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Before his tenure at CGD, Steve was deputy assistant secretary of the U.S. Treasury for Africa, the Middle East, and Asia from 2000 to 2002. He left CGD to become chief economist for the U.S. Agency for International Development.
Last week the Center for U.S. Global Engagement, the new educational arm of the U.S Global Leadership Campaign, launched Impact '08: Building a Better Safer World, a national campaign focused on inspiring the 2008 U.S. presidential candidates to prioritize development and diplomacy as keystones of America's engagement with the world. CGD senior fellow Steve Radelet chaired the bipartisan, multidisciplinary working group that drafted the campaign's policy framework and answers questions on this exciting new initiative.
Q: What is Impact '08 and why is it important?
A: The interconnected global challenges and opportunities facing America in the 21st century call for smart power -- elevating diplomacy and development assistance while integrating them with our economic policies, defense and intelligence activities. Through the Impact '08 presidential initiative, a diverse network of leaders and foreign policy experts will be working to reshape U.S. foreign policy by elevating diplomacy and development programs as a priority for the 2008 presidential campaign and the next administration's foreign policy and national security strategy. America cannot rely on the military alone for national security. Making greater and more effective use of our development and diplomatic tools will advance global health, economic prosperity and international cooperation while restoring America's global image and moral leadership.
Q: There are lots of initiatives around U.S. foreign assistance reform and the use of smart power. How is Impact '08 different?
A: The existence of so many initiatives aimed at elevating development and diplomacy is terrific. It shows a demand for new terms of global engagement by the United States. Impact '08, CGD reports and congressional testimony, the CSIS Commission on Smart Power, the Brookings/CSIS U.S. Foreign Assistance Reform Project and other initiatives share a common call: progress on today's tough security and global challenges requires smart investment across the full range of instruments of national power. We must complement our defense policies with wise investments in diplomacy, foreign assistance, and reinvigorated global economic policies that promote cooperation, encourage democratic and responsive governance, and expand economic opportunity, basic education, and improved health. We now substantially under-invest in these tools, weakening our ability to enact effective foreign policies that respond to the new environment of the 21st century. Impact '08 will leverage all the good work of these initiatives through a three-pronged strategic outreach and engagement strategy: engaging presidential candidates and key advisors; encouraging debate on America's role in the world; and keeping Americans informed. Through meetings and forums at both the national and state levels, the Impact '08 network will connect with the candidates and the public to educate them on the importance of greater U.S. investments in development and diplomacy.
Q: What is the potential for Impact '08 to succeed in getting smart power into the national debate?
A: Impact ’08 launched with a bang. Our working group included fifteen experienced and deeply committed foreign policy professionals from both parties that were able to reach consensus on these critical issues. Inspired by Impact '08 co-chairs Madeleine Albright and Frank Carlucci, more than two dozen former cabinet officials, congressional and foreign policy leaders -- from both political parties and spanning development, diplomacy and defense sectors -- have endorsed a summary policy framework and more are signing up every day. Several presidential candidates have already included smart power concepts in their foreign policy addresses. I think we are at a pivotal moment in our history. I think Americans want to engage in the world of hope, not fear, and on the strength of our values and statecraft, not just our military might. Recent polls show Americans don’t mind not being liked, but they care deeply about being respected. And smart power, done right, can bring this respect and goodwill, which in turn greatly enhances our ability to achieve our most important foreign policy goals. A Pew Global Attitudes survey finds America's image slipping. Terror Free Tomorrow found that foreign aid dramatically improved public perceptions of the United States in Pakistan, Bangladesh, and Indonesia, for a sustained period following U.S. generosity in the wake of the tsunami and the Pakistan earthquake. The Program on International Policy Attitudes/Knowledge Networks found that fully 57 percent of Americans favor building goodwill toward the U.S. by providing food and medical assistance to people in poor countries. Every American can make a difference in elevating smart power into the national debate: here’s how.
Access the full Working Group report: Challenges and Opportunities for the New Executive Director of the Global Fund: Seven Essential Tasks (pdf)
Rapport plein en Français (pdf)
Reporte completo en Espanol (pdf)
In its first four years, the Global Fund to Fight AIDS, Tuberculosis and Malaria has quickly become one of the most important aid agencies in the world. It has approved over 360 grant programs in 132 countries valued at $5.6 billion, and it has disbursed over $2.7 billion. Next week the Fund will select a new Executive Director (ED). CGD senior fellow Steve Radelet chaired a working group to identify key challenges for the Fund ahead of the selection. He explains the purpose and scope of the forthcoming report, which will be released on October 26th.
Q: What is the purpose of the Global Fund?
A: The Fund was created to substantially increase funding for programs aimed at fighting HIV/AIDS, TB and malaria in countries around the world. These diseases needlessly kill more than 16,000 people every day. Until the founding of the Global Fund and the launch of other programs in recent years -- like the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) -- the international community had done shockingly little to respond to the crisis. The Fund is a foundation -- not a U.N. agency or a broader development agency -- and as such it acts primarily as a financing mechanism, rather than an implementing agency or a clearinghouse for technical assistance. It works in cooperation with other groups -- multilateral organizations, bilateral agencies, NGOS, civil society and faith based groups -- that help design programs, provide technical assistance, and otherwise provide support for country programs.
Q: The Global Fund seems to operate differently from many other organizations. How is it structured?
A: The Fund is really quite an unusual organization. It is governed by a 24 member Board of Directors consisting of donor governments, recipient governments, people living with the diseases, NGO representatives from both donor and recipient governments, the Bill & Melinda Gates Foundation (its largest non-government donor), and private sector representatives. The ED manages a very small Secretariat: just 240 staff, all based in Geneva, overseeing 360 grants, making it one of the leanest of all major international organizations. In recipient countries, overall responsibility falls with a Country Coordinating Mechanism (CCM), a group whose composition in some ways mirrors the Board: government officials, NGOs, civil society and faith based groups, and multilateral and bilateral representatives. The CCM is responsible for designing programs, submitting grant proposals to the Global Fund, and picking one or more organizations to implement programs. The Fund takes very seriously -- much more seriously than most organizations -- the ideas of country ownership, broad participation in key decisions, and transparency. Its focus on these principles, along with striving for accountability in results and low administrative costs, sets the Fund apart, but also leads to some of the key challenges and tensions we describe in our report.
Q: What impact has it had so far?
A: As of June 2006, its grants were supporting antiretroviral (ARV) treatment for 544,000 people living with HIV; testing and counselling for HIV for 5.7 million people; directly observed treatment short course (DOTS) for 1.4 million people with TB; and 11.3 million insecticide-treated bed nets for malaria prevention. These are the numbers of people already being reached -- the targets for current programs are even higher.
People associate the Global Fund mostly with HIV/AIDS, but it is crucial to remember that it funds programs in all three diseases, and proportionally on a global scale it makes even bigger contributions to TB and malaria. Currently the Fund provides two-thirds of global donor funding for malaria, 45 percent for TB programs, and about 20 percent for HIV/AIDS, numbers I find impressive for a four-year-old organization.
With grants disbursing in 128 countries, the Fund's global reach is broader than any organization outside of the United Nations. This is a very tall order, and while the Fund has made commendable progress, it faces some significant challenges as well.
Q: What are some of the biggest challenges?
A: Well, with 360 grant programs in 128 countries, you're bound to get some programs that work well and others where there are concerns. In some countries the CCM process works fine, but in others there are concerns about who is included and who is excluded, government domination over NGOs, and the quality of CCM oversight. The ideals of broad participation and country ownership -- which many donors don't even attempt -- are very hard to put into practice in many countries. And as with any broadly participatory process -- like democracy -- the process is sometimes slow and not as decisive as it could be. But the process helps build legitimacy, create some buy-in, and build capacity over time.
A huge challenge is that when the international community designed the Global Fund to be primarily a financing mechanism, they assumed that others would be able to step up and provide countries with other support needed to make programs work, such as technical assistance, on-the-ground monitoring, and other inputs. But this hasn't always happened, and country capacity to absorb funds and implement programs was more of a constraint that many foresaw. Building strong capacity in countries that will allow them to implement effective programs over the long term is an enormous challenge. Going forward there will need to be much greater cooperation across agencies, and stronger support for other organizations to allow them to ramp up technical assistance and other support to countries facing major capacity constraints.
The Fund also faces the big challenge of how to ensure results. From the outset, the Fund has tried to emphasize performance-based funding, but as other organizations have found out, this is not easy. Just determining what to actually measure and collecting the data is far from easy, and figuring out how to independently monitor progress on the ground is a major challenge. And once problems are detected, it is not straightforward to determine when the best course of action is to try to reprogram or refocus the grant, or to cut off funding and redirect it another country where it might be more effective. Some of the biggest debates around the Fund in the last year have been whether or not to cut off funding to a small number of poorly performing grants, and these debates are unlikely to be any easier in the future.
Q: What about funding?
A: This is a big concern, and not just for the Global Fund. Although world-wide funding has increased significantly in recent years, the diseases are continuing to spread, and all estimates for global needs show a sharp escalation in coming years. According to estimates from UNAIDS, Roll Back Malaria, and the Stop TB Partnership, global needs to effectively fight the three diseases already top $20 billion annually and are increasing steadily. Obviously the Global Fund doesn't have to fund all of that, or even necessarily be the largest funder. But to effectively address the three diseases, the Fund faces two major challenges. First, it must significantly ramp up its contributions from traditional and non-traditional donors and the private sector to meet these growing needs. Second, since even with increased funding its resources will always be less than needs, it must determine how best to allocate its funds and manage it grants across countries to ensure maximum impact and have the greatest possible impact on the diseases.
Q: How is the new ED being chosen?
A: The Global Fund Board created a Nomination Committee in April 2006, which, among other steps, hired an Executive Search firm to help in the process. In all, 334 people applied for the position. The Nomination Committee, through several rounds of consideration, has narrowed the list to five finalists: Hilde Johnson (Norway), Michel Kazatchkine (France), Congressman Jim Kolbe (U.S.), Bill Roedy (U.S.), and Michel Sidibe (Mali). The Board is now interviewing the five candidates via teleconference. At its next Board meeting on October 31st in Guatemala City, the Board will make its decision and choose the new ED. Assuming all the arrangements can be put in place, the new ED will start very early in 2007.
Q: The working group you chaired offered several recommendations for the new director. Can you tell us, in advance of the release of the report on Thursday, some of the most important issues it examines?
A: We identified seven key tasks for the new ED to focus attention, ranging from strengthening in-country operations, ramping up efforts for more effective technical assistance, strengthening procurement and supply chain management systems, and improving relationships between the Board and the ED, which have not always been smooth. For each task, we make several specific recommendations. Some recommendations are very specific and seem small, but can have big impacts, such as the Secretariat quickly distributing information it picks up in its Early Warning System to a wide range of interested parties -- multilateral organizations, bilateral agencies, NGO groups, as well as host governments -- so that steps can be taken rapidly to address weak programs.
Some recommendations will require much greater cooperation with other organizations, since the Global Fund by design must work together with other agencies to support country programs. Thus we recommend establishing a "Heads of Agencies Group" in which the heads of the Global Fund, UNAIDS, WHO and the World Bank (and perhaps a very small number of others) would meet regularly to work out at the highest levels key strategies for jointly addressing technical assistance, global procurement, program monitoring and other issues.
In terms of the Secretariat, we recommend the new ED commission a management audit of the Secretariat to help determine its optimal size and staffing patterns, and focus particularly on steps to strengthen the work of the Fund Portfolio Mangers that support each grant. We also recommend that the Secretariat add to its staff a full-time, professional, fundraising team. And although our focus in on the ED, we make a few recommendations to the Board in how it can help the ED succeed. In particular, we recommend that Board make the ED a non-voting member of the Board to help strengthen communications and improve Board decisions.
The new ED joins the Global Fund at a critical time as it shifts from an innovative start-up to a mature organization. The next two years will have a tremendous impact on defining the future role and sustainability of the Fund and its long-term impact in fighting the three diseases. It is our hope that this report helps the new ED to better understand the key issues facing the Fund and some of the most important steps that can be taken to make the Fund even more effective in fighting HIV/AIDS, TB and malaria.
On Tuesday, June 12, 2007, Steve Radelet testified before the Senate Foreign Relations Subcommittee on International Development, Foreign Assistance, Economic Affairs, and International Environmental Protection on "Foreign Aid Reform: Successes, Failures, and Next Steps."
In this essay, CGD senior fellow Steve Radelet describes Liberia's debt situation and the key issues in moving forward on debt relief with the IMF, World Bank, African Development Bank and bilateral creditors. He explains why it is important for Liberia's recovery that the international community act quickly and outlines the key steps necessary for Liberia to achieve a debt deal before the end of 2007.
Meeting today’s foreign policy challenges requires a new vision of American global leadership based on the strength of our core values, ideas, and ingenuity. It calls for an integrated foreign policy that promotes our ideals, enhances our security, helps create economic and political opportunities for people around the world, and restores America’s image abroad. We cannot rely exclusively or even primarily on defense and security to meet these goals. CGD senior policy analyst Sheila Herrling and senior fellow Steve Radelet argue instead that we must make greater use of all the tools of statecraft, including diplomacy, trade, investment, intelligence, and a strong and effective foreign assistance strategy.
This book tackles head on the tension between foreign policy and development goals that chronically afflicts U.S. foreign assistance; the danger of being dismissed as one more instance of the United States going it alone instead of buttressing international cooperation; and the risk of exacerbating confusion among the myriad overlapping U.S. policies, agencies, and programs targeted at developing nations, particularly USAID.
New Day, New Way: U.S. Foreign Assistance for the 21st Century calls on the next American president, Congress, policymakers and the American people to overhaul how the U.S. helps poor people in developing countries. Among the recommended steps: a new national foreign assistance strategy and a new Foreign Assistance Act to replace the outdated framework that President Kennedy signed nearly 50 years ago. CGD senior fellow Steve Radelet is a co-chair of the authoring group, the Modernizing Foreign Assistance Network.
Since its inception in 2004 the Millennium Challenge Corporation (MCC) has been an experiment in improving the effectiveness of U.S. foreign aid in a small set of poor but well-governed countries. This new MCA Monitor Analysis brief based on visits to seven Millennium Challenge Account (MCA) countries between July 2005 and March 2007 draws broad lessons about the MCC’s first years of operation.Learn more
In its first four years, the Global Fund to Fight AIDS, Tuberculosis and Malaria has become one of the most important aid agencies in the world. As the Global Fund undergoes its first leadership transition, this CGD Working Group Report identifies seven tasks for the new Executive Director, starting from country operations, where ultimate results are achieved; through supporting arrangements (such as technical assistance, performance-based funding, procurement and supply chain strategies, and secretariat operations) and ending with the overarching issues of financing and Board relationships. The report offers specific recommendations for the new Executive Director and for the Board.
With President Bush's trip to Africa making headlines this week, CGD senior fellow Steve Radelet and research assistant Sami Bazzi offer a close look at the latest U.S. foreign assistance numbers. Bottom line: although America's aid has more than doubled since 2000, the new money went mostly to Iraq, Afghanistan and a small number of debt relief operations; and almost all was allocated through bilateral rather than multilateral channels. Assistance to Africa more than quadrupled from $1.5 billion in 1996 to $6.6 billion in 2006 and has been enormously important in funding humanitarian relief and HIV/AIDS programs. But even with the increases, U.S. assistance to Africa still averages less than $9 per African per year. And U.S. assistance for Africa has become less selective: since 2000 the shares going to the poorest countries and to the best-governed countries have fallen.
The US government's proposed $5 billion Millennium Challenge Account (MCA) could provide upwards of $250-$300m or more per year per country in new development assistance to a small number of poor countries judged to have relatively "good" policies and institutions. Could this assistance be too much of a good thing and strain the absorptive capacity of recipient countries to use the funds effectively? Empirical evidence from the past 40 years of development assistance suggests that in most potential MCA countries, the sheer quantity of MCA money is unlikely to overwhelm the ability of recipients to use it well, if the funds are delivered effectively.