DevPolitics

chronic malnutrition and NGO action

I attended a conference held on Malnutrition at Columbia Thursday night. MSF, David Rieff, and Barbara Cooper represented the views regarding Niger and India. My capstone has to do with malnutrition in India, so naturally I had to ask specifics about the work being done. What fascinates me about (and draws me to)  MSF is their constant rule-breaking nature--all in the name of the people, of course. It's admirable, in my eyes. There was a brief mention of the role of advocacy and how it will change the way MSF operates, and frankly I do worry that it will change things. David Rieff brought up OxFam as an example--their incredible field work has been put aside for advocacy...which is a shame, really. Where is the balance? Is there? David Rieff was an interesting character--he actually said that he was there under false pretenses and honestly stated that he did not believe humanitarian work belonged in areas of chronic malnutrition (ie India...or historically, the majority of the malnourished populations). This argument was cut short, but it is interesting to see things from that perspective. Again, where is the balance when it comes to human lives? Malnutrition is generally accepted to have historical connotations. When emergency relief is provided in chronic situations, the services that are generally regarded to be the responsibility of the local government are now receiving support. The root cause (policy, corruption, what have you) is not being addressed, and a problem receives a bandaid in the form of aid and relief. As the roles of organizations start to blend together, I have to wonder when (if, ever??) chronic issues, such as malnutrition, will be addressed.

Buzzwords and Fuzzwords

In late 2008, I had the privilege to be a part of several different projects and organizations throughout my contract in Accra, Ghana. The NYU undergrad program has a semester abroad there and I worked with Professor Regine Dupuy to hold a student based conference in response to the Accra Agenda for Action. One of the articles recommended by Professor Dupuy was "Buzzwords and Fuzzwords: deconstructing development discourse." It refers to Rist's article on the buzzword of "development" and goes into the language of development (think "poverty," "sustainability," etc) with a critical eye. I'd recommend the document if the Rist reading caught your eye.

(Hopefully the link works.)

Thoughts From the First Class

Towards the end of our first class, the discussion seemed to focus on the question of whether it is better to do something in the short run, even if this could be considered inefficient interference, or if it is better if we, as agents of development, focus on altering the larger, national and international institutional paradigms that will result in long term results.  Though I am not sure if I even believe this entirely, my thought was that perhaps it is in fact better to do something immediate and directed rather than waiting to be able to tackle what are seen as the larger problems.  

I would suggest that we consider the success rate that the US and other world powers had in the last century when attempting to undermine or overthrow what were deemed unjust regimes.  Even today we see that there is limited success in such strong arms tactics.  I believe it was Professor Gershman who suggested that if we could be more reflective in our practices and become better at making mistakes, then we would be one step closer to being more effective agents of change.  Perhaps we have already become better at making mistakes if we consider that the current era of the targeted, community-level, decentralized approach is a reaction to failed militaristic, political, and national-plan style interventions of previous decades.  

I believe that we have learned (or are in the process of learning) an important lesson:  we don't have the knowledge, power, or leverage to effectively alter political environments from the top or from without.  Situations can't be reformed by telling people to reform.  However, where we do have some knowledge - feeding, medicine, sanitation, education, etc - we can offer our support.  Some would argue that by alleviating situations of malnutrition, poor infrastructure, and ill-health, development assistance agencies are undermining local and national constituent-elected official dependency and removing the government's responsibility to their people.  This may very well be true, but it seems to me that a well-educated, well-fed, healthy, and informed populace will be better able to challenge the status quo, demand rights, and replace ineffectual bureaucrats.  While starving citizens with pitchforks might also be able to overthrow a dictator, they could also more easily be re-subjugated by the same or a new corrupt regime.  A revolution of strong-minds and bodies will be better able to achieve sustainable political and economic change.  

Thus, my stance is that the work of the Paul Farmers of the world is neither in vein nor ill-directed.  It might take longer and the path might be more circuitous, but in the end it will help people help themselves by building much needed capacity.  To rethink the babies in the river scenario, by staying downstream and fishing out babies as they pass by, one would be creating a network of individuals who can then assist in the rescue operation of their confederates.  

Should United Nations staff fly business class?

The United Nations provides an entitlement whereby its staff are allowed to fly business class instead of economy class if their journey requires them to fly more than a threshold number of hours to a destination. A quick search of typical UN flight journeys on Expedia.com reveals a major cost differential: New York to Nairobi costs $1042 economy class and $8122 business class (difference = $7080). Geneva to Bangkok costs $999 economy class and $6284 business class (difference = $5285). (Figures are lowest priced, round-trip tickets, purchased a month in advance and staying a month, thus, they are conservative price estimates). Money used for these plane trips at times comes from a general travel budget, at times from a program budget. It is also possible for staff members to participate in a corporate program that costs $90 annually that allows them to use special airport lounges for $10 when they travel. If staff members were to stop overnight en route or take an extra day of rest before starting work upon arrival, they would receive an additional DSA (daily subsistence allowance – money provided to staff to cover accommodations and other costs while traveling, amounts vary by country), which would be far less than the cost of the business class differential.

 

There may be exceptions for people with disabilities or other special circumstances. However, given the large amount of travel required by UN staff members, the enormous cost differential between economy and business class travel and the range of other ways these funds could be possibly used (for life-saving or community-designed and driven programs and more), is the business class entitlement ethical and efficient? Perhaps more importantly, are there cases where staff people choose not to fly business even though they are entitled to? Does anyone within the United Nations think about the implications of the entitlement? What do you think children and their families who raise funds for UN organizations would think if they knew about the entitlement?   

Remittances and Development

Today's New York Times has an article following the life of Dilip Ratha, a World Bank employee who produced a break-though study on remittances, as he returns home to his small village in India.  The article takes a look at the scale of remittances and their role in the larger development debate, migration, and how the funds sent home by Mr. Ratha have changed the lives of his family members back home.

Mr. Ratha's study on remittances 5 years ago was the first to see them as something greater than small amounts of extra cash sent back home.  Now totaling more than $300 billion a year, in many cases remittances rival or trump the amount of development aid received by some countries, without the restrictions that normally accompany such funds.  They are direct budget support of a more personal kind: bypassing aid agencies and governments, remittances could be considered a form of micro-finance with no interest (other than personal).

In tallying up remittances, the article writes that:

"There are about 200 million migrants worldwide, supporting as many if not more people at home. That suggests that remittances may reach almost a tenth of the world’s population.

India ($27 billion), China ($26 billion) and Mexico ($25 billion) are the leading beneficiaries. But in relative terms, small countries gain the most, with some increasing their national incomes by more than 20 percent. Egypt gets more from remittances than it does from the Suez Canal."

Some argue that because remittances bypass governments, they are little more than band-aids to development challenges.  Funding family needs, they argue, does not change the underlying social structures badly in need of repair.  Further, remittances are often spent on immediate needs or to fund new purchases. Mr. Ratha argues that not only is increased purchasing power for the poor not a bad thing, but also that remittances may be some of the best-monitored development aid out there because recipient and sender are often family.   “It comes with a lot of goodwill, advice, knowledge and punishment if necessary — keeping in mind the welfare of the recipient,” he said.

While it may be true that remittances are not designed to change institutions, I would argue that they should not be expected to, at least not directly.  Remittances by their design are intended as immediate relief to people in need.  They are the financing of everyday survival and perhaps some investment at a very micro level.  By the same token, however, remittances may end up contributing to social sector reform by giving the poor more leverage in terms of their income.  As people with resources, a village may now be able to petition the government to build a school, offering to contribute some of their own funds as an added incentive.  And, if the government does not respond, they can bypass it altogether and build their own.

As a migrant himself, Mr. Ratha has more personal experiences with remittances than most economists.  While his remittances were initially directed at his immediate family, he has also sent funds for the construction of a school.  Following him home to his village, the article reports on his observations on how much had changed since his last visit home: paved roads, new cell phone towers, children with proper clothing, and an absence of people begging on the street. 

It is impossible to say if any of these improvements are related to the funding that Mr. Ratha has sent, or how much can be traced back to more traditional development projects. The effects of his support on his family, however, are clear.  His sister achieved a master's degree; his brother, who now lives in Michigan, a PhD.  His father has a house.  His village has a school.  Arguably none of this would have been possible without outside funding.  That the funding came from remittances and not aid quite possibly made these changes all possible much faster.   

Can doing what's right hurt you?

As you read the follwing, please consider: this is not an attack on the morals/ethics of current and future development workers. It's not meant to provide advice either. I'm posting it here because it helps me remember that although I can't fix all the problems I would like to, I can at least attempt to draw attention to them. The follwing abstract is from an article recently published in USA Today. I happened to meet the so-called whistleblower through some mutual friends just this past weekend, (just as an anecdote for all of you, he's a Wagner Alumnus from the class of '95). He currently works for Smith Barney, a UN contracting firm that apparently does much of the financial work for UNDP, the latter trying to become more business-oriented in its operations. This is a bit off the topic, but I'm assuming most of you heard the latest from Jeff Sachs that the MDGs will not be reached by 2015 (I doubt anyone honestly thougt they would). What's interesting is that the apparent reasoning behind the failure is lack of financial commitments from rich countries. While that might be the case, I found out that at any point in time, if the UNDP ordered the release of funds, 1 billion dollars, in cash, could be transeferred daily anywhere in the world, in minutes. But, I think UNDP is more concerned with accruing interest on these funds, awaiting for backward governments to fix themselves so they can prove to UNDP that they are worth the aid they are receiving. I wonder if I could ever have a clean conscience working in development, knowing what most of these employees know and not want to do something about it. Without further a do, read and judge for yourselves.

Panel to probe U.N.'s N. Korea operation Posted 14d ago

By Edith M. Lederer, Associated Press Writer http://www.usatoday.com/news/world/2007-09-12-3422159597_x.htm

Event report: Philanthropy in the International Development Agenda

I attended a conference yesterday called Philanthropy in the International Development Agenda: What role can it play to achieve positive sustainable impact. The conference was organized by the International Public Service Association at NYU Wagner. Here is what I heard:

Gary LaMarche, the new president of Atlantic Philanthropies, focused his keynote speech on the US policy. He talked about the challenges that the Iraq war, the influence of the religious right, the Patriot Act and other policies create for philanthropic work here in the US and internationally. LaMarche unfortunately did not address directly the subject of the conference, but his remarks left the impression that philanthropic work should focus on changing the damaging policies.

The keynote address was followed by a panel of speakers. Raman Nanda from Acumen Fund talked about the fund’s market approach and their view that the market place allows the poor to have a voice that can be heard. He suggested that philanthropic organizations could provide more flexible capital than markets do for this kind of work, and their funds could act a s bridge into sustainable commercial funding. Susan Raymond from Changing our World suggested that philanthropy should learn from the failures of government aid over the past decades. In most cases the billions of dollars spent by the governments didn’t make a dent on poverty. Phangisile Mtshali (from South Africa, currently with Bristol-Myers Squibb Foundation) pointed out, and Raymond agreed, that most of that money actually never left the developed world, but was spent on consultants and bureaucracy. In a private conversation after the event Mtshali suggested the existence of an “aid complex”, similar to the military-industrial complex, with its own narrow interests and lobby groups. In this context she stressed the importance of capacity building for local organizations. She talked about how funders set the agenda and the vocabulary used in international development and that people who do good work often don’t fit into the rigid criteria that funders set. According to her aid recipients should be seen as partners, but the word “partnership” is abused. Compared to official aid, philanthropy could have a lot more flexibility in all of these areas.

One of the concluding remarks mentioned the importance of working with the governments. The scale of the issues means that philanthropy alone will not be able to make a difference either. It also called for more coordination among the donor community, but no suggestions were made on how this could be achieved.

Reverse Foreign Aid

There is a very interesting article in this Sunday's NY Times Magazine by Tina Rosenberg on "Reverse Foreign Aid."
It even mentions our pal Dani Rodrik. Check it out.

http://www.nytimes.com/2007/03/25/magazine/25wwlnidealab.t.html?ref=magazine

Sachs on Global Health

This evening, the NYU School of Medicine hosted "How to Achieve Health For All" presented by Jeffrey Sachs.  As an undergraduate studying economics, Sachs seemed somewhat iconoclastic to me because he placed great emphasis on improving the health of the poor as a mechanism for eradicating poverty and increasing economic growth (this seemed somewhat revolutionary to me because my development economic coursework focused primarily on "pure economic" policy prescriptions and delved very little into social indicators).  So, for many years I was a huge Sachs fan.  I was shocked and angered that anti-malaria bednets only cost $5, yet malaria was killing in large numbers, that children around the world were dying from highly treatable diseases, and that US foreign aid accounted for only 0.25% or so of GDP.  The Sachs approach made great sense to me...until I started reading Easterly and Birdsall and the growing literature on the effects of institutional capacity, evaluation, and politics on foreign aid.  The main sticking point in my mind is that we've already spent approximately $1.7 trillion in ODA over the past four decades, yet we don't really have much to show for it.  As such, I'm quite pessimistic that more money is the answer.   But, I attended Sachs' lecture tonight with some optimism and in the hope that the economist who had once been a huge inspiration to me, would wow me once again.

Sachs opened his lecture by saying that solving the global health problem is "simply remedial," that it is "easy to get the necessary resources, and that "we can end extreme poverty during our lifetimes."  He also seemed optimistic that the MDGs can still be attained even with only nine years to go.  Sachs then spoke in great depth about the incidence and epidemeology of disease, with a main emphasis on malaria.  He peppered his speech with pictures of sick and dying children.  Sachs continued by stating that the two main underlying causes of disease are poverty and the physical ecology in which the poor live and that there is a connection between health and worker productivity / earning potential.  Then he elucidated for the audience what we had all been waiting for...the "how" in "how health could be achieved for all"...

Each person in the rich world foregoes one Starbucks per year and...oiula!

Okay, that's dumbing it down a little, but according to Sachs, 0.1% of rich world GDP per year, or $3 per year from every person in the rich world, or one foregone Starbucks trip per year by every person in the rich world will provide universal healthcare access, treatment for TB, malaria, etc., safe drinking water, and nutritional supplements.  No regard for a policy framework.  No regard for implementation or evaluation.  No regard for institutional and political factors.

When asked how the money should be spent during the "Q&A" session, he advocated supplying those at risk for malaria with bednets, rather than supplying governments with money to buy bednets, which I can understand.  But then my question would be..."How do you provide bednets to 300 million people, many of whom live in remote, rural areas of Africa?"  "How do you deal with the logistical and infrastructure issues?" Sachs also very briefly mentioned the need to "give things systematically and with accountability," but didn't talk about what that actually means.

All in all, I didn't feel that the Sachs' solution really lived up to his lecture's title.

Why We Need Africa More Than Africa Needs Us

This past weekend (11/19) in The New York Times Magazine, James Traub wrote about China’s foray into Africa as a formidable development force. Set with unique theories on development and resulting policy practices based on its own unique experience, China’s “African Adventure,” as Traub comes to call it, poses a new challenge (or should I say competition?) to the more traditional approaches of the United States and our Western international development institutions. Using the example of Angola, Traub highlights how the Chinese have come to see development assistance, in the form of whopping billion dollar loans, as strategic opportunities for resource extraction and their own economic gain; that the Angolans benefit from newly constructed infrastructure or oil wealth is a side thought that does little to motivate bureaucrats back in Beijing. With the sole motivating factor being mutual economic gains and secure sources of key resources, the Chinese have devoted little concern for the livelihood of the average Angolans and have consequently attached little conditionalities and no calls for reform to their loans and contracts. In other words, Angolan development is a byproduct of mutual elite economic interests and not due to structural adjustment policies, emphasis on democratic governance, or concerns for the capabilities and welfare of the Angolan poor.

This new policy is in much contrast to that of the United States and our Western dominated international development institutions such as the IMF and World Bank. Gone are the days of structural adjustment clocked in the name of altruism for the poor and in are the days of ‘accidental development’ as a byproduct of mutual economic gains. The Chinese policy is appealing to the Africans, as it promises across-the-board development and is particularly lucrative for elites, and is a valid alternative to decades of IMF and World Bank loans that have all but sunk the region into debt. So if the end ‘by-’product of the new Chinese policy is increased levels of development, then let it be. Who knows, maybe it will force our Western development institution to engage in some of their own much overdue reforms and policy reevaluations. But if in the process this new policy comes to further alienate the Angolan public and bolster elite authoritarianism, then China’s foray into Africa should be watched with careful eyes and challenged by new and improved Western responses. Because, as James Traub concludes his article, the West has a vested interest in securing its relationships in an emerging market and fostering healthy democratic governance: “[the West has] grown accustomed to the idea that Africa needs it; now it’s time to recognize that [the West], like China, needs Africa.”