Why GAO did this study. The Bureau supports U.S. efforts to save lives, protect the people most vulnerable to disease, and promote the stability of communities and nations throughout the world. From fiscal years 2019 through 2022, the Bureau had an annual budget between $1 billion and $1.4 billion. The COVID-19 pandemic has highlighted the importance of the Bureau’s work to U.S. foreign policy. To respond to disease outbreaks and support existing health programming, the Bureau requires a workforce with a variety of skill sets. Its ability to assess its performance is important to its preparation for future health crises. GAO was asked to review the Bureau’s operations. This report examines (1) the Bureau’s staffing and its workforce plans; (2) its performance assessments; and (3) key factors that affect the Bureau’s ability to execute its mission and priorities, and the steps it has taken to address them. GAO analyzed USAID staffing data and global health reports. GAO also interviewed USAID officials in Washington, D.C., and at five overseas missions, selected based on factors such as geography, amount of funding, and number of health program areas. What GAO recommends. GAO is making six recommendations, including that USAID ensure the Bureau develops a workforce plan, improves performance assessments and reporting, documents lessons learned from the COVID-19 pandemic, and institutionalizes efforts to address negative behaviors identified by the Bureau as affecting its culture. USAID concurred with all of GAO’s recommendations.
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