We’re at the halfway point between the upcoming Federal Budget and World Health Day – so it’s a great time to reflect on the links between health, aid and the achievement of the MDGs.

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of World Health Organsiation (WHO)  in 1948. This year, World Health Day focussed on Ageing and Health with the theme “good health adds life to years”.

Did you know that the number of people today aged 60 and over has doubled since 1980? And that the number of people aged 80 years and over will almost quadruple to 395 million between now and 2050? Such staggering statistics have prompted many to think about how good health is directly linked to people leading full and productive lives.

On World Health Day, AusAID recognised the successes of its aid programs that promote good heath in developing countries. The main purpose of AusAID is to help people overcome poverty. This has been achieved through a wide range of health initiatives, such as establishing community health clinics in East Timor, training health workers in Vanuatu, and decreasing infant mortality rates in Nauru.

In 2011-12, AusAID contributed around $759 million to improve the health of the world’s poorest people. It has been recognised that good health is a human right and is a means to achieving other development goals so it’s imperative that the MDGs, particularly those relating to good health outcomes, remain a priority.

You can help ensure that the MDGs remain a priority by taking action today to remind the Government that overseas aid, and the MDGs, should be at the top of the agenda in the lead up to the Federal Budget.

Written by Melissa Gillies, MPH Online Contributor.

Image sourced from the Make Poverty History website.

It’s great to see the debate on the Aid Review and the future of Australia’s overseas aid program and The Lowy Institute’s focus on this important area. It is also encouraging to see the considerable improvements that have been made to AusAID’s program in recent years.

For many of us who have worked for years to make a better and bigger aid program, the commitment to lift aid to 0.5% of national income offers great hope to help build a better world. The extra $4 billion dollars each year may be a relatively small amount in a global economy of $60 trillion, but if applied well it can make a very positive difference to tens of millions of people’s lives each year.

However, there are considerable risks that we won’t make maximum use of these additional funds. Given the history of the Australian aid program I think there are big dangers that:

• Much of the extra money will not reach the poor, but will go to Western firms, consultants and well paid Australian military, police and academic employees;
• It will add to the burden on developing country governments by failing to be sufficiently coordinated with other donors and harmonised with developing country systems;
• It will damage the culture and communities of some countries by promoting inappropriate economic development models;
• It will fail because of short-term and poorly informed strategies;
• It will not provide a sustainable benefit for the poor because it fails to sufficiently include them in program planning, implementation and review;
• It will focus too much on broad-based economic growth (which we don’t really know how to assist), while failing to ensure that essential services are provided for the poor.

Given these risks, World Vision has proposed in our final submission to the Aid Review five critical steps to maximise the benefits of Australia’s increased investment:

1. Increase openness and transparency of the aid program

Allow Australian civil society a real-time picture (as some other donors do) of where and how money is allocated in order to open up the program to greater constestability. The data is there it just needs to be made available. Also allow developing country civil society and target communities to be much more involved in the planning, implementation and evaluation of Australia’s aid programs to ensure that our efforts are well informed by local knowledge and really do focus on the greatest priorities of poor people.

2. Make access to essential services the foundation of the Australian aid program

The MDGs focus on the essentials and so should the Australian aid program. The Government has driven a much stronger focus on the MDGs in recent years and there has been a welcome increase in funding for the essential services of basic education, health, food and sanitation. This strategy needs to be extended further as the needs are still great (for example 8 million child deaths each year) and our contribution is still too small.

In contrast to interventions that seek to increase economic growth, aid has been proven to be effective at helping to provide essential services for the poor – better food and nutrition (MDG1), improved education (MDG 2), improved health and hygiene (MDGs 4,5,6,7). Measures of these successes include significantly decreased maternal and child deaths, millions more children in school, cuts in new HIV infections and AIDS and decreased malaria deaths. In each of these areas the major constraint is not lack of knowledge but lack of money. The additional funds available to AusAID could save at least 500,000 lives a year if applied through existing proven strategies that have an average cost of around A$2,300 per life saved.

Assistance to provide essential services is amongst the most reliable and cost-effective of aid interventions and should be the foundation of our aid program covering around half or more of our expenditure. As the UK Government has done, we should be framing our core aid goals in terms of concrete and achievable outcomes such as the number of lives saved, the number of children given access to school, the number of people with toilets.

At least then in 2015 Australia will be able to clearly point to the benefits of the program – something which has not been so easy to date. If we fail to provide these basics, Australians will be rightly asking what is the point of an aid program.

3. Focus on the poorest and weakest

This means allocating our resources more in line with need and less in line with geographic distance from Australia. Australia’s first responsibility is to our closest neighbours, however that is not where our responsibilities end.

We need to guard against giving too much support to neighbours that already receive high or very high levels of per capita aid (i.e. the Pacific receives US$184 per capita on average in total aid) and giving too little to others that may have much bigger problems (India gets US$2 and Indonesia $5 per capita from all donor nations).

We can have an aid program that focuses mostly on our region while at the same time also assisting those most in need. Providing much more finance through effective multilateral agencies (at least 30% of our ODA to multilateral core contributions, and more in partnership arrangements) is a requirement to efficiently achieve this and also necessary if we are to further improve coordination and harmonisation of aid.

Focusing on the poorest within countries is also essential – our other key recommendations to provide essential services and to increase accountability to communities will help to ensure this.

4. Increase accountability to communities and partner countries

As several ODE reports (the Office of Development Effectiveness monitors the quality and evaluates the impact of the Australian aid program) have pointed out, AusAID needs to broaden its notion of risk management and focus on the risks for the poor as much as on fiduciary risk to the Australian Government. Accountability has to be to poor communities, partner governments and the Australian Government. Accountability to poor communities will involve much more active communication with communities and civil society in partner countries – something with which Australian NGOs can help.

As part of greater community accountability, gender equity must be given much greater focus – AusAID needs to lift its efforts for women even further and make sure that women not only benefit from the aid program but also are equal partners in shaping it. The aid program needs to actively support the needs and rights of women, and mechanisms need to be established within AusAID to ensure near-equal gender representation in planning, implementation and review of the program. The development discourse is currently dominated by male economists despite 70% of the poor being women.

5. Ensure coherence of development policy and greater international leadership by Australia

Aid is not the only way that Australia can support international development. To maximise Australia’s effectiveness as a development player it is critical to increase the coherence of government policy and to ensure whole of government support for development. The position of developing countries and their fortunes are shaped by a wide range of international arrangements in the areas of trade, environment and finance.

Australia is an influential middle-level power with significant respect from other nations and is a member of several important international bodies such as the G20, APEC, the Commonwealth and the East Asia Summit. We are also one of the leading donors to the Asia-Pacific. Australia is in a powerful position to promote greater international action on development and to encourage more effective coordinated action to reduce poverty and assist developing countries.

Important actions could include: encouraging full funding by all donor countries for effective multilateral aid bodies; supporting greater action to reduce international corruption and illicit financial flows; ensuring that intellectual property laws do not damage growth prospects for developing countries; providing opportunities for seasonal workers to work in Australia; making better use of Australia’s research infrastructure to address developing country needs.

There is a big risk that come 2015 we will look back and wonder just where all that extra money went. However, if the Australian Government and AusAID take these five steps then we will be able to say that Australian aid has made a large difference and that millions of people’s lives have been saved and improved by our efforts.

Garth Luke is a senior researcher for World Vision Australia

First published on the Lowy Interpreter

The Australian Government has established an independent panel to undertake a review on the future direction of Australia’s aid program. The review will examine whether the current systems, policies and procedures for the aid program maximise effectiveness and efficiency. The outcomes will help guide the future policy direction of Australia’s aid program.

Below is the submission from Make Poverty History:
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First things first: Make Poverty History (MPH) recognises that globally there have been very significant improvements in human welfare in recent years and the Millennium Development Goals have played a critical role in helping to motivate people and focus global development efforts. While not all the Goals are being achieved in all countries, overall there has been remarkable progress with millions more children in school, a dramatic and increasing rate of decline in child and maternal mortality, a turnaround in the growth of the major infectious diseases and huge increases in access to clean water and hygiene knowledge. Advances in technology, economic growth and improvements in development are all playing a part. There are still lots of problems, new threats to human welfare on the horizon and still lots of aid inefficiencies, however there is also much to be proud of.

Make Poverty History believes that the Government and AusAID also have much of which to be proud. The Government’s commitment to increase aid to at least 0.5% of GNI, to meet our fair share of development funding for climate change and to play a leading role in international fora to promote issues such as education, health and financial stability in developing countries should all be commended. AusAID’s increased focus on key MDG sectors and increased support for basic education, food security and health, its greater openness and consultation with civil society, improved evaluation, increased support for and cooperation with other bilateral and multilateral donors and focus on meeting Paris and Accra principles are all important improvements that we have observed in recent years.

In a way our submission could simply be: more of the same please, you are heading in the right direction. But to be a little more specific MPH would like to highlight the following actions which it believes are critical to further improving the aid program.

1. Set a timetable to lift aid to the international target of 0.7% of GNI as soon as possible – act as model to encourage all donors to meet their promise of 0.7%. This is especially important at this time of budget pressures for many donor nations.
2. Provide our fair share (ie around 2.5% of the costs, in line with our share of OECD DAC GNI) of the donor funding required to achieve the MDGs. This will require approximately A$800 m a year for agriculture and food security, A$450 m a year for basic education, A$1200 m a year for health, $600m for water and sanitation and our share of the agreed amount for climate change adaptation and mitigation.
   • Progress on important commitments such as basic education for all, a 2/3rds reduction in child deaths, universal prevention and treatment of HIV are all falling short largely because of a shortage of funds – these are things the world knows how to achieve. Contribution of Australia’s fair share in these sectors will have a direct benefit of critical additional funding which will make a big difference in life and death terms. It will also have and the indirect benefit of encouraging others – both donors and developing countries – to meet their commitments also. We cannot expect that other developed and developing nations will do the right thing if we don’t. We cannot expect improved governance in developing countries if we do not show it ourselves.
3. Increase funding to those countries in our region with the greatest number of people in poverty and increase efficient global support by increasing funding to effective multilateral programs.
4. Increase the transparency of the aid program – make the database of currently funded activities publicly available, meet the International Aid Transparency Initiative standards and shorten the time between evaluation and reporting.
5. Ensure civil society engagement by relevant groups in Australia, in each country and in the communities affected in the planning, implementation and evaluation of the aid program. This will be one of the hardest things to achieve, however the government and AusAID have the full support, the expertise and the networks of Australian development NGOs to help achieve this.
6. Work to ensure women have near equal representation in all planning, implementation and review activities from the community level to the most senior management of AusAID. Equal gender representation will make it much more likely that programs will meet the real needs of the poorest and most vulnerable and should act to ensure a better balance between support for practical basic services and for the theoretical goal of economic growth.
7. Protect the aid budget from the additional costs of climate change adaptation and mitigation. Follow the UK policy that no more than one tenth of the aid budget be spent on specific climate change activities to ensure that the vast bulk of climate change expenditure is truly additional to existing aid commitments.
8. Make greater use of Australia’s influence to promote effective joint action on a range of key development concerns such as climate change agreements, gender equality and the reduction of violence against women, a pro-poor conclusion to the Doha round of trade discussions, more inclusive international business investment, innovative development finance, measures to effectively stem the US$160 billion in illicit financial flows from developing countries, ,fairer international intellectual policy frameworks, more just international financial rules, aid commitments and coordination and adequate funding of joint initiatives and multilaterals. Australia should also take a leadership role in the Asia-Pacific region to ensure that aid from all donors is effectively targeted, coordinated and sufficient.
9. Increase the focus on equity. Ensure Australia’s aid projects focus on the poorest and marginalised groups, support grass roots governance activities such as budget monitoring and community level corruption control, and increase support for Australian and local NGOs working with the poorest.
10. Double efforts in line with the Paris and Accra agreements on aid effectiveness to make aid more long term and predictable, harmonised around country systems and needs, coordinated with all other major donors in each country and accountable to beneficiaries.
11. Increase resources on the ground – learn from the weaknesses in PNG and some other country programs where too much money has gone to overpaid and often ineffective Western consultants and not increased the resources for services that people need. Use country systems, increase general budget support and sector wide programs, put downward pressure on contract prices and actively support the development of within-country expertise.
12. Build parliamentary understanding and support of development issues – take MPs ‘to the field’ by producing an easily digestible and graphic annual publication that share with them the stories of Australia’s development efforts, stories they will remember and can share with their constituents.

Download the submission:

  MPH submission to AusAID review (142.9 KiB)
Make Poverty History's submission to the government's review on the future direction of Australia's aid program.

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Do you agree with our submission to the aid review?
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Mae-Sot in Thailand is only the width of the Moei River away from Burma. Visitors to the township can clearly hear occasional gunfire, as if to remind them of the grim realities of life on the other side of the border.

I travelled to Thailand last week for meetings with 40 other young MPs from around Asia, discussing the best ways to tackle child and maternal mortality in the region. At World Vision’s invitation, I went on to the border zone to see projects funded by Australia on the ground, working to reduce exploitation and improve the health of the Burmese.

The Friendship Bridge at Mae-Sot, which links Thailand and Burma, was built in 1997, but the Burmese closed the bridge and the frontier earlier this year. However, this hasn’t stopped people trying to make the crossing. Sitting on the bank of the river for just 10 minutes, I saw people crossing the river on old tyre tubes – I thought to myself that in Australia Opposition Leader Tony Abbott would call them ‘‘tyre people’’.

Last month, on the day of the elections, 25,000 Burmese flooded across the border at Mae-Sot. The media coverage has since moved on, most of the 25,000 have been forced back to Burma – but the danger is as real as ever.

Thailand is not a signatory to the UN Refugee Convention, and the government has set its own rules, with a narrower refugee definition than the UN. There are still 150,000 people in official camps dotted along the border. The township of Mae-Sot acts as a default refugee camp for another 200,000 people who are categorised as illegal migrants.

It’s not uncommon to find 15 people living in a single-room hut surrounded by sewage and rubbish piles. This poverty makes the township a hotspot for ‘‘brokers’’ – traffickers who look for women and girls to sell into sex work and move to Bangkok and abroad.

Non-government organisations such as World Vision and other aid agencies try to fill the void left by the lack of official support. I found myself at a makeshift camp with 600 people — mostly families with young children and pregnant mothers – who were sheltering under tarps having fled across the border that same day because of renewed shelling. Some said they had been in Mae-Sot a week or so earlier, and had been pushed back by Thai soldiers. The shooting had not stopped, however, and they had been forced to flee again. There is a growing emergency here that needs to be addressed.

Meanwhile, organisations on the ground have been calling for a removal of Australia’s restriction on the funding of cross-border aid to Burma’s border areas. Labor stated before the federal election that it remained opposed to cross-border aid because it was not sanctioned by Thailand or Burma, was highly dangerous and difficult to monitor.

The reality is that there are at least 500,000 internally displaced people inside Burma in desperate need of aid. Yet what’s our government’s excuse? That the Burmese government, ruled by a military junta that detains and tortures dissenters, says it doesn’t want us to help its people.

Come on Australia, it’s time to allow our aid to go where it can best help those in need.

Sarah Hanson-Young is an Australian Greens Senator for SA
First published on the National Times

The Make Poverty History (MPH) coalition has welcomed the Australian Green’s commitment to have a Minister for Development Co-operation overseeing a separate Department of International Development, and has urged other parties to make similar commitments.

Currently AusAID is part of the Department of Foreign Affairs and Trade (DFAT). Shifting overseas aid from DFAT to a separate department would give Australia’s international commitments greater political prominence and make it more likely that Australia would match the commitments made by other similar nations to the fight against poverty.

“It is time for Australia to have a cabinet level Minister for Development Cooperation and improve the design and purposes of Australian aid. Aid should be seen as more than a foreign policy instrument and instead should focus on the attainment of the Millennium Development Goals,” said Tim Costello, co-chair of Make Poverty History.

In the lead-up to this year’s federal election, Make Poverty History is asking the Federal Government and the Opposition to commit to increase Australia’s aid budget for developing countries to 0.7 percent of our gross national income (GNI).

“The focus of this additional aid money should be on improving maternal and child health, food security, education, gender equality, and providing safe drinking water and sanitation,” said Make Poverty History co-chair Andrew Hewett.

“Having a separate department and cabinet level minister will improve the quality, accountability and focus of the aid budget and make sure we have a whole of Government approach to aid”.

Make Poverty History is a coalition of more than 60 aid agencies, community groups and religious organisations working to hold governments accountable to their commitment to halve global poverty by achieving the Millennium Development Goals.

For media inquiries contact: Ariani Soejoeti (+61448684033)