Changes at USAID headed by Rajiv Shah as it makes more room for private initiative of local groups and funding of local groups in countries being helped, and shifting away from handing whole projects to U.S. government contractors. Another change is the harnessing of the efforts of U.S. corporations interested in emerging market countries for introducing their products as part of an aid effort. An example is GE for medical equipment at Nelson Mandela Children's Hospital opening in South Africa in 2016. In countries where corruption is widespread such as Afghanistan, giving money to government ministry creates risks of waste and corruption, a problem which is however part of larger problem of wasted resources in that country. The basic concept of using private initiative and getting the involvement of local groups, U.S. corporations interested in emerging markets at the aid level for their products, taken up by Shah is sound and was overdue. It is already the practice as the Bill and Melinda Gates Foundation is doing much of the heavy lifting and large scale aid effort in poor countries of Africa and Asia. Shah worked at that the Gates Foundation before USAID. An example is the Grand Challenges for Development program to get innovators to help tackle problems in poor countries- the Pratt Pouch a small pouch with anti-AIDS drugs not requiring refrigeration was developed at Duke University and could potentially prevent transmission of HIV to 400,000 babies a year. Shah's own background of immigrant parents coming from India gives him a unique insight into how to combine the involvement of the creative abilities of well intentioned Americans at universities and private companies and local groups in poor countries, to leverage the results. He has a medical degree from the University of Pennsylvania....