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Episode 44: The Data Revolution

Everyone seems to be talking about the data revolution these days. In this episode of Development Drums, I speak with two people who have thought more about what it is, how to make it happen, and what it means for development than just about anyone else. Claire Melamed is the Director of the Growth, Poverty and Inequality Programme at ODI. She was previously the Head of Policy at ActionAid UK. Her work focuses on measurement of poverty and inequality and on how to use the insights from measurement to improve policy and outcomes

Image polio-e1386948226901.jpg

Is the world on track for polio eradication by 2018?

This video describes the tools available and discusses the challenges that remain for wiping out the disease.

Ebola

The ethical debate over the use of an untested Ebola drug

The disease is Ebola. The outbreak is In West Africa. Two infected Americans — and no Africans — got the drug, which is called ZMapp. Kevin Fitzgerald is a medical ethicist at Georgetown University who says there are good reasons not to use untested drugs, but “compassionate use” is part of the ethical consideration.

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How the aid and development industry helped cause Africa’s Ebola outbreak

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Yeah, that’s a provocative headline. No, we’re not talking about some movie thriller like Constant Gardner, in which an evil drug company does some deadly experimentation on hapless Africans. We’re talking about reality with a medical anthropologist, James Pfeiffer, about one of the root causes of the massive outbreak of Ebola now ravaging West Africa. It is


Hospitals for Health – Amanda Glassman

Where do you go when hit with a serious medical condition? “The hospital!” is an obvious answer for people in high income countries, but for people in low-income and emerging market economies, access to a proper hospital is often just a dream. Why are decent hospitals in the developing world so few and far between?  

This week I invite senior fellow Amanda Glassman  on the Wonkcast to discuss a new CGD Working Group  that is studying the problems that result in a lack of effective hospitals in low-income and emerging market countries.  

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Consultation Draft: Send your feedback to Rsilverman@cgdev.org by November 1, 2014.

Why focus on hospitals now? While news from the front lines of Ebola  has made the entire world aware of the dearth of hospitals in the afflicted countries, Amanda notes that within the global health community the shortage of hospitals in the developing world was already a hot topic.

For years donors have focused their attention and resources on primary care and preventive services—the kinds of help that can be provided at low cost in a village or neighborhood clinic.

“We’ve pretty much picked that low-hanging fruit,” Amanda says. “Now we’re thinking about health systems in a more integral way… Not just the hospital buildings but the but structures and policies that are needed to make hospitals function efficiently, contributing to health.”

What can be done?

CGD’s Hospitals for Health Working Group’s newly released consultation draft  of its forthcoming report proposes a “Global Hospitals Collaborative,” an entity that would  facilitate a network of individuals and institutions dedicated to fostering improved policymaking, investment, and management for emerging-market hospitals. Specific activities would include setting benchmarks, gathering and sharing data, analyzing the barriers to more and better hospitals—and finding solutions.

“There’s a need to establish some kind of baseline,” Amanda says. Those studying the problem lack the basic information needed find solutions to the problem, she adds.

“A global collaborative could recommend directions for data and analytics, possible reforms, and for learning one from the other,” she adds.

Wouldn’t the World Health Organization (WHO) be the proper home for such an entity?

Amanda thinks not. “Now more than ever the WHO needs to be focused on those global public goods of disease surveillance, control and prevention, as we see in the case of Ebola,” she says.

While she believe the WHO needs to be deeply involved, she also believes such a collaborative would benefit from the greater flexibility available in a less institutionalized setting.

Learn more about why hospitals may be the missing link in developing country health care and how the proposed collaborative could help. Tune into the  Wonkcast and read the report

My thanks to Kristina Wilson for recording and editing the Wonkcast and for a first draft of this blog post. 


Episode 44: The Data Revolution

Everyone seems to be talking about the data revolution these days. In this episode of Development Drums, I speak with two people who have thought more about what it is, how to make it happen, and what it means for development than just about anyone else. Claire Melamed is the Director of the Growth, Poverty and Inequality Programme at ODI. She was previously the Head of Policy at ActionAid UK. Her work focuses on measurement of poverty and inequality and on how to use the insights from measurement to improve policy and outcomes


Is the world on track for polio eradication by 2018?

Image polio-e1386948226901.jpg

This video describes the tools available and discusses the challenges that remain for wiping out the disease.


Unpacking WHO’s Shocking Ebola Maps–Mead Over

As the Ebola epidemic continued to spread in West Africa, with more than 3,000 cases and 1,500 deaths, I invited CGD senior fellow Mead Over, a health economist and one of the world’s top experts on the economics of HIV/AIDS, to discuss newly released maps from the World Health Organization (WHO) and measures for limiting the economic fallout from the epidemic.

“Ebola is much more like Avian Flu and SARS than AIDS,” Mead tells me. Its gestation period is very rapid, and that stirs a panic that creates an economic impact.

In the case of the SARS epidemic, he notes, there were only about 800 deaths but the economic impact of reduced trade, tourism and investment was estimated at about $40 billion—the equivalent of $50 million per death.

In the case of the Ebola epidemic, where cases will far exceed those of SARS, the economic impact could be far greater, he says.

He emphasizes however that the Ebola epidemic so far is tiny compared to the toll of malaria, tuberculosis, and HIV, “all of which are many multiples more deadly on a continuing basis.”

Our conversation then turns to two maps that the WHO released late last week, one showing the location and spread of the Ebola virus (Figure 1), the other showing the location of laboratories and treatment centers (Figure 2). 

Figure 1:  Location of cases throughout the countries with most intense transmission

Location of cases throughout the countries with most intense transmission

Figure 2: Response Monitoring

Response Monitoring

These maps are very helpful to those of us who are trying to grasp what’s happening in real time in West Africa. What they show is that we have a long way to go, Mead says.

He adds that it is “shocking” how few laboratories able to confirm the diagnosis are shown in the map. While there may be some additional laboratories that are not shown, the WHO maps are presumably the best information available, so either the data or the labs themselves are alarmingly lacking.

“Labs are necessary to confirm a diagnosis of Ebola. The inability to confirm a diagnosis makes it much harder for the physicians and nurses to protect themselves. It means there’s a need to quarantine people who would not otherwise need to be quarantined. And quarantining is extremely difficult,” he explains. 

Released along with the two maps last week was WHO’s “Ebola Response Roadmap” which outlined steps for affected countries and the international community to contain the epidemic. 

WHO projects that if all recommended measures are taken the epidemic may be contained within 6-9 months with perhaps more than 20,000 cases.

Noting that most of the cases shown on the WHO map are recent, Mead says that the toll may be much higher.

“That’s an indication that this epidemic is growing very rapidly in the countries of Liberia, Sierra Leone, and Guinea. The reported cases do not seem to be close to the border of Senegal or Guinea-Bissau, but there are cases close to the borders of Mali and Cote d’Ivoire,” he says.

So while this epidemic has been confined primarily to three countries, the governments of Cote d’Ivoire, Mali, and Guinea-Bissau are all on the alert.

“There’s a need for all those countries to strengthen their health infrastructure at the borders,” Mead says.

Mead concludes by discussing the international community’s response to minimize the economic fallout, an issue he addresses in greater detail here


The ethical debate over the use of an untested Ebola drug

Ebola

The disease is Ebola. The outbreak is In West Africa. Two infected Americans — and no Africans — got the drug, which is called ZMapp. Kevin Fitzgerald is a medical ethicist at Georgetown University who says there are good reasons not to use untested drugs, but “compassionate use” is part of the ethical consideration.


A Surprising Indigenous View of REDD+ – Mina Setra and Frances Seymour

Mina Setra, the deputy secretary general of the Indonesia’s Indigenous Peoples’ Alliance of the Archipelago (AMAN), recently visited CGD to speak at an event about Indonesia’s efforts to prepare to participate in REDD+, the UN program for Reducing Emissions from Deforestation and Forest Degradation that would offer payments from rich countries to keep tropical forests standing. Afterwards I invited Mina and CGD senior fellow Frances Seymour, the former head of the Center for International Forestry Research to join me on the Wonkcast. Our controversial topic: the complex relationships linking Indonesia’s forests, its indigenous peoples, and REDD+.

REDD+ aims to provide incentives for forest protection. That’s nothing new to Indonesia’s 70 million indigenous peoples, who, Mina tells me, “have been protecting the forests for decades” because “for us, for indigenous peoples, forests are everything.”

Though much of Indonesia’s land has belonged to and been managed by indigenous peoples for centuries, formal documentation of such ownership has typically been lacking. Mina tells me about a 1999 forestry law that claimed traditional indigenous forest as “state forest” to be managed by the ministry of forestry. As a result Indonesia’s indigenous peoples lost millions of hectares to individuals and corporations that seized control and cleared or otherwise degraded the forest through logging or conversion to palm oil plantations. Mina says that the subsequent displacement of many indigenous peoples “created a lot of problems, not only that we lost our forests but further economic and social problems.”

Frances recalls that when she first arrived in Indonesia some 25 years ago, “indigenous peoples were not only invisible, but to talk about indigenous peoples’ rights was a taboo.” Although indigenous people were recognized in the constitution, they did not have any actual operational rights to their traditional lands, she says, adding that conversations about such rights only began to gain momentum three or four years ago.

AMAN had tried to raise the issue of indigenous peoples’ rights nationally without success, Mina said. It was only when “the international community started talking about forests and REDD+ that we had the opportunity to show that we do exist,” she added. “When talking about forests, you cannot escape talking about the people who have been living there nurturing the forests since even before Indonesia existed.”

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Indigenous Peoples Rights and Redd+ by Frances Seymour

Not everybody views REDD+ so favorably. Indeed, a lively debate about the impact of REDD+ on indigenous land rights continues, as Frances explains in a new blog post marking the International Day of the World’s Indigenous Peoples. Some people continue to worry that payments for forest protection envisioned by REDD+ will provide yet another reason for outsiders to push indigenous people out of their forest homes.

“The change in positioning of indigenous groups in recognizing REDD+ as having elements of opportunity and not just threat” is quite recent, says Frances. One reason: REDD+ programs developed in consultation with indigenous peoples, such as Indonesia’s ongoing national mapping initiative.

The maps give indigenous groups the opportunity to prove the legitimacy of their land claims, and Mina hopes it will continue to grow. “We hope that in 2022, we can map forty million hectares of indigenous territories all over Indonesia, as evidence that we do exist,” she says.

However, the continued success of the REDD+ programs depends on international support, Frances explains. With the noticeable exception of Norway, this has yet to happen.

Listen to the full Wonkcast for more on indigenous efforts to be recognized in Indonesia and how Mina and Frances view the interaction between indigenous people’s rights and the global effort to reduce protect forests and thereby reduce the emission of heat-trapping gases.

My thanks to Kristina Wilson for recording and editing the Wonkcast and to Kristin Sadler for a first draft of this blog post. 


Tensions mount between healthcare workers and Ebola-infected communities in West Africa

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The Ebola virus continues to spread in West Africa months after the outbreak began in Guinea. As the deaths mount, mistrust has also boiled to the surface between affected communities and foreign healthcare workers. From PRI’s The World.


CGD Hosts Advocates at Girl Summit Satellite

(We hope that listeners who normally download the Wonkcast audio feed will find this video-rich blog post of interest!)

Nearly 200 practitioners and advocates gathered at CGD recently for an update on efforts to end within a generation female genital mutilation (FGM) and child, early and forced marriage. A satellite event for a Girl Summit in London hosted by British prime minister David Cameron and UNICEF, the CGD event was organized in conjunction with British Embassy, Girls Not Brides USA, and the Coalition for Adolescent Girls.

Welcoming the audience to the Birdsall House, CGD president Nancy Birdsall said that she had agreed to name the conference center in her honor provided that it serves not only as a space for presenting CGD’s own work but also as “a welcoming venue for the community concerned with women and development and gender equality.” She described CGD’s previous work on girls’ health and education (see here, here and here) and said that CGD senior fellow Charles Kenny is leading efforts to “find where we can have value added to an incredibly rich body of policy work and research.”

Patrick Davies, deputy head of mission at the British Embassy, then described the Summit’s core themes: “Sharing What Works” and “Agreeing an Agenda for Change.” Quoting from prime minister Cameron’s remarks at the London event, Davies said: “It is absolutely clear what we are trying to achieve. It such a simple, but noble and good ambition, and this is to outlaw the practice of female genital mutilation and early and forced marriage; to outlaw them everywhere, for everyone within a generation.”

The first panel, on Sharing What Works, was moderated by Judithe Registre, PLAN International USA, Coalition for Adolescent Girls Steering Committee, and featured:

  • Ann Warner, Senior Gender and Youth Specialist, International Center for Research on Women (ICRW), Representative, Girls Not Brides, who highlighted ICRW strategies to help end child marriage: (1) providing social support and education to girls who are at risk of early marriage and who are already married, and (2) working with girls’ families and communities as girls often don’t have the power to control their own futures. Warner announced ICRW and the World Bank will be conducting a three-year study to define the economic costs of child and early forced marriage.
     
  • Antonia Kirkland, Legal Advisor, Equality Now, stressed that ending FGM—which she said affects an estimated 3 million girls each year—is a human rights issue. While enforcement of laws prohibiting FGM can be a major deterrent, ending FGM will require further raising awareness and educating people about how they can help to prevent the practice.
     
  • Jeanne Smoot, Senior Counsel for Policy and Strategy, Tahirih Justice Center, described a 2011 US national survey of 500 teachers, police officers, domestic violence advocates and social workers, which revealed 3,000 cases of forced marriage had been encountered in the US. She announced that the Tahirih Justice Center, in collaboration with a partner in Canada, will be launching a major outreach tour this September in New York.

Between panels, a brief video of UN General Secretary Ban Ki Moon from the London event was shown. Secretary Ki Moon called for the end of FGM and early and child forced marriages and commended “global leaders and brave activities for confronting these problems, especially the courageous young women in these affected communities.”

The second panel, on Agreeing an Agenda for Change, focused on UK and US governments’ commitments to help end FGM and early and forced marriages. The panel was moderated by Rachel Vogelstein, Director of Women and Girls Programs, Clinton Foundation, and featured:

  • Emma Wade, Counsellor of the Foreign and Security Policy Group, British Embassy, who shared the UK government’s efforts, including donating $50 million to support 17 African countries to end FGM, $40 million to a joint UN program around ending child marriage, and $50 million to a new research program to find the best ways of transforming the lives of poor girls. Domestically, the UK has established and is enforcing relevant laws to provide the legal framework to address such issues and prime minister Cameron has committed $2.4 million to a prevention and care initiative.
     
  • Carla Koppell, Chief Strategy Officer and former Senior Gender Coordinator, US Agency for International Development, underscored that an integrated framework to ending FGM and child marriage – i.e., one that includes the education, health, legal and economic sectors – is critical to USG efforts. She also reiterated USAID administrator Raj Shah’s announcements from the London event, highlighting that the USG has committed to investments in Nepal, Bangladesh, and Yemen that will build on existing programs and complement efforts to change behaviors and attitudes and enforce laws surrounding FGM and child marriage.
     
  • Wanda Jones, Assistance Secretary for Health, Department of Health and Human Services, noted that data on the prevalence of FGM and child marriage in the US has been extremely limited. Efforts to raise awareness and build accountability for these issues in the US are just beginning, she said.

You can watch a video of the entire event here. To learn more about FGM and child and early forced marriages, and to sign the Girl Summit pledge, visit girlsummitpledge.com.

 

 

 

 


Episode 43: Complexity

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In this episode of Development Drums, I speak with Ben Ramalingam and Stefan Dercon about whether complexity and systems thinking offers actionable insights for better development interventions. Ben Ramalingam is an independent researcher who has worked with development and humanitarian organisations including UN bodies, NGOs, the Red Cross movement, and government agencies. He is affiliated with the London School of Economics and the Overseas Development Institute, amongst other institutions and is the author of Aid on the Edge of Chaos: Rethinking International Cooperation in a Complex World. Stefan Dercon is a Professor of Development Economics at the University of Oxford and the Chief Economist at the Department for International Development, the UK government’s aid agency.. In the podcast, I ask Ben to pin down what we’re talking about when we talk about complexity and complex systems, and ask Stefan whether any of this is actually new to development economics research or policy, which has long incorporated elements of complexity thinking. We debate whether systems thinking gives donors and governments new and useful tools, including for humanitarian intervention.


A TPPing Point on Trade? – Harsha Singh

TPP? TTIP? In the world of trade negotiations, there is no shortage of acronyms. And who better to break them down for us than Harsha Singh, former deputy director general at the World Trade Organization? Harsha recently visited CGD to join Kim Elliott in leading a roundtable to discuss with other trade experts the implications of these proposed mega-regional trading blocs for developing countries. After the roundtable, I invited Harsha to join me on the Wonkcast to explain the development implications of these trade deals to interested non-experts, with a particular focus on the impacts of smaller, poorer countries who are unlikely to be included.

Proposals for the Trans-Pacific Partnership (TPP) and the Transatlantic Trade and Investment Partnership (TTIP) arose in part out of frustration with the World Trade Organization’s Doha Round, Harsha explains. (The TPP is proposed to include the United States, Canada, Mexico, Peru, Chile, Australia, New Zealand, Brunei, Singapore, Vietnam, Malaysia, and Japan; TTIP would include the United States and the EU.)

The TPP and TTIP aim to enhance trade and investment among members, but they could also pose huge challenges for small, poor countries that find themselves excluded, he says. One of the primary concerns “is the diversion of markets away from their products to those who get preferential treatment as members of these mega-regionals.” Harsha says that while most of the focus has been on tariff preference erosion, nontariff barriers to market access may pose a much more serious problem. 

“The important thing is not just meeting the standards, but also the system which is used to determine that the standard actually is consistent with what is being demanded,” Harsha explains. “That system can often be exclusionary.”

For more on these issues, read Kim Elliott’s account of the roundtable discussion and listen to the Wonkcast. Among the topics we tackle: the impact of the mega-regional trade deals on the big emerging market economies, Brazil, China, and India, and the global value chain for an iconic 21st century product: the iPhone.

My thanks to Kristin Sadler for a first draft of this blog post and to Kristina Wilson for recording and editing the Wonkcast. 


Africa’s Data Revolution – Amanda Glassman

Is the revolution upon us? When it comes to data, the development world seems to be saying yes, Yes, YES! To look beyond the hype, I invited Amanda Glassman, a CGD senior fellow and director of our global health policy program, to join me on the show to discuss a new report from the Data for African Development working group that looks at Africa’s statistical capacity, warts and all. It turns out that the revolution may not be all it’s cranked up to be, and that well-intentioned outsiders—donors especially—are too often part of the problem.

A partnership with the African Population and Health Research Center in Nairobi, the working group found that in Africa such statistical fundamentals as taxes and trade, births and deaths, and growth and poverty are frequently outdated, inaccurate or simply unavailable. How badly out of whack? In recent months Ghana and Nigeria have recalculated the size of their economies and come up with GDP estimates that are more than two-thirds larger.

I ask Amanda if big data is going to solve these problems. Is there hope that Africa will simply be swept up in a big data tsunami?

Amanda has her doubts. In much of Africa, she says, statistical capacity is at such a standstill: it has remained unchanged for the last ten years according to the index of statistical capacity published by the World Bank.

“Certainly big data and new technologies are very exciting, and offer some really interesting opportunities to collect new data… On the other hand, if countries don’t have a national statistical system in place that to just produce the basics, they will be missing opportunities to harness these new capabilities and the opportunities to use big data.”

Why the lack of progress? Amanda says there’s plenty of blame to go around (she calls it “collective guilt”), specifically a mis-match between the priorities of African governments and the donors. Governments need sub-national data to help guide budgetary and policy decisions, she explains, while external donors often want national-level data to make allocation decisions across countries.

How to resolve this tension? The working group proposes a data compact that would be initiated by an African president or minister of finance and draw upon the support of interested external funders. The compact would be a means for all interested parties to agree upon a phased set of actions to address data problems, and a method for tracking progress. The compact could even take the form of a pay-for-performance endeavor (see CGD’s Cash-on-Delivery Aid proposal for one such example).

“The idea would be to say ‘we’re going prioritize some aspect of the building blocks (such as data on births and deaths) that we have not achieved in our country,’” Amanda explains. Compact participants would agree on measures of progress in the accuracy, timeliness and openness of that data. A big, high-level political commitment could be useful in mobilizing the necessary funding from a combination of donors and governments, she says.

We close our conversation with a look toward the post-2015 development framework. Will the working group’s findings and recommendations become a part of that ongoing debate? Absolutely, Amanda replies. “We’ll do our very best to let it be known that this would be a good idea. Certainly were engaged in the process and talking to all the different people who are involved.”

To learn more about the working group’s findings and recommendations, listen to the Wonkcast, see Amanda’s blog post, or read the report.


If China Sneezes, Will Latin America Catch Pneumonia? – Liliana Rojas-Suarez

My guest on this Wonkcast is CGD senior fellow Liliana Rojas Suarez, who serves as chair of the Latin American Shadow Financial Regulatory Committee (CLAAF). CLAAF is comprised of financial economists and former senior financial officials from the region who meet twice a year to study a current policy issue. They then issue a statement offering advice to policymakers in the region and others interested in Latin American financial regulatory issues—or just in the region’s overall economic health.

At their recent meeting here at CGD, CLAAF members considered the question: How would a Chinese Slowdown Affect Latin America? Liliana summarizes their conclusions—and recommendations for Latin American policy makers—in a blog post available here in english and en espanol.

Prefer to get your Latin American financial regulatory advice on the run, or perhaps while working out on the Stairmaster or stationary bicycle? We cover it all, and more, in this 22 minute Global Prosperity Wonkcast. Listen now, or download it for future listening.


West African dance tune carries public health message about Ebola

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There’s a new dance tune that’s caught on in Liberia and Guinea. It’s called “Ebola’s in Town.” The song is the creation of three Liberian musicians: D12, Shadow and Kuzzy of 2 Kings. And yes, the Ebola in the title is a reference to the Ebola virus. PRI’s The World’s Carol Hills explains, and discusses the good and the bad of this kind of song.


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