INSIDE DEVELOPMENT
In this section:
Improved Agriculture Policies Needed to Cut Hunger,
Says a Top USAID Official
NGOs, USAID Share Ways to Work Together
Shorter Country Strategy Policy Cuts Red Tape
Global Health Campaigns Saved Millions of Lives,
Study Says
Referendum Lets Peruvian Voters Set Health Priorities
Fern Holland 1970–2004
Improved Agriculture Policies Needed to Cut Hunger, Says
a Top USAID Official
COLLEGE PARK, Md.—Without improving agriculture,
developing countries—particularly in sub-Saharan Africa—will
experience significantly more hunger in 2011 than in 2001,
said a top U.S. aid official.
Hunger is a looming threat, due to changing patterns in
the global food supply, increased demand, population growth,
and resource limits for expanding agricultural production,
according to Emmy Simmons, assistant administrator for Economic
Growth, Agriculture, and Trade.
More developing countries must adopt agricultural policies
that enable markets and science to work together on solving
hunger and poverty problems, Simmons said at a Dec. 2, 2004,
world hunger conference sponsored by the Joint Institute for
Food Safety and Applied Nutrition at the University of Maryland.
Sub-Saharan Africa is getting further from meeting the internationally
accepted goal of halving by 2015 the 1990 level of the number
of people living with hunger, Simmons said.
Currently, the region accounts for 38 percent of the world’s
population experiencing chronic hunger. Without an increased
focus on agricultural development, 50 percent of the world’s
hungry people will be living in sub-Saharan Africa by 2011,
she added.
Increased income levels in some Asian emerging economies,
particularly China, are resulting in demand for more types
of food—such as meat—that require more agricultural
inputs. That means that the poorest countries are facing increasing
competition for food staples from global supplies. Because
people in the poorest countries don’t have the purchasing
power to buy food imports, they must produce the food they
need, Simmons said.
She urged developing countries that still try to control
food prices to change their policies. Artificially low food
prices are a disincentive to local farmers to grow food that
could feed their communities or be sold and generate income.
Simmons said governments also should lower their barriers
to trade so more food can be available to their populations
at lower prices.
Mali is one example of a country that has adopted agricultural
policy reforms, Simmons said. It invested in broadening its
irrigation systems, increasing the capacity of its arable
land to produce food. Mali also liberalized food prices and
established a market information system, which is updated
daily so farmers can learn about current prices. And the country
has established buffer stocks of both food and money that
can be tapped in the event of a crisis.
Simmons said USAID supports efforts to expand trade and
to increase farmers’ access to adequate information,
distribution, and storage systems.
USAID also supports using science and technology to increase
both production quantities and the value of farm outputs.
The Agency is working to build more partnerships with agricultural
research institutions in the United States and in the developing
world, with a focus on adaptive research.
Cliff Gabriel, associate director of the White House Office
of Science and Technology Policy, cited examples of current
agricultural research conducted with U.S. support, such as
root health improvements so that plants can grow in weak and
dry soils. Other efforts are going into technologies that
decrease evaporation rates of scarce water resources and boost
nutrition levels of foods.
NGOs, USAID Share Ways to Work Together
WASHINGTON—This year’s annual PVO conference
ushered in what may become a new series of events for U.S.
private voluntary organizations. More than 400 people, including
managers and directors, attended the two-day event. For the
first time, representatives from overseas NGOs were also present.
The conference titled “What Makes a Good NGO?”
was sponsored by USAID’s Office of Private Voluntary
Cooperation–American Schools and Hospitals Abroad (PVC-ASHA).
It was held Jan. 13–14 at the Renaissance Washington
Hotel.
“While annual PVO conferences have been held for a
number of years, the January 2005 PVO conference represented
a significant departure from prior years,” said Judith
Gilmore, director of the PVC-ASHA. “In the past, the
annual PVO conference focused on funding opportunities for
U.S. PVOs, whereas this year the conference was focused on
the substantive work of U.S. PVOs and local NGOs, in partnership
with USAID, in ensuring effective, accountable, and sustainable
implementation of our activities.”
Some 515 American PVOs and 58 international groups are registered
with USAID. The Agency distributed $7.1 billion in grants
to NGOs, businesses, international organizations, and other
government agencies during 2003. PVOs received just under
$1.9 billion.
The conference opened with panels on major issues facing
PVOs and NGOs and some examples of how PVOs and NGOs have
dealt with those issues. Coralie Bryant, co-director of the
Economic and Political Development Program at Columbia University,
stressed the importance of organizations becoming flexible
enough to learn from their mistakes and make strategic alignments.
“Learning starts with listening and allowing older suppositions
to be displaced,” she said. “It is not easy.”
A session titled “USAID 101,” for instance, targeted
newly registered PVOs. A nearly packed auditorium got an overview
of the sometimes extensive procedures faced by PVOs, including
how to get funding and the hallmarks of a good submission.
Another session covered standards and certification for
PVOs and NGOs, which is a topic of growing congressional interest.
Given the recent outpouring of donations to NGOs in response
to the tsunami in Asia and concerns about accountability of
many of these groups, the session was particularly timely,
Gilmore said.
There was significant interest in this year’s theme,
said Gilmore, who quoted one participant as calling the event
a “superb experience.”
Shorter Country Strategy Policy Cuts Red Tape
A new strategic planning process eliminates lengthy country
strategy papers that bureaus often spend years writing, only
to find they become obsolete as conditions on the ground change.
The new system involves shorter country strategy documents
and operational plans. It also contains concise frameworks
that lay out priorities at the Agency, bureau, and mission
levels.
The process is part of a larger series of reforms that grew
out of the Business Model Review, which changes the way USAID
conducts strategic planning, monitoring, and reporting.
“The new policy will reduce the workload on our missions
and redirect attention from planning to operations,”
said Joseph Lombardo, director of the Office of Strategic
and Performance Planning.
Shorter strategy papers will allow missions to spend more
time contemplating and discussing their overall approach,
said Gloria Steele, deputy assistant administrator for Europe
and Eurasia.
“We can channel some of the freed-up time from writing
less to thinking more about what we are trying to achieve,
how we will achieve it, and how we convey our strategy in
the clearest and most concise way,” she said.
The new process has
- Agency and bureau frameworks that will establish major
priorities and policy directives at headquarters and regional
levels
- Mission strategy statements capped at 5 to 10 pages—rather
than up to 200—that will outline a broad vision for
a country
- Operational plans that will focus on tactical issues
and plans over three years
- Program components, a list of major development activities
that will be required with missions’ strategic objectives
(SOs)
An SO entitled “Support the Peace Process in Sudan,”
for example, would be associated with three program components:
improved community-based reconciliation, support for democratic
local government and decentralization, and dealing with conflict
transition issues.
Over the next year, the working group that crafted the new
process will oversee the development of common indicators
for each program component to allow the Agency to capture
its performance across all operating units.
This should make it easier for USAID to tell its story and
highlight accomplishments to Congress and the public, said
Joanne Giordano, senior advisor to Administrator Andrew Natsios,
who approved the strategy Nov. 10.
Global Health Campaigns Saved Millions of Lives, Study Says
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Two Sudanese boys use pipe filters to protect themselves
from contracting Guinea worm disease, a parasitic water-borne
disease that breeds in stagnant pools of water. The
water is strained though a nylon material attached to
one end of the straw-like device. The Carter Center
blanketed Sudan with more than 9 million pipe filters—one
for every man, woman, and child at risk of Guinea worm
disease. Today, the disease has been reduced by more
than 99 percent.
The Carter Center/Emily Howard Staub |
Millions of people have been saved from disease, thanks to
international health campaigns against polio, guinea worm,
tuberculosis, measles, and diarrhea, according to a new book
by the Center for Global Development (CGD) released Nov. 30.
Millions Saved: Proven Success in Global Health tells
the history of global health campaigns that dramatically reduced
or eliminated 17 diseases once synonymous with death and permanent
disability.
Its authors say the book shows that large-scale efforts
to improve health across the globe can work.
“The conclusions… leave little doubt that some
efforts to save lives and livelihoods through health interventions
have worked, and have done so at remarkably low cost, compared
with the benefit,” CGD President Nancy Birdsall said
in the book’s preface.
,
The 17 examples “show that major public health efforts
can and have changed the world for the better,” she said.
Nearly 60 health projects were nominated for the collection,
said Molly Kinder, one of the book’s authors. That number
was winnowed down to 17 because, in most cases, “there
is a very serious lack of evidence—stemming largely from
insufficient program evaluation,” she said.
Five of the 17 health campaigns that saved millions of lives
had significant USAID support:
- Family planning in Bangladesh
- Trials for a vaccine against bacterial meningitis in
Gambia, followed by national immunization
- A global campaign against guinea worm
- The control of onchocerciasis or river blindness in sub-Saharan
Africa
Eclipsing those in scope, however, was the Agency’s
effort to prevent diarrheal deaths in Egypt.
In 1977, before intervention, diarrhea caused at least half
of infant deaths in the country. It can lead to serious dehydration
in children, and loss of only 10 percent of body fluids can
be fatal.
With $43 million—of which USAID contributed $26 million
as grants—the National Control of Diarrheal Diseases
Project was formed.
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Scene from Nijeke Jana (Know Yourself) a health video
designed to teach adolescents about their bodies, abstinence
before marriage, and other family planning issues. The
program is run by the Bangladesh Center for Communication
Programs and was designed in collaboration with Johns
Hopkins University.
Bangladesh Center for Communication Programs. |
The project mounted a promotional campaign for a low-cost
mixture called oral rehydration therapy (ORT). The program
targeted mothers and health workers through mass media and
training sessions. Soon, nearly all mothers in Egypt were
aware of ORT and could successfully mix the solution.
Between 1982 and 1987, deaths due to diarrhea fell 82 percent
among infants and 62 percent among all children.
The infant mortality rate in 1977 was 100 deaths per 1,000.
It fell to only 33 per 1,000 births this year. And it will
drop further—to 18—by 2020.
Worldwide, ORT has cut deaths from diarrhea among children
by half, saving about 1 million lives, CGD said.
The authors of the case studies said success is possible
even in the poorest countries. Contrary to some beliefs, governments
are in some cases the chief funders. Technology is an aid,
but behavior change is fundamental to improvements. Moreover,
saving lives saves money.
“This effort puts to rest the notion that nothing works
in global health,” CGD’s Birdsall said.
Figuring out how these successes can be repeated is a next
step. The book says urgent problems persist: HIV/AIDS, health
gaps between rich and poor, child mortality in African countries,
and cardiovascular and other chronic diseases that have been
called a “hidden epidemic” in developing countries.
Referendum Lets Peruvian Voters Set Health Priorities
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Health promoters and members of the National Office
of Electoral Processes (ONPE) motivating rural voters.
PHR Plus |
LIMA, Peru—A recent referendum, or consulta
ciudadana, on health priorities in Peru is giving a voice
to rural people unaccustomed to the voting process.
The Lambayeque regional government placed a referendum on
the November 2004 ballot to gauge which health issues were
priorities for its residents.
Government officials agreed to incorporate the vote results
in its next five-year strategic plan.
“The consulta ciudadana was intended to determine
health priorities as a primary goal,” said Luis Deza,
regional health director for Partners for Health Reform (PHR)
Plus, an NGO funded by USAID.
“But more importantly, the vote addressed the fact
that Peru’s rural population was accustomed to being
excluded from the government decisionmaking process.”
“In the end, 123,627 citizens—32 percent of them
from rural areas—helped to set priorities and experienced,
possibly for the first time, what enfranchisement of their
voice means.”
In addition to rural voters, the consulta urged military
personnel, police officers, and public school students aged
14 and older to vote. These groups are typically excluded
from the voting process as well.
The top health priorities identified in the referendum were
- Scarcity and deterioration of water services and waste
pickup (18 percent)
- Marginalization of the poor to health services (14 percent)
- Mental health (13 percent)
- Malnutrition (11 percent)
- Maternal health (8 percent)
In rural areas in Lambayeque, only 27 percent of residents
are connected to municipal water systems, and 11 percent do
not have adequate sanitary disposal facilities. Statistics
also show inadequate health insurance coverage, which often
leads the very poor to forgo healthcare.
“The referendum is a good alternative to lead our region.
There have been many cases of corruption [and] bad attention
to the public,” said a 15-year-old from a rural school
in the Montsefu district. “I think this should be a priority
for the regional government and for the National Health Directorate:
for them to promote the development of good health services.”
The vote was supervised by Peru’s National Office of
Electoral Processes, with participation from an external team
of observers that included representatives from the United
Nations, USAID, and nongovernmental organizations.
“This was a successful exercise in small d democracy
that, hopefully, will have an impact on the health of rural
people of Lambayeque, especially those who have typically
been excluded from the process,” said Nery Saldarriaga,
PHR’s regional vice president.
“We hope and look forward to more civic participation
from this segment of the population that has unfortunately
not had a means to contribute their opinion to their local
government decisionmakers.”
Fern Holland 1970–2004
Fern Holland, a former USAID contractor who was killed in
Iraq March 9, 2004, has been posthumously named Oklahoman
of the Year by Oklahoma Today magazine.
Holland and two other aid workers with the Coalition Provisional
Authority were the first U.S. civilians to die in Iraq. A
gunman riddled the car they were in with bullets as the three
left a women’s center Holland had helped create in Karbala.
Beginning in July 2003, Holland worked for USAID in Al Hillah
on human rights and women’s issues as part of the Abuse
Prevention Unit. A lawyer, she interviewed Shiite survivors
of massacres during the 1991 uprising after the first Gulf
War.
The magazine, which features Holland on its January/February
2005 cover, said the aid worker’s efforts in Iraq “showed
the world her fearless determination, generous spirit, and
ceaseless work ethic.”
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