BY IAN ANDERSON
NEW FORMS OF AID, including “philanthro-capitalism” such as The Bill and Melinda Gates Foundation, are rapidly altering the international aid architecture for health. These organisations have financial power, actively shape agendas and influence policy.
The rise of non-traditional donor organisations creates opportunities and has implications for Australia as it scales-up its aid program. AusAID could collaborate, complement, compete with, or copy these organisations. Arguably the biggest strategic implication is that they expand AusAID’s programming choices.
This increased flexibility could be used to leverage and accelerate further reforms in the UN and elsewhere. But choice is a two way street. Developing countries may prefer large, grant financing from non-traditional aid organisations and choose to bypass traditional multilateral and bilateral development agencies…..
Collaboration can – and has – occurred between The Bill and Melinda Gates Foundation [BMGF] and AusAID in program areas of common concern, such as maternal and child health. Collaboration has also occurred in knowledge generation.
For example, AusAID, BMGF, and the University of Queensland collaborated in estimating the costs of scaling up proven interventions for maternal and child health in Asia. Arguably, the combination of these three institutions working together magnified the profile and reach of the work much more so than if each had acted separately.
AusAID and BMGF can also complement each other’s strengths. AusAID has excellent, ongoing, access to key Government policy makers throughout Asia and the Pacific; is experienced in service delivery; has professional and experienced staff posted across the Asia and Pacific; and has a scholarships program that builds capacity.
BMGF has excellent access to scientific research in health; has convening power amongst many stakeholders including the private sector; and is deeply and widely engaged in Africa.
However, in some circumstances, AusAID and BMGF may be competitors. Both are grant, untied, financiers chasing viable development opportunities. Both wish to recruit good, experienced, international and local talent. Both operate in the same sectors in the same countries: potentially with quite different policy advice to government.
BMGF is increasingly likely to win policy debates at the country level, at the expense of AusAID views, unless AusAID continues to build up its own in–house technical expertise, and invest more in operational research. Both BMGF and AusAID are also likely to compete for influence and ideas on the boards of international organisations.
AusAID could also copy some of the BMGF approaches, particularly the emphasis given by BMGF to rigorous operational research. Access to finance is rarely the binding constraint to development in fast growing Asia or the aid supported Pacific, but access to useful and usable knowledge is.
Developing countries often know what to do, but are less sure about how to do it in their own country circumstances. Consultancy based advice is no substitute for field based operational research and assessment of the counter–factual….
The international environment – especially for health – is rapidly changing. Standing still is to be left behind, less and less able to influence global health events that will affect developing countries, as well as Australia.
Australia’s decision to scale up its development assistance program is a sound investment in the future, especially in an increasingly inter-connected world. Making good choices – including how to best work with relatively new, but influential, institutions such as the Bill and Melinda Gates Foundation will be an important part of that task.
Ian Anderson (ian.anderson.economics@gmail.com) is Director of Ian Anderson Economics Pty Ltd, a consultancy firm specialising in the economics and financing of maternal and child health
Source for extracts: Anderson, I. (2011), “The Bill and Melinda Gates Foundation: bureaucracy versus business in international development” discussion paper 2, Development Policy Centre, Crawford School of Economics and Government, The Australian National University, Canberra
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