Fifty years ago, no one could have predicted South Korea’s astounding transformation from assistance partner to trade partner because everyone assumed South Korea would follow a slow, linear path of development. But South Korea was able to bend the curve of its development progress and dramatically accelerate its growth.
Today, we must approach development assistance with a similar mindset. Rather than achieve incremental gains by following status-quo approaches, we must bend the curve of progress, devising new ways to deliver better results more quickly and more cheaply. While this letter concentrates on how we’re doing this in food security and global health, USAID is focused on accelerating progress across a range of issues, from supporting women and girls, to improving global education, to strengthening democracy and governance.
In 2008, the world witnessed a shocking development. Steep food prices led to threats of famine in East Africa, riots in 30 countries, and for the first time in decades, a rise in the number of people living in dire poverty, earning less than $1.25 a day. Over 100 million people, who had already escaped a brutal condition of constant hunger, were thrown back into its grips.
Over the last year, wildfires in Russia, floods in Australia and the current drought in China have all led to a similar rise in global food prices and human suffering. The cost of staples like wheat rose by as much as 60 percent in 2010.
Once again, millions who must spend more than half their income on food are being thrust into poverty and hunger, and the threat of food riots and famines threatens to tilt states toward failure.
Traditionally, the development community’s response to food riots and famine has been to send supplies of wheat, corn and other staples to these countries, what we collectively call food aid.
Food aid is critical—it saves lives and protects children. But the truth is, it will never end global hunger. We must continue to send food aid in times of need, but we must also prevent hunger from ever occurring in the first place.
In the ‘60s, USAID partnered with foundations and foreign governments to launch the Green Revolution, which did exactly this. We invested in new seeds, fertilizer and irrigation systems, so countries like Mexico, Brazil and India could grow enough food to feed themselves. As a result, hundreds of millions of lives were saved in probably the greatest development intervention the world has ever witnessed. And that effort had lasting effects: it helped those countries escape the trap of hunger, so they could focus on growing their economies.
Today, USAID is leading a whole-of-government effort called Feed the Future designed to deliver the same kind of success.
In countries like Honduras, Ghana, Tanzania and Bangladesh, we’re working with governments and private sector partners to make smart, efficient investments in their agricultural sector.
We chose these countries selectively, based on their commitment to strong governance and a willingness to increase their own investments in agriculture, while encouraging investment from other donors, foundations and private companies, ensuring every dollar we commit generates significant leverage.
In Ghana and Tanzania, we are supporting the efforts of American companies like Kraft and General Mills to connect poor farmers to local and international food markets. But the main private sector partners aren’t global firms; they are the local entrepreneurs who sell seeds and transport goods and the millions of mostly female smallholder farmers that are the key to this Initiative’s success.These people are all key to this initiative’s success.
And to develop the next curve-bending agricultural technologies, we’re partnering with the U.S. Department of Agriculture, American land-grant universities and international agricultural research partners. These partnerships focus on developing new seeds that can provide better nutrition while resisting the drier and hotter growing conditions increasingly seen around the world. We did this with wheat in Mexico and rice in South Asia during the Green Revolution; we need to develop drought-tolerant maize, a more nutritious sweet potato and other heartier, nutritious crops in Africa today.
Across 20 countries, Feed the Future will help nearly 18 million people—most of them women and children—grow enough food to feed their families and break the grips of hunger and poverty. If we can do that, we believe we can end hunger in a generation.
Compared to 1990, today four million more children live past their fifth birthday every year, because they have access to simple vaccines against diseases like measles and polio. Five million HIV patients no longer face a death sentence because they’ve been supplied with lifesaving antiretroviral drugs. And 188,000 more women survive the natural act of childbirth, thanks to the skilled attendants by their side.
Our ability to save these lives is a remarkable development success. But that same success has also established a system of care organized around diseases, not patients. Throughout the developing world, you’ll find separate clinics in separate places for AIDS, children’s health, family planning and maternal care.
The Obama Administration developed the Global Health Initiative to end this situation, providing different services at single points of care. In Kenya, we worked with PEPFAR, the President’s Emergency Plan for AIDS Relief started by President Bush, to couple HIV/ AIDS treatment with maternal and child health services. As a result, we’ve extended the availability of reproductive health services from two to all eight of the country’s districts, at no increase in cost.
Every dollar we save through this approach is another dollar we can use to reach those who suffer. To put it simply: saving money saves lives. But we can get even more value for our investments if we extend the reach of care beyond hospitals, into the villages and communities where people need it most.
In Senegal, we worked with the government to build “health huts,” small facilities in rural villages staffed by volunteers providing basic health services to their community. By building over 12,000 of these facilities throughout the country, we’ve managed to reach 400,000 more children at a much lower cost. No doctors, no hospitals—but access to quality, critical care for those who need it most.
In the future, our biggest opportunity to save lives in global health lies in inventing a new wave of medical technologies that are cheap, easy-to-use and can be delivered anywhere. After all, a world-class vaccine doesn’t need to be administered in a world-class hospital for it to be effective.
A prime example of this type of breakthrough came last December, when a USAID funded trial at a South African AIDS research lab gave women around the world a new way to reduce HIV transmission: a microbicide gel. Though still in development, women will eventually be able to use this gel to protect themselves against HIV.
If we can discover similar breakthroughs that can be delivered in health huts, not hospitals, we’ll have a remarkable opportunity to save lives.
If we can develop new, cheaper vaccines against pneumonia and diarrhea—the two leading causes of child death—we can save the lives of over 3 million children.
If we can devise a way to quickly diagnose malaria in the field, and come up with safer and more effective insecticides and drug treatments, we can save 500,000 lives and remove malaria as a major global health problem in sub-Saharan Africa.
And if we can create new technologies and procedures that allow a woman to give birth safely without a doctor by her side, we can save the lives of 200,000 mothers. We recently worked with other donors and foreign governments to unveil Saving Lives at Birth, a partnership designed to inspire inventors and entrepreneurs to solve this grand challenge for development.
Inventing these technological breakthroughs may sound audacious. But only by setting big goals can we inspire the innovation necessary to bend the curve of progress and meet them.