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These initiatives have strengthened the foundations of a state that can serve its people. Rather than providing or contracting for services directly, USAID, the World Bank and the European Commission have strengthened the capacity of the Ministry of Public Health to develop and implement health policies, oversee programs, manage resources, engage communities and control the delivery of services.
Unfortunately, such work for Afghanistan's future is at risk. In an effort to win over populations in Taliban-controlled areas, the Obama administration is considering reducing overall funding for USAID health programs and concentrating development resources to support military operations. This means moving funds to certain geographic areas and emphasizing immediate results. Yet there is no evidence that expensive "quick impact" health projects that are not integrated into a larger strategy, or that do not actively engage locals, either contribute to security or wean populations from the enemy.
And the real kicker:
If the Obama administration is serious about supporting the emergence of a legitimate Afghan state and meeting the needs of people who have suffered for decades, it should not confuse health policy with military strategy.
This story encapsulates the current debate and all the underlying tensions over what to do with USAID (autonomous cabinet agency? More integrated into State? Subsumed into DoD?) My own view is that long-term “institution building” is always going to get crowded out by shorter-term security and diplomatic demands. It seems unrealistic to ever expect USAID to try to resist this or to be able to do both well, no matter what kind of beautiful restructuring we do or how much cover the White House thinks it can provide. To me, it would appear much better to recognize this and just have cleaner lines of responsibilities: let USAID do humanitarian, post-conflict, and other emergency assistance; State can handle counterterrorism, diplomatic bribery, etc.; and leave the long-term stuff that you want to insulate strictly to MCC and the multilaterals, especially the World Bank. Perhaps this is also too naïve?
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.
By Mark Lowcock and Masood Ahmed
Countries risk a ‘dangerous divergence’ in economic fortune unless more is done to help
At the spring meetings of the IMF and World Bank this week, we can expect measures to support low- and middle-income countries’ pandemic recovery that are laudable but fall well short of what is required.
One likely outcome will be an allocation of up to $650bn in IMF special drawing rights, the fund’s reserve currency that is used to supplement members’ official reserves. An extended pause on debt service payments for the poorest countries and a commitment from wealthy nations to help finance the global distribution of Covid vaccines will probably also be agreed.
All these measures will be welcome. But they will be only marginally helpful for countries where the end of the pandemic remains far off. They certainly will not prevent IMF managing director Kristalina Georgieva’s warning of a “dangerous divergence” between economies from becoming a reality.