Following is DAI CEO Jim Boomgard’s Foreword to Access for All, Brigit Helms’ new book on economic inclusion:
For the first time in my career as a development professional—a career that goes back to the early 1980s—informed observers are talking in credible terms about ending extreme poverty, not just within our lifetimes but within the foreseeable future. These aspirations are reflected, to take just one example, in the United Nations’ Sustainable Development Goals (SDGs).
In Nigeria, as in many countries, the government faces practical hurdles to funding health systems adequately and preventing sickness and disease among its most susceptible citizens. As Health Systems Advisor for DAI Global Health on the Integrated Approach to Neglected Tropical Diseases (UNITED) programme, I advocate for increased, cost-effective health funding in Nigeria so more people can benefit from health services.
In 2017, the UNITED programme’s mass drug administration (MDA) to prevent neglected tropical diseases (NTDs) reached 39 million people, and by programme’s end will have distributed more than 110 million treatments in the five northern states of Kano, Katsina, Kaduna, Niger, and Zamfara. These drugs are donated, in whole or in part, by pharmaceutical companies and distributed by community volunteers. The MDA cost comes to $0.08 per person per year and leads to countless additional years of productive life. These are cost-effective results that funders like to see, including government budget officials in Nigeria and donors such as the U.K. Department for International Development, which supports UNITED. But we need to communicate these results in the right way if they are to support the case for continued funding.
Effective health advocacy depends on demonstrating measurable value for money and translating it into easy-to-grasp formats for busy policymakers, an information-overloaded public, and the headline-grabbing media. In today’s media landscape of snappy 30-second videos and tweets, advocacy must be equally attention grabbing but also strategically deployed. Four considerations stand out:
Understand the political and economic dimensions of the health sector. Those with power often resist changes to the status quo—a good political economy analysis will inform your strategies on how to confront and positively influence recalcitrant parties. As my DAI colleagues...
As a grad student in London in the 1990s, I earned a bit of extra money sourcing and exporting handcrafted furniture from India to the United States for interior designers. My U.S. customers were small businesses, but I was even smaller, so if I wanted to sell to them I had to take on most of the risk. On school breaks I would travel to India, find what my customers were looking for, purchase it, accompany it to the port, and—when I could—watch as it was loaded onto a ship.
Girls and women in Afghanistan are transitioning away from Taliban-era oppression to attend school, get jobs, and fully participate in mainstream life. Afghan leaders and politicians have enacted national laws to support this movement, but the reality in Afghanistan’s 34 provinces is another matter. Girls and women in too many locales routinely endure child/forced marriage, domestic assault, and injustice, and female leaders become targeted for reprisals. In the space between the national law and local reality, various groups are working to preserve hard-earned gains and advocate for Afghan women. This is the space where the Musharikat program works.
Too often, in our experience as development professionals, baseline surveys can seem like proforma exercises—dry, mechanical constructs conducted at the beginning of a project, shelved almost as soon as they are done, then dusted off for the midline survey. By the time we conduct the endline, the project is closing. Baseline findings don’t drive programming.
Governments in many low- and middle-income countries have committed to provide affordable and high-quality health services to their citizens. To make good on these promises, they need to identify more money for health expenditure and need to invest it more wisely. Our recent policy paper—Financial Management Mechanisms to Support Increased Government Spending on Health—provides some guidance on how they might do that.