Lancet World Report examines elements of President Barack Obama’s U.S. Global Development Policy strategy that he unveiled during the U.N. summit on the Millennium Development Goals (MDGs) in September. The article summarizes the new approaches described in the U.S. Global Development Policy, pulling direct quotes from Obama’s speech, before writing, “Despite the excitement over a more unified, rational U.S. 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.”

“There are too many cooks and there’s no top chef,” the Center for Global Development’s Nandini Oomman said of the strategy. For instance, “[t]he 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 Lancet writes. “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,” according to the article.

The article examines how Secretary of State Hillary Rodham Clinton fits into the U.S. Global Development Policy, writing that some see Clinton as “the ‘top chef’ … a situation that has benefits and drawbacks. … On the one hand, having the Secretary of State as an unabashed supporter of development ensures it a high profile. On the other hand, it inextricably links development with diplomacy in a way that makes some uneasy.”

Lancet also describes the concerns expressed by some that the president “did not move faster to ensure long-lasting changes to foreign assistance. Without turning the policies into law, they can be easily reversed by the next president.” The article speculates what the outcome of the November mid-term elections, as well as worries over the U.S. economy and deficits, might mean for foreign assistance funding. The piece also includes comments by Bread for the World President David Beckmann (Bristol, 11/13).