Monday, September 27, 2010

Talk is cheap ... and there is a lot of it!

Dear Colleagues

I have been an active observer of the UN activities in New York over the past few days. The UN General Assembly is bad enough, but when combined with an MDG Summit and activities like the Clinton Global Initiative and other side-shows ... it becomes a huge circus.

The amount of "talk" is impressive. Sadly, people like me have not completely lost our memories, and much of the talk is a recycling of talk that has taken place over and over again over a very long time.

In health, I am reminded of the 1978 UN Al-Maty declaration about Health for All by 2000 ... and I was very discouraged by the MDG initiative by the UN in 2000 to introduce a whole new set of goals to be achieved a "safe" fifteen years into the future. In 2000, it would have been much more useful to have taken a good hard look at why so little progress had been made in the previous forty-plus years and do something practical to do things better.

My interest in accounting and accountability goes back a very long time. As someone trained professionally in accountancy, I am quite capable of "following the money" and it is appalling that this is so rarely done within the public sector and the international relief and development community. Without control of the fund flows ... anything goes ... and this is a formula for disaster for society as a whole, while perfectly suited to the greedy, corrupt and powerful.

The major personalities in the UN and the international community have made their speeches ... and a lot of big numbers have been thrown out. Where the money is going to come from is less clear. The UN especially is good at talking about big numbers, but less capable of mobilizing the money in practical terms. There is an urgent need for the high profile global leadership to "get real" about the money that is going to be available, and how it can be used to get the most benefit.

The efficiency of the system is awful ... and with rather modest amount of money there could be huge progress if the money was used well. Few of those in power are interested in low resource flows being used well ... for obvious reasons. With such abject system failure and so much deep poverty a results oriented use of funds can have a huge impact and be a step forward to progress out of poverty. There needs to be really clear focus on addressing needs ... but also using available human resources as the major resource to satisfy needs ... not merely mobilizing money and essentially wasting it!

With good management ... good decision making ... there can be better performance. Part of the reform has to be making way better use of data for decisions and accountability.

The e-list message that sparked this not is set out below


Peter Burgess

UN launches $40 billion health drive
By Tim Witcher (AFP) – 2 days ago

UNITED NATIONS — UN Secretary General Ban Ki-moon on Wednesday announced a 40-billion-dollar drive to improve the health of women and children, which he said would save millions of lives around the world.

Governments, philanthropists and private groups pledged the cash, giving a spectacular end to the UN summit on eliminating poverty, a campaign that has been badly battered by the international financial crisis. "We know what works to save women's and children's lives, and we know that women and children are critical to all of the Millennium Development Goals," Ban said.

"Today we are witnessing the kind of leadership we have long needed," he declared ahead of the close of the summit when US President Barack Obama will be the keynote speaker.

Ban estimated that his Global Strategy for Women's and Children's Health could save 16 million lives by 2015. Of the eight key development targets set a decade ago, cutting deaths of women during pregnancy and childbirth and those of children younger than five have seen the least progress.

Countries from Afghanistan to Zambia -- but also including Australia, Britain, China, France, Germany, India, Japan, Russia and the United States -- have contributed to the drive. The foundations of the world's richest men, Mexican tycoon Carlos Slim and Microsoft billionaire Bill Gates, were among the contributors. They joined rights groups such as Amnesty International and multinationals such as LG Electronics and Pfizer.

"Never have so many come together to save the lives of women and children," commented Norway's Prime Minister Jens Stoltenberg, whose country is one of the world's top aid donors.

US Secretary of State Hillary Clinton said investing in women and children's health was "an issue that deserves to be at the top of our development agenda."

A UN statement said the deaths of more than 15 million children under five would be saved between 2011 and 2015 through the initiative.

It added that it would prevent 33 million unwanted pregnancies and 740,000 women from dying from complications relating to pregnancy and childbirth. It estimated that 120 million children would be protected from pneumonia.

It was unclear how much of the 40 billion dollars announced is a new spending commitment and reaction to the announcement was mixed from aid groups. "We have learned to be skeptical of big announcements at summits, and we question how much of this money can possibly be new," said Emma Seery, a spokeswoman for Oxfam.

"What really counts is where the money is coming from, which means leaders going home and putting that money into national budgets." Seery said 88 billion dollars was needed up to 2015 to meet child and maternal health goals.

Several governments in poor nations promised major increases in spending as part of Ban's initiative. Afghanistan said it would increase per capita health spending from 11 dollars to at least 15 by 2020. The UN said that Britain will spend an additional 2.1 billion pounds (3.2 billion dollars) on child and maternal health from 2011 to 2015. The three-day summit was called to rejuvenate the eight development targets set at the 2000 Millennium summit, aiming to be reached by 2015.

The goals set target of cutting by two thirds the number of children who die before they are five, and reducing the number of women who die during childbirth by three quarters.

>From 1990 to 2008 the number of child deaths fell by 28 percent, but there are still almost nine million deaths a year.

The Millennium goals also included cutting the number of people who survive on less than one dollar a day by half, halve the number of people who suffer from hunger, halt the spread of AIDS and other killer diseases, achieve universal primary education and empower women.

The United Nations has estimated that at least 120 billion dollars will be needed over the next five years to meet the MDGs, which most experts predict will not be met by the 2015 target date.

From AFRO-NETS, an e-forum on health research and development in Africa

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