Anyone who has ever been to the Central African Republic (CAR) knows that the country has huge infrastructure needs after years of internal turmoil and strife. But when you look up how much of the government’s investment budget actually was implemented and financed infrastructure development in 2009 for instance, you find a stunningly low execution rate of 5 percent.
As prominent advocates for anti-malaria efforts in Africa cautioned at the United Nations yesterday, recent successes against malaria—however significant—are still fragile. Both the malaria parasite and the mosquitoes that carry it can develop resistance, to drugs as well as to insecticides, and therefore the fight against malaria must gain rather than lose momentum.
“The British army surgeon who in 1897 helped discover that malaria is transmitted by mosquitoes predicted it would be eliminated in two years, but the parasite has remained a silent and stealthy killer,” said World Bank Group President Robert Zoellick, noting that the preventable and curable disease continues to have a debilitating effect on many African economies.
Zoellick acknowledged the tremendous job that Ray Chambers, the UN Special Envoy for Malaria, had done to raise money for anti-malaria efforts, in conjunction with the African Leaders Malaria Alliance. Anti-malaria funding, which stood at just $175 million in 2005, is $1.6 billion today thanks to their efforts and many countries such as Rwanda and Zambia have made dramatic progress in recent years.
Africa's Infrastructure: A Time for Transformation
Yesterday in New York I attended a discussion on infrastructure in Africa. As co-author of the Africa Infrastructure Country Diagnostic, I've been talking with people for years about the importance of reliable infrastructure for economic and social activity in Africa. Today we're talking about how infrastructure can help achieve the Millennium Development Goals (MDGs).
The core of the MDGs is poverty reduction and improved human development, but how can those goals be met without basic infrastructure to create economic opportunities and support public service delivery? This is a critical question when you think about the facts that 30 Sub-Saharan countries have a power supply crisis, their road freight moves as fast as a horse-drawn cart, and less than 5 percent of agricultural land is irrigated. Although Africa’s infrastructure needs may look daunting, countries like China have shown that it is possible to deliver on the requisite scale.
This morning, 69 million children would not have gone to school around the world. And of those who did, many did not learn what they should have. It is a good thing that education has such energetic champions as Queen Rania of Jordan and Gordon Brown, former UK Prime Minister, both of whom made strong statements today in New York in support of universal access to good-quality education.
“I have one goal—to advocate that every child receives a quality education,” said Queen Rania, who is the co-founder and co-chair of 1Goal , a campaign that was founded with the objective of ensuring that education for all would be a lasting impact of the 2010 FIFA World Cup.
The Millennium Development Goals Awards ceremony last night in New York was a brief moment of celebration for the wonderful progress that some countries have made towards the goals. Even as we dwell this week on sobering statistics and the tough road ahead, these awards are an inspiring reminder that success is possible in the face of tremendous odds in poor countries.
This morning, on my way to an advocacy event on “Delivering for Girls, Women, and Babies” at the Waldorf Astoria hotel in New York, I was thinking about a pregnant Tanzanian woman in a film preview I saw recently. The preview of No Woman, No Cry had captured with terrifying clarity the helplessness of a sick pregnant woman in a remote village in Tanzania. I couldn’t help thinking the Manhattan streets around me were far removed from such painful realities.
But, as Graca Machel pointed out during the event, this wasn’t always the case. A women’s hospital had once occupied the site of the historic Waldorf Astoria—it was in fact the last hospital in the United States for women with obstetric fistulas. “We should make every fistula hospital in the world just as unnecessary as this one was found to be,” Machel said.
At an event a few days ago at the Spring Meetings on Africa and the Millennium Development Goals—or MDGs for short—the speaker who left me with the strongest impression of hope for 2015 and beyond was Ted Sitima-Wina, Malawi’s Principal Secretary, Planning. Malawi, a small landlocked country with a per capita income of $280, is on track to meet five out of the eight goals, no small achievement in a region where most countries appear off-track on most goals, and many started from a very low base in 1990.
So what worked in Malawi? According to Sitima-Wina, it was aligning the Malawi National Development Strategy closely to the MDGs. “Papers signed in 2000 showed us goals and targets,” he said, “but what we did in Malawi was to contextualize them in our own poverty reduction strategy.”
Perhaps one of the most famous steps that Malawi took to cut poverty and hunger was a targeted subsidy which allowed poor farmers to afford fertilizer and hybrid seeds. With this, the country has moved from being a net importer to a net exporter of food. A recent survey showed that over the past few years, people in rural areas have reported that food is available, despite the crisis.
Ray Chambers, the UN Secretary General’s Special Envoy for Malaria, was here today to thank President Zoellick for $200 million to fund bed nets that will help prevent malaria in Africa. Chambers, who wants to bring a swift end to what he calls “the genocide of apathy,” conveyed a sense of great urgency as he described the UN’s sweeping campaign with 50 celebrities on Twitter—from Ashton Kutcher to Bill Gates. Through them, and through millions of tweets and re-tweets, money is being raised to ensure that all vulnerable people have bed nets by the end of the year. Yes, that’s this year.
As African governments look for ways to help the poorest people in the wake of the food, fuel, and financial crises, I think this was a very good moment for President Zoellick and Africa Vice President Oby Ezekwesili to note that anti-malaria efforts are relatively straightforward, with high returns on investment. The Bank’s effort to help close the gap—by funding 25 million of the 50 million remaining nets needed—is a timely one. It will cover seven countries—the Democratic Republic of Congo (DRC), Ethiopia, Ghana, Kenya, Mozambique, Sierra Leone and Zambia—among the 31 hardest hit by malaria.
“This was a highlight of my trip to Washington this spring,” said Uhuru Kenyatta, Kenya’s Finance Minister, “It is a key step to restore dignity to so many African men, women, and children.” Kenyatta called for a concerted effort by African governments to make sure that funds are used as intended and to scale up their own malaria funding. Finance Minister Mapon of the DRC spoke of great successes against malaria in his country, but noted that the “need remains sizeable.” And Zambia’s Minister Musokotwane echoed this conclusion, calling malaria “an obstacle to development.”
The key to understanding what is underway is Mr. Zoellick’s speech to the Woodrow Wilson Center on April 14. This was probably the most important speech by a Bank president since McNamara’s Nairobi speech of 1973 – even more important, I would argue, than Mr. Wolfensohn’s 1996 speech on corruption. For the first time in many years, the Bank is at the leading edge of thinking about global trends. Mr. Zoellick’s blunt declaration that the era of the Third World is over and a new, more complex arrangement is emerging, challenges everyone at the Bank and everyone working in development to think and act differently. It sets in context why the reforms underway across many areas of the Bank are really necessary, why we need a new approach to investment lending, to knowledge, to our location and operation as a global bank.
The end of the Third World does not mean that there are no poor countries, or that all countries are equally advantaged. It means the landscape has changed so much that our thinking and behavior must shift. To think of China, India, Brazil, Mexico, Russia, South Africa and Malaysia as developing countries seems anachronistic. Yes they have poverty and challenges, but… “developing”? They play a regional and global role of real significance. They have civil servants, academics and businesspeople as skilled as (and many more skilled than) World Bank staff. Developing just doesn’t capture it.