It is presented to groups or individuals in recognition of exceptionally outstanding service or achievements of marked national or international significance.

[1] The award consists of a gold medal set and a certificate signed by an assistant secretary, an official of equivalent rank or the Mission Director.

Due to the demanding nature of the criteria, the award is not routinely issued.

Nominations initiated in Washington are reviewed by the USAID bureau/office with final approval by the appropriate assistant administrator or office head.

Upon authorization, members of the U.S. military may wear the medal and ribbon in the appropriate order of precedence as a U.S. non-military personal decoration.