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This week a report entitled Goalkeepers: The Stories Behind the Data, co-authored by Bill and Melinda Gates was released. The report shines a light on progresses that have been made in reducing extreme poverty and diseases.
The report tracks 18 data points from the UN Sustainable Development Goals, or Global Goals, including child and maternal deaths, stunting, access to contraceptives, HIV, malaria, extreme poverty, financial inclusion and sanitation. It also shines a light on the progress drivers; leaders, approaches and innovations that made a significant difference. Capital spoke to Haddis Tadesse, the Bill and Melinda Gates Foundation’s Country Director for Ethiopia, about the newly released report, as well as about the Foundation’s work in health and agriculture.
Capital: The Bill and Melinda Gates Foundation published a report that focuses on the development sector, showcasing the gains that have been made so far and the challenges ahead. Tell us about the main points of this report.
Haddis Tadesse: This past week, we launched an inaugural annual report showcasing the remarkable progress that has been made in reducing extreme poverty and disease in recent decades, but expressed our concerns to the world that future progress is in jeopardy. In all, the report tracks 18 data points from the UN Sustainable Development Goals, or Global Goals, including child and maternal deaths, stunting, access to contraceptives, HIV, malaria, extreme poverty, financial inclusion and sanitation. The report looks beneath the numbers to pinpoint the leaders, approaches and innovations that made a difference.
The report has first person accounts of leaders driving progress, it has breakthrough data projections, best case scenarios and worst case scenarios, so that everyone can have an idea of what to expect and see how we are doing against these goals. We are committed to publishing this report every year between now and 2030 and that is to make sure that everyone is aware of the progress, the challenges and hold people and governments accountable for the goals that the world has set.
Capital: There are other organizations that produce reports on the SDGs and other development goals. Do you believe that this report will be able to influence policy makers?
Haddis: We hope so; that is the whole idea behind the report. It is a very helpful tool to policy makers. The projections are showcased in the report and explore three potential 2030 scenarios for each indicator. The first is what could happen if we continue along the current path, based on past trends – without significant changes to approaches or current spending levels. Two additional scenarios provide a glimpse at a better and worse future: what could happen with strong leadership, innovation and investment and, starkly, what could happen if attention and funding decreases.
Capital: The foundation has been working in the health sector of Ethiopia for a long time now. What would you say is Ethiopia’s success story?
Haddis: Ethiopia’s successes in health are well documented. The country achieved MDG 4 and 5, reducing under-five mortality by two thirds to 68 per 1,000 live births well before 2015, and reducing maternal mortality rates to 350 per 100,000 live births at the end of the MDG period. A significant contributor to these milestones was the establishment of the Health Extension Program (HEP) in 2003, which created a foundation for health services including community case management of childhood illness, and has contributed to improved sanitation and hygiene, increased coverage of childhood immunizations, and use of modern family planning. Similarly, HIV, TB, Malaria and other infectious diseases are down.
Despite impressive progress, Ethiopia continues to face health challenges. At the system level, variable performance across woredas suggests a need to improve management and governance. Information systems exist but are fragmented. Data is produced in prodigious quantities but much can be done to improve the quality and utilization, particularly in terms of how data are aggregated, interpreted and used to manage services. So, we need to re-energize and work towards solving those problems.
Capital: Another challenge that is always pointed out is that there is still a gap when it comes to health professionals, do you have a project where you focus on capacity building in that area?
Haddis: I think it’s true that Ethiopia can improve the quality of health care provided. At the tertiary level, the health extension platform has done a good job of reaching families and making sure that the basic needs are met; that’s why you see all the progress in the sector.
Today I think the government and a number of donors are going through a process to improve and revitalize the health professionals but it is not, to be realistic, going to happen very quickly.
We still have to deal with the fact that most of the challenges we face with maternal and child mortality happen in the rural area. So reaching the rural community is the key. Institutional delivery is very important for this. There has been progress; in 2011, only 20 percent of women gave birth in a health facility. Today that figure is 73 percent; so more and more women are going to health facilities. We invest in programs that train and educate local leaders and health workers in the benefits of seeking skilled care before, during and after childbirth. With skilled care, we can reach women with low-cost, high-impact solutions that could save their life or the life of their child. Things like: Post-partum hemorrhage prevention and treatment, Penicillin and Resuscitation.
Capital: The issue of funding continues to be a big one. What would you say would be the consequence of it all, if we end up seeing big budget cuts?
Haddis: That is a very timely question. You have to look at the funding issue from a couple of perspectives. One is around domestic funding. We hope as Ethiopia gets richer, it will be able to put more resources to development. Then there is the donor resource.
Here we see an emerging risk as governments shift their focus to other issues. Quite simply, budget cuts mean more people will die. As the youth population continues to grow, we need more funding, not less. The decisions we make today matter. We can choose to continue on a path of progress to improve the lives of the poorest of the poor, or we can fall off that path. For example, our report shows a mere 10 percent cut in global donor funding for HIV treatment could result in more than 5 million more deaths by 2030.
We are constantly advocating in the US and European countries that cutting resources at this time is not the right thing to do and we have spoken to various administrations in support of Ethiopia and other countries saying that you should maintain or increase the support and we will continue to put in our resources.
The last component I will talk about is in addition to adding more resources, we should focus on efficiency gains that can contribute to the overall availability of resources. So I think governments and others should try to become more efficient with the resource that we have while we seek external resources.
Capital: You have several projects in agriculture as well and Ethiopia is being affected by drought currently? How have you been participating in the relief work?
Haddis: The foundation is closely aligned with the Government of Ethiopia on the vision for success in terms of both the transformation and the areas of focus which align to strategic pillars of Ethiopia’s agricultural sector Growth and Transformation Plan (2015-2020). While we have identified many potential investment themes to pursue in Ethiopia, a subset was prioritized based on our comparative advantage, potential impact at scale, existing investment gaps, and opportunities to coordinate with other major donors.
Based on this approach, two overarching objectives were identified: (1) strong system-level enablers (institutions and policy); and (2) geographically-targeted last-mile delivery.
To achieve these broad goals, we have prioritized: (1) modernizing the research system to enable sustainable productivity gain; (2) increasing timely availability of input (basic seed and blended fertilizer); (3) improving accountability of the extension system; (4) increasing availability of appropriate genetic and animal health technologies; and (5) increasing local and foreign investment in profitable, competitive agribusiness. We also will continue our cross-cutting support of the sector in strengthening strategic planning, performance monitoring, and coordination (for example, ATA) to accelerate agriculture transformation as well as in improving nutritional outcomes and gender empowerment.
You mentioned the drought; over the last two years we have been involved in helping coordinate responses for the drought which we have provided support for the national coordinating committee. We think that the long-term play is really about helping the smallholder farmers increase their productivity and encourage the private sector to do more in the agricultural sector.
Droughts always happen, it is how you mitigate and adapt to the situation that’s going to matter. Ethiopia over the years have done better in handling the droughts but a significant increase in the production of crops and livestock, expanding markets both domestically and internationally will solve problems. That is where we are focusing on.
Capital: Speaking of Increasing productivity, some of the things other countries look into advanced technologies such as GMO seeds. Is there a plan to bring that kind of technology here?
Haddis: Helping farmers increase their productivity requires the development of seed varieties adapted to local conditions and tailored to the demands of a changing climate. For example, we have worked with research partners to develop new varieties of seeds that grow even during times of drought and flooding. Some of these new crops can be bred through traditional means, but the world has to invest in advanced genetic techniques to accelerate plant breeding and expand the range of important genetic traits.
Our role is to provide options to smallholder farmers (both conventional and non-conventional including GMO) by investing in improved products. The choice of using GMO or not is the role of the Governments.