A Deeper Look

  • The specter of segregation haunts global health

    There is no question that the greatest health achievements under the Millennium Development Goals have focused on single diseases. Arresting the spread of HIV and AIDS and malaria is perhaps the most significant development success of the new century. And vaccination, especially of measles, is one of the reasons that deaths among older children have fallen faster than deaths among infants or women during pregnancy and childbirth.

    In contrast, the lowest-performing areas across all eight MDGs — reducing infant and maternal deaths — are targets that don’t lend themselves to a single disease strategy. Just six countries have met the MDG target for reducing infant deaths, and only 15 countries have achieved the target for reducing maternal deaths.

    Could these targets have actually been achieved if we had pursued an integrated approach to advancing the health of women and children? Did our fascination with and confidence in the segregation of single-disease initiatives cost us achievement in other areas requiring more complex solutions?

    Read the remainder of the blog here.

  • Let’s get real in Addis: The high cost of people-centered development

    When heads of state, ministers of finance and leaders of the international development community gather in Addis Ababa this July for the Third Conference on Financing for Development, I hope that the discussion will be grounded in the hard realities facing the least-developed countries struggling to provide basic services to their growing populations.

    I also hope that conference participants rise above the popular but misleading narrative that the private sector is the panacea.

    Looking to the private sector as the primary source of financing for development is particularly seductive for two reasons: Statistical evidence seems to support the argument, and it provides a rationale for reducing official development assistance at a time when donor nations are struggling with debt and budget crises.

    However, placing unrealistic expectations on the private sector to meet basic needs in health, education and public administration clouds a critical debate.

    Part of the problem is definition. “Private sector financing” is one of those catch-all terms. It encompasses business spending (foreign and domestic direct investment), remittances from migration in a globalized world, user fees to private providers of public services, and large-scale private philanthropy that has exploded out of the technology revolution.

    Read the remainder of the blog here.

  • Words count!

    Let’s start the New Year by looking at how we talk about development. It is striking how certain concepts and buzzwords rally people around ideas and mobilize us into action. The buzzwords themselves become powerful change agents. Yet, when they mature into unquestioned orthodoxy, they can restrict our vision and dull our understanding. Here are two buzzwords we love to use in development that are ripe for a deeper look.

    Sustainability

    Development and sustainability go together like bricks and mortar. But this term now has two distinct meanings in development parlance. One meaning refers to policies and actions that safeguard the environment and do not deplete our natural resources. This meaning has gained currency over the last 15 years. The second, and at least in my experience more common use, refers to a recipient partner’s interest and ability to continue projects or reforms financed by donors once donor funding ends. This use is closely associated with the concept of country ownership. When USAID adopted sustainable development as its credo in the mid-1990s, it was a response to the criticism that donor-funded projects collapsed when the funding ran out, often up-ending years of effort. This was partly a result of donors not wanting to take on recurrent costs that were seen as the partner’s responsibility. The lack of serious planning for recurrent costs remains a major challenge in international development.

    Yet, should sustainable development even be an objective in a world where technology is changing everything around us at an exponential rate? Do we really want to sustain yesterday’s solutions? I think not.

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