Secretary of State Marco Rubio criticized the long-standing U.S. approach to international health aid, arguing that billions of dollars intended to support healthcare in developing nations have often been routed through non-governmental organizations in ways that reduce the amount of money reaching patients.
Rubio said the United States has spent decades funding health initiatives across the globe but suggested that the current system frequently relies on American and international NGOs to run programs that might otherwise be handled directly by the countries receiving aid.
“The United States has spent billions of dollars over the years in helping with health strategies all across the world,” Rubio said while describing how the system has operated. He explained that over time officials began recognizing patterns in how those funds were distributed and managed.
According to Rubio, the process often begins when the U.S. government commits funding to assist a country’s healthcare system.
Instead of channeling the funds directly through that country’s institutions, the money is typically awarded to outside organizations tasked with implementing programs.
“What we learned over time, and especially after coming here, is that oftentimes, and I’m oversimplifying it, but this is an accurate description,” Rubio said.
“What would happen is we would go to a country and say, we’re going to help you with our healthcare needs. Then we would drive over to Western Northern Virginia somewhere find an NGO, one of these organizations, give them all the money, tell them go to this country and do their health care program for them.”
Rubio said that once NGOs receive those funds, a portion is used for administrative and overhead expenses before the remaining money is used to implement the healthcare programs on the ground.
“That NGO would then take about some percentage of that money for their overhead and administrative costs,” Rubio said.
“And by the time it got down to it, the host country had very little influence.”
He argued that this structure often leaves local governments with limited input on how programs are designed and implemented within their own healthcare systems.
“It was sort of imposed on them, and only a percentage of the overall money ever actually reached the patients and the people on the ground that we were trying to help because of these costs,” Rubio said. “This makes no sense.”
Rubio also questioned why American and international NGOs are frequently tasked with operating healthcare systems that run alongside or even compete with the existing systems in the host countries.
“So why are we hiring American and international NGOs to go into other countries and run healthcare systems that are parallel and sometimes in conflict with the healthcare systems of the host country,” Rubio said.
The Secretary of State said the United States should instead work directly with the governments of countries receiving assistance, allowing them to maintain control over how funds are used to address their healthcare challenges.
“If we’re trying to help countries, help the country, don’t help the NGO to go in and find a new line of business,” Rubio said.
Rubio indicated that the administration is seeking to move away from the model that he described as heavily dependent on NGOs.
“And so that’s what the model that we’re breaking,” Rubio said.
“We’re not doing this anymore.”
He also raised concerns that in some cases key partner countries have had little say in how U.S. health aid is distributed, despite being directly affected by the programs.
“We are not going to spend billions of dollars funding the NGO industrial complex, while close and important partners like Kenya are either have no role to play or have very little influence over how health care money is being spent,” Rubio said.
Rubio said the United States should focus on partnerships that give countries a direct role in shaping the healthcare programs that are intended to support their populations.
“Bottom line is, if you want to help a country work with that country,” Rubio said.
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