Comments

For me, I think ultimately it comes down to the fact that distributing medical supplies through a system like Coca-Cola's is a great solution for the short-term. For the long-term, however, we need to be investing in building robust supply systems that do not require support from producers with potentially questionable interests.

Very well said Garth. The health strategy is about building health systems. Using Coke's distribution networks might be a quick fix but does nothing to build strong systems in the Pacific. Great blog Sam - a very good read. The thing that I would add is that the whole "let's use Coke to distribute medicines" thing was a big deal in the African ART context around 2006. The Australian government is just getting on to this in mid-2015...

I am sure that one of the most important options to help develop emerging societies is to democratize their governments, in these directions: empowerment of women, transparency in the use of the economical resources given, rendition of clearly use of the resources, caring of the environment, human rights and autosustainability. Otherwise all the amounts of money and human educated resources that they provide to these countries will not achieve their objectives, which in fact is that the purpose of helping those societies to generate jobs, and infrastructure that dignifies the life of such societies, and will in the near future enable those poor countries to avoid expelling their populations as immigrants to the developed countries. Education is the key to develop the society, thus it is very important to improve the educational methodologies to approach the bigger number of children, women and adults who are the ones who should support the development and democracy of the underdeveloped countries, to bring them up, as modern and democratic, just, dignified, self-sustained societies.

Coca Cola is a product available for people to decide whether they want to purchase or not. To change the behaviour of people when it comes to their lifestyle, we should not necessarily be depriving them of that (since, by using this logic, one of the aims of aid in the Pacific could be to prevent Coca Cola, junk food and cigarettes from getting into stores). Instead, we should be helping Pacific Governments to educate people on why deciding to buy Coca Cola or packet of cigarettes is bad for them, and providing support for the emergence of healthier, affordable alternatives.

Thanks Amanda. Your innovation will work well for collecting government information (e.g. in your example of district court clerks), stock supply levels or enrolment figures. We do a lot of research in remote Australian communities to inform policy (as part of the Cooperative Research Centre for Remote Economic Participation (CRC REP)) and I wonder if some of our experiences can add to yours. Most of Australia's remote communities have no mobile phone connectivity, so we use pre-loaded iPads (later downloaded) that are operated by local Aboriginal Community Researchers (ACRs). We have a network of around 200 trained ACRs – who are culturally empathetic and can work bilingually in an inclusive, respectful and genuinely consultative way. They are skilled at working independently or alongside communities and service providers to bring about positive impacts. They are mentored and trained by research leaders from UniSA, UNE, Curtin, CDU, Flinders and SCU. I'm sure PNG could mount a similar capability, even with a bit of help from DFAT (this may already be happening). It isn't easy and it’s expensive on the surface, but it's much more effective and cheaper than using FIFO consultants.

Coca Cola might very well have knowledge and skills which could be useful in improving medicine and food distribution networks in developing countries and I think we should make use of their advice. However Coca Cola's clear contribution to ill health seems to me to make it highly inappropriate and not constructive to link health service delivery to their activities. In addition, if we would not rely on private food companies to distribute medicines here, why would we promote this in other countries? It is clear that many poor countries do run effective health services and drug distribution networks and we should be providing effective assistance to our Pacific neighbours to help them to do likewise.

Hi Sam, Good post. I would add two points: 1. I don't know what parts of the Pacific Minister Bishop has been to, or which hills she has scaled, but Coke was scarce in the parts of rural Solomons I travelled through. Rural health clinics, on the other hand, while under-resourced, were present, could provide first aid, and were possibly the cause of the decline in Malaria that was frequently commented on by people I spoke to. 2. Beyond that: Coke and medicines are, conceptually, two very different things. Coke is a private good (we don't worry too much if people can't afford it); medicines are merit goods (we hope to live in a world where anyone can access the medicines that they need). With private goods it is comparatively easy to leave it to markets to deliver (and if they don't it's not usually the end of the world). With merit goods there is often a need for government subsidies to make sure that everyone has access. But having the government subsidising private delivery networks brings with it accountability and political economy risks of its own. (How do we know the private sector is actually delivering what it says it has? And can we be sure that the potential for profit is not causing it to exert undue influence on what should be technocratic or democratic decisions about distribution?) This doesn't mean we should never engage with the private sector in delivery, but it does complicate matters considerably, particularly in poorly functioning polities. Thanks for a good post on what sounds, at first glance, to be a poorly thought through decision. Terence

Hi Jo, That's a very good question. As you note, DFAT/AusAID has been doing elements of health system strengthening for a long time and the evidence of positive impact in PNG and Solomons is probably limited. The strategy does not directly cite successes from the Pacific. A couple examples of positive results from Indonesia and Cambodia are noted. Others have critiqued the focus on health systems noting that the global results are not amazing - but the Lancet paper tries to address that - and I really don't see any alternative to focusing on health systems. No one ever said it was gonna be easy!

I abhor cuts to Australian Aid but are Afghan health and education programs sustainable in the present security climate?

Thanks Joel. I've been meaning to read the health strategy and your blog means I can cross it off the list. It offers a comprehensive summary. A question. Australia has engaged with some countries over quite long time periods to strengthen their health systems, such as Fiji and the Solomon Islands. Did the strategy reflect on, or incorporate, any learning from past DFAT (AusAID) experience in this area?

We the people of Gulf must mentally change our attitudes of asking MPs for money please..!! Money will never get us out of the way instead. You eat and use money but you will never change and improve in all areas of physical lives, therefore, we must all cry, beg and ask for services and new developments.

It's true Dr. Amanda, I agree with you that mobile phone sms is one cheapest and fastest way of sending and receiving data on time. It truly covers the gap for poor internet services, poor postal services, poor telephone link etc... Practically, mobile phone sms is very helpful regarding timely data. Thank you Tina