Showing posts from category Guest Contributor.
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How Family Planning Meets Development Goals
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“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent event in Chapel Hill.
The other panelists at “How Can Family Planning Efforts Help Us Achieve the Millennium Development Goals?” (Dr. Martha Carlough of UNC, Dr. Ward Cates of Family Health International, and Pape Gaye of IntraHealth International) all provided compelling statistics demonstrating the effectiveness of family planning as an intervention that addresses the Millennium Development Goals (MDGs).
MDGs 4, 5, and 6 – reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases, respectively – all have obvious connections to health and woman’s reproductive health. An unmet need for family planning, which is measured as the percentage of women of reproductive age who desire to space or limit their births but are not using contraception, can undermine the achievement of these goals.
For example, very early motherhood not only increases the risk of dying in childbirth, it also jeopardizes the well-being of surviving mothers—and their children, too. A child born to an adolescent mother has a greater risk of dying in infancy or childhood.
“Contraception is the best-kept secret in HIV prevention,” said Dr. Cates, who cited research that found that “current contraceptive use in sub-Saharan Africa prevents an estimated 577,200 unplanned births to HIV-infected mothers” and thus prevents the birth of an estimated 173,000 HIV-infected infants each year.
Family planning can help meet the other MDGs, including ending poverty and hunger (Goal 1); providing universal primary education (Goal 2); and promoting gender equity (Goal 3). Young mothers frequently miss out on education and socio-economic opportunities. Being able to make their own decisions about family planning and reproductive health can empower women and improve gender equity. When women are given equal opportunities for education, health, and employment, they are more likely to invest in the education and care of their children. This helps them break the cycle of poverty, hunger, and disease.
Although the MDGS don’t include any formal targets for sexual and reproductive health, the UN Millennium Project has stated that the MDGs cannot be achieved in low-income countries without access to sexual and reproductive health services, including family planning. The panelists agreed that family planning is a cost-effective intervention that provides broader positive benefits for development.
But the real strength of their presentations lay in the personal stories behind the statistics. Middleberg closed the discussion with a story about a woman in Latin America who told him that she loves her husband but was afraid of him every time he touched her. Now, after having undergone sterilization, she no longer worries and can love her husband with no fear of becoming pregnant.
A mother of six interviewed in a 2009 news article about the Philippines’ new family planning bill said, “How can one keep on having children? We don’t earn enough to feed them, much less send them to school.” New York Times columnist Nicholas Kristof interviews a Haitian woman with 10 children in a dramatic video interview, “Saving Lives with Family Planning.”
Underlying all of these facts and stories is the belief that one’s health and well-being, including access to family planning, is a right. But as Middleberg said, believing is not enough.
EngenderHealth, an international reproductive health organization working to improve the quality of health care in the world’s poorest communities, is asking Americans to create a video explaining why we should care about international family planning. Contribute your thoughts on YouTube’s Video Volunteers project.
Lisa Basalla, MPH, is a research associate with the Carolina Population Center. She graduated from Case Western Reserve University with a MPH focusing on reproductive and adolescent health. She has worked with Johns Hopkins University’s Center for Communications Programs on its reproductive health knowledge management project as well as a HIV-prevention behavior change communication project in Malawi.
Photo: A billboard promoting family planning in Phnom Pehn, Cambodia. Courtesy flickr user olerousing. -
Budgeting for Climate
›Update: Read a response by Miriam Pemberton“The Obama administration…has identified the task of substantially reducing greenhouse gas emissions as one of its top priorities,” writes Miriam Pemberton in a new report from the Institute for Policy Studies, “Military vs. Climate Security: Mapping the Shift from the Bush Years to the Obama Era.”
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Copenhagen’s Chance to Reduce Poverty and Improve Human Security
›The climate community is under increasing pressure to help the developing world, especially those at the “bottom of the pyramid.” The people who did the least to cause climate change will suffer its effects the most.
A critical part of the solution to this problem will be enhancing market-based incentives for climate-friendly behavior. The projects that generate credits for sale in the carbon markets vary widely in scale. However, the most successful have focused on large, localized sites, such as the smoke stack of a single plant. These “centimeter-wide, kilometer-deep” projects are easy to monitor and verify.
In contrast, most projects that benefit the poor are “a kilometer wide, a centimeter deep,” with each family across a large territory producing a small emissions reduction. Monitoring and tracking these community-based projects is usually cost-prohibitive.
DRC: Reducing Emissions and Improving Security
A Mercy Corps project in the refugee camps in the eastern Democratic Republic of the Congo (DRC) seeks to improve the security of women and children while simultaneously reducing carbon emissions.
In the war-ravaged province of North Kivu, the total number of Internally Displaced Persons (IDPs) exceeds 850,000. Demand for resources, particularly fuel wood, vastly exceeds the available supply. To collect wood, women and children have to leave the relative safety of the refugee camps, making them vulnerable to sexual assault and child abduction by rebel groups and the army. Mercy Corps surveys indicate that nine percent of women in camps have been raped or otherwise assaulted.
Mercy Corps installs fuel-efficient stoves that reduce the need for dangerous trips into the forest. A commercial carbon broker develops carbon credits from the reduction in emissions that arises from the use of stoves instead of open fires. The upfront funding from the broker supplements a UNHCR grant supporting the project, and serves to help more than 20,000 families in one of the most dangerous places on Earth.
This extreme example is one of relatively few carbon projects generating revenue that benefits vulnerable people. Yet if this kind of project can be successful in the DRC, larger projects in safer countries may be able to generate massive emissions reductions. The Copenhagen conference needs to set the stage for these types of market incentives for better climate behavior.
Raising a REDD Flag
A relatively new, UN-backed initiative known as Reduced Emissions from Deforestation and Forest Degradation (REDD) seeks to compensate forest-rich countries for protecting or regenerating their forests. However, REDD may have the unintended consequences that further erode the human rights of marginalized people dependent on those forests.
For decades, tropical forests have been logged legally and illegally by states and private companies, without any input from or compensation to indigenous forest communities, who, in many cases, were displaced or worse.
REDD thus raises a troubling question: If countries can generate carbon revenues through REDD, to whom do the revenues belong, and how will they be allocated? Many forestry ministries have a long history of corruption and mismanagement. There are already signs of ministries competing over putative REDD funds. And high-level discussions in only a few countries have included the role of communities and civil society in implementing REDD and distributing revenues.
The Copenhagen conference will be a critical milestone in the global fight to address climate change. Yet it raises significant and far-reaching questions concerning economic development and human rights of the world’s most vulnerable citizens that must not be swept under the rug.
Jim Jarvie is director of climate change, environment, and natural resources at Mercy Corps. In a recent video interview, he spoke to ECSP about how humanitarian groups are responding to new climate challenges.
Photo: Stoves that are more fuel-efficient not only help curb rapid deforestation, but help women spend less time gathering wood in dangerous areas. Courtesy Dee Goluba/Mercy Corps. -
Who Does Development? Civil-Military Relations (Part I)
›USAID convened a study group to determine the future civil-military relationship between USAID and the Department of Defense. Two members of the study group, Dr. Frederick Burkle and Dr. Gene Bonventre, offer their thoughts.In the first decade of the new millennium, the relationship between the Department of Defense and civilian governmental agencies and NGOs has been a rollercoaster ride. At the high point of civil-military cooperation—the response to the Kurdish refugee crisis after the first Iraq war—the U.S. military provided security, access, and logistics, while USAID and NGOs provided direct assistance and expert advice to the 800-pound uniformed gorilla.
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Who Does Development? Civil-Military Relations (Part II)
›USAID convened a study group to determine the future civil-military relationship between USAID and the Department of Defense. Two members of the study group, Dr. Frederick Burkle, Jr., and Dr. Eugene Bonventre, offer their thoughts.
The success of all interventions and relief efforts in conflict and post-conflict situations is dependent on politics and political action. For the United States, political action translates into military action. During my career, I’ve been involved in five conflict situations with the U.S. military, and each one made a different claim and set different restrictions for intervening with “aid.”
In the 1990s, after several frustrating years of failures, many in government believed that humanitarian assistance without political solutions achieved nothing. In good Wilsonian fashion, they saw political action—and the military interventions that followed—as a means to project, influence, and spread U.S. values. As such, the military became the security and protection tool of political humanitarianism, especially among those who considered that the convergence of humanitarian actors with the military ensured that the duty to provide assistance and the right to receive it was guaranteed.
The Kurdish crisis after the Persian Gulf War was instrumental for many reasons. One, it was the first time the Security Council did not veto a resolution to protect vulnerable populations within a sovereign state. Two, it was considered in most circles to be a success, because the coalition led by the U.S. military was considered by the humanitarian community to have been an ally in the struggle to provide security and assistance. The military presence allowed the humanitarians to work in an austere environment and to save lives.
What happened afterwards is a different story. Influenced by the post-9/11 global war on terrorism, increasingly insecure conflict environments, and the unilateral approach to conflict management, the military began to provide direct assistance to the population themselves. Liberties were taken: NGOs were recruited as “force multipliers,” “a second front,” or “part of our combat team.” The traditional leaders of humanitarian assistance and disaster relief, the Red Cross and the UN’s Office for Coordination of Humanitarian Affairs, were ignored. A “partnership” of the U.S. military-political command, the World Bank, corporate contractors, and like-minded NGOs dominated the scene.
In the last four months I’ve been confronted by two retired generals. One strongly insisted that the military must “stay within their lane” or risk destroying the military and supporting the perception of a U.S. politico-military “empire.” The other strongly insisted that the only entity in the world that could do humanitarian assistance and disaster relief is the U.S. military
So who should be leading these efforts for the United States? USAID, which was decimated in the 1980s, has never come back. The more than 12,000 USAID professionals during the 1960s-70s now number only 2,000. Reestablishing USAID’s place in development and relief will take much money, time, and expertise.
In the meantime, the only show in town, DoD, grows even larger and stronger. Gates’ statement that more civilians are needed in Afghanistan and Pakistan was actually a request for more “civilians” to be coordinated by the military.
It is not unusual to find those who think that the politico-military “relief and reconstruction complex” is impossible to change, especially when they are favored by Congress over USAID and State to solve these problems. But if “outcome indicators” rather that the current DoD-dominated “achievement indicators” were used to measure success, they would tell a totally different story.
In the last few years, the argument that such efforts are essential to “winning the hearts and minds” of a population has come out of nowhere. This claim is not grounded in accepted measures that monitor and evaluate such success. Yet the defense budgets that are heavily supported by Congress are based on achievement indicators alone.
President Obama does not come to the table with a strong and substantive knowledge or experience with the nuances of foreign assistance and the critical importance of the traditional humanitarian community. He is currently hearing only voices from the military and industry on this issue. We owe it to both the humanitarian community and the military to ensure that evaluation of their effectiveness is transparent, accountable, and evidence-based.
Current USAID leadership, short of a named Administrator, must speak up. The opportunity to reestablish USAID’s role in development and humanitarian assistance may never come this way again.
Dr. Frederick M. Burkle, Jr., is a professor and senior fellow with the Harvard Humanitarian Initiative, Harvard University; a senior public policy scholar at the Woodrow Wilson Center; and a retired Navy Reserve Captain and combat decorated for service with the U.S. Marines. -
Post-Conflict Recovery in Biodiversity Hotspots
›The prevalence of armed conflict in areas of high biodiversity is alarming, though not entirely surprising. According to “Warfare in Biodiversity Hotspots” (abstract online), which was published earlier this year in Conservation Biology, 80 percent of the major armed conflicts between 1950 and 2000 took place in biodiversity hotspots. While natural resources are rarely the principal causes of conflict, their allocation and ownership are frequently among its drivers. -
The Scoop on Development Reform
›The development reform picture became more complicated after a recent speech by Senate Foreign Relations Committee Chairman Senator John Kerry (D-MA) and congressional testimony by Deputy Secretary of State for Management and Resources Jack Lew.
Revamping State and USAID
At a Brookings Institution speech (transcript) on May 21 entitled “Diplomacy and Development in the 21st Century,” Kerry laid out the Senate Foreign Relations Committee’s plan for strengthening the civilian agencies that deal with these issues.
In the short term, Kerry favors the recruitment of more diplomatic and development professionals and a stronger emphasis on their training and education. He also expressed his desire to “untie the hands of our aid workers” by streamlining outdated regulations and rebalancing the relationship between Washington and the field.
“Over the long term, we need to take a close, hard look at exactly what we want our diplomatic and development institutions to achieve,” said Kerry. “We need to make sure that we give those people the resources they need to get where we have decided they must go.”
To meet these goals, he and Senator Richard Lugar (R-IN) will introduce two pieces of legislation: a Foreign Affairs Authorization Act and a foreign aid reform bill, which will serve as precursors to a more comprehensive overhaul of the 1961 Foreign Assistance Act next year, said Kerry.
A Power Grab by State?
On May 13, Lew testified on the FY2010 international affairs budget request (webcast; testimony), outlining five “smart power” funding objectives:
1. Build civilian capacities in State and USAID;
2. Promote long-term development and human security;
3. Enhance strategic multilateral and bilateral partnerships (e.g., with Israel, Egypt, Pakistan, and Afghanistan);
4. Strengthen global security capabilities (e.g., nuclear non-proliferation); and
5. Maintain the resources to respond to urgent humanitarian needs.According to Lew, State’s approach to development will be both “top-down”—strengthening “the ability of governments to support just and capable institutions that meet the basic needs of their populations”—and “bottom-up”—partnering with civic groups to build human capacity to innovate, cooperate, and solve problems.
Lew indicated that State should coordinate multiple agencies’ efforts to address challenging, cross-sectoral problems. He said, “We must be able to look at a country, a function or an objective and be able to identify everything that the U.S. government is doing in that area—not just State.” For instance, he wants the State Department to lead “a whole-of-government process to design and implement a new food strategy.”
Lew’s testimony seems to indicate that State wants to oversee all of development policy, with no apparent role for the National Security Council (NSC). But it is not at all clear that State has the human and financial resources to coordinate all the other agencies involved in development. If State were granted this authority, the organizational implications would be immense.
At the NSC, development issues fall under the purview of Deputy National Security Adviser for International Economic Affairs Michael Froman, but he has many other issues on his agenda, including the G20 and the G8. I would be surprised if the NSC does not see this kind of overall coordination as part of its mandate. But there have been no public reactions to State’s grab for power.
At the same time, both Kerry and Congressman Howard Berman (D-CA), chairman of the House Foreign Affairs Committee, see development reform as a major part of their portfolios. The State Department has strongly opposed Berman’s bill mandating that the administration produce a government-wide “National Development Strategy,” on the grounds that the responsibility for drafting such a document should be given to the State Department, and not (as it is now written) to the President. The future of Berman’s legislation is not clear, but Kerry also has indicated his desire for an overall strategy paper.
USAID Still Seeking Chief
Finally, USAID still lacks a director. The latest rumors in the blogosphere revolve around Dr. Paul Farmer, the renowned physician who founded Partners in Health, a major NGO focusing on global health. Farmer would be the first USAID administrator in recent years with extensive on-the-ground development experience, but I understand he has no experience with Washington bureaucracy (outside, perhaps, of the health arena). Furthermore, he is known more as a charismatic leader than as a manager.
Farmer would be an unconventional choice for running USAID, though there are conflicting opinions on whether he even wants the job. But if he does want it, he should ensure he had a deputy secretary rank, as well as authority over the Millennium Challenge Corporation, the President’s Emergency Plan for AIDS Relief, and other independent development programs. He also would need the funds and staff to completely revamp USAID to meet the challenges of the 21st century.
John W. Sewell is a senior scholar at the Woodrow Wilson Center and the former president of the Overseas Development Council. ECSP published Sewell’s review of Trade, Aid and Security: An Agenda for Peace and Development in ECSP Report 13. -
Pakistan’s Daunting—and Deteriorating—Demographic Challenge
›Every day it seems the headlines bring new worries about the future of Pakistan. But among the many challenges confronting the nation—including a growing Taliban insurgency—one significant problem remains largely undiscussed: its rapidly expanding population.
Consider this: Pakistan’s population nearly quadrupled from 50 million in 1960 to 180 million today. It’s expected to add another 66 million people—nearly the entire population of Iran—in the next 15 years. UN projections predict that by the late 2030s, Pakistan will become the fourth most populous country in the world, behind India, China, and the United States.
And believe it or not, the demographic outlook for Pakistan got bleaker in recent weeks. The new medium-range UN projections for Pakistan’s total population have been raised to 335 million for 2050—45 million higher than the UN projection just two years ago. Why the change? Because birth rates aren’t falling as had been predicted—women in Pakistan have an average of four children—and unmet need for family planning remains high.
The case of education provides a snapshot of how these demographics affect Pakistan, from basic quality-of-life issues to the country’s overall stability. Even though the official literacy rate in Pakistan has increased from about 18 percent to 50 percent since 1970, the number of illiterate people has simultaneously jumped from 28 million to 48 million. The literacy rate for women stands at a shockingly low 35 percent.
As public schools have become increasingly overcrowded, more parents have turned to madrasas in an attempt to educate their children—or at least their sons. It’s no secret that some of Pakistan’s madrasas have ties to radical religious and terrorist-affiliated organizations.
So what does this portend for the future?
Even assuming large infusions of assistance from the United States, Pakistan’s public school system will become even more overwhelmed in the years ahead. Building enough schools and hiring enough teachers would be daunting in any country, let alone one facing as many challenges as Pakistan. It seems likely that enrollments in madrasas will swell, and more children will face a future with no schooling whatsoever. Clearly, this is not a recipe for a more stable and peaceful Pakistan.
Pakistan’s rapid population growth is not inevitable, however. A key driver is lack of access to family planning, which is symptomatic of the overall poor status of women and girls. More than 25 percent of Pakistani women have an unmet need for family planning—meaning the demand is clearly there—and nothing in the Koran prohibits its usage. In other majority-Muslim nations, such as Algeria, Bangladesh, and Iran, family planning has been prioritized and is widely used.
Unfortunately, family planning programs in Pakistan and many developing countries have suffered from both inattention and funding cuts in recent years. Traditionally, the United States has been a major source of funding and technical assistance, but since 1995, U.S. international family planning assistance has fallen 35 percent (adjusted for inflation), even as demand has increased.
Today, more than 200 million women—many of them in the most impoverished parts of the world—have an unmet need for family planning. In countries like Pakistan, the resulting rapid population growth makes it increasingly difficult to provide sufficient education, health care, housing, and employment—and depletes land, water, fisheries, and other vital natural resources.
The Obama administration recently proposed a new U.S. assistance strategy for Pakistan—and a key component is a significant increase in development and economic assistance. Let’s hope it will include an increase for family planning. It would be a wise investment in a brighter, more stable future—for Pakistan and for the world.
Tod Preston is vice president for U.S. government relations at Population Action International.
Photo: Children in Jinnah Colony, Karachi, Pakistan. Courtesy of Flickr user NB77.
“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent 
The climate community is under increasing pressure to help the developing world, especially those at the 
USAID convened 
USAID convened 
The prevalence of armed conflict in areas of high biodiversity is alarming, though not entirely surprising. According to “
Every day it seems the headlines bring new worries about the future of Pakistan. But among the many challenges confronting the nation—including a 
