varying degrees by state governments, resulting in an uneven welfare state. Programs overall provide only minimal support.

The healthcare system is fragmented, with about half of the population relying on employer-based insurance, limiting labor mobility. Quality is outstanding at best, but access to the system is extremely uneven. Health outcomes are often poor, especially for low-income populations. The federal focus on gender equality depends strongly on the particular administration.

Federal law allows for 12 weeks of unpaid family leave. Some childcare costs can be deducted from tax bills. Social security pensions are often supplemented by private pension schemes. Old-age poverty rates are comparatively high. Very large numbers of legal and undocumented migrants enter the country every year. The U.S. is the world’s largest foreign aid provider.

Sustainable Education System

#24

To what extent do policies and regulations in the education system hinder or facilitate high-quality education and training?

10
 9

Education policies are fully aligned with the goal of ensuring high-quality education and training.
 8
 7
 6


Education policies are largely aligned with the goal of ensuring high-quality education and training.
 5
 4
 3


Education policies are only somewhat aligned with the goal of ensuring high-quality education and training.
 2
 1

Education policies are not at all aligned with the goal of ensuring high-quality education and training.
Policies Targeting Quality Education
6
The United States has a complex education system. It is not entirely accurate to speak of “the education system” of the United States, given that education has historically been a policy competence of each of the 50 state governments. The national government only became significantly involved in non-higher education in the 1960s, and it is still far less involved in education than many other central governments. The Department of Education is one of the smallest departments in the U.S. federal government. Most education funding comes from state and local taxation. Teachers are employed by local and state governments, with over 10,000 different school districts managing education administration and policy.
It is almost impossible to speak definitively about the integration of sustainable development in the U.S. school curriculum because no single curriculum exists. However, some states have integrated sustainable development into their curricula. For example, California has the Education and Environment Initiative (EEI), which incorporates environmental literacy into the curriculum from elementary to secondary school. Many states have adopted the Next Generation Science Standards (NGSS), which teach students about the interconnectedness of humans and the environment, as well as other areas of sustainability. Additionally, some schools include global citizenship education, which aims to encourage students to consider themselves connected to the well-being of others worldwide.
Despite significant state-level variation, we can make some general statements about the U.S. education system. The system faces a chronic teacher shortage, one of the reasons being low pay. Teachers’ wages, never high, have stagnated or even declined.
Teachers, however, have a reputation for professionalism. Over 90% of U.S. teachers participate in some form of professional development, which is often mandated by their employers.
The federal government has made limited efforts to raise overall standards. The Common Core program aims to ensure that all states meet a basic level of numeracy and literacy for all their pupils.
There is a substantial higher and further education sector in the United States. Community colleges and universities offer a wide range of traditional and online courses, degree programs, non-degree programs, and continuing education programs. Additionally, various community organizations and public sector bodies, such as local governments, provide free or subsidized lifelong learning opportunities, including skills training, language development, and personal intellectual enrichment.

To what extent does the current policy approach in the education system hinder or facilitate equitable access to high-quality education and training?

10
 9

Education policies are fully aligned with the goal of ensuring equitable access to high-quality education and training.
 8
 7
 6


Education policies are largely aligned with the goal of ensuring equitable access to high-quality education and training.
 5
 4
 3


Education policies are only somewhat aligned with the goal of ensuring equitable access to high-quality education and training.
 2
 1

Education policies are not at all aligned with the goal of ensuring equitable access to high-quality education and training.
Policies Targeting Equitable Access to Education
4
The U.S. education system exhibits high levels of inequality, largely due to its highly fragmented nature in both standard-setting and financing. Generally, poorer localities have fewer resources to allocate to their schools compared to wealthier ones, which only entrenches inequality further.
The federal government makes some efforts to correct these inequities, but they are insufficient. The Head Start program, a product of Lyndon Johnson’s Great Society in the 1960s, provides preschool education to low-income children, as well as family support services and basic nutrition. Child Care and Development Block Grants (CCDBG) are funds the federal government disburses to state governments, which are then expected to develop programs to help fund quality childcare and early years learning, especially for low-income children.
Title I is a federal program that allocates additional resources to schools with high concentrations of children from low-income backgrounds. The Individuals with Disabilities Education Act of 1990 (IDEA) builds on previous legislation and was designed to provide funding for resources that enable disabled children to integrate into mainstream schools rather than be educated separately. Millions of U.S. children receive educational support through this fund.
Community colleges offer individuals the opportunity to pursue further and higher education at a relatively low cost, thanks to public funding. However, access to these colleges, as well as the generosity and prevalence of their programs, is often tied to state or local funding issues. Many community colleges are also connected to adult education and literacy programs, such as Adult Basic Education (ABE) and English as a Second Language (ESL) classes. The General Educational Development (GED) program enables people who did not obtain their high school diploma to receive an equivalent through study and training.

Sustainable Institutions Supporting Basic Human Needs

#29

To what extent do existing institutions ensure equal access to essential services and basic income support for those in need?

10
 9

Existing essential public services and basic income support are fully aligned with the goal of ensuring equal access for those in need.
 8
 7
 6


Existing essential public services and basic income support are largely aligned with the goal of ensuring equal access for those in need.
 5
 4
 3


Existing essential public services and basic income support are only somewhat aligned with the goal of ensuring equal access for those in need.
 2
 1

Existing essential public services and basic income support are not at all aligned with the goal of ensuring equal access for those in need.
Policies Targeting Equal Access to Essential Services and Basic Income Support
4
The U.S. federal government provides a limited basic social safety net, implemented or supplemented to varying degrees by state governments, resulting in a fragmented and uneven welfare state. Several federal programs support low-income individuals and families.

SNAP is a federally funded program that is administered at the state level. The program provides cash for a pre-approved set of food and basic items. It is more limited than a direct cash transfer because it cannot be spent on goods like alcohol and tobacco, which have not received federal or state approval. Temporary Aid to Needy Families (TANF) is essentially a means-tested child benefit. Medicaid offers public health insurance to low-income Americans. Both TANF and Medicaid are run by the states, and eligibility criteria and benefit levels vary from state to state within a broad federal framework. Supplemental Security Income (SSI) serves as a federal disability benefit for low-income older people and individuals with disabilities.
The federal government also funds support for housing and education. Section 8 is a federal housing program that provides rent subsidies to private landlords who participate in the scheme. Head Start supports low-income families who wish to enroll their children in nursery school or childcare. Pell Grants are federal grants for low-income Americans pursuing higher education.
The federal government also allocates grants to low-income localities, known as Community Development Block Grants, which can be used for anti-poverty programs. State and local governments can apply for grants to support public transport schemes and other forms of local infrastructure, such as sewers and energy.
On their own, these programs provide only minimal support for individuals, offering almost no disposable income and a constrained quality of life. U.S. social policy is based on the idea of poverty as a temporary misfortune. Consequently, these programs are designed to be used only in the most dire economic circumstances.
A $1.9 trillion pandemic relief bill signed by President Biden in 2021 offers a variety of benefits intended to address economic hardship caused by the pandemic, including an expanded, fully refundable child tax credit worth $3,600 for each child under six and $3,000 for those aged six to seventeen. The credit resembles much-debated proposals around basic universal income, which would send cash to families every month.

To what extent do existing institutions and policies ensure high-quality services and basic income support?

10
 9

Existing essential public services and basic income support are fully aligned with the goal of satisfying basic human needs.
 8
 7
 6


Existing essential public services and basic income support are largely aligned with the goal of satisfying basic human needs.
 5
 4
 3


Existing essential public services and basic income support are only somewhat aligned with the goal of satisfying basic human needs.
 2
 1

Existing essential public services and basic income support are not at all aligned with the goal of satisfying basic human needs.
Policies Targeting Quality of Essential Services and Basic Income Support
3
In general, the United States has an underdeveloped welfare state, and the quality of its public services does not have a good reputation. Public transport, for example, is generally quite cheap, but it is underfunded, often inconvenient, and in some places, almost nonexistent.
The adequacy of public services varies significantly based on geography and subnational policies. Gaps in coverage exist throughout the country. Local governments differ widely in their ability to fund high-quality services. Some localities benefit from a wealthy tax base, small populations, or low need. These areas often enjoy excellent public services, including top-notch state schools, public libraries, and community infrastructure. Other parts of the country, however, may have a lower tax base and/or higher-need populations, resulting in abysmal quality of public services.
The Biden administration invested heavily in infrastructure, particularly in renewable energy, highway, and digital infrastructure, in an effort to modernize public infrastructure.

Sustainable Health System

#26

To what extent does current health policy hinder or facilitate health system resilience?

10
 9

Health policies are fully aligned with the goal of achieving a resilient health system.
 8
 7
 6


Health policies are largely aligned with the goal of achieving a resilient health system.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving a resilient health system.
 2
 1

Health policies are not at all aligned with the goal of achieving a resilient health system.
Policies Targeting Health System Resilience
5
The U.S. healthcare system is highly fragmented. About half of Americans receive healthcare through their employer or a family member’s employer. Approximately 20% obtain healthcare from Medicare, which is public health insurance for those over 65 years old. Another 20% receive their healthcare through Medicaid, which is public health insurance for those who are impoverished. A small proportion get their healthcare through other public health insurance programs such as the Indian Health Service, which serves Native Americans, and the Veterans Administration, which covers current and former soldiers and their dependents. The remaining U.S. population must purchase health insurance on the private market, though some are eligible for a tax credit subsidy thanks to the Affordable Care Act (ACA, often referred to as “Obamacare”).
This patchwork healthcare system has various negative implications. For one, it limits labor mobility. Workers are reluctant to change jobs if it risks depriving them and their families of health insurance. Although Medicaid is federally funded, state governments administer it, setting different qualification thresholds and inconsistently covering treatments and health services depending on the state.
The federal government funds certain programs to help improve health system resilience, such as the Public Health Emergency Preparedness program administered by the Centers for Disease Control and Prevention (CDC). The program focuses on six main areas of preparedness for local public health systems: community resilience, incident management, information management, countermeasures and mitigation, surge management, and bio-surveillance.
The COVID-19 pandemic highlighted the massive inequalities at the center of the U.S. healthcare system. Immediately after becoming president, Biden signed several executive orders to reverse some of the Trump-era policies on healthcare that aimed to weaken the ACA. In March 2021, the American Rescue Plan was signed, incorporating temporary increases in premium tax credits and other measures to improve access to healthcare coverage. The administration aims to make these policies, which are only in effect until the end of 2022, permanent, a move that would positively impact healthcare provision in the United States.
In general, the fragmented character of the healthcare system and the influence of special interest groups makes it hard to achieve the goal of a resilient health system for all people.

To what extent does current health policy hinder or facilitate achieving high-quality healthcare?

10
 9

Health policies are fully aligned with the goal of achieving high-quality healthcare.
 8
 7
 6


Health policies are largely aligned with the goal of achieving high-quality healthcare.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving high-quality healthcare.
 2
 1

Health policies are not at all aligned with the goal of achieving high-quality healthcare.
Policies Targeting High-Quality Healthcare
5
The United States. boasts some of the best healthcare in the world, characterized by highly trained and experienced doctors, cutting-edge medical technology and facilities, and significant spending and investment in health research and practices. However, access to this system is extremely uneven and largely depends on the personal economic resources of individual Americans and their families.
American health outcomes are not as impressive as they should be given the medical resources available in the country. Much of this stems from inequality in the American healthcare system, with poor Americans struggling to access preventive healthcare, lead a healthy lifestyle, and reach health services in a timely fashion.
In addition, the “fee for service” model of American healthcare rewards the volume of interaction with the health service, not the quality of interaction. It is in the economic interest of medical providers for patients to return frequently rather than be kept healthy and away from their practices.
There are some federal policies designed to increase and protect the quality of care for the unwell. The Affordable Care Act of 2010 (Obamacare) created Accountable Care Organizations (ACOs), entities that promote collaboration among healthcare providers with the intention of improving care coordination, increasing quality, and reducing costs.

To what extent does current health policy hinder or facilitate equitable access to high-quality healthcare?

10
 9

Health policies are fully aligned with the goal of achieving equitable access to high-quality healthcare.
 8
 7
 6


Health policies are largely aligned with the goal of achieving equitable access to high-quality healthcare.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving equitable access to high-quality healthcare.
 2
 1

Health policies are not at all aligned with the goal of achieving equitable access to high-quality healthcare.
Policies Targeting Equitable Access to Healthcare
3
The United States does a poor job ensuring equitable access to high-quality healthcare. Although the Affordable Care Act of 2009 (Obamacare) improved the situation somewhat by requiring minimum coverage for insurers and eliminating discrimination based on a “pre-existing condition,” the legislation did not guarantee an equitable standard of healthcare to all Americans, regardless of economic resources. Americans still experience different quality of healthcare based on their ability to pay.
State policies contribute to these inequities. For example, under Obamacare, states have been encouraged to expand the Medicaid health insurance program to cover all citizens living at or below 137% of the federal poverty line. The federal government would pay for nearly all of the coverage for these additional Medicaid recipients. However, for largely ideological or partisan reasons, a handful of states have refused to expand Medicaid or have only done so with conditions like work requirements, depriving millions of Americans of access to public health insurance to which they would otherwise be entitled.

Gender Equality

#22

How committed is the government to ensuring gender equality in all respects?

10
 9

The government is clearly committed to the goal of ensuring gender equality.
 8
 7
 6


The government is largely committed to the goal of ensuring gender equality.
 5
 4
 3


The government is only somewhat committed to the goal of ensuring gender equality.
 2
 1

The government is not at all committed to the goal of ensuring gender equality.
Policy Efforts and Commitment to Achieving Gender Equality
6
The federal government’s commitment to gender equality depends to some extent on the particular presidential administration in office at any given moment. For example, the current administration has a White House Gender Policy Council. Under Barack Obama, there was the White House Council on Women and Girls. However, during the Trump administration, there was no such policy.
There are more durable elements of gender equality promoted by the federal government in both law and practice. For example, Title IX of the Education Amendments of 1972 requires substantial support for equal higher educational opportunities for women, including extracurricular activities and, crucially, sports. The Violence Against Women Act of 1994 provides funding to support women who experience domestic violence, including housing support, crisis hotlines, and legal aid. It also funds community prevention programs designed to educate, inform, and prevent violence against women.
Efforts to incorporate gender equality into the U.S. Constitution have failed. The Equal Rights Amendment (ERA) was a significant national initiative aimed at enshrining women’s rights into the Constitution. Although it garnered two-thirds support from both houses of Congress, it did not secure the necessary approval from three-quarters of state legislatures in the 1980s.

Strong Families

#30

To what extent does the current family policy approach support or hinder unpaid family care work?

10
 9

Family policies are fully aligned with the goal of creating the conditions for strong families.
 8
 7
 6


Family policies are largely aligned with the goal of creating the conditions for strong families.
 5
 4
 3


Family policies are only somewhat aligned with the goal of creating the conditions for strong families.
 2
 1

Family policies are not at all aligned with the goal of creating family-friendly conditions.
Family Policies
5
There are some federal policies designed to facilitate or offset the costs of family care work.
The Family and Medical Leave Act of 1993 allows for up to 12 weeks of unpaid leave for family care, including childcare (after the birth or adoption of a child) or care for a spouse or parent with a serious medical condition. Although the leave is unpaid, legal protection is provided to prevent the employee from being dismissed. However, there are few paid family leave options, which depend on the beneficence of the employer or, in rare cases, on state law. Many states operate their own programs to subsidize childcare and early childhood education after means testing.
The child tax credit was created in 1997 (Taxpayer Relief Act of 1997). Under President Donald Trump, the amount was increased to $2,000 per child (Tax Cuts and Jobs Act of 2017). The credit was temporarily expanded further in the American Rescue Plan Act of 2021, increasing the credit to $3,000 – $3,600 per child. Families earning (jointly) $150,000 or less were eligible, covering 88% of children in the United States. Since 2022, the amount has reverted to $2,000 per year. Millions of children are lifted out of poverty thanks to this program.
The Child and Dependent Care Tax Credit allows taxpayers to reduce their childcare costs from their tax bill, with the maximum deductible amount ranging from $3,000 to $6,000 depending on the number of children in a household.
In 2023, the Biden administration issued an executive order on increasing access to high-quality care and supporting caregivers. This order aims to provide high-quality care for older Americans and support family caregivers, long-term care workers, early educators, and veterans.

Sustainable Pension System

#28

To what extent does the current pension policy approach prevent poverty among senior citizens?

10
 9

Pension policies are fully aligned with the goal of preventing old-age poverty.
 8
 7
 6


Pension policies are largely aligned with the goal of preventing old-age poverty.
 5
 4
 3


Pension policies are only somewhat aligned with the goal of preventing old-age poverty.
 2
 1

Pension policies are not at all aligned with the goal of preventing old-age poverty.
Policies Aimed at Old-Age Poverty Prevention
6
The Social Security Act of 1935 established a federal public pension scheme for American workers. Before this legislation, many states had their own pension schemes, and workplace pension schemes were becoming more common. The original act had many gaps, particularly its exclusion of workers in agriculture and domestic service, which disproportionately affected African Americans.
Today, the U.S. public pension, known by Americans as “Social Security,” is a bedrock welfare benefit that enjoys widespread public support. When President George W. Bush attempted to privatize the scheme following his reelection in 2004, he faced significant backlash and had to abandon his plans.
Social Security is a protected part of the federal government’s spending regime. It is a non-discretionary program, meaning it is not subject to annual budget wrangling. The benefit is automatically adjusted for cost-of-living to account for inflation. However, there are criticisms that these adjustments are not always sufficient to meet the rising needs of American pensioners.
The federal Social Security pension is insufficient for a comfortable retirement in most parts of the United States, especially for those with low earnings during their working years. As a result, many Americans rely on private pension schemes, typically provided by their employers, which offer more generous benefits. However, not all workers or Americans have access to such schemes, leading to significant variability in retirement economics. Consequently, many elderly Americans continue working to supplement their income. Additionally, old-age poverty is comparatively high in the United States.
In 2022, the Biden administration awarded $36 billion to prevent cuts to the pensions of union workers and retirees. The funding comes from the American Rescue Plan.

To what extent does the current pension policy approach hinder or promote intergenerational equity?

10
 9

Pension policies are fully aligned with the goal of achieving intergenerational equity.
 8
 7
 6


Pension policies are largely aligned with the goal of achieving intergenerational equity.
 5
 4
 3


Pension policies are only somewhat aligned with the goal of achieving intergenerational equity.
 2
 1

Pension policies are not at all aligned with the goal of achieving intergenerational equity.
Policies Targeting Intergenerational Equity
5
Social Security, the U.S. federal pension program, acts as a basic social safety net for American retirees. Although many Americans believe Social Security is a personal benefit accrued through workplace contributions during their working lives, this is a misconception. Instead, current workers pay for the current generation of retirees. Demographic shifts, therefore, could pose challenges to the system. The U.S. retiree population is growing, as is the overall U.S. population. However, the ratio of workers to retirees has shrunk. If this trend continues, there are concerns about the continued viability of Social Security in its current form.

Changes to the Social Security system impact intergenerational inequality because they deny younger generations the benefits they have paid for the current generation of retirees. Consequently, maintaining Social Security in its current form is seen as politically important. Since George W. Bush’s politically disastrous attempt to change the system, few major politicians have sought to alter it. This reluctance spans both the left and the right. Indeed, one of Donald Trump’s major social policy pledges was to protect Social Security from cuts.

Sustainable Inclusion of Migrants

#14

To what extent does the current policy approach hinder or facilitate the inclusion of migrants into society and the labor market?

10
 9

Integration policies are fully aligned with achieving the sustainable inclusion of migrants in society.
 8
 7
 6


Integration policies are largely aligned with achieving the sustainable inclusion of migrants in society.
 5
 4
 3


Integration policies are only somewhat aligned with achieving the sustainable inclusion of migrants in society.
 2
 1

Integration policies are not at all aligned with achieving the sustainable inclusion of migrants in society.
Integration Policy
6
Several agencies manage immigration policy in the United States. The Department of Homeland Security has overarching responsibility for immigration administration, including U.S. Citizenship and Immigration Services (USCIS), U.S. Customs and Border Protection (CBP), and U.S. Immigration and Customs Enforcement (ICE). USCIS handles visa petitions and naturalization applications. CBP manages the Border Patrol force and seeks to enforce U.S. immigration law at borders and ports of entry. ICE investigates breaches of immigration law and initiates deportation proceedings. ICE’s Enforcement and Removal Operations (ERO) carries out deportations.
Other federal agencies play an important role in the U.S. immigration legal infrastructure. The Department of Labor’s Employment and Training Administration certifies conditions for employment-based visas. The Department of State’s Executive Office for Immigration Review conducts immigration court proceedings and hears cases involving asylum claims and violations.
The United States admits more than a million legal immigrants each year. The Census Bureau’s Current Population Survey records that nearly 50 million U.S. residents were not born in the United States, making up 15% of the total U.S. population. The Census Bureau had previously estimated that this proportion of foreign-born residents would not be reached until 2033, ten years later than has actually happened.
There are various schemes to attract migrant laborers to the United States. These include employment-based visa categories, which often allow the inclusion of dependents and other family members (sometimes known as chain migration). IR visas are for “immediate relatives,” including spouses, children (including married children), adopted children, and parents.

Several types of employment visas exist. These include “priority workers” (which actually targets high-end business professionals), skilled workers, and special workers (for example, individuals who have worked for the U.S. government in conflict zones like Afghanistan and Iraq). The United States also issues visas for refugees and asylum-seekers, as well as visas for victims of human trafficking. High-level investors in the U.S. economy might be eligible for a special visa.

The Diversity Visa Lottery, established in 1990, allocates a modest 55,000 visas to the United States on a random basis.
The United States has a substantial undocumented migrant population participating in a large shadow economy. Certain sectors, such as agriculture, are highly dependent on illegal migrant labor. Some reports suggest that over half of U.S. farm workers are in the country illegally. The federal government typically does not deport individuals who have entered and settled in the country with a clean criminal record. Most deportations occur against undocumented arrivals apprehended at the border, with 2.5 million attempted border crossings in 2023 (homeland.house.gov) and 2.2 million in 2022 (nytimes.com).
The federal government has created programs to provide illegal immigrants with routes to the U.S. education system and labor markets. The Deferred Action for Childhood Arrivals (DACA) scheme allows individuals who were brought into the U.S. illegally as minors to apply for a renewable 2-year deferral from deportation and access to a work permit.
To become a U.S. citizen, an immigrant typically must first qualify for Lawful Permanent Residency (a green card). This can be obtained through employment, family sponsorship, refugee status, or other qualifying categories. The green card holder must then live in the U.S. for three to five years, demonstrate good moral character (avoid committing crimes), undertake language and citizenship tests, submit a naturalization form, provide biometric data, pass an interview with a U.S. Customs and Immigration Service officer, and swear an oath of allegiance to the United States.

Citations:
https://www.nytimes.com/2020/04/02/us/coronavirus-undocumented-immigrant-farmworkers-agriculture.html
https://homeland.house.gov/2023/10/26/factsheet-final-fy23-numbers-show-worst-year-at-americas-borders-ever/
https://www.nytimes.com/interactive/2023/10/29/us/illegal-border-crossings-data.html

Effective Capacity-Building for Global Poverty Reduction

#22

How committed is the government to helping build the capacity to reduce poverty and provide social protection in low- and middle-income countries?

10
 9

The government’s development cooperation strategy is fully aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
 8
 7
 6


The government’s development cooperation strategy is largely aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
 5
 4
 3


The government’s development cooperation strategy is only somewhat aligned with the goal of improving capacity-building in poverty reduction in low- and middle-income countries.
 2
 1

The government’s development cooperation strategy is not all aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
Management of Development Cooperation by Partner Country
6
The United States is the largest aid provider (in raw terms) in the world. The main agency for foreign assistance is the U.S. Agency for International Development (USAID). USAID provides aid to support low- and middle-income countries’ economic development, public health, education, governance, climate resilience, gender equality, and more.
In addition to specific aid to countries, USAID supports many ongoing, wider projects and initiatives. These provide a certain degree of predictability and stability for foreign partners. For example, Feed the Future was founded in 2010 during the Obama administration to address global hunger and food insecurity. Feed the Future works in 20 target countries in Africa, Asia, Latin America, and the Caribbean. Feed the Future assists farmers in boosting their sales, providing them access to new markets and the infrastructure to expand their operations. Its investments total $2 billion per year.
There are also cross-agency initiatives that aim to fight poverty and ill health in the developing world. One prominent example is the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by President George W. Bush in 2003. The initiative, which coordinates agencies across the federal government and works with international partners, is credited with saving over 25 million lives, mainly in Africa.
The U.S. government supports multinational aid initiatives and aligns its operations with the Sustainable Development Goals. For example, the United States is a strong supporter of global vaccine initiatives. The United States supports Gavi, the Vaccine Alliance, which works to increase immunization coverage and strengthen health systems. The United States also participates in the Global Health Security Agenda (GHSA) to improve health security worldwide.

Citations:
https://www.feedthefuture.gov/resource/2023-progress-snapshot/
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