To the Editor.
—The Letter From Nicaragua by Garfield et al1 states that following the 1990 election, which brought President Violeta Chamorro to power, US Agency for International Development (USAID) assistance to the Nicaraguan health sector was confined to responding to several emergencies. The article goes on to state that the Pan American Health Organization (PAHO) was the only international organization able to respond quickly to the new situation.The facts are quite different. In 1990, during the first 8 months of President Chamorro's government, USAID provided a total of $9.4 million in assistance to Nicaragua's health sector. Of this total, $2.2 million was used to procure emergency medicines after the former Sandinista government had ransacked the state-run medical supply cabinets; $6.5 million was used to fund private voluntary agencies engaged in providing immediate health services to war victims as well as poor women and children; $700 000 went
Ballantyne JC. Nicaragua: The Role of USAID. JAMA. 1994;271(8):586-587. doi:10.1001/jama.1994.03510320026019