POVERTY: Nepal’s Monsanto debate spotlights seed sovereignty

KATHMANDU, 10 January 2012 (IRIN)

 Photo: David Longstreath/IRIN
Agriculture drives Nepal's economy, but less so its research agenda

An effort by US donors and multinational agribusiness Monsanto to partner with Nepal to boost local maize production with imported hybrid seeds has met civil society opposition calling - instead - for home-grown solutions.
“If an organization like USAID [US Agency for International Development] wants to help us with a company like Monsanto, we would hope that they would help us to actually develop our own hybrids instead, not to import their foreign seeds,” said Hari Dahal, spokesperson for the Ministry of Agriculture and Cooperatives, at a recent parliamentary hearing on food sovereignty, as reported in local media.
USAID announced last September its intention to set up a pilot training partnership with Monsanto and the Nepali government, which promotes hybrid maize seeds to boost yields in a country where 41 percent of the population is estimated to be undernourished.
Maize is a staple of the local diet, especially in the maize-producing hilly central interior of the country, which suffers from chronic food insecurity.
In addition, Nepal grows only half of the maize demanded by the animal feed industry and imports the shortfall of 135,000 tons annually, according to USAID.
Demand for hybrid maize seeds, used primarily in the animal feed industry, has increased as animal feed has constituted a growing source of income for commercial farmers.
Opponents of the proposed partnership say it would substitute one form of dependence for another - from the currently imported maize to maize seeds from abroad.
According to the government, the country required 22,656 tons of maize seed in 2011* - less than 1 percent of which was supplied by registered imports.
Calling the US-headquartered Monsanto a “biotech Goliath”, local activists have taken to social media to block the company’s expansion in Nepal, citing concerns of loss of local seeds, dependence on seed imports and environmental damage to the land and surrounding communities.
Known for its genetically-engineered products worldwide, Monsanto has been sued - and settled out of court - in the Americas throughout the last decade multiple times for alleged health and environmental damages linked to its practices. It has also sued farmers whom it accused of patent infringement.

Silent entry
While this would be the first time a donor subsidizes the cost of hybrid seeds on such a large scale in Nepal - targeting 20,000 farmers in three commercial maize-producing districts of Kavre, Chitwan and Nawal Parasi along the southern lowland belt in the Terai region bordering India - Monsanto has been exporting hybrid maize seed to Nepal since 2004.

 Photo: Smriti Mallapaty/ IRIN
Hybrid maize varieties are filling more fields like this one in the lowlands of Nepal in Nawal Parasi

Kiran Dahal, Nepal country representative for Monsanto, said almost 100 percent of its seed is used to produce maize for the feed industry, but it is up to the farmers to decide where they sell their maize and for what purpose.
Monsanto’s presence was unheralded, unsubsidized and until recently, largely unnoticed, said Sabin Ninglekhu, an organizer of the Facebook campaign. “To be honest, we didn’t know Monsanto was in the country before the USAID announcement.”
Over the past decade commercial farmers in the lowlands have started using hybrid varieties, drawn by the potential of higher yields.
In hybrid breeding technology, strains are cross-pollinated to create offspring with combined strengths. Agronomists note that although first-generation hybrids produce higher yields, their offspring often may not give the same results, requiring farmers to purchase new seeds every season.
As yet, no comprehensive long-term report on the distribution and yield of hybrid seed application in Nepal has been produced, according to the Agriculture Ministry.
But preliminary findings in the lowland Nawal Parasi and Palpa districts in 2011 suggest almost doubled yields from hybrid seeds over openly-pollinated local varieties - from 0.8 to 1.5 tons per hectare - as reported by the South Asia office of the International Center for Maize and Wheat Improvement (CIMMYT) based in Kathmandu.

Do it ourselves
But blocking seed imports is only the initial goal of local NGOs protesting against Monsanto: The end objective is to boost local seed use and production by investing more in agricultural research and development, said Facebook campaign organizer Ninglekhu.
“We have used this Monsanto movement as an opening to talk about the ministry’s agricultural vision, its understanding of food security and seed sovereignty and what policies are in place to address these. Monsanto is not the only option.”
Nepal’s political climate was still fragile in late 2011, five years after the signing of the Comprehensive Peace Accord to end a decade of civil war, noted the Washington DC-based International Food Policy Research Institute.
Both the agriculture and science ministries “lack the power, capacity, and continuity to set the country’s long-term agricultural R&D [research and development] agenda,” IFPRI concluded.
The principal government agency devoted to such research - the National Agricultural Research Council - has produced only two hybrid corn strains since its establishment in 1991.
One type has not been taken up by private seed producers as it was deemed not commercially viable, and the other is still undergoing approval, said Chitra Bahadur Kunwar, a senior scientist at the council’s National Maize Research Programme.
Meanwhile, the increasingly scant availability of openly-pollinated local seeds, which can be reused from one season to the next, leave farmers vulnerable to the caprice of importation, said Durga Lamichhane, a commercial maize farmer from Gaidakot in Nawal Parasi District.

 Photo: Smriti Mallapaty/IRIN
Commercial farmer, Tilak Prasad Kandel, on his land in Nawal Parasi District in Nepal where he is growing hybrid maize

“Our local seeds are about to disappear. If for some reason these hybrid seeds do not come, we would be in a situation of emergency,” said Lamichhane, referring to a growing trend among commercial farmers not to save local seeds due to a preference to buy hybrids and other improved seed varieties.
But striving for no seed imports is not realistic, noted Andrew McDonald, a CIMMYT cropping agronomist for South Asia.
“Nepal is not alone: the food security of almost every nation is contingent on input supply chains that transcend national boundaries.”

Call for locally developed hybrids
For Tilak Prasad Kandel, a commercial farmer with a hectare of land in Nawal Parasi, the concern is not dependency, but rather lack of government spending to develop local hybrids. “There are alternatives to Monsanto.”
Though promoting maize hybrids is important to boosting maize production and profitability in Nepal, USAID’s decision to partner with Monsanto alone was questionable, said McDonald.
“I don't think USAID should be in the business of choosing `winners’ by working with a single seed company in a market environment where many private companies are active.”
The US ambassador in Nepal, Scott H. DeLilsi, noted on his own Facebook page on 2 December that “the critical discussion is not about the role of a single company but about the future of agricultural development in Nepal,” and in a 5 December statement USAID said project consultations are on-going.
“We have not worked out the details of the pilot as yet and are still consulting with a variety of groups including the private sector, academia, the MOAC [Ministry of Agriculture and Cooperatives] and Nepal Agriculture Research Council (NARC), civil society and farmer groups. We will take their feedback into account as we further discuss the form of partnership that best meets the needs of Nepali farmers.”
About 16 different maize hybrids from multiple companies are registered for sale by the government’s regulatory process.
No matter the source of seeds, the USAID pilot project would help farmers trying to grow hybrid maize, said Kandel. Not only would it subsidize seed costs, but also provide much-needed education on how to use the seeds, which is the biggest problem for farmers, he added.
According to farmers in Nawal Parasi, the subsidy would cover 75 percent of the cost of Monsanto seeds.
But for now the partnership remains a proposition as the government has not joined.
USAID has stated it “will not move forward independently to fund such a programme” and “encourages this dialogue, which underscores the critical need for Nepal to increase its agricultural production through improved seed technologies and cultivation practices”.
The government’s Natural Resources and Means Committee has requested a report addressing concerns about seed sovereignty from the Agriculture Ministry for a hearing expected to be held in January.

*this figure was incorrectly attributed to the animal feed industry in a previous version and has been corrected
http://www.irinnews.org/report.aspx?reportID=94611

MALNUTRITION: US–Nepal hybrid maize project runs into criticism

[KATHMANDU] Smriti Mallapaty : 30 November 2011
 Flickr/CIMMYT: Critics are concerned about the loss of local maize varieties


Uncertainty hangs over a proposed partnership between US and Nepalese scientists to promote hybrid maize in the Himalayan country, after the project sparked local concerns over the potential loss of traditional local varieties and weak biotechnology regulation.
The pilot project of the US Agency for International Development (USAID), Nepal's Ministry of Agriculture and Cooperatives and US agricultural corporation Monsanto — announced earlier this year (13 September) on USAID's website — aims to train 20,000 farmers on hybrid maize production practices, and facilitate links between producers and end-users.
But concerns have been expressed by civil society organisations, as well as some government officials, and now neither USAID nor the ministry will confirm whether the project is going ahead.
Nepal imports half of the estimated 270,000 tonnes of maize it uses a year, at a cost of about 200 million Nepalese rupees (US$2.5 million).
Hybrid seeds are formed under controlled pollination conditions between two plants selected for specific traits such as high yield or pest resistance. The first generation of hybrid seeds has higher yields than the locally available varieties, but farmers need to obtain new seeds from suppliers each year if they are to maintain these high yields.
Members of civil society organisations expressed concerns at a meeting this month (15 November) that foreign hybrid maize seed could replace local varieties, increase Nepal's dependence on imported seed and pave the way for the introduction of genetically modified (GM) crops later because of weak biotechnology regulation.
But Monsanto's Nepal representative, Kiran Dahal, told SciDev.Net: "The farmers are already using hybrid seed; we are just trying to support them".
Monsanto has been importing conventionally bred seeds into Nepal for the past 15 years, including 100 metric tonnes of hybrid seeds in 2010, he said. He added that the partnership was pending the Nepalese government's approval.
But government officials declined to comment on when this might happen or what the final deal will look like.
Hari Dahal, a spokesperson for the ministry, said it was unlikely the agreement would be signed in its current form.
"Mass importation of hybrid seed goes against our obligations under the International Treaty on Plant Genetic Resources for Food and Agriculture," he told SciDev.Net. "If the partnership seeks to improve our own hybrid seeds, then an agreement is possible."
A senior ministry official told SciDev.Net on the condition of anonymity: "If we import hybrid seed our local varieties will disappear. The rights of the farmers will be in the hands of private companies."
Nepal's agriculture policy, announced in 2004, encourages the production and use of hybrid seed varieties; and their distribution after testing, certification and registration.* Since 1960, Nepal approved 25 maize varieties, hybrid and non-hybrid, of which 16 are local. The nine foreign maize varieties include three Monsanto varieties listed in the pilot project.
http://www.scidev.net/en/agriculture-and-environment/agri-biotech/news/us-nepal-hybrid-maize-project-runs-into-criticism.html

MALNUTRITION: Kenya: USAID activity

Jill Richardson :: What Our Friends at USAID Are Up To in Kenya, Part 1


A document entitled "Strategic Review" from the Feed the Future program in 2010 shows what is likely a powerpoint presentation on Kenya. It includes several maps, and honestly, I can't make heads or tails of them. One of them shows poverty in terms of density (density of poor people in an area). As you might guess, where there are more people, there are also more poor people. I don't find that nugget of information very useful.
Next are maps of malnutrition and food insecurity by percent of the population, not absolute number. These are more helpful - or should be - but they have a bit of conflicting data. That is, where the children are the most stunted, they are not the most wasted. (Stunted means low height for age; wasted means low weight for height. Stunting is due to chronic malnutrition, whereas wasting is due to acute malnutrition.) However, the area with the most stunting is also the area with the highest food insecurity. The high population areas seem to have the least amount of malnutrition and food insecurity as a percent of the population, but might have higher absolute numbers of both because they just plain have more people, both rich and poor, well-fed and malnourished. Coast province (the southeastern most province) seems to be moderately bad but not the worst in all three measures.








Out of Kenya's population of 38.6 million people, some 17.8 million are considered poor. Those break down as follows: 7.2 million live in rural areas with high rainfall; 5.5 million are urban poor; 2.9 million live in semi-arid rural areas; and 2.2 million live in arid rural areas. They broke the country down into the following regions:





They chose which areas to focus on based on three factors. First, which regions have the most rural poor? HR1, HR2, SA2, and A2. Of those, which produce the most food? That eliminates A2. From there, which set of regions would represent the most diverse group of people receiving aid? That narrows it down to HR1 and SA2.
As I've noted before, Kenya's ethnically very diverse. The map used by USAID shows Kikuyu majorities in Western and Central provinces. Nyanza province is Luo and Kisii. My friend who I will visit there in Luo. Rift Valley is mostly Kalenjin. North Eastern province and the northern half of Eastern province are dominated by a Somali majority. The southern half of Eastern Province (SA2) is a mix of Kamba, Embu, and Meru. Last, Coastal province (in the southeast) is a mix of Mijikenda, Taita, and Swahili.

Here's an excerpt from a longer, more detailed version of USAID's plan in Kenya.
As part of their intrinsic market-based approach, all Mission value chain programs will be coordinated closely with USAID/EA programs in promoting private- sector-led market and trade development and regional integration and investment.
At the same time, to ensure access to food in lower potential areas, the USG through the Mission and partners will make markets work better for the poor and for women by investing in affordable inputs, delivery of services adapted to their needs, and development of better market linkages.
In other words, they want to turn peasants into entrepreneurs.
In 2010, they planned to focus on 5 areas:
1. Staple food value chain development, including livestock and livestock products;
2. Rural finance;
3. Policy analysis, advocacy and capacity-
building;
4. Agricultural research and technology transfer, and
5. Water and sanitation.

#1. Staple Food Value Chain Development
They list "Current and Potential USG and Development Partners" as:
USDA's Animal & Plant Health Inspection Service (APHIS)
USDA's Foreign Agriculture Service
USAID East Africa
Foreign Commercial Service
U.S. State Dept
Peace Corps
Agricultural Sector Coordination Unit (Govt of Kenya)
Dept for International Development (UK)
EU
UN Food & Agriculture Organization (FAO)
International Fund for Agricultural Development
Japan International Cooperation Agency
World Bank
Kenya Agricultural Research Institute (KARI)
Kenya Bureau of Standards
Kenya Dairy Board
Kenya Plant Health Inspectorate Services
Eastern Africa Grain Council
Kenya Livestock Marketing Council
UNICEF
UN World Food Programme
Gates Foundation
Rockefeller Foundation
Alliance for a Green Revolution in Africa

This investment focuses on improving agricultural productivity through value-added techniques, market linkages, diversification, and off farm income generation. Farmers will be linked to input and output markets through private agribusiness...
Two early areas being targeted are: 1) expanding smallholder farmer participation in structured grain markets, allowing greater use of the nascent grain warehouse receipts system for maize and staple food crops; and 2) addressing key market and trade constraints, including animal health sanitary issues, within livestock value chains.
Programs include: Kenya Maize Development Program (KMDP), Staple Food Crops Program, Kenya Dairy Sector Competiveness Program (KDSCP), Kenya Horticulture Competitiveness Program (KHCP), Kenya Access to Rural Finance (KARF), Drylands Livestock Development Program, and WFP pilot program Purchase for Progress (P4P).

And check this one out:
To further sound market-based policies for agriculture, the Mission value chain programs will undertake interventions to improve the institutional, policy and regulatory environment. They will continue to collaborate with USAID/EA programs such as COMPETE and the USAID/East Africa pastoral livestock and livelihoods activities, to promote policy initiatives and institutional structures that foster more and efficient marketing and trade of food crops and livestock. This includes harmonized commodity standards and inspection systems in the region.
This collaboration will be furthered through expansion of the Eastern Africa Grain Council's Grain Warehouse Receipts System and the strengthening of regional markets for livestock. The Mission will continue to engage with the Kenya Food Security Steering Group to improve early warning systems and build capacity to better integrate data and methodologies with the WFP G/EWS and FAO FAOSTAT systems.
This is getting long, so I'm going to end it here and continue in another post in the next day or so. Ultimately, I'd like to dig deeper into what each of these programs does and where each one is operating.
http://www.lavidalocavore.org/diary/4974/what-our-friends-at-usaid-are-up-to-in-kenya-part-1

MALNUTRITION: Lack of data on droughts hampers risk reduction efforts

Andrew Purcell : 4 July 2011
 Drought can hit crop yields hard : Flickr/ ian t taylor

[LONDON] Droughts pose a "hidden risk" as they are poorly understood and lack reliable data that could inform mitigation strategies, says a report on global disaster risk.
Lack of systematic monitoring means that the risk of impeding drought is largely invisible despite having significant effects on agricultural production, rural livelihoods and economies, says 'Global Assessment Report on Disaster Risk Reduction 2011: Revealing Risk, Redefining Development'.
According to the report, published by the UN International Strategy for Disaster Reduction (UNISDR), current drought risk models are inadequate. Although efforts such as the US Agency for International Development's (USAID) Famine Early Warning System (FEWS Net) show how drought risk can be modelled when data is available, there is not enough data to do this at a global level.
"We had hoped to come up with a global risk assessment for drought, but we found that the data was simply not available," Andrew Maskrey, coordinator of the report, told SciDev.Net at the United Kingdom launch last week (30 June).
Although droughts have had catastrophic effects in the past — reducing crop yields by up to 40 per cent in the Caribbean, or causing total crop failure for 75 per cent of farmers in Syria — there is still no way of globally assessing risk.
"It will take probably 8–10 years more work to get a global risk model for drought of a similar level to those which we currently have for other weather-related hazards," said Maskrey.
Global annual water demand has tripled since 1960 and is likely to increase due to climate change, says the report, which comes as the worst drought in 60 years is hitting the Horn of Africa, according to UN media briefing last week (28 June).
It calls for increased global drought surveillance and monitoring of its effects on food security and poverty.
It highlights urbanisation, industrialisation, tourism and agribusiness, as well as inappropriate soil and water management as catalysts for local drought risk.
Molly Brown, a senior earth scientist at FEWS Net and a researcher at NASA (the US National Aeronautics and Space Administration) said: "Despite the increasing scientific understanding and ability to identify meteorological and hydrological drought when they occur, there is a widespread lack of appropriate ways to interpret the findings and a lack of commitment to appropriate response.
"Without a clear link between drought identification (physical science domain) and drought response (social and political domain), the risk of widespread and large scale impacts of drought will remain."
Randolph Kent, director of the Humanitarian Futures Programme at King's College London and one of the contributing authors, emphasised the role science must play in tackling drought risks but warned that various barriers may prevent policymakers from taking advantage of scientific innovations.
The temporal and geographic scale at which science is produced is not readily translatable to policymaking contexts, said Kent, and the different terminologies and metrics used by scientists and humanitarian planners also pose an obstacle.
The report, of which one chapter focused on drought risk, was first launched during the Third Session of the Global Platform for Disaster Risk Reduction (8–13 May) in Geneva, Switzerland.
http://www.scidev.net/en/news/lack-of-data-on-droughts-hampers-risk-reduction-efforts.html

MALNUTRITION: Occupied Palestine: USAID says widespread malnutrition

Palestinian mother Miriam Jafra holds her infant Amir, while her three-year old son Mahmoud looks on, as they wait for treatment for heart problems and anaemia at a clinic in the West Bank town of Turkumiya July 29, 2002. A U.S. Agency for International Development (USAID) report said malnutrition is widespread among Palestinian children and that many rural Palestinians, who live surrounded by Israeli army closures, do not have adequate access to medical care.
http://www.trust.org/alertnet/multimedia/pictures/detail.dot?mediaInode=32e6fec2-3f3d-4ed9-93a7-924f7c72b2a8

ETHIOPIA: Five-year project to benefit OVC

ADDIS ABABA, 16 June 2011 (PlusNews)

 Photo: Kate Holt/IRIN
Households caring for orphans are often forced to sell land and domestic animals to feed their families

Kokobe Abate is a widow struggling to raise her daughter Almaz in the Ethiopian capital, Addis Ababa. The death of her husband hit the family hard, but he had given up on life long before he died.
"Even before he passed away, he had stopped providing for us," Kokobe said. "He couldn't bear the idea of living with HIV. I think the guilt is what killed him - after we found out our HIV status he started drinking."
She says the only thing that kept them from joining thousands of families living on Addis Ababa's streets were handouts from neighbours and a 'keble house', a state-owned, subsidised home that her husband left behind, for which she pays 18 Birr (about US$1) per month.
"I tried to do everything out there - washing clothes for people, selling bread, and 'injera' [Ethiopian flat bread], and even opened a 'gulit' [small vegetable shop] in front of my home but I hardly made enough money even to eat a good meal once a day."
Kokobe's luck began to change in September 2010, when she and 13 other unemployed people in her neighbourhood were selected to work in a nearby parking lot, issuing tickets to motorists. She now takes home about 700 Birr (about $41.50) every month.
"I make money now; whether it is enough or not is another thing, but I have a regular income," she said. "[I can buy] exercise books, uniforms, shoes and most importantly, food for both of us, and also [pay for] power and water."
Kokobe was fortunate to find work. Millions of Ethiopians caring for orphans in an economy where annual inflation topped 34 percent in May are forced to sell their property or send young children out to beg.
Now, a new $100 million project aims to assist thousands of families caring for orphans by providing safety nets for an estimated 500,000 Ethiopian children affected by HIV/AIDS every year for the next five years.
Officially launched in May, the project is financed by the US President's Emergency Plan for AIDS Relief and will be implemented by the US Agency for International Development and its partners, including the UN Children's Fund, an international NGO, Pact, and 50 local NGOs.
Official figures estimate there are 5.5 million orphans in Ethiopia, or almost 15 percent of the country's children. About 800,000 of the orphans have lost one or both parents to AIDS-related illnesses.
According to a 2010 study [ http://www.ncbi.nlm.nih.gov/pubmed/21073083 ] of 334 households caring for orphans in Ethiopia's Southern Nations, Nationalities and Peoples Region, at least 22 percent of orphans had a history of involvement in child labour, and households caring for orphans often had to sell land, household equipment and domestic animals to feed their families.
We know that this money isn't adequate to cover... all the needs of the children, but we know that something is better than nothing
"This programme is expected to provide several service areas: nutrition, health, education, psychological support, legal support, shelter and so on," Walelign Mehretu, the USAID Ethiopia orphans and vulnerable children programme advisor, told IRIN/PlusNews.
The programme will also build the capacity of the Ethiopian government to use improved data management systems, and a national monitoring system for orphans and vulnerable children.
Walelign noted that the average of $200 per child over the five years would not be enough to support all the needs of the targeted orphans.
"One child may only need education materials, which is an expense of once a year so the money could be adequate... of course, some children may need all the services; in that case, what the programme is anticipating is to mobilize the community and to have some other source of resources," he said.
"The problem of orphans and vulnerable children is severe and we know that this money isn't adequate to cover all the expense and all the needs of the children," Walelign commented. "But we know that something is better than nothing."
http://www.plusnews.org/report.aspx?reportID=92991

POVERTY: Head of USAid: one of his biggest challenges is to persuade Americans that foreign aid is in their interests

Madeleine Bunting 15 June 2011
Rajiv Shah is one of the most powerful men in development policy – and one of the youngest. He arrived at the helm of the US development agency USAid just short of 37, as the highest ranking Indian-American in any presidential administration. Six days into the job, Haiti's earthquake struck and he was plunged into an intense three months of one of the biggest US aid initiatives in recent decades.
Nor has the pace or intensity of the job eased much since, but in London on Tuesday he was delighted as an audience of academics and activists – not usual enthusiasts for US aid policy – at the London School of Economics congratulated him several times for his commitments on food and health initiatives, in particular the US pledge of $450m to the Global Alliance on Vaccines and Immunisation (Gavi) on Monday.
The appreciation must make a change from the fierce battle in Washington over USAid's budget, which is the target of a House of Representatives bill for $121m in cuts. At a time of economic hardship in the US, opinion surveys show aid's unprecedented unpopularity. One of Shah's biggest challenges right now, he told the Guardian, is persuading the American people that aid is in their interests.
"On the logo of USAid, it says "from the American people", but our work has to be seen as "for the American people", Shah argues. "Development is a fundamental part of our national security. It is extreme poverty – the realities of access to water and food – which creates the long-term drivers of our insecurity. Most wars are fought over scarce resources, and that is going to accelerate in the future. The food spike of 2008 led to food riots and instability. Bob Gates [the outgoing secretary of state for defence] has said, 'It is cheaper to do development than to send soldiers'. Admiral Mike Mullen [chairman of the joint chiefs of staff] is one of our strongest advocates."
In fact, the Pentagon has been a stalwart defender of USAid's budget in the current battles on Capitol Hill. An interesting contrast to the UK, where the defence establishment has been eyeing the aid budget with envy – and some resentment. Shah's defence of aid in terms of national interest reflects Barack Obama and Hillary Clinton's overhaul of US foreign policy, which was spelled out in the Quadrennial Diplomacy and Development Review late last year. Shah in part attributes the increased emphasis on aid to the experience of Afghanistan and Iraq, where the military has recognised the crucial role of governance and development to an exit strategy.
On Afghanistan, Shah is defiant of the many critics. Last week a congressional report damned USAid's programme there, and said much of the $18.8bn of funding had been "poorly spent" and was unlikely to prove durable. Afghanistan and Pakistan are the top two recipients of USAid by a large measure.
"It's been costly. We've lost 300 people working for USAid or our partners in eight years and it's cost a lot of money, but we have gone from 900,000 children in school to 7 million. Two and half million of them are girls. Health access has gone from 9% to 64% with huge falls in morbidity. Five million have moved out of poverty, with economic growth rates of 8%-10%. Agricultural productivity is up by 50%-70%. A huge amount has been achieved.
"Now our challenge is how to make that sustained as we embrace the transition. It's been a tough environment, and we have trebled staff in Afghanistan to improve accountability and audit our partners because of concerns about corruption."
But the subject that is probably closest to Shah's personal interests is food security. For seven years, he was director of programmes at the Bill and Melinda Gates Foundation on agriculture. And well before that, he remembers as a small boy visiting India for the first time with his parents from his home in suburban Detroit and experiencing with shock the slums of Mumbai and the acute human suffering he saw there. That childhood experience is what has driven his career.
"The 2008-09 food crisis pushed 100 million people back into poverty. We have been here before. In the late 60s, Paul Ehrlich was warning of a population bomb in which millions would starve, but that led to US agronomist, Norman Borlaug and his work on the green revolution – which has saved hundreds of millions of lives. We have learned a lot now about the environmental degradation it caused.
"But Africa was bypassed, and in 2006 the US was spending only $240m of its aid budget on agriculture, less than 3%. We have now increased that to $1.2bn in a programme, Feed the Future, which is working in 20 countries. The aim is to lift more than 18 million out of poverty and ensure that 7.1 million children are no longer malnourished."
Shah sees a big role for the private sector in this programme but also emphasises that the biggest impact on poverty will come from reaching small-scale women producers. USAid is working with co-operatives in countries such as Uganda.
"This is a structural challenge in global development: there are agrarian economies where large numbers of families devote 70% of their income to food, and that makes them highly susceptible to price shocks. A huge risk."
He believes that the right combination of technology and political will can have a huge impact in tackling this challenge, and points to the past as a reminder of what aid can achieve. "The Marshall plan for Europe after the second world war, the green revolution and oral rehydration are three examples of initiatives which have saved millions of lives. The last was the invention of USAid when diarrhoea was ravaging families in many developing countries and much of the effort was focused on extending healthcare services. But a simple rehydration solution given to mothers has empowered them to save their children's lives. It's one of the greatest success stories of aid. Not only does it save lives, it reduces the disease burden of stunted development."
On such subjects, Shah is a powerful advocate for aid, but question him on controversial aspects of US development policy, such as subsidies to US cotton farmers that hit west Africa so badly, and he becomes vague – an indication of how USAid can find its work undermined by other government department policies such as on trade or agriculture.
He was also evasive about the International Aid Transparency Initiative, which the US has not signed up to. Instead, he points to a new website he has set up to track all USAid spending, but he acknowledges it doesn't track other US government departments' aid spend.
He has instituted a big reform of USAid, but perhaps even more influential on policy has been the Arab spring. He admits that it has shaken up how the agency works and who it works with. There needs to be a greater focus on smaller, grassroots organisations instead of larger, well-established institutions; less bureaucracy and fewer rules; more flexibility and risk-taking to back innovation. At the same time, Shah repeats frequently that he wants to show results for every taxpayer dollar spent. It all adds up to a demanding agenda.
http://www.guardian.co.uk/global-development/2011/jun/15/rajiv-shah-america-aid

MALNUTRITION: Bolivia: Quinoa Questions -- Production and Food Security

 Emma Banks, : May 17, 2011

In January and March 2011, several English-language press outlets ran stories on quinoa production in Bolivia. National Public Radio and the Associated Press reported on quinoa as a development project, hailing its benefits to farmers in the altiplano region of Bolivia. The New York Times article focused on quinoa’s rising popularity abroad making it less affordable for low income Bolivians. Both AP’s “Quinoa’s Popularity a Boon to Bolivians,”[i] and the Times’ “Quinoa’s Global Success Creates Quandary at Home” highlight the complex relationship between food security and economic development in Bolivia, although with differing perspectives.
The impact of rising food prices is complex and encompasses food security and sovereignty debates, issues that are difficult to address thoroughly in brief articles. Until a comprehensive study provides insight into rising quinoa prices, it is difficult to make strong affirmations. The impact of quinoa production and export must be understood both within the framework of global food security issues and specific local contexts. While these articles presented some important issues, challenging local conditions that affect quinoa consumption and production also substantially affect income generated by this crop.
Quinoa fetches a guaranteed high price affording farmers economic stability. This economic power has also translated into political power though producers’ associations and cooperatives. Since the 1970’s, these organizations have worked toward greater producer control of the market, spurring other political actions such as blockades and protests for greater economic and environmental rights in quinoa-growing regions.[ii]

Missing key aspects of the “quinoa quandary”
Unfortunately, the Independent article, “The Food Fad That’s Starving Bolivia,” and several online reposts of the Times piece misrepresented the complex relationship between malnutrition and rising quinoa prices by encouraging North American and European consumers to stop buying Bolivian quinoa. Although the Times never suggested this solution for Bolivian malnutrition, a letter to the editor advocated that exact idea.[iii] Adam Sherwin made glaring and easily avoidable errors in the Independent, for example citing the North American Aztecs when he should have mentioned the Andean Incas. Furthermore, whole paragraphs of Sherwin’s article are copied almost word for word from the Times’ piece, yet Sherwin manipulated its conclusions.
He further incorrectly argued: “There is a potential threat to South America’s farmers – quinoa can thrive in the wet climes of Bolton as well as Bolivia. An increasing number of Britons are cultivating their own supply of quinoa in kitchen gardens and allotments,”[iv] suggesting that small-plot quinoa production in North America and Europe threatens Bolivian farmers’ income. In doing so, he implies that buying Bolivian quinoa negatively affects Bolivian consumers, yet growing it at home negatively affects Bolivian farmers. He thus conflates consumption and production issues, with no supporting analysis., and misrepresents the role of international consumers..

Complications of price-based analysis
Simon Romero and Sara Shahriari wrote in the Times: “Fewer Bolivians can now afford [quinoa], hastening their embrace of cheaper, processed foods and raising fears of malnutrition in a country that has long struggled with it.” By ‘processed foods,’ the authors clarified that they meant simple carbohydrates such as white flour and rice, rather than canned or pre-prepared products with chemical additives that provide lower nutritional value. However, less nutritious white rice and wheat actually require cheaper, simpler processing than the costly, complicated procedures necessary to make quinoa edible. Raw quinoa must be soaked, rolled, and rinsed to remove the bitter resin covering its seeds.
It’s important to understand comparative food prices accurately presented by the Times in context. Quinoa does on average cost U.S. $4.85 per kilo in Bolivia, compared to white rice at about $1.10. However, quinoa is more filling than rice and as a result, generally is eaten in smaller portions. For example, many people add small amounts of quinoa to soups and stews. Furthermore, the Bolivian government subsidizes staples including wheat and rice, artificially lowering prices. Currently the Morales administration struggles with how to keep food prices affordable while satisfying producers’ needs (See “Ongoing, Unresolved Issues Likely to Perpetuate Tensions in Bolivia”).
Furthermore, rising food prices are a global problem, and virtually all staples have increased in price in Bolivia. For example, rice prices have almost doubles during the last five years.[v] While most pasta often costs less than quinoa, prices vary greatly. Some pasta varieties – particularly whole-grain and more nutritious types – cost over $5.00 per kilo, more than quinoa. These prices do not reflect rising international costs, but domestic consumption preference; there is lower demand for the more expensive varieties.
While quinoa is extremely healthy, Bolivia also produces other highly nutritious seeds and grains, including kañawa[vi] and amaranth. Both are increasingly available in flours, granolas, and baked goods. Encouraging production of these grains and seeds for domestic consumption could provide alternatives to high priced quinoa for Bolivians. These grains are not yet widely grown for export, and could therefore remain economical in the national market. Quinoa is not the only nutritious part of the typical Bolivian diet, and with properly managed development and nutrition programs the Bolivian government could expand production and consumption of quinoa alternatives.
It is crucial to compare current malnutrition levels to statistics from the 1970’s – when quinoa production for export initially accelerated – to accurately analyze its effect on farmers’ nutrition. The causes of malnutrition in the altiplano, a historically poor and under-served part of the country, are multi-faceted and linked to harsh agricultural conditions, poor infrastructure (which makes food products from the rest of the country less accessible and more expensive), and low economic opportunity.
Families make complex choices between keeping quinoa for their own consumption or selling it to invest in education, housing, small businesses, and other food staples. In fact, most quinoa-producing families still eat quinoa at least once a week, and others do so daily. [vii]

Harsh Production Conditions Help Explain Higher Prices
Farmers face additional challenges, both in growing and selling quinoa. Smugglers take quinoa into Peru, selling it at a higher price without benefitting Bolivian producers. Some of this quinoa later makes it way to international markets, giving the bulk of profit to Peruvian sellers.
Periodic droughts in the altiplano, which will likely increase with global warming, can kill crops or delay production. Furthermore, altiplano soils are dry and lacking in nutrients, making organic and sustainable farming a challenge. However, many farmers continue to practice organic techniques since organic quinoa fetches a higher market price.[viii]

The importance of a balanced historical perspective
Quinoa production is far more robust than it was before the 1970’s.[ix] It is crucial to examine long-term trends to understand why quinoa is such a valuable resource.[x]
In general, the quinoa boom greatly benefits farmers in spite of little state support. [xi] According to Kevin Healy, “The fact that some indigenous quinoa pioneers had to seek out adequate technologies for quinoa processing in neighboring Peru is a testimony to the low public status which quinoa agricultural development faced for various decades of the modern era despite Bolivia’s position as the world’s premiere quinoa producer.” [xii]
The Times article links to the United States Agency for International Development (USAID) website when it cites “American foreign aid organizations” that helped farmers start growing quinoa for export (along with European groups). However past projects, many funded by (USAID), often encouraged farmers in the altiplano to grow wheat[xiii] instead of traditional crops. In the 1950’s and 1960’s, these projects largely failed, especially as farmers could not compete with low-cost wheat from of U.S. food assistance programs.[xiv] Furthermore, international aid organizations and the Bolivian government continued to encourage both wheat and rice production – helping to explain its continued prevalence in the Bolivian diet.
In fact, the smaller, more pragmatic U.S. Interamerican Foundation and various European organizations helped support farmers’ initiatives to significantly enhance their income through export. USAID support only began within the last five years, after production and export circuits had been established and prices had already increased.

Personal preferences matter
Quinoa production and consumption in Bolivia vary by local context and individual choice. According to Andrew Ofstehage, Bolivian quinoa farmers often make individual decisions. Some farmers prefer not to market their quinoa through co-ops because they gain greater benefits and avoid prohibitive transport costs. [xv] Instead, they sell to intermediaries or barter to enrich their diets with fresh fruits and vegetables, as well as other staples.[xvi]
As Romero and Shahriari suggest, quinoa consumption in Bolivia fluctuates by region and personal preference. They quote the Bolivian Vice Minister of Rural Development and Agriculture: “It has to do with food culture, because if you give the kids toasted quinoa flour, they don’t want it; they want white bread. If you give them boiled water, sugar and quinoa flour mixed into a drink, they prefer Coca-Cola.”[xvii]
Outside of the altiplano, Bolivians consume quinoa less frequently, especially in the lowlands, since it is not grown there nor considered a staple food, although this pattern has shifted due to highland migrants moving into the lowlands. Quinoa has been part of the diet in the mid-highland regions, such as Cochabamba, for centuries. In past decades, quinoa’s popularity declined among the upper middle classes in favor of wheat and rice that they perceive as more “sophisticated” and “upwardly mobile.” Ironically, the valorization of quinoa in North American and European markets has caused many up-scale Bolivian restaurants to begin serving quinoa and the middle and upper class to consume more of the grain.

Conflicting data complicates research
The lack of verifiable data complicates quinoa research. For example, the Bolivian government, quinoa producers’ associations and the United Nations Food and Agricultural Organization (FAO) all track quinoa production, yet release completely different statistics. Contraband quinoa smuggled into Peru, informal sales of quinoa, and lack of documentation in all quinoa-producing parts of Bolivia all further complicate tracking the percentage of quinoa exported versus sold domestically. This situation highlights the need for more careful and precise reporting on quinoa production and consumption.

Big picture: Food security and development are complex, global issues
Recent media coverage on quinoa lauds Bolivian rural development initiatives or highlight food security concerns. In reality, the “quinoa quandary” encompasses both approaches; examining it through only one lens obscures the multi-faceted nature of quinoa production and consumption in Bolivia.
Food security and sovereignty are ever evolving – neither term has a universal definition or scale of reference. Food security, at the most basic level, implies an adequate food supply to give all people proper nutrition. Proponents of food sovereignty, on the other hand, affirm that small producers and consumers should have influence in shaping food policy.[xviii] As a result, it is crucial to acknowledge the global scale and system that affects food prices and consumption choices.
Experts on food issues point to the need to consider the multiple hierarchies of power involved in food production and prices in order to understand how positive changes can be made.[xix] The Times published a letter to the editor that asserted: “While I appreciate being able to find such a nutritious and satisfying product on the shelves of my local supermarket, I’d gladly give it up to ensure that Bolivians can afford to eat it. Having foods from around the world is a convenient luxury so long as others are not paying a hefty price for it.”[xx] Foreign consumers of quinoa can stop buying the grain, but this change would actually intensify existing poverty and malnutrition by taking away Bolivian producers’ steady source of income. True food and economic security must be achieved simultaneously.
Bolivian quinoa production straddles the line between food and economic security. There is no easy answer to the problems created by rising food prices. However, the positive changes for quinoa producers cannot be ignored in the debate. As Healy explains:
Quinoa’s current boom would probably have been much weaker had the Quechua and Aymara producers themselves not organized producer associations to revitalize quinoa real (the most commercial variety of quinoa) back in the late seventies and eighties. In contrast to Peru where quinoa received a big boost from the national government, Bolivian state institutions with the exception of several agricultural research stations provided little support to producers for credit, marketing or processing nor promote recognition of its food value among Bolivian consumers.[xxi]
Just as they have pushed to expand the quinoa industry, Bolivian producers and consumers must be the catalyst to push for greater food security and sovereignty. Bolivian Government nutrition programs have begun to incorporate quinoa into school breakfast and new mothers’ subsidies,[xxii] finally recognizing the important role quinoa can play in food security. Quinoa farmers, government entities and funding organizations must work collaboratively to insure that quinoa continues to benefit both producers and consumers in Bolivia.
http://ain-bolivia.org/2011/05/bolivian-quinoa-questions-production-and-food-security/

MALARIA: As DDT Makes a Comeback, Uganda Must Weigh Its Costs

JOSH KRON : May 18, 2011
 Marc Hofer for The New York Times
Bosco Acope and his family tend their farm in Atek, Uganda, where the government's use of DDT has threatened their livelihood.

Growing up as a child here along the muggy, isolated plains of northern Uganda, life was not easy. His parents were poor. He did not attend secondary school. Many of his friends died from bouts of malaria, a scourge that has plagued this agrarian society.
Mr. Acope, 49, survived. At 19, he became a small-time farmer, with one acre of land. He married. He sowed. “I have been a farmer in this life,” he said.
When the American government, a generous and close friend to Uganda, began an organic-farming program to help rural economies here, Mr. Acope expanded, selling a wide variety of commodities at good rates.
His one acre became seven. Mr. Acope fathered 11 children. Uganda was developing, and Mr. Acope was one of many who were riding high, he said.
But the very next year came winds of change. Faced with unrelenting malaria, which threatened both lives and livelihoods, Uganda’s government teamed up with the United States to use chemical insecticide sprays — including DDT — to try to eliminate the disease. Mr. Acope’s home district, Apac, which has some of the highest malaria rates in the world was chosen for spraying in early 2008.
Mr. Acope said an official from the organic-farming company he sold to, which was also supported by the United States, warned that the sprays were dangerous. Mr. Acope’s produce would no longer be guaranteed to be organic — especially since many crops were stored indoors, where the spraying occurred — nor would it be bought at a lucrative price.
“I was told to protect my market, to try to stop the spraying,” Mr. Acope said. “But the whole village was sprayed.”
One morning, he recalled, he watched a group of men in gas masks who were carrying metal canisters pass through the village, and just like that, Mr. Acope’s organic-food market was gone. He said he had to pull three of his children out of school. Furthermore, the chemicals in the insecticide lasted so long that the organic-farming companies said they would not be back for 15 years.
So Mr. Acope is helping to take his government to court.
Once condemned as poisonous and inhumane, DDT has staged a recent comeback. In 2006, the World Health Organization strongly endorsed the chemical’s use on indoor walls as a cheap and long-lasting weapon in the fight against malaria. The United States also sanctioned DDT to combat the disease in African countries with “a high burden of malaria,” including Uganda.
The United States sprayed DDT to eliminate the last remnants of malaria across North America. The disease’s eradication was a milestone in public health and development. Malaria almost thwarted construction of the Panama Canal and “influenced to a great extent human populations and human history,” the Centers for Disease Control and Prevention says.
But the United States banned the use of DDT in 1972 over the chemical’s hazardous environmental impact. Studies have also linked DDT to diabetes and breast cancer. One examination of the consequences of using DDT to fight malaria in sub-Saharan Africa, conducted by the National Institute of Environmental Health Sciences, said the chemical might have increased infant deaths.
Still, the risks of not spraying are clear as well. In Africa, malaria kills 2,000 children each day, according to Unicef, and costs approximately $12.5 billion in lost incomes each year, the Malaria Consortium says.
“It really affects the whole fabric of the economic system in Africa,” said Dr. Patrick Lukulay, a consultant to a United States Agency for International Development initiative to treat malaria. “It prevents people from being productive citizens.”
In the Apac region of Uganda, the United States focused on two conflicting agendas: developing organic farming and eradicating malaria, ultimately affecting the livelihoods of tens of thousands of farmers.
U.S.A.I.D. “has supported agricultural development in Uganda for many years, including the promotion of organic farming in Northern Uganda,” said Michael Brander of BioVision, a Swiss organization focused on eco-friendly economic development. “Organic farming provided a good price at low production costs for farmers; however, it was exactly in those areas they also supported spraying of DDT.”
Now Uganda’s constitutional court is expected to hear a case brought by a Ugandan environmental organization against the government that asserts that officials failed to meet W.H.O. standards for using DDT, including failure to properly prepare the local population.
But given the prevalence of the disease, “chemical spraying with strict monitoring and supervision is one of the most effective measures to control malaria in high-risk areas,” said a United States Embassy official, who was not authorized to speak publicly.
The village of Atek is a place where mangoes can be eaten directly from trees and children walk to school shoeless. Farming is a way of life, and the American aid agency’s organic-farming program gave the village a competitive edge.
When the DDT was sprayed, organic-farming companies say they lost the bulk of their supply immediately. An American-owned company, Dunavant, had 50,000 certified organic farmers in areas affected by the spraying, according to the Uganda Network on Toxic Free Malaria Control, the organization taking the government to court. Shares, another farming company, said at least 16,000 of its suppliers were affected.
“All that got lost,” said Jan-Alex Fokkens, the director of Shares. “It was game over.”
The organic-farming companies sued the Ugandan government after the first rounds of spraying, and a high court issued a temporary injunction on the use of DDT in 2008, but the case was later dismissed.
The American government says it has not returned to using DDT in Uganda since the court ruling, even though the Ugandan government has made numerous references to reinstituting the chemical. Now, the main chemical being used in the insecticide-spraying program, bendiocarb, has also been discontinued in the United States, and it is considered to be more expensive and less efficient than DDT.
“At a certain point bendiocarb will fail,” said Richard Onen, a field coordinator for Abt Associates, a business contracted by U.S.A.I.D. to carry out its indoor spraying program. “I cannot rule out the possibility of using DDT. It is cheap.”
But there are questions as to how well DDT worked in Uganda in the first place. “Mosquitoes had become resistant to the DDT,” said Kale Dickinson, a nursing officer at a local health center. “DDT was not effective.”
For Lillian Etime, Mr. Acope’s neighbor and a mother of six, the death of her chickens during the first round of spraying set off alarm bells. “We feared that the children could touch the wall,” where spray was administered, “and they could die,” said Ms. Etime, 32. Ultimately, it was business that suffered the most, she said, with her revenue reduced by more than half. “The problem I experience is the problem of money,” she said.
Underneath a mango tree nearby, Mr. Acope lamented his own reversal of fortune, but remained stoic. “I am now working on my own,” he said. “Still growing.”
http://www.nytimes.com/2011/05/19/world/africa/19uganda.html?_r=1&pagewanted=all

MALNUTRITION: Getting the recipe right for US food aid

JOHANNESBURG, 13 May 2011 (IRIN)

 Photo: Manoocher Deghati/IRIN
More of all the good things - protein and vitamins

Changing the food the US government supplies as aid could deliver better results and still save money, a new study says. The review for the US Agency for International Development (USAID) by researchers at the Tufts University Friedman School of Nutrition Science and Policy has been welcomed by NGOs and US food aid experts, but the findings have also come in for some criticism.
The two-year review considered if USAID food aid was up to date with current science, especially in its use of blended food and whether programmes matched the right products with expected outcomes.
"What we're recommending is approaches to enhance the many great things already being done with US food aid under the most difficult circumstances imaginable," Amelia Reese Masterson, research coordinator of the review, wrote to IRIN, referring in part to USAID’s budget pressures.
The review came up with 20 recommendations on some of the food products and programmes under Title II of the US Food for Peace Act, which covers food aid provided in emergency and non-emergency situations.

Getting the ingredients right
The Tufts review addressed the issue of the source of protein in food products for children, pregnant and lactating women, and undernourished people on HIV medication.
Médecins Sans Frontières (MSF) has noted that US food aid destined for children usually comprises fortified flours based on grains and pulses such as corn-soya blend (CSB) or wheat-soy blend (WSB) and has lobbied for the inclusion of other sources of protein, vitamins and minerals.
Recent scientific evidence shows that animal-source proteins such as milk, better promote the growth of muscle tissue and resistance to infections, and are critical to children recovering from severe malnutrition, the Tufts review agreed. It also acknowledged that ready-to-use therapeutic foods (RUTF), usually lipid-based spreads, whose ingredients typically include nuts and milk powder, have led to a radical change in the way severe malnutrition is treated.
The review recommended that a wider range of products, offering varying quantities and types of nutrients for different programmatic contexts, be made available.
It is here that the review has contradicted itself, Nathalie Ernoult, Stephane Doyon and Susan Shepherd, members of the MSF's nutrition team, maintained in a written submission to the Tufts academics.
"The report itself states that there can be no 'one-size-fits-all' food supplement, and we could not agree more," the MSF team said, yet it "focuses primarily on how to improve the nutritional value of fortified blended flours."
The Tufts study argued for a single formulation for a cost-effective, enhanced CSB, which they dubbed CSB14, to meet the minimum nutritional requirements of three key target groups: infants from 6 to 11 months; children between one and three years; and pregnant women.
The MSF team said at least two enhanced CSB formulations would be necessary: one tailored to the needs of infants and young children and those affected by moderate acute malnutrition; the other for older children and adults.
UN organizations the World Food Programme (WFP) and the UN Children's Fund (UNICEF) are also considering experimenting with different formulations of CSB.
"As a field-level agency and occasional implementing partner for UNICEF and WFP, we [MSF] cannot over-emphasize the need for coherence in the nutritional supplements on offer for a given category of beneficiary," the MSF team said. "If the fortified foods provided by WFP, UNICEF and USAID for similar programmes are not interchangeable, nutrition programmes will simply become confused and ineffective."
MSF maintained that the formulation for younger children should have a higher protein content from animal-sourced food; and that the proposed fortification levels of iron and zinc were also too low.
Zita Weise Prinzo of the World Health Organization (WHO) said they were recommending that the diets of moderately malnourished children contain animal-sourced foods, without specifying how much. WHO is expected to release its guidelines for food formulations for moderately malnourished children in June 2011.
According to MSF, the proposed second formulation for older children and adults, would not require animal-sourced ingredients, and the current CSB recipe, with some adjustments to its vitamin and mineral content, would serve the purpose.
However, a senior nutritionist who preferred not be named told IRIN that in many instances it would be hard to imagine relief agencies successfully distributing two or more similar looking products for different segments even within a single family.
"Most large-scale programmes using CSB-type products involve take-home rations. It would be difficult for a programme to ensure the proper use of several similar products at home. The solution could be to have one ‘generic’ option used by most big programmes, similar to that proposed by the [Tufts] paper, and then several other options that would be used by ‘speciality’ programmes."
The CSB14 formulation depends on the addition of oil fortified with vitamin A to provide enough of the vitamin. "Our experience shows that it is difficult to count on the prescribed amounts of oil being added to the porridge in the home, not to mention all the logistical difficulties encountered with the distribution of multiple commodities to constitute a single ration," the MSF team pointed out.
The chemical forms of micronutrient supplements proposed by Tufts also differed from those on the list approved by the WFP, the biggest dispenser of US aid. "It is very important to come to common agreement on a list of acceptable chemical forms for all additives," the MSF team noted.

PEPFAR food
Programming should "be evidence-based, not driven by simple data on tonnages and 'hungry people fed', but by an understanding of the unit cost of impact," and this included HIV/AIDS-related programmes, said the review. It found that orphans and vulnerable children, and HIV-positive pregnant and lactating women, identified for priority food assistance in the US President's Emergency Plan for AIDS Relief (PEPFAR), were receiving not getting priority compared to other HIV-positive women and adults.

Photo: Jason McLure/IRIN
US food aid is evolving

The review suggested stronger links between ongoing antenatal, Prevention of Mother-to-Child Transmission (PMTCT), and Maternal and Child Health (MCH) services, and with programmes treating malnourished children.
PEPFAR country coordinators reported that requests to approve the use of funds for food were "commonly met with caution", the review said, which "contributes to low coverage of food assistance within programmes", and PEPFAR needed to send a stronger signal on supporting the allocation of funds to food in HIV support.

Saving money
Budget-constrained donors were "facing hard trade-offs between feeding as many people as possible and providing higher quality foods to improve nutritional impact per person," said Christopher Barrett, a food aid expert who teaches development economics at Cornell University in the US.
Scarce resources should be put to work more efficiently, and the Tufts review contributed significantly to improving understanding of these tradeoffs by policymakers, operational agencies and commercial suppliers, Barrett commented.
"It's important to move beyond a dollar-per-ton of food metric - the conventional way of looking at things - since that does not take into account exactly what kinds of foods are used for what purposes," said Patrick Webb, principal investigator of the Tufts review project.
"If we become more efficient in treating or preventing malnutrition, then it's the cost per case of malnutrition treated or prevented that matters, and that will go down when the appropriate tools (foods)are used in the right ways, even if unit costs of products rise slightly... because less is needed (over a shorter period of treatment)."
Some of the Tufts recommendations would cost more money - the addition of dairy products, new smaller packaging of some products for mothers and infants to prevent it from being consumed by the entire family - but Webb said the costs would be offset by improved targeting of the enhanced products.
Barrett noted that "With greater bang for the buck, it also becomes easier to defend valuable food aid programmes against those looking to trim budgets."
The review, the issues it covers and its recommendations will be debated at the US government's annual conference on food aid in June.
http://www.irinnews.org/Report.aspx?ReportID=92717

Battle to End Malaria Counts Community Health Workers as Foot Soldiers

Angela Rucker : April/May 2011
credit: Richard Nyberg, USAID
In 2009, at least 82 percent of households in Senegal had at least one bednet compared with 36 percent in 2006. Here, Rougiatou Diallo settles down for a nap with her two children, Serigne Fallou, 3, and Mame Cor, 1, in the district of Guédiawaye near Dakar.

To date, the President's Malaria Initiative and other global efforts have helped cut malaria cases in half in more than 40 countries worldwide. Meanwhile, the quest for a vaccine to help eradicate the disease continues.
Long before the United States launched the President’s Malaria Initiative (PMI), Fatou Diouf was going house to house in her village of Kignabour in Senegal to keep malaria and other illnesses from sickening her neighbors.
Twenty-eight years later, and with a fresh injection of U.S. support, she is proud of the impact her work continues to have on her community.
“This year, for example,” she said, “we had in all of the village only one case of malaria—from a population that totals 1,553 inhabitants.”
In the five years since it was launched, the PMI, which is led by USAID and implemented together with the Centers for Disease Control and Prevention, has moved closer to its goal of cutting malaria-related deaths in half.
The U.S. Government has allotted $1.2 billion in 15 African countries on malaria prevention and treatment. The program puts a special focus on pregnant women and children under age 5—the groups at greatest risk of dying from the disease.
Officials say that global malaria control efforts, including the PMI, have helped cut malaria cases in half in more than 40 countries.
“Today we help save nearly 150,000 lives every year,” USAID Administrator Rajiv Shah said on World Malaria Day 2011, April 25. “In seven of the original 15 Presidential Malaria Initiative countries, we’ve seen reductions in all-cause child mortality by 23 to 36 percent. Once more data becomes available, we expect to see similar results in the remaining initiative countries.”
Malaria is entirely preventable and curable, which makes it a prime target for the global health community. But as backers of the PMI and other efforts know, those efforts are not easy or inexpensive.

A Challenging Disease
Malaria has been around for centuries and is spread by the bite of the female Anopheles mosquito. Once endemic, malaria has been eliminated from most developed nations for many years. It is the poorest nations and those in tropical climates—prime real estate and reproductive territory for mosquitoes—where malaria is stubbornly staying put.
About 1 million people die of malaria annually. Between 300 million and 500 million people will get the disease each year, and most live in sub-Saharan Africa. Uncomplicated malaria causes flu-like systems, such as fever, headache, and vomiting. If left untreated, the disease quickly can lead to death. Even if a child survives severe malaria, he or she is often left with chronic disabilities—hearing loss, paralysis, and learning disabilities.
An estimated 30 percent of all outpatient visits and inpatient admissions among children under 5 in Africa are due to malaria. And in the economic realm, the disease results in $12 billion in lost productivity every year on the continent.

Muscular U.S. Response
Working with other U.S. Government and international partners, the PMI uses a mix of tools: long-lasting insecticide-treated bednets, indoor insecticide spraying campaigns, artemisinin-based combination therapies, prevention of malaria in pregnancy, and community education campaigns. The PMI is also helping train lay and professional medical personnel to care for people with malaria, and is helping governments take charge of malaria campaigns in their own countries.
“The United States is focusing on building capacity within host countries by training people to manage, deliver, and support the delivery of health services, which will be critical for sustained successes against infectious diseases” like malaria, said U.S. Global Malaria Coordinator Timothy Ziemer.
And, while a malaria vaccine is not on the immediate horizon, USAID is backing researchers and pharmaceutical companies in the effort.

Knocking on Doors, Saving Lives
For now what is happening on the ground in malaria-affected communities is vital. And community health workers like Fatou Diouf are key to the activities.
Diouf is part of USAID/Senegal’s integrated community case management program, which is supported by the PMI and uses trained community workers to provide basic health services. One of the greatest barriers to rapid and effective treatment of malaria in Africa is lack of access to health facilities for people living in rural areas. Many countries deploy community health workers to compensate for the limitations of their formal health-care systems.
Diouf, who was selected by her community to train as a health worker in part because of the long distance to health facilities, says the people she serves today know more about malaria than when she started two decades ago.
In the beginning, some people declined to use bednets or used them improperly, she said. Some even told Diouf they did not need to use bednets because they saw no mosquitoes in their rooms. Today, Diouf, 53, goes door to door to educate families about malaria and the proper use of bednets. As a member of the community, she easily won their trust.

Senegal and Malaria Eradication
“Senegal’s northern areas could be malaria-free in the next few years. Indeed, some districts have already achieved this impressive goal,” the country’s health minister, Modou Diagne Fada, said late in 2010. “This is the first time that our country has achieved a level of malaria control that could put malaria elimination within reach.”
In-country malaria-control experts say funding from the PMI and other sources was key to vastly increasing bednet distribution—in late 2009, at least 82 percent of households had at least one bednet compared with 36 percent back in 2006—and to providing other malaria-related services to as many people in the country as possible. The country recruited celebrities, well-known athletes, and religious leaders to support its efforts.
The PMI also tracks closely to the newer Obama administration push, the Global Health Initiative (GHI), which began last year. The GHI, like the PMI, looks to reduce disease and promote healthy communities with a particular emphasis on women, babies, and young children.
The PMI, which was reauthorized for another five years in 2009, will run through fiscal year 2013. With its renewed funding, the PMI is a key component of the comprehensive GHI. In Senegal, PMI represented over 40 percent of donor support for malaria control in 2009.

GHI-PMI Double Punch
“I believe we can save an additional 500,000 more lives a year, most of them young children,” Shah said. “To do this, we need to scale up the distribution of insecticide-treated bednets, boost indoor residual spraying, use more effective antimalarial drug therapies, and target vulnerable populations for treatment.”
That will take additional funding in a time when national and global budgets are tight. Or, as Ziemer put it at a malaria conference in Oslo earlier this year, “we have to go forward with a heavy dose of reality because there will be less money.”
Forming partnerships, including with the private sector, will be key to stretching scarce government resources, he said. The PMI announced recently that it is collaborating with the U.S. Peace Corps in 14 African countries where the two efforts overlap to expand malaria control and prevention.
Ultimately, health advocates say a vaccine against malaria is needed to eradicate the disease, much like what occurred with small pox and polio decades ago. USAID was critical to both efforts. Researchers believe that an effective vaccine could take another 10 to 15 years.

http://www.usaid.gov/press/frontlines/fl_apr11/FL_apr11_MALARIA.html

MALNUTRITION: US to Supply Healthier Food to World's Hungry

Steve Baragona April 27, 2011
US to Supply Healthier Food to World's Hungry : Focus is on proper nutrition for the 1st 1,000 days of life

 Photo: Sue McIntyre/USAID
A Bangladeshi man receives food aid from USAID following Cyclone Sidr in 2007.

New recommendations call for significant changes in the nutritional content of foods the United States delivers to the world's hungry.
The United States is the world's largest supplier of food aid, reaching 55 million people in 46 countries last year, according to the U.S. Agency for International Development (USAID).
That assistance has saved millions of lives over the years.
But Tufts University nutrition expert Patrick Webb says, "There was a bit of an impression that as long as you delivered food, that was enough. And really, what we have been arguing and demonstrating is that, no, just any old food isn't enough."
Webb says that's especially true for young children, who have greater nutritional needs in the first thousand days of life. In the new report commissioned by USAID and released Tuesday in Washington, Webb and his colleagues note that malnutrition in the period from the womb to age two can cause irreparable damage to a child's growth and brain development. That in turn affects a child's ability to learn and ultimately lowers national productivity.
The report recommends more nutritious foods for children under two and pregnant women.
USAID Administrator Rajiv Shah says the report may lead to significant changes. "We'll look specifically into the recommendations into how to get more animal protein into foods so kids don't just get calories, but get the nutrition they need for brain development and human growth."
The report also recommends improving the vitamin and mineral content of grains and oils. Those are relatively easy fixes that may reach beneficiaries this year. But adding animal protein to food targeted for young children is more difficult to accomplish.

 USAID
A man receives 50 kilograms of US sorghum in southern Ethiopia during 2010.

"Unfortunately, there are manufacturing challenges that come to bear, looking at things like shelf life as well as cost," says Stephen Moody, USAID food technology expert.
But Susan Shepherd with the humanitarian group Doctors without Borders says the report does not go far enough.
"It's not at all clear to me that this report is making a strong stand in terms of improving the quality of foods they're trying to give to children," she says.
Shepherd adds that while the report acknowledges the value of nutrient-packed ready-to-eat foods for treating malnutrition, it continues to rely on cheaper fortified grain and soybean blends that do not provide enough nutrition for young children.
And she says it does not provide aid workers with enough guidance on using ready-to-eat foods.
"If I read this report as somebody in the field, it's all over the map," she says. "I don't know what I should be using when. And as long as they keep focusing on how much it costs, how much it costs, how much it costs, then these kids are never going to get what they need."
But USAID officials say they are already seeing benefits in programs that are currently following the report's recommendations. They say within a year other programs will start to see changes that will fight malnutrition more effectively among some of the world's most vulnerable people.
http://www.voanews.com/english/news/usa/US-Looks-to-Supply-Healthier-Food-to-Worlds-Hungry---120781594.html

MALNUTRITION: FOOD: Biofuels make a comeback as prices rise

JOHANNESBURG, 18 April 2011 (IRIN)

 Photo: Manoocher Deghati/IRIN
An increase in the price of a staple cereal triggers a domino effect in grain markets

The combination of higher fuel prices and increased biofuel production, a main driver of the 2007/08 maize price hike, is back in the news because stocks are at their lowest levels in 30 years in the US, the world's largest exporter.
Maize prices have more than doubled since April 2010, said Abdolreza Abbassian, secretary of the Intergovernmental Group on Grains at the Food and Agriculture Organization (FAO). An increase in the price of a staple cereal triggers a domino effect in grain markets as people opt for cheaper alternatives.
Higher food prices since June 2010 have forced an additional 44 million people into hunger, the World Bank noted in a new report.
2010 ended with food prices at their highest since 2008. In January 2011, IRIN looked at whether the world was headed for another crisis but experts thought price escalation had not yet hit the benchmark for a crisis as recorded in 2008, when global supplies of all staple grains were affected.
Christopher Barrett, a food expert who teaches development economics at Cornell University in the US, said maize stocks in the US were "down to less than six months' consumption”.

Are we in a crisis?
No, say the experts, but their level of concern has gone up a notch since January. High crude oil prices, a weak US dollar, widespread unrest in the oil-producing regions of the Middle East and North Africa, and the situation in Japan, where damaged nuclear reactors raise demand for conventional fuel while the threat of radiation exposure decreases food supplies, are not a recipe for price stability any time soon. "The next few months will be critical," said Abbassian.
Crude oil prices surged by 10.3 percent in March and were 36 percent higher than at the same time in 2010, the World Bank noted in its Food Price Watch for 2011. "These oil price increases impact the price of food - a 10 percent increase in crude oil prices is associated with a 2.7 percent increase in food prices in the World Bank Food Price Index."
Crude oil is maintaining prices well above US$100 per barrel, which they last reached in the 2007/08 food price crisis.
High fuel prices mean that more maize, vegetable oil and sugar cane are used to produce biofuel. The US Department of Agriculture (USDA) in its World Agricultural Supply and Demand Estimates report, released in April 2011, reported that the use of maize to produce ethanol rose from 31 percent of total maize output in 2008/09 and would reach a projected 40 percent in 2010/11.
High fuel prices also mean more expensive farm inputs such as energy for irrigation and transport, and other production costs. The World Bank said maize prices had increased in Tajikistan, Azerbaijan and the Kyrgyz Republic in the past year, reflecting increased transport costs from Kazakhstan.
Abbassian said US-made maize ethanol could possibly compete with high petrol prices without any subsidy in the long term, which was "worrisome." He was also concerned about tight maize supplies in China, where production was affected by weather conditions in 2010. There was also uncertainty about the level of Chinese imports in 2011.
Stocks of other staples, "in particular, wheat and soybeans… haven't seen nearly the same draw-downs," Barrett said. "Production has been pretty good in South America, and thus far the USDA reports that indications in the US for the 2011 harvest are good, so the supply-side issues are mainly inadequate growth in yields to keep pace with demand."
Abbassian pointed out that in the first week of April 2011, wheat prices were 84 percent higher than in the same period in 2010, whereas the price of rice was up by only six percent.

Are developing countries affected?
Although it takes time for global price hikes to be transmitted to domestic markets, the impact is determined mostly by local conditions.
Poor rains in the Horn of Africa have seen the price of white maize rise in Kenya, Somalia, Uganda, the Democratic Republic of Congo (DRC) and Benin, with the biggest jump - 80 percent - in Mogadishu, the Somali capital, between January and February 2011, and a year-on-year increase of 340 percent compared to the same period in 2010.
Production uncertainties pushed up global rice prices by 18 percent between June and December 2010 and led to large importers increasing domestic stockholdings, said the World Bank. Prices have been coming down in countries like Bangladesh and Mozambique.
In West Africa, depreciation of the CFA franc against the US dollar has driven up prices by 10 percent to 20 percent since March 2010, according to FAO.
Conflict in Côte d'Ivoire has disrupted supplies of processed foods such as dried milk, sugar and vegetable oil to the landlocked countries of Burkina Faso, Mali, and Niger, making these commodities more expensive, the World Bank said. Prices were rising in Sudan, Ethiopia, India and Colombia, and the impact of high wheat prices was also being felt in Mongolia, which depended largely on imports.
On the upside, high prices have encouraged farmers in the European Union (EU), Russia and Ukraine to plant more wheat, resulting in bigger harvests in 2011. "But if you have another bad weather spell [like the drought in Russia in 2010] we could be facing a crisis," said Abbassian.

What should countries do in the meantime?
Countries that buy most of their food should monitor import tariffs and reduce rates to keep prices low, suggested Barrett. "In many countries, a domestic currency naturally strengthening against the [US] dollar will already be serving that anti-inflation purpose, although pushing the exchange rate as a means of stemming inflation is a dangerous strategy because of likely consequences for their agricultural and other tradables (e.g., the light manufacturing and tourism) sectors."
Abbassian said countries should have had enough time since the last crisis in 2007/08 to contemplate safety nets. "If not, start putting a strategy in place now."
Barrett noted that higher market prices for staple cereals gave farmers and countries an opportunity to invest in upgrading irrigation and other improvements that could bring long-term benefits.
The World Bank focused on what Arab countries, the largest net cereal importers in the world, could do to reduce costs and found that logistics contributed substantially to the price of imported wheat. For instance, vessels carrying wheat routinely wait up to 10 days before they unload cargo. The Bank suggested improving capacity and upgrading infrastructure in ports to lower costs.
In times of unforeseen crisis - floods, unexpected disasters affecting production - countries should take steps to protect themselves from the large margins between the contracted price and the delivery price, so that they do not pass on a price shock to the local markets.
The Bank suggested that small regional humanitarian reserves be set up in disaster-prone, infrastructure-poor areas, such as the Horn of Africa, to meet emergency needs quickly.
The US Agency for International Development (USAID), aid arm of the US government, the world's largest food aid donor, has a warehouse in Djibouti, in the horn of Africa, where food aid is prepositioned for possible emergencies in Africa and Asia.

http://www.irinnews.org/report.aspx?reportid=92502

MALARIA: The real-world effects of budget cuts

Michael Gerson, April 7,
So far in the budget debate, the Obama administration has drawn few bright lines, preferring to blur distinctions with concessions. But last week, a neon line was drawn by an unlikely administration official. Rajiv Shah, the administrator of the U.S. Agency for International Development, possesses the mildest of manners. Testifying before the House state and foreign operations subcommittee, however, Shah had this to say:
 “We estimate, and I believe these are very conservative estimates, that H.R. 1 would lead to 70,000 kids dying. Of that 70,000, 30,000 would come from malaria control programs that would have to be scaled back, specifically. The other 40,000 is broken out as 24,000 who would die because of a lack of support for immunizations and other investments, and 16,000 would be because of the lack of skilled attendants at birth.”
This is the hardest of hardball politics — accusing budget cutters of unwitting complicity in the deaths of children. House GOP lawmakers responded angrily. “Nearly every administration witness appearing before the Appropriations Committee,” said Rep. Jerry Lewis (R-Calif.), “has put forward nightmare scenarios and dire numbers to argue why we should not be reducing spending in any program. Republicans won’t be drawn into a debate over what might happen based on speculations and hype.”
But it is not realistic to take credit for cuts while forbidding a discussion of their consequences. Republicans were drawn into this debate when they proposed major reductions in foreign assistance, believing this category of spending to be an easy political target. Instead, they have stumbled into what one poet called “a problem on the borderline of ethics and accounting.”
By way of disclosure, I was an advocate in the George W. Bush administration for the creation of the President’s Malaria Initiative, designed to reduce mortality by half in 15 affected African countries. Most who die of malaria are children under 6 — several hundred thousand a year in sub-Saharan Africa. I recall one in particular — an infant, her head covered by a cloth, carried by her mother out of the gates of a hospital in Uganda, among the loneliest sights I’ve ever witnessed.
This background allowed me to see how anti-malaria programs are designed. The interventions — insecticide-treated bed nets, new combination drugs, indoor spraying — are neither complicated nor controversial. It is possible, with some accuracy, to determine how many lives will be saved at a certain level of spending. Which means it is possible to determine how many lives would be lost at a certain level of cuts.
USAID estimates that reductions proposed in the 2011 House Republican budget would prevent 3 million malaria treatments. Because the disease is misdiagnosed about half the time, this means about 1.5 million people in need of treatment would not receive it. About 3 percent of untreated malaria infections progress to severe malaria — affecting 45,000 children. Of those children, 60 to 73 percent will not survive, yielding 27,000 to 30,000 deaths. This does not take into account the 2.8 million children who will go unprotected by bed nets and insecticide spraying. Similar estimates can be made concerning cuts to immunization programs.
Despite Lewis’s claim, global health programs are not analogous to many other categories of federal spending, such as job training programs or support for public television. A child either receives malaria treatment or does not. The resulting risk of death is quantifiable. The outcome of returning to 2008 spending levels, as Republicans propose, is predictable.
Fiscal conservatives tend to justify these reductions as shared sacrifice. But not all sacrifices are shared equally. Some get a pay freeze. Some get a benefit adjustment. Others get a fever and a small coffin. This is not fiscal prudence. It is the prioritization of the most problematic spending cuts — a disproportionate emphasis on the least justifiable reductions. One can be a budget cutter and still take exception to cuts at the expense of the most vulnerable people on earth. In Britain, Prime Minister David Cameron is pursuing even greater austerity while increasing funding for development.
Cuts for global health programs should be of special concern to those of us who consider ourselves pro-life. No pro-life member of Congress could support welfare savings by paying for abortions. No pro-life member of Congress could support Medicare savings by cutting off life support for the sick. And it should give any pro-life member pause to support minuscule budget savings that risk the death of children from malaria.

michaelgerson@washpost.com

http://www.washingtonpost.com/opinions/the-real-world-effects-of-budget-cuts/2011/04/06/AFpEFXxC_story.html

POVERTY: How to Protect U.S. Foreign Aid? Improve It

March 14, 2011,  TINA ROSENBERG
Tina Rosenberg won a Pulitzer Prize for her book “The Haunted Land: Facing Europe’s Ghosts After Communism.” She is a former editorial writer for The Times and now a contributing writer for the paper’s Sunday magazine. Her new book is “Join the Club: How Peer Pressure Can Transform the World.”

A Bloomberg National Poll says that more than 7 in 10 Americans think that Congress can find major savings in the federal budget by slashing foreign aid. It’s a new poll, but this is old news.
Americans want to help others, but they’re skeptical that foreign aid can do much good.
Americans have always vastly overestimated how much we spend on foreign aid. A 2010 survey asked Americans what percentage of the federal budget went to foreign aid. The median response was 25 percent. When asked what percentage would be appropriate, the answer was 10 percent. Polls going back at least a decade show similar responses. In fact, foreign aid accounts for less than 1 percent of the federal budget
If Americans are asked whether they want to help bring health, water, education and other crucial resources to poor people around the world, they say yes, by overwhelming majorities. But Americans are skeptical that foreign aid accomplishes these things.
The truth is, much of foreign aid works. Hundreds of millions of people around the world are better off because wealthy countries pay to vaccinate children, dig wells, build roads and buy schoolbooks. But some foreign aid is wasted, stolen or spent on projects that don’t really help people.
The facts about foreign aid are crucial to drive home to the American public today, as the political debate over the budget has led many Republicans to single out foreign aid as a target for cuts. (Frank James, who writes a blog at NPR, suggests a novel way to spread the word, using Charlie Sheen’s Twitter account.)
But let’s talk about on-the-ground practical solutions, The Center for Global Development, a Washington think tank led by Nancy Birdsall, has an intriguing idea that might help. It could make some forms of foreign aid more effective, less corrupt and more responsive to what people need. And in doing so, it could capture more public support for something that improves, and often saves, the lives of millions.
The idea is called Cash on Delivery: instead of rich countries paying for all the little pieces that go into a poor country’s program, they pay only when something good comes out. Aid would get transferred when there are measurable, provable results.
Today, rich countries pay for what goes into a poor country’s program. Why not pay when something good comes out?
Paying for results is nothing new in the world of business, of course. But that’s not the way foreign aid has worked. Let’s say that the United States and Malawi decided to help Malawi increase the number of children who finish primary school. Here’s the current strategy: Aid officials would work with Malawi’s government to decide on whether to build more schools, lower school fees or hire more teachers. Washington would put up the money up front. It would be very involved in the program — vetting Malawi’s strategy, recommending approved ways of going about it, and perhaps even requiring that technical advice or materials come from the United States. Monitoring would be very close; Malawi would have to do a lot of paperwork to get the money and constantly show it is being spent well along the way.
As for the question of whether the program succeeds, we might find out later how many teachers were hired or schools built — or we might not. But we would not attempt to measure whether our aid actually resulted in more children finishing school — in fact, it would likely be impossible to prove such a link. And if the money was squandered or stolen, the only possible penalty would be a cutoff of future aid.
How would this project work with Cash on Delivery? The United States and Malawi would draw up a five-year contract that specifies a set of payments and what Malawi must do to get them. These would be made public. The contract would set a baseline: perhaps the number of children expected to finish school next year. The year after that, and every year for five years, Malawi would receive $20 for every child who finishes school up to the baseline number — and, as an incentive to do even better, $200 for every child over that number. The results would have to be accurately measured by Malawi – since school records are often spotty, Malawi would administer a standardized test and count the number of students who took it, and make those results public by district or even school. Those numbers would be verified by independent auditors. There could be steep penalties for lying.
By basing aid on performance, cash on delivery could reduce waste and corruption.
Once the contract is signed, Washington would then step back and keep its hands off. No monitoring would happen until the audit. Malawi could ask for technical help if it chose to, but how it chose to reach the goal would be entirely up to Malawi. Would more children stay in school if they had school meals? Schools in every village? Or a water supply closer to their homes so girls didn’t have to leave school to fetch water? Malawi could do whatever it thought would solve the problem. If it squandered its efforts in waste or corruption and produced fewer graduates, it would get less money. By definition, then, donor money would not be wasted.
No one is suggesting that Cash on Delivery should replace traditional aid. For one thing, it has yet to be tried — the British Department for International Development is going to be the first. It is working with Ethiopian schools on a program to give payments directly to secondary schools for each extra girl who finishes.
But in certain situations Cash on Delivery might turn out to be a useful alternative to traditional aid. And its advantages may go beyond a more effective use of dollars: it might increase political support for foreign aid.
Paying for results is attractive. People don’t have to worry that the money has gone into some government official’s pocket, as taxpayers in wealthy countries won’t be sending money unless there are results. “This focuses on a few simple outcomes that people can understand,” says Birdsall. “You can say to the taxpayer: mortality fell by this amount.”
It could also help to create more accountability in poor countries. In most aid-dependent countries, citizens have no idea how much governments are getting in aid and how they spend it. Cash on Delivery sets clear goals and requires that all information be public. The idea might also lead to more sustained progress, as the strategies would be fully devised and implemented by local officials based on what they think would work best. It would also alleviate the sense that a country’s problem was fixed by outside intervention; local officials and citizens could claim ownership of the solution.
Experimentation in foreign aid is valuable — and rare. Public bureaucracies are not naturally innovative, and the tendency to stick with the pretty-good is especially strong when people see programs as under siege, a feeling that is fairly constant in the foreign aid business. Because there is such a small political constituency for foreign aid and it is so vulnerable to cuts, many people who work in it feel the best course is not to raise questions about its effectiveness — even if they share those questions themselves.
Cash on Delivery as the Center for Global Development imagines it is yet untried, but other forms of pay-for-results are being used. Perhaps the program closest in spirit is one run by a nonprofit group called the Global Alliance for Vaccines and Immunization (GAVI), which has prevented more than 5 million child deaths by increasing vaccination rates and bringing new vaccines to poor countries. GAVI employs a variety of creative financing mechanisms, including a pay-for-results plan that has been used in 53 of the world’s poorest countries. The goal is to increase the number of children who complete the three-dose series of DTP (diphtheria, tetanus and pertussis) immunizations. For every child immunized above the baseline, the government gets $20. The plan lasts at least five years. For the first two years, the government gets a fixed amount of money. The pay-for-performance kicks in during year three.
The program has helped many countries to increase their vaccine coverage. An evaluation by Abt Associates of the program’s first five years concluded it had a “significant positive impact.”
It is, however, a work in progress. “It worked, but we need to be cautious and not see it as a magic bullet,” said Julian Lob-Levyt, who was head of GAVI until recently. “We underestimated the management skills needed.”
One problem was that in some countries while the national health ministry understood the requirements and realities of pay-for-performance, this this knowledge did not trickle down to the district health departments that had to manage the program. That might be easy to solve — but there were more difficult issues. A paper in the Lancet argued that the temptation to exaggerate success was overwhelming — after all, that’s what the money rides on. The authors said that countries did improve their vaccination rates, but not as dramatically as they claimed to. The study shows the need for any pay-for-performance program to do extensive independent auditing to check a country’s claims.
There are other programs that pay for results, and on Friday I’ll look at what we can learn from them, what Cash on Delivery might be used for, and some of the roadblocks that may await it.
http://opinionator.blogs.nytimes.com/2011/03/14/how-to-protect-foreign-aid-improve-it/?pagemode=print