Duncan Green's Blog, page 151

How will the Paris attacks affect the outcome of the Climate Change talks?

When British Prime Minister Harold MacMillan was asked what he most feared in politics, he replied ‘Events, dear

boy. Events’. The official sherpas and their political masters preparing for the global climate change talks in Paris, which start today, must be feeling much the same way, their already complicated task further beset by concerns over security, following the appalling attacks on Friday 13th.

Beyond questions of security, the attacks are likely to have much broader impacts on the climate change talks, which are a make or break moment in the effort to prevent runaway global warming. Politics and diplomacy have a long track record of being shaped by events, which open or close windows of political possibility. In the UK, the shock of World War One helped bring about universal suffrage, while World War Two made a welfare state possible.

In recent years, terrorist attacks have played significant roles as drivers of change. In 2001, the 9/11 attacks galvanized a dormant attempt to launch a global round of trade talks. I was in Qatar six weeks after the attack on New York’s twin towers, and watched as world leaders swallowed their differences in a collective determination to show that the international community could come together in the face of atrocity, launching the Doha round of WTO trade negotiations.

Four years later, the British government and Make Poverty History campaigners put debt relief and aid on the agenda of the G8 summit at Gleneagles in July 2005, but it was the 7/7 London bombings in the middle of the summit that made it diplomatically inevitable that the other G8 leaders would ‘throw Blair a bone’ in the form of an ambitious agreement on aid and debt.

This Changes Everything

In Paris in the weeks to come, there will be an equal determination to close ranks and give President Hollande a much-needed diplomatic victory. The President has already set the tone by telling a joint session of the French parliament that the conference would go ahead, to “show that the world must stay united against terrorism.” President Barack Obama will still speak in person at the beginning of the conference. With that kind of political momentum, the window is now open for a more ambitious climate change agreement than might otherwise have been possible.

After the attacks, the language around the impending ‘Conference of the Parties’ will undoubtedly be full of the need for a moment of global solidarity, moving on from the tit for tat horse trading that has typified international climate negotiations to mutual cooperation between governments to tackle what Lord Stern has called ‘the biggest collective action problem in history.’

But the lesson of 9/11 and Doha is that the new momentum behind a deal could be a double-edged sword. There, pressure was piled on developing countries to dilute their demands in the interests of ‘standing up to terrorism’. The trade talks soon slid back into the mire as North-South differences resurfaced.

There is a risk that a similar lowest common denominator deal could be agreed in Paris by

Penny for your thoughts, Sally

negotiators understandably keen to grab diplomatic victory and jump on the first plane home.

That would be a terrible missed opportunity, because the tide of events on climate change is already heading in the right direction – since failure in Copenhagen in 2009, developing and developed countries have got on board, the scientific consensus around the need for action has grown even stronger, and new technologies have made the inevitable carbon transition less painful.

Leadership, public pressure and not a little luck will be needed to make sure that Paris produces a deal worthy both of the moment and the climate challenge that faces us all.

The Adaptation Gap (and how to deal with it)

Ben Ramalingam , newly appointed leader of the Digital and Technology cluster at IDS , and author of Aid on the Edge of Chaos , shares some thoughts on ‘adaptive management’.

Over the next few weeks, Duncan has agreed to run a series of posts by participants in the recent USAID-IDS workshop on adaptive management, to share their ideas, insights and suggestions. As co-designer and facilitator of the workshop, I wanted to kick-off with a summary of my opening remarks.

Adaptive management is very different from traditional aid approaches. Andrew Natsios, former USAID administrator, famously described how the strategic and managerial agendas of development evolved over time in a landmark paper. In it he argues that the principles of scientific management, developed by Frederick Taylor and famously implemented by Henry Ford in the early 20th century, have come to exert a disproportionate influence on the aid enterprise. ‘Fordism’ is about standardization and control, change efforts that are driven top-down, and a reliance on management planning and execution of repeatable tasks.

Adaptive management by contrast, (to the extent that it is clearly defined), is much more about interaction and change, and requires much more focus on emergence and context. Instead of planning and precision, adaptive management places greater emphasis on capacities and processes to generate productive novelty in day-to-day work.

To put it another way, traditional management assumes we have the answers and puts in place an engine for delivering those answers in as replicable a fashion as possible. Adaptive management assumes we don’t have the answers, and puts in place a network to generate those answers when and where they are needed.

So why do we in development need adaptive management? Because development is best seen as a complex adaptive process that emerges from the interaction of a whole range of factors and actors. It is fundamentally shaped by diverse behaviours across dynamic networks.  In such cases, traditional management doesn’t work, because it is based on an ordered and predictable response: an answer delivery system built on the insight, innovation and leadership of people who work far from the problem.

However,  the evidence from many different sectors is that responding adequately to complexity requires an answer discovery approach: an adaptive response rather than an ordered one, which tries to trust and empower those closest to the problem.

So how are we dealing with this? My concern is that the typical response of many development organisations has been to respond to complexity with directives and systems that seek to restore a sense of order and control. It’s what I call doing the wrong thing righter.

Specifically:

We assume user needs can be assumed, predicted, influenced, even over-written
We aim for large volumes and replication
We focus on pre-determined answers and offerings
We work in contractual ways that retains control at the centre and the top of the system
We work in systems where both the parts and the people are assumed to be replaceable

Doing the above ad infinitum has led us to teeter on the edge of an ‘adaptation gap’, which might be defined as follows:

“The gulf between the growing need for adaptive management and the level of capabilities, cash and commitment that we have in place to meet this need”

So how do we address this gap? Well, I think it is increasingly evident that knowledge and learning is a core capability for adaptive management.

In practical terms, that means individuals, groups, organisations and networks need to invest in enhanced capabilities to:

specify interventions that are relevant to context, drawing on insights of those in that context
implement interventions in ways that support the ongoing and real-time sensing of information, insights and ideas from the internal organisational system, from partners and peers, and most importantly from communities and others embedded in operational contexts;
make sense of this information, insights and ideas in ways that is relevant for the programme or policy, to support more appropriate, contextually relevant decision making
make appropriate changes and adjustments at a strategic and tactical level.
Do all of the above on an ongoing basis, in continuous cycles of ‘learning by doing’.

At a minimum, aid organisations that addressed the adaptation gap would,:

Operate from the “end-user-back”, and not from the “organisation-forward”
Develop knowledge, information and data capabilities and tools to anticipate and interpret problems, emerging needs, and to respond to uncertainty and change
Empower organisations and teams to make decentralized decisions based on a shared understanding of organizational purpose and values
Foster new kinds of networks and partnerships to achieve goals in a highly collaborative fashion
Develop and adapt business models as necessary to ensure relevance in a highly fluid and dynamic world

In case you missed it, the great post here on adaptive management and Sasquatches two weeks back illustrates exactly this kind of working in practice. But as Lisa points out, such case studies are rarely spotted, and even more rarely documented. We need to get better at learning from positive deviants, who are able to apply adaptive approaches despite the considerable constraints they face. And we need to network them together, to bring about wholesale change in the way development works.

The stakes couldn’t be higher. During the End to End Review in DFID, which led to the development of the Smart Rules and a whole host of adaptive management-focused reforms, there was repeated reference to ‘the battle for the soul of the organisation’. I think this applies more widely:  the relevance and value of the aid system in the 21st century is fundamentally dependent on how well we manage to bring about more adaptive changes in how we work.

That probably sounds a bit heavy, so let me give a last, lighter, word to Dilbert, who as ever, anticipates the trends in development jargon and spin by about a decade.

What can today’s activists learn from the history of campaigning?

Spent an afternoon recently discussing the lessons of UK history with an eclectic mix of historians and modern day campaigners. Organized by Friends of the Earth’s Big Ideas project and the History and Policy network, it was the second instalment in a really interesting process (see here for my post on an earlier session).

This time around, H&P had commissioned a set of short case studies on historical UK campaigns: Abolitionism; the Decriminalisation of Homosexuality; Women’s Suffrage; the campaign to repeal the 19th C Contagious Diseases Acts; the campaign against Irish Home Rule; the National Viewers and Listeners Association (aka Mary Whitehouse); the Anti-Corn Law Campaign; the Chartists and the 1984/5 Miners’ Strike. Each author was asked to discuss the campaign’s focus, methods, contestation and outcomes. The draft case studies can be found in this drop-box folder.

Every participant had to agree to read at least 3 of the case studies as homework – I chose the least familiar ones to me (Anti-Contagious Diseases Act, Irish Home Rule and Chartists). Great fun. From those 3 I drew some standard lessons (importance of critical junctures like wars and political upheaval; leadership) and some new ones (at least to me). These included:

The extraordinary context in the 19th Century: progressive extension of voting rights, rise of new social actors like the urban, industrial working class, increasing support for women’s rights – an exhilarating backdrop and linking thread in a number of campaigns (activists often moved between them)
Some spectacular stunts – the Chartists at one point produced a petition that was 6 miles long, with a third of the UK population signed up. And all without social media – match that, modern-day campaigners!
A process of deterioration, as big tent movements focussing on a few core demands fragmented into internal factional fights over detailed policy positions (sound familiar?)

The seminar highlighted some useful lessons and challenges to modern day campaigns:

Motivation: a lot of the great campaigns were based on moral arguments – the fight for a new world, or a vision of a new way of living/being. In contrast, many modern campaigns are more ‘managerial’ – ‘don’t frighten the horses’,

Early Infographic

argue for the shift of state spending resources from one place to another, rather than something more transformational. Is that partly linked to the creation of a professional campaigner caste? Or the way modern campaigns are funded? Or is it just a creation of hindsight – we remember the great transformational victories, and forget all the failures?

Religion: Linked to this emphasis on The Moral, faith groups played a huge role in many of the campaigns, often fighting proxy battles through the different campaigns (eg liberals v conservatives). In contrast, the secularism of much modern campaigning is striking.

Waves v Tides: FoE’s Craig Bennett argued that social change is like waves on a beach – they surge to and fro. The job of campaigners is not to resist the retreat of each wave, but to build the underlying tide so that each wave washes higher. Which made me wonder which comes first – to what extent is the tide (the zeitgeist) driving the waves (the campaigns) or vice versa? In practice, activists usually exaggerate the waves (i.e. their own role), and downplay the historical tides – big mistake.

Does winnability matter? Modern campaigns emphasize the A (‘achievable’) in SMART campaigning, but the Chartists never seriously believed they would get Parliament to abolish itself, and the former Newbury bypass activists in the room swore they never really thought they would stop the road. Their aim was to change the debate, trigger wider change. But it’s all too easy to claim that a flopped campaign ‘changed the terms of debate’ – how do we know if it’s true?

Linked to that, the whole nature of ‘success’ and ‘failure’ in campaigns is much more complicated than it looks. Some failures sow the seeds of future success; often there is little correlation between the peaks of campaign mobilization and when the campaign actually wins. Does that mean there is still hope for Occupy?

Narratives: successful campaigns on eg gay rights or anti-smoking tried out various narratives before finding the ones that resonated with the public (respectively, love rather than respectability, and the impact of smoking in public places). Does that mean we should more consciously experiment with multiple narratives and test which ones work?

We can learn from her too……

Coalitions and Awkward Allies (eg feminists and Social Purity advocates working together to repeal the Contagious Diseases Act) can be effective, but also have intrinsic benefits – look at how the unlikely coalition between striking miners and gay rights activists change Labour Party policy on gay rights. The best coalitions emerge organically, responding to the moment, but campaigners are also surrounded by ‘zombie coalitions’ that suck up energy while looking for a cause. Do we need to get better at killing off the zombies to make space for new alliances?

So is all history contextual or can we learn lessons, or at least see repeated patterns, within it? Best quote of the day, c/o Andrew Simms: ‘History teaches us nothing, but only punishes [us] for not learning its lessons’. Thanks to Vasily Klyuchevsky, (19th C Russian historian) for that little gem.

What’s changed since Copenhagen? Curtain raiser for the Paris climate talks

Tracy Carty, Oxfam Climate Change Policy Adviser, with an excerpt from its Paris media briefing, published today

The last time leaders got together to agree a global climate deal it ended in multilateral meltdown.  Copenhagen was widely condemned as a failure – a failure that still haunts the climate negotiations, and one that governments meeting in Paris next week will not want to repeat.

Six years on, what’s changed and what are we expecting in Paris?

The first major difference is a change in expectations.  Unlike Copenhagen, COP 21 is not being hailed as the silver bullet that will save the climate. But instead, a turning point towards increased ambition over time – as part of the journey, not the final destination. Expectations for Paris are much lower than they were for Copenhagen, increasing the likelihood of a deal, but raising alarm that it will fall far short of what is needed.

Politically, the biggest shift since Copenhagen has been the new willingness to act shown by the world’s biggest emitters, the US and China. Over the past 18 months the world’s superpowers have made historic joint announcements on reducing emissions and found common cause on many key issues in the negotiations. China’s motivation is likely threefold: as an international power they are seeking to play a constructive leadership role in matters of global governance; they do not want to be blamed for failure in Paris as they were in Copenhagen; and chronic air pollution is choking China’s major cities.  Meanwhile, in the US: climate change has replaced healthcare as one of President Obama’s top three second term priorities; the shale gas revolution has helped get emissions down, creating political space for US leadership; and Chinese willingness to act has also been a catalyst for US political will.

The end of the US-China stalemate suggests that a Copenhagen-style collapse in Paris is unlikely.  But with convergence on a softer, weaker global climate framework between the US, China and other key players (including a ‘nationally-determined’ bottom-up, non-binding, non-standardised approach to domestic commitments), it risks being a deal that is not commensurate with the challenge of avoiding dangerous climate change.

On the ground, the low carbon transition in now well under way.  The years since Copenhagen have seen spectacular growth in solar and wind power and a huge shift in the economics of renewables, which are now the world’s second largest source of electricity (behind coal) and cost-competitive in a growing number of countries. Significantly, 2014 saw emissions in the energy sector stall for the first time even as the global economy continued to grow. But in spite of this progress, coal and other fossil fuel use continues to rise at an alarming rate.

Climate-related shocks have increased.  Since Copenhagen, the consequences of climate change are a reality for an increasing number of people: from the 2011 drought in the Horn of Africa, to Hurricane Sandy that struck the United States in 2012, and Typhoon Haiyan which battered the Philippines in 2013.  These events have raised the spectre of climate change, helped put a human face on the unfolding catastrophe and increased support for climate action.

Emission targets are on the table. Unlike Copenhagen, countries have tabled their emissions reductions pledges before Paris. More than 150 countries have submitted their INDCs (Intended Nationally Determined Contributions), the most ambitious of which, according to a recent civil society equity review, have come from developing countries.  But even if all countries meet their commitments, the world is likely to warm by a devastating 3°C or more (see here, here, here and here for assessments).  The credibility of the Paris outcome thus rests on the strength of any mechanism to increase ambition from 2020, when INDCs and the new agreement take effect.

Finance is not on the table. In Copenhagen, the commitment to mobilize $100bn per year by 2020 (combined with a Fast Start Finance pledge of $30bn) saved the summit from being a complete disaster. But over the past six years the money has been slow in coming, and adaptation finance has consistently been neglected. Oxfam estimates that public climate finance provided by developed countries was around $20bn on average in 2013–14, of which adaptation’s share was only around $3-5bn.  Everyone knows that finance will be needed to seal the deal, but going into Paris it’s the biggest known unknown.

A lot has changed since Copenhagen.  In many ways the pre-COP context is more favourable than ever before.  But we are not where we need to be.

Today Oxfam publishes Game-changers in the Paris climate deal, which sets out game-changers over the next two weeks that could make a real difference to the type of agreement reached.  Two critical questions will determine the extent to which the Paris deal helps those on the frontlines of climate impacts. The first is whether there is enough finance in the deal for poorer countries. The second is whether the deal is strong enough to keep the goal of 1.5°C, or even 2°C, within reach: crucially, whether a robust INDC review mechanism is agreed.

 

 

Here’s my attempt at a takeaway message on How Change Happens – what do you think?

Reminder – if you are one of the truly alarming number of people who have downloaded the 160 page draft of How Change Happens , the deadline for comments is just two weeks away – 10th December. Background to the book here .

One of the main messages already emerging from feedback is that I need to ‘throw readers a bone’ in the final chapter, in the form of some rules of thumb they might want to adopt in working on issues of power and systems (the core narrative of the book). Rules of thumb are under-studied – they are actually what guides our decisions from day to day (sorry evidence geeks, but it’s true). But since one of the conclusions of the book is that all those toolkits and best practice guidelines are often incompatible with systems thinking, a tricky balancing act is required.

So I want to run my response (both as powerpoint bullets and text) past FP2P readers and see if it works/how you would improve it. Step forward the ‘How Change Happens Power and Systems Approach’ (PSA). This covers two areas:

How we think/feel/work
The questions we ask (and keep asking)

Intro: A Power and Systems Approach differs from conventional ways of working in some important aspects: a conventional aid project or campaign tends to do all the analysis up front, come up with a plan, find the money and then stop thinking to focus on action, until the project is completed.

Well I couldn’t not use it, could I?

Since no amount of upfront analysis will enable us to predict the erratic behaviour of a complex system a PSA interweaves thought and action throughout. The purpose of initial study is to enable us to place our bets intelligently. The crucial decisions come after that: how we continue to ‘study’ during the course of our efforts, and adjust according to what we learn.

A PSA encourages multiple strategies, rather than a single linear approach, and views failure, iteration and adaptation as expected and necessary, rather than a regrettable lapse.

How we think/feel/work [6 dance moves?]

The powerpoint slide:

Curiosity – Study the history; ‘learn to dance with the system’
Humility – embrace uncertainty/ambiguity
Reflexivity – be conscious of your own role, prejudices and power
Be searchers not (just) planners
Include multiple perspectives, unusual suspects
Regular time outs to learn from failure and success, and adapt

The text: A PSA means become ‘reflectivists’ as well as activists, nurturing a genuine curiosity about the complex interwoven elements that characterize the systems we are trying to influence, without abandoning the desire to take action. We need simultaneously to be observers and activists.

Dancing with complex systems is like navigating through traffic – success depends on fast feedback to detect new situations and having the ability to respond quickly (a pedestrian has stepped out into traffic – hit the brake!). We need to analyse and reanalyse the context, spotting new windows of opportunity (and threats), learning from failure, trying out different things until we find something that works.

Curiosity about the system needs to be laced with humility and self knowledge. We don’t – can’t – have all the answers; we can’t predict events; what works in one place won’t work in another. We need to get comfortable (maybe even enjoy) messiness and uncertainty, giving far more weight to local knowledge and feedback. We need to include a more diverse range of people and viewpoints in any discussion, and (however busy we are) take regular time outs to assess what is/isn’t working and change course accordingly.

We need to recognize that ‘we’ are not lofty, disinterested observers. Power flows within our own networks; it influences our relations with partners and allies. We make decisions at least partly based on our default models of the world and assumptions not based on evidence.

The questions we ask (and keep asking)

The powerpoint slide: [6 questions]

Everyone enjoying this?

What are we trying to change? (Policy; Practice; Norms)
Are there current/past examples of success that we can learn from?
How are decisions on this issue taken? By whom?
Who holds what kind of power (especially excluded groups – women, indigenous, older people etc)
How can we foresee or respond to any critical junctures?
Can we identify any quick wins or implementation gaps to build momentum and confidence?

The text:

What problem are you trying to address? Is it specific (e.g. improving livelihoods for a group of women farmers) or systemic (changing government policy or prevailing norms)? Is it primarily economic, political, social or a combination? Local, national or global?

What is your understanding of the origins of that problem? Have you considered a positive deviance study to explore where the problem has already been solved and how? Who has the ability to solve it? Does the barrier to change lie in laws and policies, or in social norms, attitudes and beliefs? Or is the issue rooted in conflicting interests?

Whatever the issue we are thinking about and seeking to change, everyone involved will be linked by a subtle and pervasive force field of power. A good power analysis should identify the players (both individuals and organizations), how they relate to each other, who or what they are influenced by (peer persuasion or rivalry? Evidence and example? protest?) and the different kinds of power in play (conventionally visible power, or something more behind the scenes, like the power of ideas, or peer pressure and ‘old boy networks’?).

A power analysis should suggest strategies for engaging with the main public or private institutions that drive or block change. It should dissolve the monoliths of ‘the state‘ or ‘big business‘ or ‘the international system‘ into turbulent networks full of potential allies as well as opponents. A power analysis should also help us understand why change doesn‘t happen – the forces of inertia and paradigm maintenance.

A power analysis disaggregates power, exploring the role of ‘power within’ (e.g. empowering women to become more active social agents), ‘power with’ (collective organization) or ‘power to’ (e.g. supporting CSO advocacy)? That helps move the focus to groups of people (women, poor communities, indigenous groups, those living with disabilities) who are often excluded from decision-making, and whose empowerment is at the heart of many change strategies.

Can you foresee any likely critical junctures when change is more likely to occur (e.g. new governments, changes of leadership, election timetables)? When operating in complex systems, you are only as good as your feedback loops. What systems do you have in place to spot and respond to new opportunities and threats as they emerge? Or monitor your own work, spot failures, and change course?

Implementation gaps – institutions, policies or budgets that have already been agreed but exist purely on paper – often provide fertile grounds for action that generates quick wins, which can have a galvanizing effect – plucking a few low-hanging fruit is great for morale, motivation and momentum.

The argument of the book is that those ways of working, and asking these kinds of questions, should broaden the range of allies, ideas and strategies, introduce better feedback, learning and adaptation and (fingers crossed) make us more effective change agents. Convinced?

Links I Liked

Spending the next two weeks in Australia (Melbourne and Canberra) and Vanuatu consulting on the book draft and

scavenging some last minute new material. Speaking in Melbourne at launch of Politics of Results book on Tuesday. Details here. Otherwise it’s all non-public events at ANU, DFAT etc. Also means I’m glad to see this Economist graph on how much safer air travel has become.

Back to last week’s links:

Why South African students have turned against their parents’ generation. Fascinating Guardian ‘long read’ by Eve Fairbanks

In Bangladesh, a half-century of saving lives with data. New angle on a massive health success story

Changing times. New African Centre for Obesity Prevention, launched in Johannesburg. South Africa is the worst affected (26.8% of population are obese)

The only thing Americans like less than Syrian refugees in 2016? Jewish refugees in 1939

How is Development Economics Taught in Developing Countries? More diverse, more case studies, less maths than in the North. Authors seem to think that is a bad thing. Sigh……

Magisterial and upbeat overview by planetary boundaries guru Johan Rockström of the state of the Anthropocene ahead of the Paris climate talks

A Western-educated leader is four times more likely to preside over a democratic transition. Cue discussion on direction of causation

There are at least six completely different meanings of ‘interesting’ in British English (cf Eskimos and snow)

Against the odds: Lovely photos of newborns & new mothers in Malawi, by Jenny Lewis for WaterAid

The best and worst aid videos of 2015

The people have spoken, and we have winners for both the best and worst aid fundraising videos of 2015. Let’s start with the crap ones, cos that’s more interesting. The audience voted (predictably) for the Band Aid retread, but I thought this one from the One World Campaign was magnificently terrible (and almost unwatchable).

As for the best video, the audience chose this moving story of the work of the White Helmets in Syria

Fair enough, but I loved this witty WaterAid take on ‘If Men Had Periods’ (especially the Kevlar and NASA – great touch)

More background and finalists here. Thanks for brightening our lives (and powerpoints) to the organizers, the Students’ and Academics’ International Assistance Fund (SAIH)

Why is the World Bank Group dragging its feet over its disastrous PPP policy on funding healthcare?

Oxfam health policy lead Anna Marriott gets back from maternity leave to find that the World Bank Group is dragging its feet over a disastrous health contract in Lesotho

Back in April 2014, World Bank Group President Jim Kim said in a televised interview (19 ½ minutes in) that his organisation would be ‘the’ go-to group to understand how health sector public private partnerships (PPPs) have worked out all over the world. He was responding to a report by Oxfam and the Lesotho Consumer Protection Association (LCPA), which showed how the IFC’s flagship health PPP in Lesotho was now swallowing over half the national health budget in that country and diverting urgently needed resources from the rest of the health system (see Duncan’s blog on our report). Kim said that he was personally looking into the Lesotho case very carefully to see if ‘tweaks’ needed to be made.

The interview was a high moment for the Oxfam and LCPA teams. It had not been an easy task to produce and verify our findings on Lesotho. It was particularly rewarding for me – I could start my maternity leave a week later knowing that our case was being taken up at the highest level and most importantly that action would be taken to mitigate at least the most damaging features of the Lesotho hospital PPP.

White Elephant or financial Black Hole?

Fast forward 18 months. My baby is now a happy toddler. And developments on the IFC and health PPPs?  A few developments (not necessarily correlated with our work on Lesotho) – the UK government stopped funding the IFC’s health PPP advisory facility, a planned IFC health PPP in Benin seems to have been canned, and in a Lancet article this week that follows up on the Lesotho case, the IFC head of health PPPs Paul da Rita is quoted as saying health PPPs ‘don’t always work’.

But how much has been learnt? The IFC still has 17 ongoing and 13 ‘closed’ health PPPs across Africa, Asia, Latin America and the Caribbean that we know next to nothing about.  When the IFC says that health PPPs don’t always work, which cases or models are they referring to? Why don’t they work? In which contexts do they work?

In England, which is the largest testing ground for health PPPs, the House of Commons Treasury Select Committee said PPPs (or private finance initiatives (PFI)) should be used as sparingly as possible due the higher cost of capital, the lack of savings and benefits, complex and costly procurement procedures as well as inflexibility. Is the IFC applying such lessons when it advises on similar PPPs in Lesotho, Nigeria, India and Bangladesh? Did it share lessons of failures at the 7th annual Africa PPPs conference held in London last week? Maybe they did, I didn’t get an invite. Lesotho?

The Lesotho case is critical in the broader international health PPP debate. The IFC has consistently marketed it (and

Cuckoo in the Nest

still does) as opening a new era for private sector involvement in health care in Africa and a model (the first of its kind in any low-income country) to replicate. The explicit promise made by the IFC as ‘transaction advisor’ was that the new PPP hospital, headed up by South Africa’s Netcare, would provide vastly improved, high quality health services for the same annual cost as the old, widely condemned public hospital it was to replace.

Not so. Our report found that the PPP hospital was costing at least 3 times what the old public hospital would have cost today and was sucking up over half the national health budget. Based on the financial model underpinning the PPP (something we were never supposed to see) the private sector consortium shareholders were expecting to receive a 25% return on equity and a total projected cash income 7.6 times higher than their original investment.

This week’s Lancet article provides an important update, reporting that World Bank-commissioned studies show significant improvements in both clinical services and health outcomes at the PPP hospital. It suggests quality improvements at the facility might help entice desperately needed health workers back to the country. All such developments are very welcome – countries like Lesotho need good health facilities that make workers proud and happy to work in them and that provide quality services to all.

The big downside is that the article finds that the PPP remains an unsustainable drain on the Ministry of Health’s budget and while quality might be improving in this one particular hospital, more serious gaps are appearing in the rest of the health system because of it. The head of the Lesotho Ministry of Health’s PPP co-ordination unit said: “The rate of payment increase [on the PPP] is scary. ” She cited a rise of almost 80% since the original contract was signed.

Despite Jim Kim’s aspirations, the IFC response to the Lesotho case both publicly (including in the Lancet) and privately suggests that learning and, more importantly action, has remained disappointingly shallow. A quick check this week of the IFC website shows no response even to the Lesotho Consumer Protection Association’s most basic request to remove misleading marketing materials on the Lesotho case that encourage other countries to follow suit (see box).

In the Lancet, IFC’s Paul de Rita points to three main lessons: 1. The need for sustained efforts to build PPP contract management capacity at the local level 2. The need to engage in broad primary health systems strengthening when delivering a secondary and tertiary high quality facility [to avoid excessive demand at the top of the system] and 3. In reference to the improved clinical performance at the facility, that it’s possible to deliver good results even in difficult contexts.

Is that it? Is everything else OK with the PPP then? No flaws in the financial model underpinning it? No imbalance in the way risks and benefits are divided up between public and private partners? No problematic loopholes in the contract? And what about government capacity – should a high level of capacity have been in place before negotiations for the PPP even began or is it OK to try and step up contract management capacity after the deal has already been done and the government is locked in for 18 years?

We at Oxfam have been surprised and disappointed by the lack of any substantive comment or action from the IFC on the devastating financial impact of this PPP for the Government of Lesotho. There was a half hearted (and evidence-free) effort back in April 2014 to challenge our figures, but the IFC have limited wriggle room here as their own figures the year before showed the PPP was already costing 41% of the health budget and between two and three times that of the old hospital.

Otherwise the IFC have attempted to claim that higher than expected costs can be attributed to higher than expected demand by patients – the hospital is a ‘victim of its own success’ and an ‘island of excellence’ in an otherwise poorly performing health system. That could be good news. But the numbers don’t add up – payments for ‘excess patients’ only account for 9.6% of the total PPP cost in 2012/13 and 14% in 2013/14.

I’m labouring the point because it’s crucial. The international experience on health PPPs suggests that escalating costs are a common feature of the model itself – some inherent and some due to serious oversights in the contracts underpinning them (also arguably inherent because the contracts are so hideously complex).

This is where we would like the IFC to get ‘nerdy’ as well as go public with their learning, as Jim Kim suggested. They could start by directly responding to the list of specific problems we identified in our report about Lesotho, including cost escalation at the preferred bidder stage; poor projections of patient demand; flawed indexation of the PPP unitary fee; an increase, rather than decrease in costly patient referrals to South Africa; late payment and loan default interest charges; and the very high weighted average cost of capital (that nerdy enough for you?)  Beyond these problems, were alternative options genuinely explored during the design phase – for example, the feasibility and cost of managing the project through the public sector?

But the problems in Lesotho require a much bigger and more urgent response. The IFC as the transaction advisor surely can’t keep brushing aside the enormous financial implications of this PPP for the nation’s health sector as if people won’t notice. 18 months ago Oxfam and the Lesotho Consumer Protection Association called for the World Bank Group to finance and publish a fully independent and transparent expert financial audit and broader review of the Lesotho health PPP in partnership with the Government of Lesotho. This should include an evaluation of the IFC’s role to date and a presentation of the full range of options available to remedy the negative impact of the partnership. We have heard the Government is making a start by developing a terms of reference…

Here’s a 5m Oxfam video on the Lesotho project

Reading the tea leaves: What the women’s movement can learn from a victory in India

This piece by Devaki Jain, an Indian feminist economist,  originally appeared on the scroll.in website

The good news for the women’s movement in India came from Munnar, a hill station in Kerala, last month where a group of women workers won a signal battle against their employers, a tea estate by the name of Kanan Devan Hills Plantations.

One of the slogans at the protest read: “We pick the tea leaves, we heave the sacks of the tea leaves, you heave the sacks of money leaves, there has to be an end to this.”

These protesters did not allow men to be a part of the protest. “Men don’t do the work that we do,” they said. “We are the ones who pluck the leaves, carry the burden all day and even load it onto trucks.”

They did not allow unions to interfere in their protests either. Despite being in a state that has very influential unions and union leaders, the women did not allow them to become a part of their struggle. The women alleged that union leaders had colluded with the management to keep their bonus down.

And this is what made this protest and success unique. These women managed to keep politicians and union leaders at bay for nine days of protest that saw their numbers swell from 4,000 to an estimated 6,000, before the management gave in to their demands for higher bonus.

This is a true feminist assertion. Those unions, affiliated to the Congress or the Communists, dominated by traditional male leaders, were taken by surprise at first. Those leaders who thought they could gain visibility and power by appropriating this unique protest faced the full fury of the women protesters.

Buoyed by the success of this protest, women tea pickers employed in many other tea plantations in the region have gone on strike to press for higher wages.

A model of protest

Like tea picking, there are other “women’s only” occupations where this protest would have a clear resonance: paddy transplanting, agarbatti and bidi rolling, prawn peeling, silk-worm rearing, cashew nut husking etcetera. Much has been written about this phenomenon and why women predominate in these jobs, but not enough on why women are paid less than men, or on the specious argument that they contribute less.

This is where the Munnar struggle becomes significant because it shows that this discrimination can be fought, on women’s own terms. This uprising draws attention to many aspects of the Indian economy and the role women play in it. It also affirms the need for women to organise themselves across differences – caste, colour, politics – for justice and bringing in change.

Examples abound of such brave struggles especially on economic and survival issues like at Manek Chowk in Ahmedabad, Gujarat, where women vendors did a sit-in to protect against the reallocation of their vending space, which they had used or sat in for over 100 years, to a car park. The women vendors of Ima Keithel, Mothers market in Imphal did a sleep-in to hold on to their traditional market place. Struggles in Darjeeling, however, led to closure and deep distress for women. The broader feminist movement should support women’s unions and strengthen their voice, helping sharpen economic arguments for justice.

This becomes even more important when we realise that instead of addressing the question of increasing economic inequality, at the macro level, labour legislation is being revised as part of a programme to reduce costs and make India’s production of goods and services more competitive. Capital and its returns are not being touched. With a large, poor and unemployed population, the opportunity to make in India, at least cost, could afterall be vitiated if labour is allowed to demand its fair and legitimate rights.

In various fora, feminists are critiquing the economic models based only on the propellers of Gross Domestic Product growth, arguing that it creates inequality and is biased against the poor. But they have not been able to bring their collective voice as a challenge to economic policy discourse at the high levels of decision making.

Economic policy discourse at the macro level does not have what can be called a reasoned feminist intervention nor is there a strong enough voice as we saw when there was an uprising against the Land Acquisition Act by farmers leading to some success or the struggle in the Narmada Valley, which recently has had some success in the matter of compensation.

Gender is seen as a stratification. Gendered and feminist analysis is not seen as a theoretical framework, or as a form of economic reasoning or as a powerful ground level movement.

A spark that can start a fire

In this Munnar struggle we have a spark which the women’s movement should fan to start a fire. It has all the characteristics of an economic scenario that we criticise – unprotected labour, the betrayal by employers of labour agreements, and the power, courage, and unity of women as workers.

The Munnar struggle illustrates many of the issues that are taken up as part of the global and national discussions by the women’s movement, governments and the United Nations, namely that women are paid less than men, that women organise themselves more effectively than men, that women provide the core sustenance to their families and are willing to place their bodies on the line to that end.

It is important for the feminist movement to take the spark of this struggle into the high visibility arenas, as they did when they protested the gang rape in a bus in Delhi. Making that incident into a bigger movement helped bring about a dramatic change not only in laws, but also provided women the courage with which they are now coming forward to report cases of sexual violence.

This remarkable women-led struggle by workers in Munnar can be a platform for the women’s movement to establish the point they have been trying to make. Not only on gender inequality, not only on women’s stereotypical work, but on the economy, on economic policy, on labour and other legislation, on export industries, on corporate power.

With inputs from Neha Choudhary. Devaki Jain is an Indian feminist economist and writer. She is one of the founders of DAWN ( Development Alternatives for Women in a New Era ), a southern network that has influenced development thinking from a southern and feminist perspective. A Devaki Jain Inaugural Lecture will be given by Graca Machel at St Anne’s College, Oxford on 25 November.

What can violence/conflict people learn from the governance debate (and vice versa)? Report back on a day discussing new IDS research

I recently spent a day among conflict wonks (a thoroughly charming and unscary group) to discuss IDS’ research programme on Addressing and Mitigating Violence. There are piles of case studies and thematic papers on the website (here’s a collection of abstracts); this seminar was part of bringing them all together into some kind of overarching narrative.

The starting point for the programme was the World Development Report 2011 on ‘Conflict, Security, and Development’. WDRs are often highly influential, and this one is credited with moving the debate on from a focus on war, pacification, demobilization etc to consider repeat cycles of violence, the role of institutions, and the idea that violence goes much wider than episodes of armed conflict.

Since then there has been progress both on policies and responses, neatly captured in the recently agreed SDG 16 to ‘Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels’.

In classic IDS fashion, the speakers stressed that violence is really complicated: different types of violence (gender-based, criminal, armed) interlink both with each other and with broader political processes. How people experience it is shaped by age, gender, poverty, ethnicity, religion. Local, national and global violence is all interwoven.

I was asked to be a ‘scavenger’ (interesting new job title) and feed back impressions at the end of the day. Here they are:

There were many parallels with the kinds of discussion I’ve been having with governance people (Doing Development Differently, Thinking and Working Politically). This included a rejection of best practice approaches in favour of helping different solutions and responses to emerge from different contexts.

An example from Pakistan’s Swat Valley: After the military kicked out the Taliban, the international community came in to support the formalization of the rule of law. But at same time, an entirely parallel process emerged, as local jirgas and the police and judicial system started renegotiating their relative roles, without any involvement of the internationals. In different parts of the Valley, this led to big differences between local institutions and lots of innovation, including on the involvement of women. The internationals were amazed by the flexibility and innovation on display. (Background to this research here)

One place where the discussion seemed an improvement on the governance debate is an explicit rejection of a purely ‘elite pact’ approach. The way different factions of the political and economic elite reach agreement (or fail to) is undoubtedly important, but in some corners of governance discussions, it seems to be the only thing anyone wants to talk about. One speaker characterized the 1990s as a time when civil society was the fad, ‘then we rethought and grabbed onto the next thing – elites and political settlements’. But she, along with many others, stressed the any lasting security means building the social contract between citizens and state, not just getting a quick fix between factions of the elite that stops the fighting, but then either reverts to conflict, or leaves poor people still exploring daily violence (as they have after many so-called peace settlements). At worst, the ‘peace’ becomes the peace of the graveyard, a mere absence of conflict, with none of Amartya Sen’s ‘freedoms to be and to do’.

This got me thinking about language (as I often do during these events). ‘Violence’ is more useful than ‘conflict’ in that it isn’t just an issue for states with conflict – Yemen, Libya and so on. We also see it in the US, or Mexico, India, or other advanced economies. But maybe we need to go even further – does ‘violence’ really capture the experience of poor people? I went back to the World Bank’s great Voices of the Poor study of the 1990s, which found that perhaps the most essential characteristic of living in poverty is uncertainty, anxiety and fear of what the future may bring. Perhaps the opposite of peace is not war, but anxiety. Could IDS, the Bank or someone else repeat that exercise, and produce a ‘Voices of the Anxious’ study for the 21st Century?

One implication is that we need a better mix of disciplines in the room – how can you understand anxiety and fearfulness without psychologists? Or hybrid institutions without anthropologists? And of course, a shift from outsiders to insiders, both outsider-insiders (middle class aid or research types from the capital who may not understand everything out in the villages, but have a better chance of doing so than foreigners), or (even better) insider-insiders from the affected communities.

Which brought us back to another IDS’ tradition – a focus on participation, and taking the time to understand what is going on. Crucial, but there were real doubts that such approaches might be incompatible with the rhythms and practices of today’s aid business and (particularly in the week after the Paris attacks) an increasing focus on security and counter-terrorism, rather than any broader concepts.