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From C Bateman-Steel on Australia’s idealistic medical students: an under-exploited development opportunity?
Thank you for the interesting post. I too salute the idealism and motivation of medical students, many of whom genuinely came into medicine to 'make a difference' and are keen to do this in a global context. Having been one of these medical students in the UK and devoted my student days to setting up opportunities (in the form of Medsin http://medsin.org/) for students to follow their global health passions I have great sympathy with your point. I do also recognise the complexities and dangers and think it is important to come up with solutions that strengthen both the training path of the students but also ensure that any initiatives fit with development best practice. I have seen wonderful student/junior doctor projects and disastrous ones. The best cases are when the enthusiasm of the medical student body can work with strong long-term projects to bring energy and committed workforce to support an ongoing project, whilst also giving the student/doctor an experience that fits into a recognised training path in their own country. The worse cases I have seen have placed the volunteer in danger, or been damaging to the community in which they were placed. The other danger is that the student/doctor can feel very lost on return as the establishment does not recognise their experience.
I think it is vital to work with the medical education establishment to ensure that there is plenty of opportunity within the curriculum to learn about global health and development, but also to work with Colleges to ensure that these kinds of experiences are valued and even recognised as training. This may help the student/doctor not to suffer from the confusion of their global health interests not fitting with the constraints of medical career paths. Also, if partnerships can develop between the medical establishment in Australia and institutions in developing counties it provides the kind of bilateral capacity building that is ideal.
In my junior doctor days we set up the UCL Institute for Global Health ( https://www.ucl.ac.uk/igh/undergraduate/ ) specifically to provide education in global health for undergraduate medical students. It would be great to see more undergraduate global health teaching developing, as a core part of the medical curriculum, to support the incredible motivated students that you describe.
From Peter Graves on How a journalist reignited the Sachs-Easterly aid war
Thanks to Mr Sachs for his offer of 1 February.
The stories on the success of aid for public health are always worth reading, especially as they contribute to taking the debate beyond the query still current "does aid work".
Some of the evidence has been established in a 2010 report by the World Health Organisation titled "Protecting Health: Thinking Small" (WHO Bulletin 2010:88:713-715). That report demonstrated the value of linking microfinance lending with a package including health-care subsidies, training and interventions for social inclusion.
From Archer Davis on Does foreign aid really work?
"there is widespread evidence of donors continuing to recruit public servants to implement their projects, which undermines national capacities, especially in contexts where they are particularly weak."
This depends on your viewpoint, of course. If you think that a govt dept is the place for highly educated professionally qualified people, mired in bureaucracy and political influence peddling, then you would take this view.
From my perspective I would say that taking this demographic cohort out of that context and introducing it to the private sector context of projects, deadlines, measured outputs etc. is a valuable life skill training intervention. The national capability is not just public servants - the broader economy of that country benefits from autonomous professionals who can be mobilised into all sorts of useful activities, rather than attending interminable meetings and industrial tourism visits to irrelevant work environments, as is frequently the case for tenure protected bureaucrats.
From Robin Davies on Australia’s overseas aid program: a post-surgical stocktake
The agreement (p. 11) commits funding for only the first two years of the five-year agreement period, with further funding subject to a review that was to be undertaken in 2012. I could find no indication that further funding had in fact been agreed on either the relevant pages of the DFAT web site (<a href="http://aid.dfat.gov.au/publications/Pages/aus-gov-ilo-partnership-agreement.aspx" rel="nofollow">here</a>) and the ILO web site (<a href="http://www.ilo.org/asia/WCMS_159330/lang--en/index.htm" rel="nofollow">here</a>).
However, on poking around a bit more I found <a href="http://www.ilo.org/wcmsp5/groups/public/---dgreports/---exrel/documents/genericdocument/wcms_172445.pdf" rel="nofollow">this </a>mid-2013 publication from the ILO's Better Work Programme which does refer to fresh funding for years 3-5 of the agreement. It specifies the amount allocated to the Better Work Programme (just under $13 million), though not the amounts allocated to other programs.
The additional funding for years 3-5 would have required an agreement specifying the allocation of the funds to programs and various other things. The agreement doesn't seem to be publicly available so I can't be sure what sort of escape clause it might have contained. The words 'subject to annual budget appropriations' are common in such agreements. This formula provides plenty of scope to stop paying when appropriations are dramatically reduced, as in 2013-14. Whatever the escape clause was, it might have been activated.
If that's the case, it tends to reinforce my view that the government, contra Sheridan, could and have would have cut other multilateral allocations if it wanted to. The fact that it didn't do so suggests there has been a welcome recognition that most of those allocations are entirely appropriate.
As for the case of the ILO, it's unfortunate that it is and always has been a political football. The government, and the UK government, should look at the organisation on its merits after reflecting on the fact that it's a tripartite body and not some sort of multilateral council of trade unions. The cut to the Better Work Programme, if it is a cut, is particularly disappointing.
From Simon Field on Australia’s overseas aid program: a post-surgical stocktake
I am confused about the statement. Perhaps, as Sheridan claims, the multilateral slashing will commence once existing funding agreements expire (the contribution obligations under the ILO agreement had already expired). The agreement link shows an agreement period 2010 - 2015 and expiring in June 2015. The government in 2013 committed to 3 years of ongoing support and transferred a payment in the 2012/2013 financial year to the ILO. There appears to be no transfer of funds in the current financial year 2013/2014. Your understanding of the situation would be greatly appreciated.
From Tess Newton Cain on Development Entrepreneurship – a new model for the DFAT aid program?
I agree with Chris that there are signs of DFAT working with these approaches in the areas that he has referenced. As part of the push for more value for money within the aid programme I would like to see how DFAT can improve its knowledge management practices so that the lessons learned by PLP/DLP (and others many of whom are not 'in' the aid programme as such) can be really shared across the programme - putting things on a website is a really good first step but there is much more to be done besides.
From Chris Roche on Development Entrepreneurship – a new model for the DFAT aid program?
Neil I couldn't agree more. It strikes me that DFAT are already attempting to do some of this both at a practical level through the Pacific Leadership Program (http://www.plp.org.fj/), and at a research and theory level through the Developmental Leadership Program (http://www.dlprog.org/). Perhaps it could be drawing lessons from these experiences to help shape and inform DFAT's policy and practice?
From Jo Spratt on Development Entrepreneurship – a new model for the DFAT aid program?
Great blog, thanks Neil. (And I hope you got to read the Mockingjay in the end - an excellent read.) Your summary, and Diana's comment, reminded me of all the work going on in the area of complexity thinking and development.
Duncan Green had a <a href="https://devpolicy.crawford.anu.edu.au/department-news/2553/duncan-green-devpolicy" rel="nofollow">great presentation</a> at the Development Policy Centre last year, with a good set of slides offering ideas about how to work with complexity.
And over on the Poverty to Power blog there are <a href="http://oxfamblogs.org/fp2p/tag/complexity/" rel="nofollow">regular posts</a> about complexity.
Lots to think about. Actors seem to play the leading role in the Asia Foundation's case studies, with a lesser role for ideas. I'm guessing institutions are an important component in the mix, too. We need many more case studies such as those you summarise here. And more conversations about how to actually implement these findings, working with complexity in ways that doesn't always involve providing money (which has its own impact within a system) and figuring out which actors are the best ones to support - a reason for knowing the history and context as well as possible.
From Ashlee Betteridge on Four reservations about political settlements
Just a quick note to flag that Tony Hughes has made a contribution to this discussion on political settlements, which we have posted as an 'In Brief' on the blog <a href="https://devpolicy.org/in-brief/political-settlements-implies-an-unrealistic-permanence-20140212/" rel="nofollow">here</a>.
Ashlee
From Diana Keating on Development Entrepreneurship – a new model for the DFAT aid program?
Neil, thank you for this really helpful summary. Your article, and second (I think most important) point about "development entrepreneurs" reminds me of AusAID's interest many years ago on the political economy of change. There were reports called "Drivers of Change" which tried to identify how policy change happened - and invariably they pointed to a champion, or a champion organisation, that cajoled, advocated, and acted to make the change happen. My personal experience is likewise that change requires champions, or "development entrepreneurs," and that we need to follow these champions (requiring flexibility of programming) and support their efforts because ultimately they will be more successful than stand-alone, self-initiated programs. There's other theory that supports this "follow the champion" approach - "hot hands" is a well known phenomena in the investment community, for example. Of course, sometimes champions will fail (your acceptance of failure point), but their average will be better than otherwise and my experience suggests there is greater potential for real, long-lasting change than may otherwise be the case.
It's a shame the system almost mitigates against this approach. I wonder how we could work to address this?
From Conrad Holland on Energy poverty and access to electricity in the Pacific: heading in the wrong direction?
While I agree with your conclusions with regard to renewable energy as a solution for Small Islands Developing States (SIDS) of the Pacific, the argument is different. One of the key barriers to electrification, especially rural electrification in the Solomon Islands is land and land ownership. It is only in areas adjacent to the main population centres where there is an effective cadastre, while the remaining land is in customary ownership. As an opinion the existing land in customary ownership will always remain in customary ownership which makes developing any large scale infrastructure difficult. The issue then becomes how you align traditional land ownership patterns with electrification; there are several options that come to mind. One is the Pelena Energy model whereby the scale of electrification, such as mini hydro, is aligned with the geography of a community or adjacent communities. Another is individual electrification solutions such as solar home systems, which have minimal impacts on communal land and the traditional urban approach whereby a diesel genset is installed on alienated land and the associated distribution network is run in a defined road reserve. This is perhaps one of the reasons why diesel gensets have historically been the default solution in parts of Pacific, i.e. they occupy a small area of leaseable alienated land. I also acknowledge that diesel gensets have a low capital cost and were, but no longer, cheap to run.
From Simon Field on Australia’s overseas aid program: a post-surgical stocktake