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September 2011 Vol. 29 Issue 9
MonDaY DeveLopMents Magazine

the Latest issues and trends in international Development and Humanitarian assistance
Science Diplomacy
practical tips for
Building Better,
With Muslim states
Building Green
Creating Powerful Videos

U.s. Leadership in
Nature of Development
Crowd Sourcing Using U.S. Democracy
Bounded to Further Your Cause
The
The Decade of Vaccines
www.mondaydevelopments.org
InterAction 1400 16th Street NW, Suite 210 Washington, DC 20036
THIS ISSUE
September 2011
25 Bringing the story Home
DepArtmeNtS
4 reflections from the president 5 Feedback 7 infoBytes 35 Best practices 37 events 38 job opportunities
[Also visit our online job board at careers.interaction.org]
Vol. 29 No. 9
Practical tips for creating powerful videos. By Ryan Hill
10
27 Bounded Crowd sourcing
A twist on open crowd sourcing offers promise for global health efforts. By Marya Lieberman, Edwin Michael and Joseph Bock
29 Focus on Drug Quality

Improving global health initiatives for lasting impact. By Patrick Lukulay
31 U.s. Leadership in the Decade of vaccines

Promising prospects and continuing challenges. By Erin Fry and Philip Carroll
33 science Diplomacy with Muslim states

Advancing relations through health innovation. By Kaitlin Christenson and Kimberley Lufkin
FeAtureS
10 the nature of Development
19 Building economic Bridges
19
Uniting conservation and development efforts. By Stephanie Cappa
Key linkages between economics, democracy and governance affect economic growth. By John D. Sullivan
21
15 green Building: a Window of opportunity

In the Palestinian Territories, environmentally friendly construction is taking root. By Kari Jorgensen Diener and Anjad Hithnawi
21 What about Democracy and governance Here at Home?
Creating deep relationships to advance change. By Sam Daley-Harris
17 Climate Change: Bringing governments on Board
23 guarding the guards

Governance guidelines as tools for democratization. By Kate Steger
17
Leaders must prepare today for the environment of tomorrow. By Manish Bapna and Polly Ghazi
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SEpTEmbEr 2011 MONDAY DEVELOPMENTS 3
reflections from the president
Conservation and Development Can Work Together

Tremendous opportunities exist to better align the work of the development and environmental communities. Such mutually reinforcing solutions create
win-win approaches that are often overlooked. To investigate the benefits of this strategy, InterAction recently released a research paper laying out the need to integrate conservation and development policies (see page 10). This approach is not only common sense, it is also fiscally appropriate. It is often less expensive to preserve something than it is to restore or replace it later. This is especially true for a subsistence farmer or fisherman trying to eke out an existence from rapidly depleting natural resources. Foreign assistance is once again on the chopping block and our community is working hard to sustain funding at levels that do not erode decades of work. During these austere times, we also have to do our best to use every tool at our disposal to ensure foreign assistance is modernized to efficiently and effectively meet the needs of the 21st century. Aligning development and conservation policies must be part of this approach. and fresh water are far easier to restore early on rather than when these resources have either run out or are degraded beyond repair. The current famine and refugee crisis in the Horn of Africa underscores the dire need to integrate conservation into global development programs from the outset and to ultimately create more resilient societies. The UN estimates that more than 11 million people in that region need humanitarian aid due to drought, conflict and the current food crisis. Hundreds of thousands are pouring out of their ravaged communities, with many fleeing into neighboring countries. At press time, the UN estimated 1,800 new refugees were arriving in Kenya daily, and eight out of 10 of these were women and children, many of whom were malnourished. While the crisis has not aired sufficiently on U.S. television screens, the stories coming out of the region are heartbreaking. A massive global response must bolster the UN and NGOs, including many InterAction members, operating in the Horn of Africa. Yet just providing lifesaving food and nutritional help will not solve the problem. We need to take longer-term measures to promote food security and help tackle drought, water shortages and other underlying causes of the current crisis. Much of the solution lies within Africa, as countries in the southern part of the continent experience large-scale food surpluses, even as war, poor policies and a lack of infrastructure make an African-led solution difficult. Only by building the continents overall food security in a manner that preserves and properly manages limited resources can a locally sustainable solution emerge. Of course, integrating development and conservation policies wont solve all the problems in the Horn of Africa, but such an approach might contribute toward a better way of dealing with such cycles of drought, food crises and human misery in the future. Its worth a shot. MD
Managing Editor/Creative Director Chad Brobst Advertising/Subscriptions Zoe Plaugher Copy Editor Kathy Ward Executive Editor Sue Pleming News Editor Tawana Jacobs Proofreader Margaret Christoph Monday Developments Magazine is published by: InterAction 1400 16th Street, NW, Suite 210 Washington, DC 20036 Tel: 202.667.8227 publications@interaction.org ISSN 1043-8157
it is often less expensive to preserve something than it is to restore or replace it later.

As this new report makes clear, many of todays crises have at their core a resource problem that might be caused by poor governance, mismanagement, corruption or just plain-old inequity. A shortage of natural resources usually fans tensions, as has been the case in Pakistan, India and Somalia, to list a few examples. Burgeoning populations will only make this situation worse. Underscoring this point, the UN predicts that in the next 15 years nearly 2 billion people worldwide will be short of water. Hardest hit areas include Saudi Arabia, Pakistan, Egypt, huge swaths of China, portions of India and a number of states in the United States. We need to help countries protect their own ecosystems and, as international NGOs, we need to include environmental concerns in our overall programming. Preserving ecosystems must not be an afterthought. Flood prevention, pollination and pest control, soil maintenance and the provision of food
4 MONDAY DEVELOPMENTS SEpTEmbEr 2011
Monday Developments Magazine is published 11 times a year by InterAction, the largest alliance of U.S.-based international development and humanitarian nongovernmental organizations. With more than 200 members operating in every developing country, InterAction works to overcome poverty, exclusion and suffering by advancing social justice and basic dignity for all. InterAction welcomes submissions of news articles, opinions and announcements. Article submission does not guarantee inclusion in Monday Developments. We reserve the right to reject submissions for any reason. It is at the discretion of our editorial team as to which articles are published in individual issues. All statements in articles are the sole opinion and responsibility of the authors. Articles may be reprinted with prior permission and attribution. Letters to the editor are encouraged. A limited number of subscriptions are made available to InterAction member agencies as part of their dues. Individual subscriptions cost $40 a year (add $15 for airmail delivery outside the U.S.) Samples are $5, including postage. Additional discounts are available for bulk orders. Please allow 4-6 weeks for delivery. Advertising rates are available on request.
Sam Worthington president and CEO InterAction
Feedback
Send your letters to cbrobst@interaction.org
Microfinance from a Human Rights Perspective

Christopher Dunford points out in A Failure to Communicate: Microfinance Confused (MD, May 2011) that public expectations of microfinance as a poverty solution have been greatly downsized. However, we believe microfinance programs offer much to celebrate and build uponthough we must look beyond nominal financial benefits. Indeed, microfinance programs are one important tool that can alleviate economic duress enough to allow people to meet their basic needs, shift towards savings and invest in new or growing businesses. But poverty is not a purely economic phenomenon. Programs aspiring to alleviate poverty must also consider the social, cultural and structural dimensions of poverty that keep marginalized populations from overcoming barriers to economic self-sustainability. Microfinance programs that hold human rights objectives at their centernot poverty reductioncan help move people out of marginalization and attain wide-ranging social benefits. Such initiatives, especially in the form of revolving loans when controlled by local communities, can build solidarity. In countries or regions governed by oppressive regimes, the resulting cooperation can lead to changes in how communities and authorities interact. In places where the political environment makes it difficult or even dangerous to work with local communities on human rights initiatives,
Street vendors such as these reclaimed their livelihoods using revolving loans after the January 2008 post-election humanitarian crisis in Kenya.
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SEpTEmbEr 2011 MONDAY DEVELOPMENTS
Feedback
community-controlled microfinance can be a safe and unobjectionable entry point for working on additional issues. These programs can provide both an incentive and a shelter for communities to come together and they can enable local, national and international NGOs to work with affected populations. Services such as health and education, which have human-rights outcomes, can be linked successfully with microfinance programs. For example, in western Kenya, following the 2007-2008 post-election violence, a grassroots organization mobilized women who had been displaced and lost their livelihoods in the crisis. The womens participation in revolving loan funds helped them start small enterprises and gave them access to business training, counseling, family tracing and HIV testing. We have seen community-controlled microfinance programs serve as a basis for collaboration and empowerment in places challenged by political and ethnic rivalries. The multi-ethnic Kenya National Alliance of Street Vendors and Informal Traders managed revolving loan funds for over 1,400 of its members affected by the post-election violence, representing more than six ethnic groups. Through this
initiative, beneficiaries and other alliance members worked together to reconcile and build peace in the wake of the crisis. In Myanmar, amidst political strife and extreme poverty, over 50,000 people in more than 150 conflict-affected communities have initiated revolving loan funds that have enabled them to begin meeting some of their most basic needs. In the process of working together, people are confronting their common challenges. They have been able to circumvent middlemen by buying in bulk, offset teachers salaries and collectively negotiate with officials. Trust and reconciliation are increasing and communities are developing future plans. Dunford also writes that commercial microfinance institutions are reluctant to acknowledge the social value of micro-loans. But as we have seen, community-based revolving loans with economic growth linked to human-rights objectives can produce returns for marginalized communities as well as for investors. MD Ariel Jacobson, Senior Associate for Economic Justice and Gretchen Alther, Senior Associate for Rights in Humanitarian Crises, Unitarian Universalist Service Committee
Leaders Grapple with Rising Food Prices, Diminishing Food Security

It has been a turbulent year for global agricultural commodity prices and food security after more promising earlier prospects gave way to what the Food and agriculture organization (Fao) called increasingly worrisome outlooks and an escalation of international prices to levels not seen in decades. In may, the FAO food price index stood at a near historical high of 232 points. In June the Un international Fund for agricultural Development said the price increases had pushed an estimated 44 million more people into poverty. And in the Horn of Africa, persistent drought has exacerbated severe food insecurity for an estimated 12.4 million people in parts of Somalia, Kenya, ethiopia and Djibouti, displacing hundreds of thousands and causing countless deaths. It is heartening and unsurprising that addressing commodity price volatility (energy and agricultural) and bolstering food security are key French priorities for the November G20 summit in Cannes. G20 countries accounted for 54 percent of the worlds agricultural surfaces, 65 percent of farmland and 77 percent of global grain production in 2008. the French government intends to focus on four crucial areas at the summit: (1) improved regulation for commodity financial markets; (2) increased transparency for physical commodity markets; (3) better prevention and management of food crises; and (4) stronger hedging instruments to better protect the poorest populations against excessive price volatility. the global partnership for agriculture, Food security and nutrition, launched by president Sarkozy in 2008, will likely figure prominently in the discussions. Ample evidence shows the G20 is tackling global agricultural commodity price volatility and food security in an earnest, if plodding, manner. At the November 2010 Seoul G20 summit, leaders asked the FAO, the Organisation for economic Co-operation and Development and other international organizations to coordinate with key stakeholders to develop options for G20 consideration on how to better mitigate and manage the risks associated with price volatility of food and other agriculture commodities, without distorting market behavior, ultimately to protect the most vulnerable. the consortium submitted its report, price Volatility in Food and Agricultural markets: policy responses in early June before the first-ever G20 agriculture ministers meeting held in paris. the G20 agriculture ministers resulting Action plan on Food price Volatility and Agriculture created some laudable new programs that could improve transparency in agricultural commodity markets and the response to global food crises. For example, it announced the creation of an FAO-housed Agricultural market Information System to facilitate and improve the exchange of data on agricultural production, consumption and stocks. the ministers also agreed to remove export restrictions for food purchased for humanitarian purposes by the World Food programme. However, javier Blas of the Financial times echoed the sentiment of many civil society organizations noting the communiqu was watered-down on the key issues: the mandate to consume biofuels and subsidies on their production, and the [broader] use of export restrictions. Additionally, Frances call for better global regulation of agricultural commodity financial markets fell largely on deaf ears, with the final declaration lacking any specificity on how this should be done. InterActions G8/G20 task Force is publishing an updated G20 policy paper with fresh recommendations in the areas of agriculture, food security and nutrition. Samer Abraham, InterActions policy and advocacy assistant, contributed to this news item
MONDAY DEVELOPMENTS SEpTEmbEr 2011
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Progress of the worlds women

uN Women has released its report progress of the Worlds Women. It overviews the state of womens rights worldwide, mentions best practicesincluding the thuthuzela Care Centers in South Africa, which house criminal, legal, health and other services for rape victims all in one placeand makes the following 10 recommendations for further progress: 1. support womens legal organizations: Womens legal organizations step in where government-funded legal aid is limited, providing the advice and support that women need to pursue a legal case, to put a stop to violence, to seek a divorce or to claim land that is rightfully theirs. 2. implement gender-sensitive
law reform: Without a solid legal foundation, attempts to make courts more accessible to women, police less hostile to their complaints and other necessary reforms to the administration of justice are likely to founder. 3. support one-stop shops to reduce attrition in the justice chain: the justice chain, the series of steps that a woman must take to seek redress, is characterized by high levels of attrition, whereby cases are dropped as they progress through the system. As a result, only a fraction of cases end in a conviction or a just outcome. 4. put women on the front line of law enforcement: underreporting of crimes against women is a serious problem in all regions. Across 57 countries,
crime surveys show that on average 10 percent of women say they have experienced sexual assault, but of these only 11 percent reported it. 5. invest in womens access to justice: making justice systems work for womenwhether through catalyzing legal reform, or supporting legal aid, onestop shops and training for judgesrequires investment. 6. train judges and monitor decisions: Balanced, wellinformed and unbiased judicial decision-making is an essential part of ensuring that women who go to court get justice. 7. increase womens access to courts and truth commissions during and after conflict: Sexual violence as a tactic of warfare has been used systematically and deliberately for centuries.
8. implement gender-responsive reparations programs: reparations are the most victim-focused justice mechanism and can be an essential vehicle for womens recovery. 9. Use quotas to boost the number of women legislators: In countries where womens representation in parliament increases substantially, new laws that advance womens rights often follow. 10. put gender equality at the heart of the Millennium Development goals: the mDGs are interdependent and each one depends on making progress on womens rights. For more information on the project, and to download the full report or its executive summary, visit http://progress.unwomen. org/.
Contact us for further information: Kjaer & Kjaer A/S Groennemosevej 6 DK-5700 Svendborg Denmark Tel: + 45 62 221 111 Fax: + 45 62 224 422 www.kjaer.com info@kjaer.com
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Infobytes
FedEx continues to support transparency

InterAction is pleased to announce that Fedex has awarded additional funding to continue work on its Haiti aid Map through July 2012. the map, an online interactive tool that charts the location and activities of NGOs working in Haiti, was officially launched in January 2011 with Fedex support. It currently features close to 500 projects from 83 organizations, dramatically increasing transparency, facilitating partnerships and improving coordination among NGOs. using data gathered from the field, the map also helps donors and the public make more informed decisions about where to direct their resources. Haiti Aid map was developed in partnership with the U.s. Chamber of Commerces Business Civic Leadership Center (BCLC). explore the site at http://haiti.ngoaidmap.org
Solar innovations
A renewable and climate-friendly resource, solar energy is taking hold in developing countries more and more. people worldwide live near water sources that are contaminated with e. coli. A simple method to purify that water, Solar Disinfection (SODIS), already exists, but is tricky to monitor. put water contaminated with e. coli into a pet plastic bottle, set it in the sun for six to 12 hours depending on the amount of sun and the water is safe to drink. the problem is that, too often, people stop the process too soon
without realizing the water is still unsafe. For a competition run by the soDis Foundation, several groups have started researching simple solutions that are easy to manufacture and cost less than $5. One group used components that are in solar calculators to create an electronic indicator for whether the process was complete. they are now manufacturing a few hundred of the devices to begin testing in the field. For a more detailed description of the project, go to www.scientistswithoutborders.org and search for SODIS. One challenge health workers can face is finding a safe way to store vaccineswhich need to be refrigeratedwhen electricity is unreliable. A Danish company has developed a solar refrigerator, which runs while the sun is up and chills icepacks that keep vaccines cool after the sun sets. Because there are no batteries that need to be replaced, the expected lifespan of the device can be up to 20 years. the technology has been tested in Cuba, Indonesia and Senegal, and is now being installed in several locations in Kenya. For more information, go to www.trust.org/alertnet and search for Solar Fridge.
3. the death rate of a population: more than two people out of every 10,000 in a population are dying every dayaccording to prIs the World, this is four times the average rate in a food secure population. When all three of these factors are present, then a countrys governmentor, in the absence of a stable government, the united Nationswill declare a famine. For more information on the situation in the Horn of Africa today, visit www. interaction.org/horn-of-africa-crisis.
A new way of measuring hunger

With the hunger crisis in the Horn of Africa, the ability to measure hunger and malnutrition rates is more crucial than ever. two professors with the national Bureau of economic research (nBer), have released a paper with a new way to do so, which they say is more accurate than traditional calorie counts. A revealed preference Approach to measuring Hunger and undernutrition by robert t. jensen (uCLA School of public Affairs) and nolan H. Miller (Department of Finance, university of Illinois at urbana-Champaign), explains the staple calorie share (SCS) measuring system. traditionally, hunger and malnutrition have been measured by the number of calories a person ingests per day measured against the recommended calorie intake. that recommended intake, however, is a static number that does not account for age, gender, health, physical activity, or a host of other criteria that could affect the calories a person truly needs to function. Also, for various reasons, a person may not be able to absorb all of the nutrients or calories from the food they eat before it passes through their system, leaving them still hungry or undernourished. SCS works on an economic
principle. the paper defines staple calories as calories that come from the cheapest available food source, or staple food, such as rice, wheat or cassava. the poorest people will eat primarily from staple calories. As incomes rise, there is a point where people can afford to eat from more expensive calorie sources, such as meat. SCS tracks the amount of income that people spend on staple calories vs. more expensive calories. the greater the staple calorie intake, the higher the rates of hunger and malnutrition. You can search for the abstract on zunia.org, which includes a link to the full paper on uCLAs public affairs website.
New report on aid recipient feedback

CDa Collaborative Learning projects has released a new report, Feedback mechanisms in International Assistance Organizations. the report was motivated by the desire they heard from many people in aid recipient societies to provide feedbackand to hear from aid agenciesabout their efforts. In over 20 listening exercises conducted globally, people talked of how they were often asked to provide information during assessments, consultations, monitoring visits, or evaluations, but they felt that they had not been genuinely heard, let alone received a response. As a consequence, they believed opportunities were missed to share important feedback on the effect of aid efforts, agencies performance, and other important issues related to the accountability and effectiveness of international assistance. to read the report, go to http:// www.cdainc.com and click the News tab. MD
Correction: In Augusts Infobyte regarding the Alliance for International Youth Development, founding member Education Development Center was incorrectly referred to as Educational Development Center.
What constitutes a famine?

many areas are food insecure, but what turns that food insecurity into a famine? In Somalia today, two causes are a prolonged drought and a lack of a government able to support its people after two decades of political instability. Worldwide, there are three indicators used to measure when food insecurity tips into famine territory: 1. the breadth of food insecurity in a population: 20 percent or more of a population have extremely limited access to food. 2. the level of child malnutrition in a population: 30 percent or more of a populations children under the age of 5 are extremely malnourished.
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Nature of Development
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by Stephanie Cappa, Legislative Coordinator for International Development, InterAction
Uniting conservation and development efforts

n estimated 12.4 million people are in dire need of assistance in the Horn of africa, where another year of failed rains has created pockets of famine and widespread food and water shortages. the crisis is a stark reminder of the connection between human health and environmental security. Former Usaid administrator Henrietta Fore recently noted that the ongoing instability in pakistan is exacerbated by land and water disputes in africa, south asia and the middle east, food prices and availability have also played a role in sparking conflict. she concluded, streamlining our programs that assist countries with securing better access to food and water, protection from disaster and local stewardship of natural resources is critical.
Photo: Shutterstock.com
Conservation
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Conservation
by Beth Allgood, Campaigns manager, and Katie Miller, Executive Liaison, International Fund for Animal Welfare (IFAW)
Valuing Nature
nterActions The Nature of Development paper outlines some critical issues related to the complex relationship between poverty alleviation and ecological sustainability. It acknowledges that the environment is not one leg of a stool, but the very fabric into which our human community is woven. If the fabrics threads break under the strain of a growing population and increasing exploitation, human survival, particularly of the most vulnerable, will be jeopardized. Yet by focusing largely on capturing the economic value of nature, the paper leaves other critical values unaddressed. more fully accounting for the economic value of nature, while an important step in assigning responsibility for the costs of environmental degradation, is not sufficient to ensure the ongoing sustainability of the planet. Indeed many ecosystem components, including the untold millions of species that remain undescribed by science, might have no economic value to some, whereas others consider them priceless. Even the most sophisticated efforts to calculate the value of nature will involve judgments made by individuals, societies and governments. These human judgments are shaped by human values, which have many dimensions beyond the economic, including ethical, cultural, social and political. For example, the many passionate and global efforts to protect habitats, species and the welfare of individual animals point to a very different type of value, that of intrinsic value: the value of something for its own sake, independent of its worth to anyone or anything else. Species cannot simply be exchanged or replaced and extinction is forever. In Yunnan province, home of Chinas remaining 350 wild elephants, IFAW has worked closely with the government and local communities since 2000 to help elephants and people coexist on the land. microcredit loans enable farmers to develop alternative income generating schemes that do not compete with elephants for habitat. A community-wide early warning system alerts neighbors of elephants in the area and ongoing education programs help en-
sure safety and effective land stewardship without harming the elephants. participating villages, which once viewed elephants as a threat to their well-being, have come to take pride in protecting this fragile elephant population. If we recognize the ethical as well as ecological and economic importance of maintaining biodiversity, we should strive to avoid consumptive use when there are viable alternatives. When managed effectively, nonconsumptive alternatives can be among the most ecologically and economically sustainable means for humans to benefit from nature. As noted in Gaining Ground: In Pursuit of Ecological Sustainability, they also provide the opportunity to recognize and highlight the importance of other values such as aesthetic, cultural, educational, intrinsic, recreational, scientific, social and spiritual values.
even the most sophisticated efforts to calculate the value of nature will involve judgments made by individuals, societies and governments.
Whale watching, which is fast becoming the predominant use of whales in the 21st century, is nonconsumptive and thus inherently ecologically sustainable when managed and regulated appropriately. It is economically sustainablein fact it is potentially a huge economic boon for most developing coastal communities worth upwards of $2.1 billion annually. And it is ethically sustainable because the entire industry is predicated upon a human appreciation of whalesa recognition of the intrinsic value of these beloved giants of the deep. The Nature of Development places ecological sustainability at the heart of the sustainable development model. but a more holistic understanding that addresses ethical, social and other often overlooked strands of natures value will be critical to safeguarding the ecological fabric into which our species and legions of others are woven.
International conservation and development actors are mobilizing to do just that. As global natural resource degradation combines with more extreme weather, development experts are increasingly focused on eliminating extreme poverty while restoring the natural resource base. And as the global population surpasses 7 billion this year and perhaps rises to 10 billion by this centurys end, international environmental organizations are increasingly focused on human development. Such integration would have profoundly positive results. Preserving functional ecosystems saves money, as it is almost always less expensive to preserve a critical ecosystem service (such as pollination, soil maintenance or fresh water) than to restore or replace it. Conserving ecosystems also ensures that gains in poverty alleviation, food security and other development fundamentals can be sustained over the long term. And conservation can prevent catastrophic loss from natural disasters caused or exacerbated by ecosystem decline and climate change. Finally, effective development and natural resource management supports jobs in both developing and developed countries. With nearly half of all U.S. exports purchased by developing country markets, the U.S. economy and U.S. jobs depend on trade with developing countries. Yet 54 percent of the developing worlds workforce is employed in agriculture, fisheries and forestry, sectors that directly depend upon the health of natural resources. Preserving the global resource base is imperative for the economic health of both developing and developed economies. With this in mind, InterAction convened a series of discussions in early 2011 to chart a common path forward for the conservation and development communities. Participants from more than 30 organizations took part, discussing key barriers to integration as well as opportunities to more effectively coordinate policy and programming. The results are captured by author Laurie Mazur in InterActions new publication, The Nature of Development: Integrating Conservation and Development to Support Sustainable, Resilient Societies. The conclusion is simple: An integrated approach to conservation and development can yield better outcomes for both. Yet the real-world policy and program barriers to integration are significant. Three of the most important are:
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Access to safe water is a challenge in the developing world.
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2011 Vestergaard Frandsen
Conservation
Siloed sectors. The environmental and development actors within NGOs, foundations, government and Congress still largely remain in separate silos, conceptually and practically. Structural flaws in resource management. Around the world, effective resource management is a major challenge. Too often, critical decisions about the environment are made without accountability, transparency or participation by those most affected, such as women, indigenous people, ethnic minorities and the poor. Incomplete measures of success. Current measurement methods do not capture the complex nature of todays environmental and development challenges. For example, governments and development agencies measure increases in food production, but not the health of ecosystems that underpin those gainsor whether those gains are sustainable over the long term. There are great organizational, governance and accounting challenges, but also clear means to address them: Effective natural resource management. Improved natural resource management will require new modes of decision-making that involve disenfranchised groups, the removal of incentives that encourage natural resource depletion and the promotion of resource rights. New and flexible partnerships. Donors, governments and practitioners need improved cross-sectoral communication and new alliances among environmental and development actors as well as with nontraditional partners, such as womens organizations, health advocates and businesses. Enhanced measures of success. An integrated approach requires more accurate and sensitive measures of human wellbeing and environmental health, including: comprehensive analyses of environmental and social assets and challenges, integrated accounting methods, new benchmarks of success, and shared information on best practices. Instead of creating new bureaucracies, increase the effectiveness of existing efforts.
continued on page 37
External view of the new green facility for Safeer Childrens Center.
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Photo: Khalid Hussein
environMentaL ConstrUCtion
In the Palestinian Territories, environmentally friendly construction is taking root.

by Kari Jorgensen Diener, Senior Knowledge management Specialist/LEED Green Associate, and Anjad Hithnawi, research and Capacity building Coordinator, CHF International
green Building:
a Window of opportunity
T IS COMMONLY ASSUMED THAT green building is a high priced construction technique, a luxury affordable only to the wealthy and elite. However, green building techniques are actually comparably priced to conventional methods and also bring a host of other benefits in terms of reducing carbon emissions, water pollution, running costs and negative impacts on human health. Like many developing countries, the Palestinian Territories are experiencing rapid population growth, urbanization and an increasing demand for energy. These demands are coupled with issues such as water scarcity, desertification, deforestation and limited public sector resources. Recent reports from the Intergovernmental Panel on Climate Change indicate that in the coming decades, the Middle East will be the region most affected by climate change. Although the Middle East as a region contributes a small amount to global greenhouse gas emissions (only around 5 percent) the regions percentage of total emissions is on the rise. Since 1990, emission rates have increased 150 percent and this amount is expected to double by 2050. Sustainable development is further complicated by the complex political context that is driven, in part, by scarce resources. Buildings contribute to 40 percent of energy consumption and 30 percent of carbon emissions worldwide. Due to the major impact of buildings on the environment, the United Nations Environment Program has stated that the building sector has the greatest level of potential for drastic emission reductions. This presents a window of opportunity for the development community to positively impact sustainable development through changes in the way we build.
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environMentaL ConstrUCtion
Building Better, Building Green

Green building aims to achieve a triple bottom line of environmental, financial and social benefits. It begins with sustainable site selection and integrative, collaborative design processes to promote: reduction of energy usage; water conservation and stormwater management; use of sustainable materials in construction and operations; and improved indoor air quality. Green building leads to new jobs and creates a new market for environmentally friendly material production that places an emphasis on local production and innovation. It can also raise property value and attract buyers and renters. Moreover, green buildings promote increased employee productivity due to improved health of occupants.
In the Palestinian Territories, typical forms of new construction, operations and maintenance strategies result in negative impacts on the local environment. Moreover, nascent urban planning policies and limited enforcement of environmental laws and regulations have resulted in ad hoc construction. Green spaces are replaced by residential and commercial buildings with poor environmental performance. A rapidly increasing demand for energy, which is growing 8 percent annually, adds to dependence on nonrenewable resources. These issues, coupled with inadequate sanitation, drainage and solid waste management systems, present serious challenges. the cost debate One of the major obstacles facing green building initiatives in the Palestinian Territories is the misconception of cost. Many established studies have proven that there is no significant difference in the cost of green buildings compared to traditional buildings. Green buildings can be built with small or no added costs and within the budget range of similar conventional buildings. Building green may also include the use of passive building techniques that do not automatically assume the application of high tech solutions alone. Moreover, any added costs are typically recovered in long-term savings in the operations of buildings. For example, at the Safeer Childrens Center, a recently constructed green building, the centers Chairman, Isa Hindi stated, From the morning until just before sunset, there is no need at all for lighting or the use of air conditioning in the summer because of the design and the large size of windows. In its one year of operation, the centers expenses for water and electricity have been 50 percent less than similarly sized buildings in the same area. This drastic reduction is due to the green building techniques used, ranging from a grey water treatment system installed at the site to low-cost sun-shades.
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opportunities and challenges Given the fact that the Palestinian Territories receive one of the highest levels of aid in the worldmore than $17 billion since signing the Oslo Accords in 1993, of which a large proportion goes to infrastructure fundingthere is great potential for integrating new sustainability approaches. Green building offers a new way for infrastructure planning and implementation, beginning with site selection and extending through to construction, renovation, adaptive reuse of existing structures and the operation and maintenance of buildings. Most importantly, green building is not a foreign concept to the region and much can be learned from the environmentally responsive elements of traditional Palestinian architecture. Traditional construction strategies enabled buildings to reach required thermal comfort levels in an arid/semi-arid area and promoted compact and dense community development. Historically, local building orientation and the careful design of windows, overhangs and insulation increased solar gain in winter, reduced buildings heat in summer and maximized natural ventilation and lighting. Moreover, buildings were designed toward the inside to shield from bright sunlight and incorporated inner vegetated courtyards. These courtyards generated a cooler microclimate, enhanced fresh air circulation and ventilation, provided outdoor shaded areas and maximized day lighting gains. In bigger buildings, solar chimneys (wind towers) were often used to aid in heating and cooling. Although methods of traditional Palestinian building promote natural heating and cooling for structures, the application of green building design has been limited. However, with the addition of green building curriculum into university courses in Palestinian engineering faculties, local expertise in
both traditional and up-to-date green building approaches is growing. During the 2010-11 school year, courses ranging from Use of Solar Energy to Environmental Systems in Architecture were offered at major Palestinian universities. Contractors exposed to new techniques are adopting new measures in construction efforts. As local material suppliers see demand growing, their green product range is expanding. In the past five years, the West Bank has seen many new businesses starting up with products ranging from geothermal services to grey water treatment systems. As government officials become more aware of the public sector benefits of green building, a legal framework and key incentives for investors and builders are slowly taking root. In November 2010, Prime Minister Salam Fayyad wrote in an opinion piece for The Christian Science Monitor: In Palestine, we are increasingly recognizing the importance of integrating green construction practices into our vision for building a viable, secure state. We must consider not only human and economic security, but in order to ensure these, we must also consider environmental security. Without ensuring that we proceed to ameliorate the effects of climate change, we cannot be assured that our efforts in construction of towns, homesand a statewill not be undermined. As demonstrated in the Palestinian Territories, climate change is a real and ongoing challenge affecting developing countries. Infrastructure development initiatives should look to green building to reduce the impact of buildings on energy consumption and climate change while also improving human health, the ability of communities to sustain construction projects and the potential for new job creation in a growing global sector. Green building does not necessarily mean using a more expensive form of building; on the contrary, it is cost-effective in pure economic terms. Green buildings often draw from traditional architecture and construction techniques, which facilitates acceptance. Potential challenges may be overcome with awareness, local skills development and governmental incentives and support. With its many advantages to human and environmental health and the economic bottom line, green building should become the standard for infrastructure initiatives implemented by the international development community. MD
CLiMate
Climate Change:
Bringing governments on Board

Leaders must prepare today for the environment of tomorrow.
by Manish Bapna, managing Director, and Polly Ghazi, Writer-Editor, World resources Institute
HE WORLD IS WITNESSING A SERIES OF WEATHER events so extreme they are at the limits of modern human experience. The record-breaking Pakistan floods and Moscow heat wave of 2010 were followed this year by a torrential downpour that swamped an area of Australia the size of France and Germany combined and by Koreas greatest snowfall in over a century. These and other disasters have already tested the capacity of affected developing countries to cope and thrown development efforts off course. Yet more frequent and intense events are only one risk vulnerable countries and their development partners must prepare for as climate change accelerates. Others include heightened climate variabilitysuch as large swings in rainfall patterns that can affect water supply and crop productionand longerterm change, such as sea level rise, which threatens many coastal cities. Planning for and adapting to these changes must quickly become a central priority of national governments. The new World Resources Report (WRR) 2010-2011: Decision Making in a Changing Climate calls on governments to start now to incorporate climate risks into decision-making processes for critical sectors such as urban development, agriculture, energy, water and forests. Unless future development is climate-resilient, the report warns, aid efforts may become ineffective and development goals missed. Making this happen is, of course, much easier said than done. For public officials in low-income countries, pressing priorities such as hunger and basic healthcare will often outweigh addressing climate change risks, which are seen as longer-term problems. And many climate change adaptation initiatives are still in their infancy. But there is also good news. For while there is much uncertainty about exactly how climate impacts will unfold, we also know a great deal
about investments and activities that can support development while also promoting climate resilience. And often these policies do not require expensive new technologies or additional spending. Produced by the World Resources Institute, the UN Development Programme, the UN Environment Programme and the World Bank, WRR 2010-2011 focuses on how governments, particularly in developing countries, can integrate both shortand long-term climate risks into national policies and plans, boosting the resilience of communities and ecosystems. The report provides guidance on five key elements of effective adaptation decision-making (public engagement, decision-relevant information, institutional design, tools for planning and policy-making, and resources) and draws on over 100 expert contributions from more than 30 countries.
For public officials in lowincome countries, pressing priorities such as hunger and basic healthcare will often outweigh addressing climate change risks.
Illustration: scusi0-9, Shutterstock.com
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engaging the public Unfortunately, many developing countries Weather Monitoring Stations Public participation in decision-making prolack the basic infrastructure and capacity needed cesses is an important asset for governments as to supply this information. Weather monitoring they seek support for adaptation policies and To plug this gap, countries and donors urgently stations collect data set priorities that inevitably involve trade-offs, need to invest in on-the-ground weather monion precipitation, winners and losers. toring stations and other data collection systems. temperature, humidity, Engaging the most vulnerable members of African nations on average maintain eight times wind speed and fewer weather monitoring stations than the minisociety is also essential for adaptation actividirection, and soil ties to respond to actual needs on the ground. mum recommended by the World Meteorologimoisture. As of 2003, For example, in Bangladesh, national disaster cal Office. In the province of San Ignacio, Peru, there were 1,152 management officials, assisted by local Disasone lone meteorological station operates in an functioning World ter Management Committees and NGOs, have area of 5,000 km2 spanning altitudes between Weather Watch stations used public participatory methods to evaluate 460 and 3,800 meters above sea level with widely in Africa - one per climate impacts and vulnerabilities in half the varying climates. 26,000 sq km. countrys 64 administrative districts. Drawing Engaging citizens in data collection efforts on these assessments, communities and officials can pay dividends. For example, farming areas have agreed to risk reduction action plans that in several African countries gather information typically include such activities as agricultural on local rainfall that is fed into meteorological risk reduction measures, disaster preparedness agency forecasting services. Such information training and raising roads. can inform both short-term needs (e.g. helping Citizens can also be a great, practical asset as countries prepare for farmers adjust their crop rotations) and longer-term adaptation measures. climate impacts. For example, Chinas government established farmers To distribute information, video, radio, mobile phone and satellite organizations and water users associations to engage rural populations data are being used in pilot projects with promising results. For example, in water saving engineering measures like deepening ditches as part Zambias national meteorological agency is disseminating local climate of agricultural adaptation activities. and weather information to remote farming communities via SMS texting. Incentives, both financial and otherwise, can provide useful carrots However it is transmitted, information should always be translated to engage a skeptical or indifferent public. For example, in Mali, bicycles into local languages and made easy to access for use on the ground. have been given to citizens taking part in government-led efforts to use rainfall gauges to record and transmit local precipitation data that farmers Designing institutions for a changing climate then use to guide crop planting. Until now, governments have mostly viewed countering climate change Innovative methods of engagement, such as games that explain solely as a matter of environmental or sector-based policy. This fails to climate risks and scenario exercises that explore possible futures, can address the wide-ranging nature of climate change impacts across society also involve the public in choosing adaptation options. One customized a reality that requires a coordinated approach among national-level agencard game, Weather or Not?, used by the Red Cross to explain likely cies and between all levels of government. Ministries on the frontline of local risks from extreme events to fishing communities in Senegal led climate impacts include energy and agriculture, water and forestry manageto a new early warning system for the coastal area. ment and meteorological and disaster response agencies. In addition, the engagement and leadership of powerful planning and finance ministries information needs for adaptation is particularly critical to ensure climate risks are integrated into national Closely allied to public engagement is the need for governments to economic development and poverty reduction strategies. collect and deploy timely and accurate information to serve adaptaEstablishing an over-arching body to coordinate climate adaptation tion needs. In so doing, ministries and donors need to focus both on activities can strengthen countries efforts. But this, too, is often lacking. A what types of information are required and how this information is 2010 UNDP survey of 32 developing countries found only 15 had estabcollected and distributed to those who need it. lished inter-ministerial committees or councils to govern climate issues. For climate change adaptation, decision-relevant information is not just (or even primarily) about climate information. Collecting Deploying tools information on local land use, poverty rates, health, water and energy Tools have a vital role to play in climate adaptation decision-making, supply and transport can be just as important since the severity of arming policy-makers to assess risks and decide among policy options. climate impacts depends as much on a communitys vulnerability as Such tools include maps, modeling, scenario exercises and tools that it does on rainfall or temperature changes. While this sounds like a forecast likely changes due to climatic shifts. Often, generic decisiontall order, often this information is already available but spread out making support tools already commonly used in developing countries amongst various government offices. can be customized for climate change. Environmental assessments and Such information should be combined with climate-specific infor- economic analyses, for example, can be used in this way. mation such as temperature and rainfall records, which can show Adaptation-specific tools being piloted by countries include hazard averages, extremes, trends and cycles, and from which public officials maps and scenario exercises that policymakers can use to play out and scientists can draw conclusions about where droughts or floods decisions under a range of possible futures. Hazard maps created in will likely occur and what impacts they will have. continued on page 38
eConoMiCs
Fatuma Mohamed enrolled in an Education Development Center workreadiness and entrepreneurship program in Garissa, Kenya, where she learned the nuts and bolts of running a business. A small grant helped her open her own beauty salon.
Building economic Bridges

Key linkages between economics, democracy and governance affect economic growth.
by John D. Sullivan, Executive Director, Center for International private Enterprise
Photo: Karl Grobl, for EDC
HE DEBATE ON THE BEST STRATEGIES TO GENERATE economic growth remains as relevant as ever, especially when it comes to the nature of political systems worldwide. What we have learned over the years is that to sustain inclusive economic growth over extended periods of time, it is essential that countries look more closely at the importance of democratizing reform and governance processes. In other words, democracy plays a key role in a countrys socio-economic development and economic reform is inseparable from the surrounding political climate. There have been numerous studies, debates and conferences on the relationship between democracy and economic growth. Hard data is inconclusive, showing that both democracies and authoritarian regimes can generate economic growth. One must look beyond macro-level numbers to understand the relationship between socio-economic development and political reform. For example, while different political regimes can generate economic growth, the nature of that growth is quite different. There seems to be a growing consensus that for economic growth to be sustainable over long periods of time, it has to be: inclusive; based on the rule of law; relatively free of corruption, especially systemic corruption; and grounded in prudent macroeconomic policy. inclusivity Regarding inclusivity, it is important to keep in mind that GDP growth figures or related numbers do not tell the full story of development. Economist Hernando de Soto began exploring the informal
sector in his native Peru in the early 1980s. He demonstrated that as much as 35 to 40 percent of the economic activity in the country was trapped in an underground informal sector, blocked from entering the mainstream market by a wall of red tape. Although the issue of informality has gained prominence, successful efforts to include informal entrepreneurs in the mainstream economy are still few and far between. Some research suggests that the size of the informal sector has grown significantly over the past several decades to as much as 50 to 60 percent in some key emerging economies. The Arab Spring is also a stark reminder of the significance of the informal sector and the political implications of the lack of economic inclusiveness. In fact, it was the frustration of a Tunisian informal street vendor, Mohamed Bouazizi, that set off a series of revolutions across the Middle East. The challenges he faced are something that millions of entrepreneurs in countries around the world relive every day; for instance, he could not rely on the legal system when police officers confiscated his goods. For growth to be inclusive, it needs to reach disenfranchised groups that remain locked out due to cumbersome bureaucratic procedures and absence of market institutions such as property rights and the rule of law.
some research suggests that the size of the informal sector has grown significantly over the past several decades to as much as 50 to 60 percent in some key emerging economies.
the rule of law The rule of law needed for sustainable economic growth includes property rights, contract enforcement and a host of other factors that depend on a healthy, functioning and independent judiciary and a sound legal system. Nobel laureate Douglass North demonstrated this some years ago in his work on new institutional economics. He famously noted that the whole history of economic growth
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can be summed up in one concept: moving from systems of personal exchange (where you can only do business with people you know and trust because the system relies on self-enforcement) to systems of impersonal transactions where you can do business at a distance with strangers. In other words, think of the difference between markets where people trade goods for cash in person and complex trading systems such as eBay or Amazon. Making eBay or Amazon a reality requires putting in place the key institutions mentioned above. If you cannot be assured that you can enforce your contract through a court system, an alternative dispute resolution system or some other mechanism, that uncertainty becomes a barrier to doing business and it keeps economic growth at relatively low levels. As North and others point out, to create a sustained rule of law you really need to have a democratic system. Corruption Sustained economic growth requires an environment relatively free of corruption, especially systemic corruption. Throughout the world, most agree that corruption hurts development in all sectors of the economy. One popular perception is that business is not interested in fighting corruption. But we have seen that this is not the case. Talk to any representative segment of the business community in emerging economies and you will find a growing awareness of the effects of corruption and the barrier it is to business development. But how can corruption be dealt with successfully?
One approach is to work with chambers of commerce, business associations, think tanks and others to create collective action frameworks. These are membership associations and other organizations where people can collectively pursue economic reforms to reduce corruption through actions such as reducing the amount of red tape. Also, it provides opportunities for citizens and the private sector to join together in self-defense to fight against extortion tactics such as the frequent inspections that plague firms (especially small- and medium-sized ones) in developing countries. In addition, we have to look at the specific country regulations and the degree of decision-making discretion that government officials have. Working with the Center for Liberal and Democratic Studies (CLDS) in Serbia, for instance, we found that in the customs authorityoften one of the most corrupt institutions in emerging marketsmultiple, overlapping bands of customs duties and the broad discretion that customs officials had to apply regulations were at the heart of the corruption issue. CLDS worked with the Serbian government to propose a series of reforms to simplify the customs authority and to make the registration of each individual transaction that occurred mandatory. As a result, corruption was reduced. prudent macroeconomic policy Prudent macroeconomic policy is absolutely key. Steven Radelet, now with USAID and formerly with the Center for Global Developcontinued on page 34
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sHaping agenDas
What about Democracy and governance

Creating deep relationships to advance change.
by Sam Daley-Harris, Founder, rESULTS Education Fund and the microcredit Summit Campaign
Here at Home?
W
Illustration: rudall30 and irish1983/Shutterstock.com, collage by Chad Brobst
HEN MOST PEOPLE READ A Monday Developments article about democracy and governance they likely think about institution building in the global South, the Arab Spring or Iraqi voters leaving polling places with ink-stained fingers. But what about democracy and civic engagement here at home? How are we doing on that front and why do the answers to those questions matter so much? Think about an issue that your institution has taken on. Perhaps it is funding for child health or basic education or agriculture. Can you imagine dozens of members of Congress calling to get your input on those issues? Can you imagine dozens of editorial writers calling to get your thoughts on an editorial they are writing about why humanitarian foreign assistance programs are so vital? Can you imagine this happening? Of course you cant. But whether you can imagine it or not, I say that it is not an impossible dream because Ive seen some of these things. My basic proposition is this: Just as there are people in the world who are hungry
for food and desperate to get an education for themselves or their children, Americans are hungry to have more meaning in their livesto live lives that truly matter. I would also venture to say that all Americans want this, but only a small number are awake to this desire. The good news is that many of those who know they want to make a difference in the world are your own donors. They truly would like to light up their members of Congress and inspire their local media on the issues that your organization cares about. But, and heres the rub, citizens are thwarted by two major impediments: (1) feelings of hopelessness and inadequacy about making a difference as an advocate; and (2) an inability to find a structure of support that will help them through their despair and truly empower them to make a difference. They are seeking a structure of support that can coach them through transformations like these: from I dont make a difference to I do make a difference and from I cant fight city hall to I am city hall. I know this still sounds far-fetched so let me
get to where you come in. If your organization has 300 U.S.-based staff or 100 or even 25, could you see assigning just one of those staff to identifying and empowering those within your donor base who want to go deep with their democracy and make an even bigger difference with their money and their voice? You must understand, however, I am not talking about a staff member who can help a cadre of stakeholders know the name of their member of Congress, how a bill becomes law or what email message to send to Congress. It is a much deeper lesson plan than that. I am talking about an inquiry more closely related to human development seminars or the most profound staff retreat you ever experienced. I am talking about volunteers having an interaction with your organization that will allow them to get in touch with their lifes purpose and a personal commitment to moving toward it. Here are some of the components of the structure of support that gives it its depth. This structure for grassroots engagement includes a commitment to several things. Breakthroughs For a citizen to go from not knowing the name of their member of Congress to having a deep, trusting relationship with them requires a series of breakthroughs; it requires moving out of your comfort zone. That is essentially the definition of a breakthrough: seeing something that seems difficult or impossible, having some discomfort in taking it on and then, with coaching and support, going through that comfort zone to experience the joy and accomplishment on the other side. These breakthroughs can happen with a member of Congress, with an editorial writer, with other leaders in the community and with oneself.
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sHaping agenDas
The latest issues and trends in international development and humanitarian assistance
the commitment is not so much to having an editorial writer or member of Congress say yes to every request, but to building a deep, trusting relationship.
engaging others Engaging other community members in being empowered volunteers is part of the structure of support. If I invite a friend to a meeting there is always the fear that they will say no or that they will come and see this as a useless activity. When volunteers become senior to that fear, when the commitment to the purpose and vision is greater than the fear of rejection, then big things can happen. Building relationships When an op-ed is selected for publication, it has less to do with the quality of the op-ed and more to do with the relationship one has developed with the op-ed editor. Of course, timing and quality are important, but I would rather have 10 people who have great, trusted relationships with op-ed editors pitch a good op-ed rather than send a great op-ed to 10 editors with whom there is no relationship. So the commitment is not so much to having an editorial writer or member of Congress say yes to every request, but to building a deep, trusting relationship. Hearing no from a member of Congress early on should be seen as just one step along the path to building a great relationship over time. Being vulnerable Showing a moving video or reading convincingly an excerpt from an emotional article to a member of Congress is more important than just sharing information. The goal is to tap into their humanity and create a deeply memorable moment. But people shy away from being vulnerable, especially with those in positions of power. However, a willingness to be vulnerable is essential to having breakthroughs, engaging others, building powerful relationships and, ultimately, success. Let me share a few specifics about this structure of support: You must have someone on the road speaking powerfully to groups in order to identify volunteers who want to take on this level of commitment and personal growth. The volunteer groups should have at least two meetings a month. One should be a national conference call committed to inspiration and empowerment with guest speakers, a designated action for the month, an accompanying action sheet and an opportunity to practice being articulate. The other session should focus on planning meetings with members of Congress, calls to editorial writers and outreach meetings to expand the local group. The grassroots advocates should receive packets to take to editorial writers and other written materialsboth informational and inspirational. Of course this is just a glimpse of what is required for having breakthroughs with Congress and the media. I began using these strategies in the early 1980s. After the volunteers generated 90 editorials in 1986 in a successful campaign to triple the Child Survival Fund from $25 million to $75 million, UNICEF Executive Director Jim Grant sent a hand-written note saying: I thank you in my mind weekly, if not more often, for what you and your colleagues are accomplishingbut I thought I should do it at least once this year in writing. So I ask again: What if 1 percent of your members were seriously engaged in making the case for international development to their members of Congress, the media and thought leaders in their communities? What if they went far beyond mouse-click advocacy and committed themselves to creating champions in Congress and the local media for the end of poverty and your institution created a profound structure of support to help make that happen? What could result from such actions? Wouldnt it be interesting to find out? MD In 2012 the author will launch the Center for Citizen Empowerment and Transformation. He will take your comments and questions on this article beginning September 1 at http://blog. interaction.org/
Monday Developments Magazine provides in-depth news and commentary on global trends that affect relief, refugee and development work. MD also features new resources for humanitarian workers, professional growth opportunities, upcoming events and employment listings.
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guarding the guards
Governance guidelines as tools for democratization.
by Kate Steger, Communications and Knowledge Exchange Coordinator, management Sciences for Health (mSH)/Kenya
Indeed it has been said that democracy is the worst form of government, except for all those other forms that have been tried from time totime.Winston Churchill
t
Photo: Kate Steger, MSH
HIS PAST SUMMER, WITH THE BIRTH OF SOUTH SUDAN coming on the heels of the Arab Spring, the winds of change could be felt blowing across the African continent. To see people unite in a determined and collective effort to throw off the chains of oppressionwhether through acts of mass demonstration like those in Tahrir Square or at rural polling stations sometimes accessed at great personal riskis always inspiring and it is easy to get carried away with optimism. But Churchills somewhat cynical observation acknowledges the complex realities of democratic societies. They are imperfect, dynamic systems created and run by flawed individuals who generally require the tedious bureaucracy of governance to keep them in line. In Kenya, a new constitution was ratified and promulgated last year after election abuses in 2008 caused widespread uproar and violence. Kenyas civil society played a major role in demanding constitutional change and continues to act as a watchdog in the implementation process. But constructively engaging an active civil society in the
reorganized government will require policymakers to strike a delicate balance between the need for inclusiveness and the need for effective and efficient operations. That may not be easy. One of the main tenets of the new constitution is the decentralization of authority and resources to support more community-based ownership and involvement. Next year, as part of this process, the country will change its current provincial organization to a countybased structure. At the same time, Kenyas health sector, divided during the 2008 political turmoil into the Ministry of Medical Services and the Ministry of Public Health and Sanitation, is meant to come together again under one Ministry of Health while also devolving certain governance powers to the county level. Dr. Goderick Onyango, provincial director of medical services in Western Province, says this process is slow and not without problems, particularly when it comes to things like disaster management or immunization programs where, he says, You must have some coordinating level higher than the county. Onyango also predicts that, given the geographic and economic inequities in the country, managing the human resource capacity for health facilities at the county level will be challenging unless the central Ministry continues to play a role. Nevertheless, Onyango supports the empowerment of communities and their engagement in the management of public hospitals and health facilities. Hospital management committees, which function as hospital boards, are already required to include members from civil society and faith-based organizations. He says they help to moderate things like fees levied against the patients. Theyll come and tell you, No, this is high, the women in this area may not be able to afford
theyll come and tell you, no, this is high, the women in this area may not be able to afford this, the children need to be treated for free, dont charge anything.
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this, the children need to be treated for free, dont charge anything. Representing the needs of their specific community to hospital staff is part of what these committee members are expected to do. Still, there is inevitably a bit of push and pull in the process. Most of it involves money. Rashid Nasoro is a community member and retired accountant who chairs the hospital management committee at the Western Provincial General Hospital. He says there is an assumption that these management committees just rubber stamp budgets submitted by hospital staff. If youre going to continue to bring numbers for me to approve and you dont expect me to know what youve done with the money before and whether it did what you requested to do, if youre not expecting those questions, do I even have a role to play? he asks. On the other hand, the hospital management teams, made up of the senior hospital staff, argue that committee members have occasionally exceeded their oversight role and tried to interfere with rather than facilitate hospital management activities. In the name of protecting public funds from real or perceived corruption, this kind of interference can create a fear of transparency and an environment of suspicion and disorder, which erodes rather than promotes community confidence and exacerbates staff retention and recruitment problems. New guidelines are meant to address issues like these and they seem to be helping (see box). But while Nasoro appreciates the clarity the guidelines have provided, he also notes there are more problems yet to solve. For one thing, he says, members of hospital management
Guidelines for clarity; guidelines for empowerment

In June, as a sign of the health sectors serious commitment to building the relevant management capacities at the community level, the ministry of medical Services launched the Governance Guidelines for Hospital Management Committees. With funding from USAID, the mSH Leadership, management and Sustainability program in Kenya worked with the ministry in developing the guidelines, training the provincial trainers and producing a national roll out plan and budget. After attending a training session on the guidelines, community member rashid Nasoro noted, The core functions of the committees have been spelled out. The members know what their roles should be, and theres actually a distinction between what the hospital management committees should be doing as against what the hospital management teams should do.
committees, even the ones from the community, are not saints. His concern is that corruption can cascade to the community level along with the devolution of authority. How the committees will be asked to report to the central ministry and how they will be held accountable still has to be determined. Borrowing a little of Churchills cynicism, Nasoro says, You need a guard to guard the guards. MD
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viDeo tips
The author interviews a rickshaw puller on the street in Calcutta, India.
Bringing the story Home

Practical tips for creating powerful videos.
by Ryan Hill, Owner and Founder, Still Life projects, LLC
technical skills, the most important skill to develop is a sense of story. Before you can connect with an audience, it is important to think about your video as a narrative and locate the story arc in your organizations work. A good story has a beginning, middle and end. Beyond that, there are a few additional elements that make for a great story. In their classic book, The Tools of Screenwriting, David Howard and Edward Mabley boil the basic story arc down to the following elements: The story is about somebody with whom we have some empathy. This somebody wants something very badly. This something is difficult, but possible, to do, get or achieve. The story is told for maximum emotional impact and audience participation in the proceedings. The story must come to a satisfactory ending. I was recently in India to produce a short piece for a client who provides education to children in the slums of Calcutta. There were several ways we could have approached the project, but our first step was to meet potential characters and look for the strongest story arc we could find. Many rickshaw pullers live in the community where our client is working. Our character Arjun would likely grow up to be a rickshaw puller like his father, but instead he has a chance to go to school and is now hoping to be a doctor someday. Rather than start with the program and talk about the impact, we started with a strong character and worked any relevant information around that story arc. To read more about the decisions we made and to view the final piece, visit http://stilllifeprojects.com/india
Photo: Still Life Projects, LLC
KNOW HOW FRUSTRATING IT CAN BE TO HOLD A VIDEO camera and have no idea what to shoot. I was once asked to make a short video for a nonprofit doing work in Nicaragua, and because I thought their work was incredible, I assumed that telling their story would be easy. My client needed a video for fundraising but was unsure what should be in it and I had no idea where to start. I foolishly thought that the more I shot, the easier it would be to edit. By the end I of my trip I had loads of random and unrelated footage. As I tried to sort through it and start editing, I realized how many things I should have thought about before I began shooting in the first place. With the increased accessibility of video cameras and editing systems, as well as outlets like Facebook and Vimeo, there is a higher demand than ever for content. Lacking funds to send film crews overseas, organizations often turn to their own employees to create the content they desperately need. Experience has taught me why my first projects were so difficult: What I really needed when I began shooting and producing was some clear direction. If you find yourself needing to create a short video for an NGO, you may be able to benefit from the lessons Ive learned over the years. What will make my video great? A great story. Story is the most important ingredient of any video, no matter the length. While many amateur filmmakers think they need better
While many amateur filmmakers think they need better technical skills, the most important skill to develop is a sense of story.
How do i know what to shoot? Once you have understood the elements of your story and have a plan for the story arc, the next step is to figure out what you will shoot while you are in-country.
viDeo tips
Create a shot list. The best advice I have received is to think about each project as a silent film. Ask yourself what you would shoot if you were not able to use any audio in your story? As you make a list of what shots you would need to tell the story you are creating your shot list. Shoot long interviews. Thankfully, you arent making a silent film and you will have the chance to interview your characters. The longer and more thorough your interviews are, the easier a time you will have while editing. Dont just skim over the information you needfocus on moments and details in your interviews. The viewer will know that the ARV (antiretroviral) treatment is beneficial for an AIDS patient, but what was the moment like when the doctor told your character that the treatment was available? How did your character get to the hospital that morning? What was going through his/her mind on the way to the hospital? The more details you collect in your interviews, the more tension you will be able to build in their story and the better your audience will connect with your characters. Do some of the interview while your character is doing an activity. Rather than save all of your interview questions for one long sit-down interview, think about asking your character some of your questions in the environment where they live and work. If your character works with youth leadership training, ask them some interview questions while they are at a youth program. Dont worry if it seems a little chaotic. The more we see them doing the things they are talking about, the more believable they are and the better idea we have of what they actually do.
Shoot your characters in real situations. The best way for a viewer to learn about your character is to watch them interact in real situations with real people. It is time consuming to do this, so often in the field you will need to arrange for these situations to happen. When I was in Moshi, Tanzania, filming at a clinic, we met Betha, who is a community health worker. She was 23 years old and HIV-positive, yet returns to the hospital to help others who are starting ARV treatment. We had finished an interview with her and taken some shots around the hospital, but we wanted to see her counseling some patients. So we arranged for her to meet with a mother and her baby. That scene allowed viewers to watch Betha at work, to see how well she interacts with the patients; it also added emotion to a scene that otherwise would have been mostly interview. To see how we used the scene visit http:// stilllifeprojects.com/tanzania. Hold your shots. A mistake I made early on was to think that once I had found and framed a pretty shot, I could move onto the next one. I didnt realize how long I needed to hold the shot before I was creating something usable for the editor. A good rule is to count to ten slowly once you have found a good shot. What will make my videos look professional? Pay as much attention to your audio as you do to your images. When people ask me which camera they should buy, Im never sure how to respond. Most people think megapixels and resolution are the most important aspects of a new camera, but the image is great with almost any camera made in the last five years. What is equally as important as the video image is the audio capabilities of the camera. My advice to people in the market for a new camera is to find a camera that will allow you to plug in a wireless mic and adjust the level from within the camera. For character-driven pieces it is nearly impossible to get the footage you need without a wireless mic. One of the biggest mistakes I see people make is to think that they can rely on the built-in microphone on their camera to get the audio they need. This almost never works. Instead, you need to have a wireless mic handy to put on your subjects when you are shooting an interview and to put on your character when you are spending time with them. Control the movement of your camera. If you dont trust your ability to hold the camera steady, I would recommend bringing along a tripod and getting as many shots as you can with the camera locked down on it. You often hear people complain about how shaky and difficult to watch some videos are, but you rarely hear people complain that the camera needed to move more. If you follow these tips you will return from your shoot with footage that looks and sounds great. You will also have a clear vision of how your piece should be edited together. While its easy to get overwhelmed by the endless number of options, it is important to simply choose the best one you can and go with it. The biggest thing to remember is that nothing ever goes as planned when you are in the fieldthe ability to be flexible and find the humor when things go wrong is the most useful skill. MD The author, whose credits include PBS, HBO and National Geographic and awards including The Overseas Press Club award for Best International Reporting on Human Rights and the 2011 Sundance Cinematography Award, can be reached at ryan@stilllifeprojects.com.
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CroWD soUrCing
Bounded
Crowd sourcing
A twist on open crowd sourcing offers promise for global health efforts.
by Marya Lieberman, Associate professor of Chemistry, Edwin Michael, professor of biology, and Joseph Bock, Director, masters of Science in Global Health program, University of Notre Dame
HILE THERE HAS BEEN CONsiderable attention of the use of social mediasuch as Facebook and Twitteramong protesters in Egypt, Iran, Tunisia and elsewhere, it is helpful to keep in mind that this new form of communication is also being applied to various global health challenges. One especially promising application involves bounded crowd sourcing. Crowd sourcing is when information is gathered from whoever hears about a data collection effort resulting from an invitation to participate. An example is when people in Kenya sent text messages to a central location in Nairobi to keep track of post-election violence. The information was posted onto an internet-viewable digital map developed by the group of journalists who started Ushahidi. Bounded crowd sourcing, in contrast, is when volunteers or paid staff members, or both, are dispersed widely among the crowds where they collect information on their cell phones and send it back to a central location. The
sources are trained in what data to gather and what data are deemed to be reliable. In some cases, information from the crowd is also collected, but it is considered less reliable. Below are three examples of how bounded crowd sourcing is being used to enhance health. tracking counterfeit drugs Crowd sourcing offers a powerful new tool for countries to better monitor their pharmaceutical supply chain. According to a 2006 World Health Organization report on counterfeit medicines, between 10 and 30 percent of the drugs sold on the open market in developing nations are fake. Counterfeit drugs are a public health threat both directly (poor patient outcomes if medication is substandard or inactive) and indirectly (low doses of active pharmaceutical ingredients contribute to drug resistance). Since analytical instruments are not widely available in regions where fake pharmaceuticals are often found, crowd sourcing chemi-
cal analysis requires creating new analytical capabilities for technological devices that are commonly available. A new research effort at the University of Notre Dame, in which one of us is involved, uses camera-enabled mobile phones as screening tools for counterfeit drugs in conjunction with a paper analytical device (PAD) about the size of a business card. The goal is to quickly screen a large number of pharmaceuticals in field settings, with appropriate protection for user anonymity. Paper devices have long been used for quick, inexpensive chemical testing; think of litmus paper for pH testing. The approach is being used to carry out more complex analytical applicationssuch as disease diagnoses on inexpensive paper devices. A drug tablet can be swiped across a PAD to deposit a small sample of its contents. One edge of the PAD is placed into a glass of water. Different chemical tests are simultaneously conducted in order to detect active pharmaceutical agents, such as acetaminophen, as well as binders and fillers. (The PAD technique is explained in detail in an 2008 article by Martinez and Whitesides in Lab on a Chip). Computer image analysis can be used to read the results of PAD tests, which greatly reduces the burden of interpretation for the user. A cell phone picture of a PAD is either sent to a central website or to a smart phone app. There, a computer image analysis program extracts critical features of the image, evaluates whether the test was run correctly and whether the tablet appears suspicious and replies to the user with a text message. Just as traffic conditions can be monitored by aggregating reports from many individuals, analytical results of drug quality from many
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Photo: higyou, Shutterstock.com
CroWD soUrCing
System architecture and data flow pathways of the Tanzania NTD MIS.
users can be aggregated to build a map of pharmaceutical quality across a region, which can quicken detection of fake drugs as they enter the market. Monitoring health system performance Health professionals are using bounded crowd sourcing to replace traditional manual field data collection systems with a mobile phone and web-based based platforms. An example is Tanzanias attempt to control or even eradicate the five major neglected tropical diseases (NTDs): Lymphatic Filariasis, Onchocerciasis, Trachoma, Soil Transmitted Helminths and Schistosomiasis. Tanzania is endemic for all of these NTDs, with recent estimates suggesting that up to 12.5 million, 1.9 million, 34.5 million, 20 million and 34.5 million people are presently infected, respectively. An alliance of national and international partners led by the National Institute for Medical Research at the Tanzanian Ministry of Health is developing a unique, highly flexible and scalable multi-platform management information system (MIS). The graphic above depicts the system structure and data flow during the drug administration phase of the integrated NTD Mass Drug Administration program, which includes basic drugs supply chain management as well as system user administration. Mobile applications used in the program are also intended to improve participation of health workers in the field (and ultimately the treatment communities) in program design and delivery. For example, a mobile news module provides an effective means of information exchange to aid implementation
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early warning of potential violence Bounded crowd sourcing is also being employed to help provide early warning of potential violence in conflict zones. Using the Ushahidi platform (downloaded free at http://download.ushahidi.com), the Voix des Kivus project in the Democratic Republic of the Congo (DRC) is serving as
Questions and comments can be sent to the authors at mlieberm@nd.edu, emichael@ nd.edu and jbock@nd.edu respectively. Professors Lieberman and Michael are also members of Notre Dames Eck Institute for Global Health.
Photo: RainConcert Technologies Private Ltd., India
officers at national and district levels as well as health workers in the field. It provides updates and news on the status of the program and treatment schedules, as well as educational material via internal emails, and chat, voice and video. Health work feedback through the system is being monitored to determine the feasibility of expanding it to gather data on program implementation issues and activities at different levels of the health system, gain better information on disease transmission at the village level, and improve engagement with health workers by recognizing and acting on their recorded experiences and local knowledge. A second module, mobile banking, facilitates direct payments, and allows for testing of ways to further incentivize health workers involved in the NTD program by compensating them for achieving treatment targets through an automated transfer either of small amounts of airtime to their phones or small supplementary direct payments. By providing such additional compensation, this program can be a model of effective data gathering through bounded crowd sourcing with implications not only for the management of the NTD program but also other health programs in Tanzania.
a pilot program. Created by the Columbia University Center for the Study of Development Strategies with funding from USAID, Voix des Kivus is focused on South Kivu Province where people do not typically have cell phones. As a result, the program has engaged in what Peter van der Windt of Columbia calls crowd seeding: Staff members distribute cell phones to people who agree to be field monitors. They distribute three cell phones per village. One goes to a woman, preferably the head of a womens association if there is one. Another goes to a village elder. And a third is provided to a person elected by the villagers. These volunteer reporters provide real-time information, using codes explained to them in Swahili. Using a laptop computer hooked to a cell phone, staff members collect the information and produce and distribute two weekly reports. One is not sensitive and is disseminated widely. Another is sensitive and goes to a select group of individuals. Voix des Kivus is focused mainly on conflict early warning and early response, but its staff have found that a substantial number of reports relate to development issues, not conflict. This is noteworthy as it relates to challenges faced by many working in NGOs and transnational organizations who seeking to integrate peacebuilding efforts into more comprehensive relief and development programs. MD
DrUg QUaLitY
Focus on
Drug Quality
Improving global health initiatives for lasting impact.
by Patrick Lukulay, Director, promoting the Quality of medicines program
T IS NO SECRET THAT MAKING AN impact through international development and relief work is complex, highly challenging and often with uncertain outcomes. This reality has been further compounded by todays economic situation. Cuts in government appropriations make aid programs a target in budget decisions and raising donor funds is harder. The recession has been felt around the globe, but if you are among the roughly 250 million people each year who contract malaria, the ebbs and flows of funding have a direct impact on your survival and that of your family: Today, a child dies every 45 seconds of malaria in Africa. So what can we do when funding is uncertain? The ultimate solution is for development work to focus on building capacity in countries so public health programs become locally self-sustaining. This is not a new concept, but well meaning people and programs often veer off course in striving towards this larger goal. My team and I run the Promoting the Quality of Medicines (PQM) Program, a USAIDfunded cooperative agreement implemented by the U.S. Pharmacopeial Convention.* While access to medicines, rather than their quality, tends to grab attention, substandard and counterfeit versions of anti-malarial, antituberculosis and anti-retroviral medicines are a formidable menace, resulting in wasted financial resources, prolonged illness, lost lives andmost threatening of alldrug resistance, which creates an endless cycle putting greater numbers of lives in danger. Already we have lost generations of effective medicines due to resistance. For malaria, the most effective form of treatment remainingartemisinin combination therapyis at risk, with evidence of drug-resistant strains appearing in Asia. PQM is committed to ensuring the quality of medicines essential to USAIDs priority health programs.
PQM works in more than 30 countries around the globe. We work to reduce the disastrous effects of poor-quality or fake medicines through a systems approach that involves strengthening quality assurance and quality control systems; increasing the supply of quality assured medicines; combating the availability of substandard and counterfeit medicines; and providing technical leadership and global advocacy. This involves everything from helping draft legislation to establish medicines regulatory bodies where they do not exist (the most fundamental of elements) to training staff at national laboratories to deploying campaigns to raise awareness that a counterfeit medicine is not like a counterfeit purseit can, and in fact does, kill. The intervention with arguably the greatest impact has been medicines quality monitoring (MQM). MQM uses strategic sentinel sites to collect medicines circulating in the market. This provides actionable, evidencebased data for medicine regulatory agencies. PQM has premiered the MQM approach in more than 20 low-resource countries in Latin America, Southeast Asia and sub-Saharan Africa. The number of countries grows every year, because the process has proven strategically important in countries with weak quality assurance systems. Developing this cost-effective approach to MQM has helped resourcestrapped authorities begin tackling the problem of substandard and counterfeit medicines, even if they lack the technical
Photo: Natalia Klenova, Shutterstock.com
DrUg QUaLitY
capacity to evaluate medicine registration dossiers or an adequate, well-trained team to regularly monitor industry participants. Findings from the MQM activity are available at www. usp.org/worldwide/medQualityDatabase/. Through our work, we have observed gaps in building sustainable improvement in global assistance. These constraints limit progress and have hindered the overall traction that programs around the globe are able to achieve. While the PQM program focuses on developing systems to improve drug quality, many of our lessons learned can apply universally to development work. Ultimately, the focus needs to be on developing pragmatic, sustainable solutions and funding needs to focus on local capacity-building with significant buy-in and input from those we strive to assist. While there are many essential ingredients to a successful program, we believe there are a few critical components. Take advantage of (or help build) regional cooperation schemes. Countries in the same region often grapple with similar
addressing the fundamental structures for a national program makes the programs we develop suitable for the full spectrum of pharmaceuticals.
issues, and in some cases regional cooperation systems are already in place. A program can maximize its impact by facilitating information sharing and mutual understanding of issues and providing assistance to build or strengthen existing systems. One country may have significant expertise in one area, while another may have a different strength; yet neither may know this. That is not surprising considering the extraordinary number of organizations working to improve global
health. One way to improve awareness is to teach local representatives to serve as trainers (in our work, retired regulators and professors) so regional expertise flourishes. Even if a program has separate funding for Ghana and Senegal, for instance, invite representatives from Ghana to witness the Senegalese training. This promotes efficiency and helps builds relationships, trust and recognition of abilities between countries. Transcend vertical funding. While funding may be specific, the focus should remain on creating cross-cutting systems. PQMs funding is vertical in some casesdisease-specific, generally for malaria, tuberculosis and HIV/ AIDSbut the systems we build or enhance can help improve the quality and safety of all medicines. Proper protocols for the registration, testing and post-market surveillance of medicines apply universally, though we focus on our priority diseases. Addressing the fundamental structures for a national program makes the programs we develop suitable for the full spectrum of pharmaceuticals. TechniAn extraordinary Master of Public Health (MPH) program to address todays crises and mitigate tomorrows
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DrUg QUaLitY
vaCCines
Photo: Sura Nualpradid, Shutterstock.com
cal issues on basics of quality controlhow to collect samples, record information and avoid the pitfalls of bad chemistryapply across the board. Avoid a piecemeal approach. As with many programs, training is a major part of our work. One key technique in our field is high performance liquid chromatography (HPLC), used to conduct assay, identification and impurities tests for medicines. However, HPLC training will not reach its full benefit in a vacuum. A comprehensive approach is critical, including training on developing a quality assurance system, record-keeping, calibrating equipment, waste management and the like. A test is only as good as the system it serves. Programs need to look at the entire picture when providing such trainings and assistance, and avoid piecemeal approaches that address a short-term need or goal. Create in-country partnerships with existing institutions and coordinate donor activities. These two points are so well known they almost go without saying. However, they are crucial and the continuing gaps between rhetoric and reality make it worth reiterating the main points. On partnerships, aid programs should be developed and implemented in coordination with the country rather than by prescribing solutions. One way to do this is to partner with institutions already established within a country, which helps to avoid building unhelpful parallel systems. On donor coordination, we all need to learn more about the other players in our space and work with them to complement each others activities. Share work plans. Tailor approaches based on what other groups are doing. Some of this is already being done, but the development community as a whole has a long way to go in this arena. In the end, programs and activities need to be designed for lasting impact. Many programs are vulnerable to economic realities or changes in the political landscape. The focus should remain on building systems and fostering inter-country cooperation and collaboration that will allow nations to continue their work when outside assistance runs dry. The ultimate goal of any program should be to eliminate the need for it to exist. MD * USP is a nonprofit public health organization that develops standards to help ensure the identity, quality, purity and strength of medicines, dietary supplements and food ingredients.
U.s. Leadership in the Decade of vaccines

Promising prospects and continuing challenges.
by Erin Fry, Government Affairs Officer for Child Health, and Philip Carroll, Senior policy Communications Associate, pATH
OR THOUSANDS OF YEARS, people across the world helplessly watched large, sometimes fatal, lesions attack one person after anotheruntil a 10-year global immunization campaign wiped smallpox from our planet. Since the day in 1980 when the World Health Assembly announced that smallpox had been eradicated, the global health community has increasingly relied on vaccines as one of the most critical tools in the prevention and treatment of childhood diseases.
The Decade of Vaccines, a new commitment among some of the most influential global health stakeholders, aims to change the status quo by speeding the delivery of lifesaving vaccines to the worlds poorest countries. The Bill & Melinda Gates Foundation launched this commitment in partnership with the World Health Organization (WHO), the United Nations Childrens Fund, and the U.S. National Institute of Allergy and Infectious Diseases at the National Institutes of Health this past December.
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vaCCines
Founded in 2000, the GAVI Alliancea partnership of UN agencies, donor and developing-country governments, vaccine manufacturers and civil society organizationssupports the introduction of new and underused vaccines through innovative financing mechanisms that yield reduced prices for the worlds poorest countries. Despite funding shortfalls, GAVI has enabled 257 million children to be immunized with new and previously underused vaccines. At GAVIs most recent pledging conference in June, donors committed $4.3 billion dollarsexceeding the original target of $3.7 billionto immunize 250 million children and prevent 4 million premature deaths by 2015. This included an unprecedented commitment of $450 million over three years by the United States. These funds, which will still need approval by Congress, will not only support the scale-up of immunization programs, but will also help introduce newer vaccines for diarrheal disease and pneumonia.
to develop and introduce an affordable new vaccine to prevent meningitis A, which was recently delivered to nearly 20 million children in three African countries. Initial data show there were no cases of the disease in those who received the vaccine last year in Burkina Faso, Mali and Niger. Partnerships were a vital component to the successful development of this vaccine. In addition to the WHO, PATH, GAVI, private industry and the Gates Foundation, the U.S. government played a crucial role. USAID funding, for instance, supported a comprehensive analysis of the economic costs of meningitis epidemics and the Food and Drug Administrations Center for Biologics Evaluation and Research developed the conjugation method used in the vaccine and provided technical expertise in transferring the technology to the manufacturer in India. Preserving and expanding these types of partnerships is critical to the cost-effective development of new products. strengthening vaccine distribution systems Even when developing countries can afford vaccines, existing distribution systems are often ill-equipped to deliver vaccines to those who need them. Some may struggle to keep the vaccines properly refrigerated during transport, particularly to remote locations, and many do not have the infrastructure or the human resource capacity to ensure speedy and safe delivery. Needed improvements in developingcountry immunization programs could save approximately 8.7 million additional lives during the next decade, according to LiST, a new evidence-based tool for estimating the impact of lifesaving interventions (available at http:// www.jhsph.edu/dept/ih/IIP/list/). Health officials in several countries are working to make these improvements. In Senegal, for example, the Ministry of Health is seeking to integrate vaccine and medical supply chains. In one region, workers are using a large, refrigerated truck to distribute supplies directly from regional facilities to peripheral health centers using Web-enabled computers in each vehicle that are connected to a logistics management information system. Harnessing new technologies New technologies are constantly evolving that make delivering vaccines safer and more
needed improvements in developing-country immunization programs could save approximately 8.7 million additional lives during the next decade.
The fact that these resources were mobilized against such a negative economic backdrop reflects a shared understanding amongst donors that this collective investment will save millions of lives. Vaccine manufacturers also heeded the call, offering to lower prices on several GAVI-supported vaccinesincluding a two-thirds price reduction on the diarrheal disease vaccinethat will help ensure the sustainability of immunization campaigns. the promise of partnership Ensuring children in poor countries have equal access to existing vaccines is just one part of the equation. Developing new and more effective vaccines is the other. Public-private partnerships, including product-development partnerships, facilitate the development of low-cost vaccines and products tailored to meet the needs of the most vulnerable. For example, earlier this year the Meningitis Vaccine Project was able
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feasible and effective in low-resource settings. While some programs are exploring the use of mobile phones by health workers to record and register individual immunizations, others are testing the use of solar-powered refrigerators in remote areas where access to electricity is scarce. New methods of vaccine stabilization to protect vaccines from heat and freeze damage are also being explored. At the same time, technologies that have been around for years are being adapted for global health purposes. Over the past 20 years, vaccine vial monitors (VVMs), a simple technology originally designed for the food industry, have revolutionized the landscape for vaccine delivery. These small stickers placed on vaccine vials change color when exposed to heat. By looking at the color of the sticker, health workers can easily tell if a vaccine is spoiled, eliminating the chance of using an ineffective vaccine or wasting what might still be potent. It is estimated that use of VVMs over a decade could avert 140,000 deaths globally and save the global health community $50 million. the way forward Although the stage is set for the coming decades challenge, developing and delivering vaccines are by no means straightforward tasks. Donors will need to fulfill the ambitious commitments made to GAVI at Junes pledging conference and also provide continued support for the routine immunizations that have given rise to these new vaccines. Efforts to expand the reach of the polio vaccine to eventually eradicate the disease must be reinvigorated. Local communities need to express to their elected leaders their need and demand for vaccines. And national governments must do their part to support the systems and procurement as they are able. It will take commitment and partnerships to achieve these goals, but the possibility of significant reductions in child deaths makes this a challenge worth fighting for. MD PATH is an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. By collaborating with diverse public- and privatesector partners, PATH helps provide appropriate health technologies and vital strategies that change the way people think and act. For more information, please visit www.path.org or email advocacy@path.org. MD
DipLoMaCY
science Diplomacy with Muslim states

Advancing relations through health innovation.
by Kaitlin Christenson, Coalition Director, and Kimberley Lufkin, Senior Communications Associate, Global Health Technologies Coalition (GHTC)
LITTLE-NOTICED STORY IN THE JANUARY 15, 2010 edition of the Wall Street Journal revealed a surprising new diplomatic tool: the polio vaccine. The story reported that the Talibans leader in Afghanistan, Mullah Mohammad Omar, was cooperating with the national government, UNICEF and the World Health Organization to distribute polio vaccines to children across the country, even in Taliban-controlled areas long considered outof-bounds. There used to be a ping-pong diplomacy, and now we have a vaccination diplomacy, explained Afghan parliament member Daud Sultanzoi. The United States also has a long history of using health science and research to improve diplomatic ties. Even in the midst of the Cold War, the U.S. and the Soviet Union quietly made a scientific agreement that led to the development of the oral polio vaccine. The vaccine eventually eliminated the disease from most of the world by 2008, while similar U.S. efforts with the Soviet Union helped develop an improved vaccine that eradicated naturally occurring smallpox by 1977. Some health and development groups are calling on the U.S. government to use this historic success story as a model for improving relations with Islamic states. As disease spreads, populations can become trapped in cycles of poverty, which in turn can breed instability and foster radicalization. Advocates argue that greater attention to health can contribute to stronger global security, at a fraction of the cost of military action. Indeed, up to 50 percent of the worlds neglected tropical diseases occur in countries with large Muslim populations
primarily Afghanistan, Bangladesh, Indonesia, Iran, Iraq, Nigeria, Pakistan and Sudan. The U.S. government has already begun one noteworthy effort to advance scientific partnerships with Islamic countries. Following President Obamas 2009 speech in Cairo in which he called for a new beginning between the U.S. and Muslims around the world, the U.S. launched a new program to deepen engagement between Americans and local Islamic communities. Partners for a New Beginning (PNB) is a collection of public-private partnerships that works to advance scientific and technological exchange in Islamic communities, in addition to addressing other goals such as promoting education and economic opportunities. Over five years, PNB hopes to impact 500,000 people in target countries. Since its launch in April 2010, PNB has developed local chapters in eight countries: Algeria, Indonesia, Mauritania, Morocco, Pakistan, the Palestinian Territories, Tunisia and Turkey. In a June 2011 DipNote blog entry, Kris Balderston, the U.S. Department of State special representative for global partnerships, said these local chapters will be the driving force behind PNBs public-private partnership model. A number of partnerships already operating across the Muslim world could serve as a model for PNB and other U.S. efforts to promote science and research. For example, the Drugs for Neglected Diseases initiative (DNDi) is working to combat two forms of leishmaniasis, a disease that affects 2 million people annually in countries such as Afghanistan, Algeria, Bangladesh, Iran, Saudi Arabia, Sudan and Syria. DNDi is collaborating on a large-scale clinical trial in East Africa to test the effectiveness of new visceral leishmaniasis (VL) treatment in Ethiopia, Kenya and Sudan. If effective, it could help combat VL, thereby improving health and living conditions for the poor populations in remote areas who are most affected by the disease. Meanwhile, the Institute for OneWorld Health (iOWH), a U.S.-based nonprofit pharmaceutical company, runs programs in Bangladesh and Nepal to develop a therapy for a form of VL spread through the bite of a sand fly. About 500,000 new infections are reported each year. In Bangladesh, iOWH is collaborating with the Ministry of Health and the International Centre for Diarrheal Disease Research on a clinical study for a new VL treatment. In addition, the Global Network for Neglected Tropical Diseases, headquartered at the Sabin Vaccine Institute, works with partners across the Muslim world to fight neglected tropical diseases. The networks partners work in countries ranging from Afghanistan to Indonesia, Iran, Malaysia and Turkey. In all of these countries, groups are working with local communities and scientific leaders to break the cycle of poverty and disease. This model could benefit PNB, which aims to work in close partnership with local communities. As Secretary of State Hillary Rodham Clinton said at a recent PNB leadership meeting: I believed in this vision and it has developed into something that is now ready to just take off. This entire effort is moving in the direction we need: partnership, not patronage. Rather than work on the premise of what we would do to someone, were pursuing an approach of what we would do with someone. We are reorienting our thinking and PNB is really such an impressive example of just that. MD GHTC is a group of almost 40 nonprofit organizations working to raise awareness about the urgent need for health tools that save lives in the developing world. For more information about these issues, please visit www. ghtcoalition.org or e-mail info@ghtcoalition.org.
Photo: Umit Kartoglu
economics
continued from page 20
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ment, has just authored the study Emerging Africa: How 17 Countries are Leading the Way. His key point is that these countries began to achieve sustained economic growth through a whole host of governance reforms, many of which led to greater democratization. This led to the phenomenon that we are now seeing in Africa: countries sustaining economic growth and beginning to attract foreign investment on a large scale. Importantly, this investment is in areas other than natural resources, such as manufacturing and export processing. This is the direct result of governance reforms and democratization in many of the countries. It is important to appreciate that it is not only mature democracies that reap the economic benefits of democratic political reform; it is the process of democratization that is the key because it is based on the active participation of entrepreneurs, civil society, labor and others. But what really is democracy? Democratic governance is more than free and fair elections. Selecting leaders is only one component. How decisions are made is equally important and gets at the governance component of democratic governance. For example, in too many cases, laws and regulations are not openly debated. Rather, they are drafted behind closed doors in executive offices to be rubber stamped by the legislature without sufficient stakeholder consultation. Having open hearings and seeking input from the business community, labor, NGOs and other groups about the effects that a proposed law may haveseeking to improve the draft law and researching in advance how it may affect investment and growthare key parts of the legislative process. When that process is short circuited, the resulting laws are less effective. This is also true of the regulatory rule-making process. These processes need to be open to citizen input, review and consultation with business people, and NGO and think tank commentary or opposition. One of de Sotos reforms in Peru was administrative simplification and making the process of regulation open to citizen input. The institutions of accountability are also important. Transparent and responsible government institutions improve decision-making. For example, the U.S. Government Accountability Office can hold people accountable by investigating and studying how decisions are made on a day-to-day basis. Accountability also helps guard against or root out embedded corruption. The national business agenda also fosters citizen input. Developed at CIPE using a multi-year format created by the U.S. Chamber of Commerce, this process brings together business people around the country in focus groups to identify the barriers to growth at the firm level and address institutional weaknesses, regulatory issues and other governance problems. It focuses on forming very specific policy recommendations and then working with business associations to advocate for reform in an open and transparent manner. In short, to be sustained, economic growth has to be inclusive, based on the rule of law, relatively free of corruption and based on prudent macroeconomic policy. For democracy to be sustained it has to deliver tangible benefits and economic growth and opportunity to all members of society. This is where democracies and economic growth come together. They are based on the same institutional framework: the framework of transparency, inclusiveness and accountability. MD
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Best practices
Beyond tokenism
Fostering lasting womens empowerment.
by Elidon Bardhi, Country Director, Adventist Development relief Agency (ADrA) International in bangladesh
THE STATUS OF WOmEN IN bangladesh is among the poorest in the world, characterized by limited decision-making power, limited control over resources, high rates of illiteracy (45 percent) and maternal mortality (570 per 100,000), a low employment rate (26 percent) and vulnerability to food insecurity. When ADrA International first designed the Women Empowerment project in the early 90s, we did not fully appreciate the impact this empowerment program would have on its community partners in the town of mymensingh. but during its implementation, our local staff realized it was creating long-lasting, positive changes at the community level. As project staff started interviewing female beneficiaries, the impact became clear as women such as Anawara told us how her life was changed by the project: When I enrolled myself into one of the womens groups I did not know how to write and read. We had a hard time making it through the month financially. my husband was standing every day at the local market hoping that someone will pick him up as a day laborer. He was the only one who could bring money at home. my children used to get sick often and we had no medical services in the community. I was not consulted from my husband on any family related issues and did not dare thinking of being consulted by the community on communitys affairs. In our community traditionally men will consult on any issues that were a concern to everybody. my life started to change after I started to write and read. I received new skills on how to identify a small business and invest my money wisely. Soon I received a $50 loan from ADrA International and with my husband decided to buy a rickshaw. It is the cheapest and ecofriendly mean of transportation. my husband was so happy that he had his own rickshaw. She kept requesting larger loans after each one that was successfully paid in full. With each new loan the number of rickshaws increased. Now she has her own travel agency of 25 rickshaws and has employed 25 people from the community. She has become a successful entrepreneur and an example for thousands of other women. To ensure an integrated approach to womens empow-
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previously poor and illiterate women have become influential members of civil society in Bangladesh who are proud to represent their communities.
erment, ADrA International focuses on building civil society, providing literacy classes, improving health and nutrition practices, providing income generation activities, and behavior change and communication. Using these tools, the Women Empowerment project is introducing positive changes in the targeted communities as thousands of previously poor and illiterate women have become influential members of civil society in bangladesh who are proud to represent their communities. Formation of Women Empow-
erment Groups (WEGs) is the first step in building civil society organizations in mymensingh. The community does it by organizing community consultation meetings and facilitating the selection of poor women to be members of WEGs. Literacy is then crucial to ensure the sustainability of WEGs. Our experience reveals that literacy and numeracy skills are not only essential to the effective functioning and self-management of WEGs, they also open doors for improved quality of life. ADrA International has successfully facilitated access by group members to governmentfunded agricultural extension services, where group members use the money they borrow to begin or expand their involvement in income generating activities. It is prudent to ensure that those who will be responsible for the production activity have adequate knowledge and production skills. The project also yielded a number of key lessons:
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When a husband and wife jointly manage income-generating activities, it improves family dynamics and increases opportunities for women.
The sustainability of any intervention is consistent with the level of ownership the community and other key stakeholders have in the project. project-related, communitybased civil society organizations fall apart if the entire community is not involved in identifying needs and implementing, monitoring and evaluating interventions. Literacy and economic development opportunities play an important role in boosting confidence among poor women and help them engage in advocacy. Networking activities between community federations and other civil society organizations build the capacity of federations to get involved in advocacy activities that benefit the whole community. When women are mobilized and their voices are heard, they can make a difference in community life. Womens participation in governance structures ensures the effectiveness and success of advocacy efforts. participation of male counterparts in agricultural-based income generation activities ensures program sustainability and facilitates women empowerment efforts. When a husband and wife jointly manage income- generating activities, it improves family dynamics and increases opportunities for women to get involved in
decision-making. Annual sharing and learning workshops build confidence among women as agents of change in the community. Demonstration plots give farmers confidence that new agriculture technology such as System of rice Intensification increases staple food yields by at least 30 percent; this is crucial, especially for poor farmers who hesitate to take risks on their small plots. regular weekly savings can make a difference in the lives of women who become entrepreneurs. When Ambia Khatun joined the group she did not know to read or write. She was an ordinary housewife with no income source. She regularly attended the weekly health and literacy meetings. When she learned how to write and read she felt encouraged to undertake an income generating activity, so she received a loan from the Sekarikanda Kazipzara WEG in mymensingh and started a poultry rearing micro-business. Gradually her income increased and she was able to contribute to her familys income. Soon she realized that she could do more to help the entire community. She decided she to become a leader in her community and improve the status of women. With training from the WEG, she improved her leadership skills and is preparing to run for local Counselor in mymensingh. Ambia says that if she is elected she will establish good governance practices at the local labor union and provide more assistance to poor families. Ambia is one of the 5,400 women who currently benefit from the project. MD ADRA Internationals David Dyjack and Nestor Mogollon also contributed to this piece.
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29 October-2 November American Public Health Association (APHA) Washington, DC 31 October The day the UN expects the worlds population to reach 7 billion www.7billionActions.org
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Conservation
As a first step, governments, foundations, NGOs and other actors should ensure their own environmental and development efforts are aligned and mutually reinforcing. One promising example is USAIDs Feed the Future initiative, a development priority of the Obama administration. Within a broader effort to improve rural agricultural development, Feed the Future explicitly elevates climate change and natural resource management as cross-cutting and priority issues. Having outlined an integrated policy, USAID now faces the challenge of execution. To overcome the siloed sector barrier, its Bureau for Food Security, assisted by a group of development and conservation organizations, held a series of discussions and presentations on both the why and the more technical how of integration. To address gaps in measures of success, the bureau developed results framework indicators that explicitly track water, land, fisheries and resource management practices on the ground. These are positive steps, but continued guidance, feedback and leadership will be needed to ensure this approach fully connects with both the field and the broader suite of USAID programming. As the above example suggests, mainstreaming an integrated approach to conservation and development must be an ongoing process. In the end, an integrated approach is not only doable and costeffective, it is necessary. As we consider next steps for this effort, we welcome feedback and engagement. MD To download the report and find out more, please visit www.interaction. org/conservation-development.
Country Directors*
The Peace Corps is looking for senior-level executives with exceptional leadership skills, international development experience (including working overseas), administrative and financial management expertise, and strong cross-cultural experience to serve as Country Directors. CDs are the senior Peace Corps representative in a country and are responsible for the leadership and direction of all aspects of the Peace Corps program: administration, Volunteer support, representation, programming and training, and safety and security. Candidates should have experience managing a program or business of comparable size to a Peace Corps country program (15 to 50 staff, 50 to 250 Volunteers, and an operating budget of $900,000 to $4 million), as well as experience managing/ supporting staff and/or volunteers. The salary range for these positions is $96,064 to $150,913.
Director of Program and Training*

The Peace Corps is looking for senior-level managers with exceptional skills to supervise staff and design and manage international development programs in a variety of fields such as health, education, small business development, and agriculture/environment. International cross-cultural and supervisory experience are required (including 1 year working overseas). DPTs manage, advise, and develop professional program and training staff to support Peace Corps Volunteers. DPTs oversee the planning, analysis, implementation, and monitoring of programs and training activities, as well as support staff and Volunteers to meet the expectations of project partners. Candidates should have work experience managing an international development program or business and managing/supporting staff, including one year of performing supervisory functions. The salary range for these positions is $61,759 to $138,137.
Administrative Officers*
The Peace Corps is looking for mid to senior-level managers with extensive administrative and financial experience, international and crosscultural experience, and exceptional management and leadership skills to serve overseas as Administrative Officers. International cross-cultural and supervisory experience are required (including 1 year working overseas). AOs ensure the effective management of country operations in support of 15 to 50 staff and 50 to 250 Volunteers. Critical services which the AO provides include direction of the administrative unit, as well as financial analysis and policy implementation. Candidates should have work experience managing a program or business and managing/ supporting staff, including one year of performing supervisory functions. The salary range for these positions is $61,759 to $138,137.
All CDs, DPTs and AOs must be U.S. citizens and must not have been associated with intelligence activities. Peace Corps seeks candidates that are reflective of the diversity of Peace Corps and its Volunteers. Employees are appointed for a 30-month tour and may be granted a second tour for a maximum of five years (60 months) with the agency. Peace Corps accepts applications for these positions throughout the year. You may apply on-line through the website, http://pcoverseasjobs.avuedigital.us/. You must complete the on-line application in order to be considered for a position; resumes are supplemental. If you have any questions, please e-mail AOandPTOjobs@peacecorps.gov for AO and DPT positions and CDselection@peacecorps.gov for CD positions.
Climate
COMMUNICATIONS DIVISION DIRECTOR

Washington, DC
IFPRI (www.ifpri.org) seeks sustainable solutions for ending hunger and poverty in developing countries. It carries out research, capacity strengthening, and policy communications to develop those solutions and catalyze policy action. We are currently seeking a Division Director for our Communications Division. The successful candidate will provide intellectual and managerial leadership to a professional team handling various aspects of the communications function and will develop, refine, and enhance the implementation of IFPRIs overall communications strategy.
DUTIES:
Bangladesh for three hotspot cities and the entire coastline have significantly increased the nations capacity to respond proactively to disasters. In 2007, thanks to early warning systems and evacuations, preceded by education campaigns in areas identified by hazard mapping, loss of life from Cyclone Sidr, a category 4 cyclone, was kept below 4,000. A previous category 4 cyclone in 1991 resulted in the loss of 140,000 lives. rethinking resources There is a critical need for countries to integrate climate risks into economic development plans. Adaptation will also require the international community to devise fit-for-purpose financing mechanisms suited to the unique and ubiquitous nature of climate impacts. Developing countries will need access to long-term, flexible financial support (since impacts such as sea level rise, for example, will play out over decades). Also critical will be credit lines that recipient countries can tap quickly when extreme events that can quickly deplete a governments resources occur. a new kind of decision-making All these examples demonstrate that governments and donors need to employ a new kind of decision-making if the world is to adapt effectively to a hotter tomorrow. The consequences of climate change will be far-reaching and long-lasting. Policies set in motion today will impact not only present but also future generations. Public officials must urgently mainstream adaptation policies and measures into national planning frameworks, balancing the short-term needs of today with the longer-term risks to their citizens and natural resources presented by a rapidly warming world. MD
Develop, implement, and monitor Institute- inimum masters degree in M wide effective and innovative communications Communications or relevant field strategies to increase the impact of IFPRIs Minimum 7 years relevant experience managing an organizations overall communications research on reducing hunger and poverty losely follow external environment with function C Demonstrated communications and marketing regard to significant policy issues/trends expertise with significant professional writing to develop appropriate communications and editing experience solutions that support IFPRIs mission Strong leadership and management skills Work with project leaders and external Demonstrated ability in coaching senior leadstakeholders to define and coordinate ers to become effective spokespeople unified project and region-specific comExperience developing innovative approaches munications strategies and activities Ability to travel several times per year. Coordinate with the CGIAR on mutual and relevant communications activities IFPRI is an equal-opportunity organization and believes that the diversity of its staff contributes to its excellence. Applications from women and developing-country professionals are encouraged.
APPLY AT: www.ifpri.org click Careers - Research Positions - Position #11-184,
REQUIREMENTS:
Communications Division Director, COM Please complete the online application, including a complete curriculum vitae and three references.
2033 K Street NW, Washington, DC 20006-1002 USA Fax: +1.202.862.8187 www.ifpri.org
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nt me at g lop ine or ve nl n. de r o io xt o t ne 38 aC ur ge er yo a t d n p .

September 2011 Vol. 29 Issue 9

MonDaY DeveLopMents Magazine

With Muslim states

Creating Powerful Videos

The Decade of Vaccines

InterAction 1400 16th Street NW, Suite 210 Washington, DC 20036

MonDaY DeveLopMents Magazine

25 Bringing the story Home

Practical tips for creating powerful videos. By Ryan Hill

27 Bounded Crowd sourcing

29 Focus on Drug Quality

31 U.s. Leadership in the Decade of vaccines

33 science Diplomacy with Muslim states

19 Building economic Bridges

Uniting conservation and development efforts. By Stephanie Cappa

15 green Building: a Window of opportunity

21 What about Democracy and governance Here at Home?

Creating deep relationships to advance change. By Sam Daley-Harris

17 Climate Change: Bringing governments on Board

23 guarding the guards

reflections from the president

MonDaY DeveLopMents Magazine

Conservation and Development Can Work Together

it is often less expensive to preserve something than it is to restore or replace it later.

Sam Worthington president and CEO InterAction

Microfinance from a Human Rights Perspective

TAKE CLEMENTS WITH YOU.

Photo: Sarah Elliott

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

Leaders Grapple with Rising Food Prices, Diminishing Food Security

MONDAY DEVELOPMENTS SEpTEmbEr 2011

Progress of the worlds women

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

FedEx continues to support transparency

A new way of measuring hunger

New report on aid recipient feedback

What constitutes a famine?

MONDAY DEVELOPMENTS SEpTEmbEr 2011

THE GLOBAL HUMANITARIAN AID EVENT 19-20 OCTOBER, BRUSSELS

The new event for the humanitarian aid community

Find out more and register free at www.aid-expo.com

Uniting conservation and development efforts

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

MONDAY DEVELOPMENTS SEpTEmbEr 2011

Access to safe water is a challenge in the developing world.

2011 Vestergaard Frandsen

MONDAY DEVELOPMENTS SEpTEmbEr 2011

Photo: Khalid Hussein

In the Palestinian Territories, environmentally friendly construction is taking root.

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

Building Better, Building Green

MONDAY DEVELOPMENTS SEpTEmbEr 2011

Bringing governments on Board

Illustration: scusi0-9, Shutterstock.com

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

Building economic Bridges

Photo: Karl Grobl, for EDC

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

MONDAY DEVELOPMENTS SEpTEmbEr 2011

What about Democracy and governance

SEpTEmbEr 2011 MONDAY DEVELOPMENTS

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