President Obama should designate one lead agency for international development to avoid costly, contentious and time-consuming interagency coordination and potential duplication of activities. For the President's Emergency Plan for AIDS Relief, for example, the staffing and level of coordination needed for 5 or 6 different government agencies working on HIV in a single country is incredibly time consuming and wasteful. In most countries, hundreds of thousands of dollars or more are spent on coordination, endless meetings, and interagency negotiations, which could be better used to help prevent, treat and care for people with HIV. In addition, it is not a good use of taxpayer money for two agencies to fund the same contractor to do the same type of HIV activities in one country (which is happening). By designating a lead agency to consolidate all development aid under one roof, will not only help ensure US taxpayer dollars are used appropriately, but also ensure that the US government is speaking with one voice on its development policy.