The Lancet quotes senior fellow Nandini Oomman in an article on U.S. foreign aid restructuring.
From the article:
The new policy outlines a higher profile role for the US Agency for International Development (USAID), including participation in National Security Council meetings and access to Secretary of State Hillary Clinton, who will “ensure that development and diplomacy are effectively coordinated and mutually reinforcing in the operation of foreign policy”.
Despite the excitement over a more unified, rational US foreign assistance policy, concerns continue about the slow pace and lack of details. Some also worry that although an important goal of the new approach is to streamline and better organise the assistance structure, they say it remains unwieldy. “The most risky piece is too many cooks in the process”, said Nandini Oomman, of the Washington DC-based Center for Global Development. “There are too many cooks and there's no top chef.”
The key health component of the policy, the Global Health Initiative, has three leaders: USAID Administrator Rajiv Shah, Global AIDS Coordinator Eric Goosby, and Centers for Disease Control and Prevention Director Thomas Frieden. The initiative aims to use in-country service delivery mechanisms set up for the President's Emergency Plan for AIDS Relief to expand US focus to health-system strengthening, maternal and child health, and tropical diseases. Although praising the inter-agency coordination intended by the leadership structure, some experts say the design has added cumbersome bureaucracy to an already complicated foreign-assistance process.