While the substantial increase in assistance in 2005 is a step in the right direction, U.S. aid as a share of income still has a long way to catch up with European countries. In 2002, the U.S. made a significant commitment to increasing ODA and targeting aid more effectively, by establishing the Millennium Challenge Account (MCA). However, the impact of the MCA on overall ODA levels has been limited so far. In particular, requests from the administration to Congress have been lower than promised, and in turn what has been granted by Congress is even less. Finally, disbursement through the MCA has been painfully slow.
The United States has also made an important financial commitment to the fight against HIV/AIDS in developing countries through the President’s Emergency Plan For AIDS Relief (PEPFAR). This involves a five-year commitment to providing $15 billion to support treatment for 2 million people, support prevention for 7 million, and support care for 10 million. Initially it was expected that funding would be additional to existing U.S. ODA commitments, however – along with the Millennium Challenge Account – PEPFAR is being financed at the expense of core development programs.