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United States of America

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United States of America

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While the US is the largest official development assistance (ODA) donor in real terms, this is only representative of 0.15% of its gross national income (GNI). The United States Agency for International Development (USAID), which has primary responsibility for administering foreign aid and development assistance, is guided by the policy document, Ending the Need for Foreign Assistance. Within global health, USAID has identified three strategic priorities: 1) preventing child and maternal deaths; 2) controlling the HIV/AIDS epidemic; and 3) combating infectious diseases. The US remains the largest global health donor and is the largest bilateral source of development assistance to mental health (DAMH) according to the Institute for Health Metrics and Evaluation. 

Global mental health support

A member of the MHPSS donor group, support for mental health is largely integrated into larger programmes, including humanitarian projects and HIV/AIDS programming. Examples of support include: funding a mental health and psychosocial support (MHPSS) project in Nepal following the 2015 Earthquake; integrating mental health into HIV services; and providing crisis response experts that assist with mental health services in disasters (via Office of Foreign Disaster Assistance). USAID also manages the Victims of Torture Fund, which supports mental health service providers and funds research in LMICs. 

USAID funded the World Bank’s first mental health advisor, and the US hosted the fourth G7 Dementia Legacy event held in 2015 following a two-day conference on the state of the science at the National Institute of Health (NIH).

The US has also announced support for the WHO’s Special Initiative on Mental Health with a US $3 million pledge. 

Strategy for global mental health

USAID does not have a stand-alone mental health strategy, however there is a MHPSS Coordinator and a dedicated team that are working to increase action on mental health. The team is an active member of the donor group on MHPSS in emergency settings.

Domestic mental health

A variety of organisations work on improving mental health services within the country, including Mental Health America, the National Alliance on Mental Illness, the American Foundation for Suicide Prevention, the The National Institute of Mental Health and the Substance Abuse and Mental Health Services Administration (SAMHSA).

A new initiative signed by Executive Order, the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS), has been initiated that will investigate veteran’s mental health and suicide within the country. 

More information can be found in the WHO Mental Health Atlas 2017 Country Profile and further resources in WHO MiNDbank.

Key stakeholders

The US Department of State sets out international policy and strategies and is headed by the Secretary of State 

USAID leads on implementation of development programmes, and supports strategy

The US Department of Health and Human Services (HHS) implements global health programmes. As part of the HHS: the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the Health Services and Resources Administration (HRSA

The National Institute of Mental Health (NIMH) is the lead federal agency for research on mental disorders, and is part of the National Institutes of Health (NIH), the largest medical research agency in the world 

The Office of U.S. Foreign Disaster Assistance (OFDA) is responsible for leading and coordinating the U.S. government’s response to disasters abroad 

The US is a member of the International Initiative for Mental Health Leadership (IIMHL)

The US is a member of APEC, but not a core contributor to the digital hub for mental health.

Key decision makers

Secretary of State: Antony Blinken

USAID Administrator: Samantha Power 

US Department of Health & Human Services (HHS) Secretary: Xavier Becerra

Financing global mental health

According to IHME data, from 2007-2019 the US contributed US $92.2 million in development assistance to health (DAMH). This figure is only representative of government resources.

US DAMH

Global health overview

The US is the largest donor to global health. Some 28% of total ODA was allocated to global health programmes in 2016 (US $10 billion). 

Around two-thirds of US funding for global health is channelled through the President’s Emergency Plan for AIDS Relief (PEPFAR). This includes bilateral funding for HIV/AIDS programmes, as well as contributions to multilaterals.

The US has made pledges and contributions to the following to global initiatives:

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Key resources