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Evaluating Progress on the UN Millennium Development Goals

Speakers: Samuel A. Worthington, President and Chief Executive Officer, InterAction, Charles A. Cooper, Vice President for Congressional and Public Affairs, Millennium Challenge Corporation, and Robert C. Orr, Assistant Secretary-General for Policy Planning, United Nations
Presider: Gail D. Fosler, President, The GailFosler Group LLC
October 4, 2010
Council on Foreign Relations

GAIL FOSLER: Welcome everyone. We've got a great group here today of councilmembers, and we also have a great group of panelists around a terrific topic. So I thank all of you for venturing out on what could only be mildly called an inclement evening. (Scattered laughter.)

It's my pleasure to welcome you to this session on evaluating the progress on the Millennium Development Goals, and as part of my housekeeping details, I have to, like the flight attendant, ask you to turn off your Blackberrys, your iPods, your iPads, anything with an on/off switch. Did I miss any electronic device? And I think that's really out of consideration for your fellow members.

And I would also like to mention that this meeting is on-the-record -- I don't know if we do have press here, but it will be on-the-record.

So I -- the way we will structure this meeting is I will begin with a few introductory questions of our panelists for about 25 minutes, and then we will open it up for member questions. And we have many members here in the audience who are active in the field, and we have a lot of new news. So I think this is going to be a great session.

So I think you all have the speaker bios, but just to be absolutely clear, we have Bob Orr here, who's assistant secretary-general for policy planning at the United Nations. We have Sam Worthington, who is president and chief executive officer of InterAction; this is the largest alliance of international not-for-profits, so he really speaks for what we've been calling sort of the third, nongovernmental organization sector.

And then finally we have Chuck Cooper, who is the vice president of Congressional and Public Affairs from the Millennium Challenge Corporation.

So we've got a number of factions represented here. And without further ado, you know, let me turn to you, Bob, and just ask you to start off with what you think came out of the session two weeks ago, in terms of where we are now with the millennium development goals.

ROBERT C. ORR: Thank you very much, Gail.

I think I want to start with an observation that if you had told me a decade ago that we'd be sitting at the Council on Foreign Relations a decade hence talking about a thing called the MDGs, I think I would have laughed in your face.

Put me down as one of the original skeptics of the MDGs. At the time they were created, I remember having an argument with someone who was then at the U.N., and I was not then at the U.N. I said, since when do you do development by goal-setting?

I've never quite seen that work. And I think I can say here today, I was proven wrong. The fact is that a decade hence, goal-setting has been a tremendously powerful tool. But it's been a very unevenly powerful tool.

And what we saw last week was the power of the MDGs in the developing world, in particular that the mobilization that has happened, around the MDGs as a concept altogether and individual MDGs, and not just at the government level but at the civil society level -- that entire societies have organized around the MDGs -- has been something that we have lacked.

We've talked about forever country ownership and national ownership of development. The MDGs have given those constituencies something to organize around. I think the meetings here in New York over the last couple weeks have really been quite striking, that in the most adverse environment possible for development and for investing in development, we saw some major new moves forward.

And that came not just from governments and not from traditional donors but from in particular the developing countries, the NGOs, foundations not just in the United States and northern governments but foundation world -- the foundation world in different parts of the world.

So as a mobilizational tool, I think a lot came out. At the most political level, the other big development is that this is now considered fair for leaders to talk about. Even when the MDGs were created, they were created by the experts.

The leaders blessed the idea of MDGs, and then it went into expert land. And it kind of worked its way back up the chain. And it took a decade to fully get all the way up the chain. But one decade out, leaders owned this agenda.

It was striking that leaders could get well off their talking points and knew exactly where they were in their countries, on which MDGs and on which targets and which ones were moving more slowly. That level of political ownership at the top of the chain is new. It's exciting.

Clearly the progress is uneven. And I think all the reports that led up to the summit, the gap reports about where we're falling short -- not just geographically but in which MDGs -- have shined a light on the different organizational problems we have for different MDGs.

The one that I think we made the most progress with last week was the one that we've moved the slowest on. And that is on maternal health. This has been the perennial basement-dweller of the MDGs.

And two years ago, the secretary-general set out to try to both figure out and then organize around the weakest performers of the MDGs, because there is a potential strategy of just riding the winners, both in terms of countries and in MDGs.

And you could gain statistical achievement of the MDGs by riding China, riding India, riding growth in parts of the world. But very specifically we have to do exactly the opposite. We have to go after the hardest places and the hardest issues. And maternal health has been the most resistant to change, the most stubborn.

And last week because of a two-year-long effort, of mobilizing all the different constituencies around women's and children's health, we saw a very strong coalition come together. And we saw 192 governments actually agree on an approach to women's and children's health. Given the food fight that we've seen over decades in this area, that's a significant development.

But then on top of that to see major new commitments against the toughest, slowest-moving MDGs and women's and children's health come simultaneously was a new development that the -- instead of kind of the cycle to the bottom that has been driven by the economic circumstances, we started to actually see a cycle to the top kind of driving forward, that when NGOs -- when governments saw what NGOs were doing and committing for women's and children's health, they did more.

And then when people in one part of the world saw that others were doing more, they did more. So I think last week was significant in terms of agreeing to an overall game plan, for the forced march that will be the next five years, to achieve the MDGs.

But we saw the political mobilization. We saw new constituencies come out together. And we saw major new commitments. Obviously it's all about what happens on the ground. But if you had given me the option a year ago, to say this is where you'll be at the end of your summit, I would have taken that deal in a heartbeat.

FOSLER: Fabulous.

Chuck, let me go to you. And we have a new organization that seems to be emerging in the administration, to deal with development. Can you -- can you sort of describe what's going on? It seems a little bit open-ended.

And how do you expect it to -- what's the change in place now? And how's it going to affect this whole process that seems to be so positive?

T. CHARLES COOPER: Well, two weeks ago at the MDG summit, President Obama used the occasion to announce the first comprehensive U.S. government development policy in over 50 years.

And we in the administration are very excited about the fact that the policy is focused and embraces the Millennium Development Goals. And as the president said at the summit, it's really important that the U.S. government focus on the fact that economic growth is really the most important antidote to poverty.

Stepping back and taking a bigger-picture look at the president's new policy, it's really a recognition that the -- poverty reduction is going to be -- is going to happen most directly as a result of economic growth. And the president has recognized that this new policy has several different components.

One is the fact that it's a moral imperative, it's a national-security imperative. And it's an economic imperative. And so what the president has said is that we're going to raise development to be one of the three real important pillars of national security, with foreign policy, diplomacy -- with diplomacy and defense. So it's really an announcement by the president that the United States government embraces the Millenium Development Goals.

And the way that we are going to approach the Millennium Development Goals is through this new policy, and it's a focus on economic growth and it's a recognition of the fact that really to make significant progress there's going to have to be engagement with the private sector, with NGOs, with other governments, and other donors to really take a coordinated collaborative effort to focus on poverty reduction through economic growth. That's one of the pillars of the new policy.

Another pillar of the policy or essential tenet of the policy is selectivity, and what the president said at the MDG summit is that we have to be very thoughtful about which countries we're choosing to partner with and so we want to look at countries that are already performing at a level from a policy perspective that we're going to be able to make significant progress with our policies as we implement to reduce -- to reduce poverty. So it's critical that we look at selectivity and we're picking the right partners.

It's also important that we think about as we work with our NGO partners and our other donors and other governments what's the division of labor. We can't be all places at all times and what we have to do is we have to develop a focus based on comparative -- comparative strengths and what we bring to the table from a USG perspective -- what role should we be playing relative to others. So there's a division of labor and we're focusing on that division of labor.

The other -- an other important aspect of the president's policy is country ownership and this is something that's been around for decades but I think it's really a central focus of the policy. And the idea is -- and this is something that we have done at the Millennium Challenge Corporation for the last five or six years since the founding of the -- of the agency -- and it's really to take a hard look at when we're working with our countries how can we involve them, engage them as much as possible. And not just the government but also the civil society, the private sector, others who are engaged in those countries, and how do we work with them to design programs, which is something that we're very much focused on.

So to get the countries involved from the earliest stage, and at the MCC one of the ways that we accomplish that is to look at and have the country look at how -- what are the constraints to growth in their countries from their own perspective and consultations with civil society, and as they determine what their own impediments to economic growth are working with us and the U.S. government, in our case the MCC, to be thinking what are the strategies that we should be employing to address those impediments to growth.

So we do economic analyses. We try to work with them as closely as possible with regard to consultations with civil society in order to come up with smart packages to address their specific -- and tailor our packages to their specific constraints to growth. And so -- and through that at the MCC what we do is in addition to working -- doing the economic analysis on the front side we also make sure that the country partner is implementing the projects so it's both the design, the identification of the constraints to growth, putting together the projects and the programs that are going to address those constraints to growth, and then working together in the implementation and, importantly, also monitoring (in ?) evaluation and making sure we're doing that in a really rigorous way.

The last thing I'll say about the president's new policy is that there's a focus on results and accountability. We have to make sure that our aid dollars are going -- that we're being effective and they're going to the best possible uses and we're allocating our resources in the most effective way. So we're really focused on results. And the way that we do that is really trying to emphasize monitoring and evaluation and particularly doing impact evaluations, which is as the programs progress we're taking a hard look and to having independent parties take a hard look at how successful we're being, how effective we're being, and whether we're achieving our objectives and to the extent that we're not achieving our objectives trying to be open and transparent about that so that we're able to make midcourse corrections and we're able to make appropriate responses to both the positive news and the not so positive news. But transparency and making sure that we're being open with that information as we do this results-oriented analysis and these impact evaluations is really important.

So I think those are the basic things that sort of are at the heart of the president's new policy and we're very excited. We have -- the U.S. government has embraced the Millennium Development Goals. We're focused on having this new policy be the means by which we align our resources, allocate resources, and prioritize what we're going to be working on and those are some of the basic principles that the president set out.

FOSLER: Well, Sam, you literally lead an army on the ground and I think it would be useful -- many people may know InterAction but I think I was stunned by the number, and I don't want to get it wrong but it was in the tens of thousands of employees that are members of your group. Can you just talk about -- you've been working fairly consistently in this space -- what seems -- what seems from your perspective to be the most new and the biggest change and how is it going to change the NGO community?

SAMUEL A. WORTHINGTON: (Inaudible) -- it's 200 members and you'll recognize them as brand name nonprofits that work overseas. That infrastructure is about 120,000 people around the world, roughly comparable to the U.N. system.

If you look at development assistance, and we tend to think of development assistance as official and official development assistance worldwide is roughly $122 billion. Private development assistance -- the individual $100 that people give to large foundations like the Bill Gateses and so forth -- is roughly around $53 billion a year. A large amount of that flows through these nonprofits that for whatever reason have gotten this term as NGO as their brand name.

Many of these are significant institutions. I think we have 32 members that manage over $100 million a year and, you now, 5 (thousand) to 40,000 staff. So there's this tremendous infrastructure that's been built by humanity as part of the development enterprise to respond to a wide range of global problems. I think the biggest change we're seeing is as we approach 2015 -- and it is likely that we will as humanity will have halved poverty by that date -- it's gone from 46 percent down to 27 percent.

Most of that drive, of course, is in China and in India but we're also looking at attendance rates in schools in sub-Saharan Africa at 90 percent -- the number of children dying every year moving from 12.3 million to an unacceptable 8.8 million but a significant drop across the board. And the shift is that the development enterprise in the 21st century is a multi-actor enterprise. It has different skill sets being brought together. It is not as simple as simply the private sector (polling things out though ?) without that engine of growth we find that we cannot sustain changes.

But if you aren't focused on, as the nonprofit world tends to do -- the NGO world -- on the most vulnerable, on the disenfranchised individuals, on women and so forth you are not tapping the capacity of societies to develop themselves. And one thing that the MDGs has done is organize the international nonprofit community to some extent around the concepts of each MDG.

The term themselves doesn't sell but if you want to help children who are orphaned by AIDS or getting girls in school or making difference to a small farmer who wants access to a value chain to sell their crops, these concepts make development understandable and manageable and at the same time get translated into small projects on the ground that actually make a significant difference in people's lives.

It is when these efforts of the nonprofit community are aligned with nation states who are creating a policy framework and an operational framework within which their society can get economic growth, can build the infrastructure of their health system or education system, and is partnering with external actors that you do begin to see significant change in a relatively short period of time. The big derailer of all this is a fragility of states. It's violence, it's human greed, and at the heart, at least in my mind, it is about not just states developing but about societies. And when we talk about civil society being active it's not simply civil society delivering projects but it's standing back and saying we don't accept this level of corruption here, shining a light on practices.

But that -- this whole of society engagement -- involving business, nonprofit actors, the nation state -- is the fundamental change that we're seeing on the ground. It is also the fundamental change we're seeing here in the United States as to how our society is approaching the Millennium Development Goals. We have what I would call a major social engagement of American people. You see this in Haiti where half the American people gave to Haiti. There's a desire to participate and be an active -- actively engaged in the world. The NGO network has tended to be that network to be able to do that.

At the same time, there is a great degree of skepticism of can we make a difference and is there a way to ensure that governments are held accountable. What's interesting about the new presidential policy directive is it take a lot of the lessons of the last 10 years or more of development and applies them to the United States.

To some extent, it's taking the Millennium Challenge Corporation's norms in terms of both growth, governance practices and so forth, and then applying them to the U.S. government. I think our challenge is, is not all the world fits that model. And while you can get modes (ph) of growth, the challenge will be countries where you don't have that degree of momentum. And we have yet, as both as a society and as a development community, figured out how to cope with what sometimes we call failed states or the more complex environment.

And yet, if I sort of look and quote Bob Zoellick in looking at Africa, you've got roughly a third of the continent with resource rich, significant growth happening. Another third of the continent actually having significant economic growth, and good social development activities happening. And a third of the continent being the Africa that gets labeled as here is the problem.

And I think our challenge is -- is perhaps to focus on that second third, which is not necessarily resource rich, but has found through a degree of descent governance, through engagement of their civil society, through good partnerships and norms through the Paris Declaration in terms of what is effective development, using the Millennium Development goals as a frame, they've been able to show that they can make significant advances for their citizens.

FOSLER: Well let me ask one general question, and you can all jump in. Or hopefully, one of you will jump in. But all of this advance with respect to development seems almost a fly in the face of all the stresses that have been created around the financial crisis. And so, you know, both in terms of commitment to pay interest, and ability to meet commitments, you know, how do you see the financial crisis having affected either countries abilities to develop even with the best intentions? Or the ability of the agreeing countries to carry forward on financial commitments?

ORR: I'd love to start because when I described kind of the process of this issue escalating to leadership level, one reason its escalated to leadership level is because of the financial crisis. Governments under extreme stresses that see that business as usual won't get the job done, that are worried about donor dollars drying up. And therefore, redoubling their own internal efforts to get themselves organized, to mobilize other constituencies, and to be able to come with a much more clear-eyed view, both to their publics But also to the international community to say well, here, here and here we've succeeded, and we want to scale up in this way, but over here we haven't and we want to try something newa and we want you to help us with it.

So I think getting to the leadership level was one of the unintended consequences, if you will, of the crisis. Not to make it too -- sound too like the silver lining overwhelms the cloud though, the real shockwaves of the financial crisis have reinforced vulnerabilities that we have not seen show up in a lot of the statistics yet. We've seen some statistics show up. But I think the bottom line is things are worse out there in all the wrong places than are showing up in our data right now.

FOSLER: Can you just be specific about a couple of those things that are likely to show up?

ORR: Yeah, I think that certainly while the poverty numbers, I think we are -- our guestimates are probably pretty good. When you get into issues of -- well I'm sorry, the other areas where we do fairly well probably is on people in school. It's easier to count and keep track.

But on things like nutrition of what are the long-term effects of this crisis. For all those kids out there that aren't getting good nutrition right now, we have decades of price to pay for that. I don't think we know how much malnutrition has really hit in what places.

This is one of our focus areas right now is, we've created at the U.N., and are creating a platform called the Global Pulse, which is using current technologies that are disseminating throughout the world to get real time data on all of these areas so that governments can actually target their interventions much more directly. So we're not just saying look there's been a crisis, things are bad and please give us more money so we can go paper the ground with food or with -- you know, assistance.

So if we can use the existing handheld technologies that are out there, we piloted it in many countries and many different spheres. But actually, integrate that into a system of real time information, we can adjust much more quickly. And I think that gets to the essence of the development problem. This is a very fluid environment.

Globalization has had one very dramatic consequence. And that is, the good, the bad, and the ugly rockets through the system much faster than it used to. And that hits poor farmers. That hits women in villages that never thought that the outside world would hit them before.

So I think if we can capture this information more quickly, and get it not just to decision makers up there -- leaders, national leaders or G-20 leaders that asked us to actually develop this, but actually into the communities themselves, tThey themselves have not had the access to this information before. So, some powerful tools out there that we could use to direct and redirect our efforts along the way.

FOSLER: Let me ask -- Sam, I'll ask you, and then, Chuck you.

Sam, how are you seeing these dynamics play in the NGO community?

WORTHINGTON: Well, if you take Gleneagles and the promises made there, the Europeans should be roughly putting about $25 billion a year into Africa. They're right around at about 11 (billion dollars) right now. So you have a major gap in promises fulfilled.

What's interesting is that at the time the U.S. was viewed as under promising, but has actually stayed relatively close to its commitments. So you've got this issue of following through on your promises. The challenge will be, of course, with the president's commitment to double foreign assistance in this fiscal environment, even though this gets significantly tied with security. And we saw increases last year as one of the few parts of the U.S. government that did, will we be able to maintain those increases? And to what extent are we playing health against security interests and so forth, which may be, at least from my view, unfortunately, I think the security interests may win out on this one.

But the challenge of the financial crisis is that it really was the third crisis to hit the developing world. We had the fuel crisis, we had significant increases in prices of fuel. And the biggest one was the price associated with food. The first wave of that roughly moved about 100 million people into food and security.

We just had a second spike right now, which we're seeing associated with the ban on exports coming from Russia, which is moving approximately 65 million people into food and security. And the challenge is, is for the first time, you really have people moving backwards associated with the shocks.

The good news around this, and we saw this in the L'Aquila G-8 summit, was that the world recognized that our -- while we had focused on health. And had recognized that we could make significant advances in different health areas around the MEGs, the area of agriculture and food security had been largely under appreciated or under invested in.

And another recognition was that you're not going to be able to simply feed the world from high output areas. And that it ultimately came down to small holder farmer, who are predominantly women in remote, rural areas, able to feed themselves and their families. And this launching of initiatives -- the U.S. initiatives Feed the Future, and there are others as part of the $20 billion commitment to in essence enable the world to feed themselves.

The big question then is, how real is that $20 billion? And our fear is that ultimately it will be a tradeoff between dollars at home and foreign assistance. And on the private side, we did just interactions -- (inaudible) -- community.

I stopped counting when our members that are -- after about 10,000 jobs laid off. And slightly over $1 billion of fewer donations going in. And those were resources and programs in essence targeting the most vulnerable.

FOSLER: Well Chuck, it seems to me that you've got an up hill battle, particularly next year. How do you convince Congress to continue to fund these kinds of initiatives?

COOPER: I think the financial crisis has meant that we're operating in a very constrained budget environment. And I think what we from the administration perspective are doing is trying to think through the president's new policy. How do we do development? How do we do assistance in as smart a way as possible, and focus on effectiveness and efficiency?

I mean, it's really critical that we're thinking about how do we use U.S. taxpayer dollars to the best possible end. And so, the president's new policy is very much focused on thinking about how can we leverage resources, non-U.S. government resources working with the private sector, working with our partners in the NGO space. To be thinking about how can we collaborate and harmonize so that we're leveraging resources in a more effective way so that there is communication and that there is a division of responsibility.

And we're thinking about how do we play to each of our strengths, and use the taxpayer dollars in a way that's going to get the biggest impact possible. But there's no question that this is a very difficult budget environment, and we have to be very focused on how we're doing aid as effectively and efficiently as possible.

FOSLER: Well, I think this is a great opportunity to turn it over to members' questions. If I can ask you to, when you're called on, to wait for the microphone, to stand, to give your name and affiliation and keep your question to one question so that everybody has an opportunity to ask. So, questions from members. Yes. Do we have a microphone? Good.

QUESTIONER: I'm Adrienne Germain from the International Women's Health Coalition. And as you mentioned, Bob, one of the highlights of the MDG Week was the secretary-general's global strategy on women's and children's health, which is going to take a magnificent effort, including from the United Nations itself. So, both specific to that strategy, but also to the forced march, I think you mentioned, of the next five years to come much closer to the MDG's, how does the secretary-general's office look at the role and obligation, really, of the U.N. system to step up in that forced march?

ORR: Well, Adrienne, as one of the pioneers in this area, I think one of the most exciting pieces of the last two weeks for me was people like you have been in the trenches on these issues for so long, telling people like me, look, there's an opportunity here. You should grab it. And for once, we actually grabbed it, and it's going.

I think that the success breeds huge responsibilities. Now, we've mobilized a lot of political commitment. We've mobilized a lot of resources that were not on the table before, but this is all about delivery, and I think, from the perspective of the secretary-general, the accountability outcome that was agreed to in that strategy -- the only part of the MDG summit where an accountability framework was agreed to be elaborated.

Member states debated whether or not to have an overall accountability framework for the whole lot, and they couldn't agree on that. But on the women's and children's health strategy, it was agreed that we will have a process over the coming year -- actually, it'll be much less than a year, I hope -- that we are going to get a multi-stakeholder agreement on accountability going all directions. And this is going to be instrumental to keeping everyone, not only up to their commitments, but keep motivating everyone, because we have made some progress in this area.

You have made progress. Others have made progress that hasn't shown up in the data again until just recently. Everyone said, oh, wait a minute. What happened? We went from half a million women dying a year in the maternal health space, to 350. That was just a statistical blip, right? Well, wrong. In fact, the increased investments have had an effect that we're just starting to see now.

But we have to know where we're having an effect and how much of an effect, and what's not working, because maternal health, for example, is not malaria. It's not a question of deployment of insecticide treated bed mats. It has multiple components, multiple dimensions in different places. And if we can't organize and reorganize ourselves around the specific challenges in those different areas, we won't keep the momentum going.

But I will say that it was shocking, actually. One prime minister who's been wonderful on these issues leaned over to me and said, "I've never seen leaders fighting to get into a room to talk about women's and children's health." And he said, "I've usually felt so lonely on this issue. And now, they're fighting to get in." We have to keep that going. We have to keep them fighting to get in, and the only way we'll do that is with some success stories.

It's the kind of brutal reality that when this was perceived as the slowest moving space, no one really wanted to joint this crusade because it was just too tough, and slogging through the trenches didn't look so attractive. But now, all of a sudden, it looks like it's possible, we've made some progress, and we have resources committed to make more.

One final thought on this is that in this strategy, one of the most exciting pieces is that the different parts of the equation are starting to see the opportunities. We've had NGOs starting to partner with businesses, starting to partner with governments, starting to partner with international organizations in a way we've never seen before.

And to come to the nub of your question, what about the U.N. system? That's where we started because we recognized we had a problem. The U.N. system was fragmented, as we are on many things, and so two years ago, the secretary-general called all the heads into a room and said, I want to focus on this issue and we're not going anywhere outside these walls until we can agree amongst ourselves what our own self diagnosis is.

So by starting with the physician, heal thyself, we were a much more credible interlocutor and were able to bring a lot of the other governments, NGOs and companies into the room. Now, I will tell you, we have a very exciting development.

In 27 different countries around the world, the U.N. country teams are operating in a almost wall-less, seamless way among the teams. And if we can keep that going, we have an organizational locus for international efforts. Twenty-seven countries, let's just see how that goes. I'd love to see that grow by quite a few in the coming year or two.

FOSLER: Exciting. Question there? In the back.

QUESTIONER: Thanks. I'm Bruce Shearer with Apollo Philanthropy Partners. We certainly appreciated all of the optimistic assessments you've given us, and some of the barriers that you've seen that need to be removed, but I was hoping we'd hear a real report on evaluating progress. Where are we going to be, you know, five years out? How far short will we be? Is it really as rosy as you've made it sound so far? (Laughter.)

ORR: I can, this should be for me since I've been the one who's been on the rosy side here. The fact is, we will fall short. We know that. But the fact is that the progress with five years to go, if we just project out current trends, we won't get there in a whole range of MDG targets and in a whole range of countries. But I think there's a lot of fluidity in this equation, and so, we are emphasizing those areas where there is movement and where we are having successes.

Not to ignore the gaps. I mean, if you read our gap report, it's pretty sobering reading. We have a lot of gaps in a lot of places. But I think the focus, not just on gaps, which is what we usually do. Let's identify all the places we're falling short and try to plug it with some money and plug it with some effort. We need to do that. But we also need to ride some of the areas where we've seen success and let that launch into other areas.

So I don't mean to make it sound too rosy. We are up against a very, very tough environment, and when I say forced march, I mean forced march. Five years to even get close to the achievement of the money and development goals in all the places is going to be a very, very great deal of work. But it is doable and I think that was one of the key messages coming out from the summit, was we have to mobilize across the board if we're to have a shot.

In 2015, do I think we're going to be there? No. Could we be significantly down the road and know how to define the next steps after that, such that we could be there in the not too distant future after that? Yeah.

COOPER: I think one of the challenges is if you did not have the economic growth of China and India, we wouldn't be seeing the indices that we have right now. And I think that lesson, and the fact the U.S. government is focusing on that lesson, other governments on how do you take advantage of this economic growth, as a tool to shift things, is, bodes well, but we need some set of goals beyond 2015 and some form of organizing principle, ideally, in our sense, based on rights going forward. So 2015 is not going to be there.

The other things I mentioned earlier, in states that are, where the nation state is so weak that it has trouble functioning -- whether it's a Haiti, you're looking at Pakistan right now as a pretty rough environment --- we have not figured out, in many ways, how to effectively assist from the outside. To some extent, it ends up with parallel systems because you've built a capacity to help people because the government can't do it.

Sometime then the government turns around and says you've built parallel systems. Well, the answer is, without those systems, your people would not have any services. How do you get those systems integrated? And the answer is going to be this willingness to work across business, government, non-profit business nexus.

And many nation states are not comfortable with that. They feel too weak to decentralize authority that way. And in many ways -- I mean, use Haiti as an example or other states, Afghanistan -- it is actually that willingness to decentralize authority that is going to help with the development of the country. And yet, it's counterintuitive because they feel so weak at the center. And that, I think, unfortunately, will get worse as the resources that are coming in decrease and this becomes a money grab with fewer resources and that could set us backwards.

FOSLER: Yes, up here.

QUESTIONER: Thank you for coming today. Laurie Garrett from the Council. Probably the single most dramatic public health achievement of the 20th century was the eradication of smallpox. But it's also a great tragedy story, because a vast infrastructure of civil society, governments, pharmaceutical industry, et cetera was allowed to simply collapse the moment the final case of smallpox was seen. Here we are pell-mell rush for the last five years and all sorts of new bridges being built, new kinds of partnerships you've spoken to, real infrastructure development. To what degree is it being done with conscious thought now, that that infrastructure cannot be allowed to disappear in 2015?

COOPER: I would say that it's just not a case of a race to the finish to 2015, but really what we're focused on is sustainability and trying to put the systems in place that are going to make us achieve sustainability. And part of that is working with our country partners to make sure that they're engaged and we have country ownership. And that we're really building capacity in-country. And that we're focusing on system-wide reforms that are going to be able to maintain and be sustained past 2015. So I think part of the benefit of the MDGs is the fact that it's galvanized and focused support. But one of the most important things that we're focused on is making sure that we have a sustainable approach so that we're able to continue to achieve and continue to realize our objectives beyond 2015.

I think -- I mean, when asked the question, you know, what is there after the MDGs of this administration? They're not answering that yet. What they have done is figure out how there's a national development strategy that uses and fits within an MDG framework, which is significantly different than the previous administration.

Many governments, particularly in Europe, did that at the beginning of the MDGs. We're doing that sort of 10 years in. It doesn't mean that there weren't significant contributions in AIDS and other areas by the Bush administration, but using the framework of the MDGs is a relatively new framework for the U.S. government to adopt. And we're sort of adopting it at the end. But what happens after that, ultimately, I think, does get to this, what is this infrastructure we've put in place. I don't see it ending but I do get concerned if there isn't some form of conceptual organizing frame that replaces it, particularly on the private side, because we have, you know, too much tendency, a cacophany of different voices and directions to not have some frame under which we should organize ourselves.

ORR: If I could, just briefly on this. I like the way you frame that, Laurie, that to go after the historic sweep of the eradication of smallpox. One of the exciting pieces of news this week -- and I think it's been building over the last two years -- is that if just sustain the effort we're making right now we're going to really be looking at the possibility of a historic achievement on malaria by 2015. If we -- we are on track to get to zero deaths by malaria by 2015 if we sustain the effort that we're seeing now. If we were to let the infrastructure kind of fade away after we do that, think of what's being deployed. We're deploying these nets to villages that have never seen a public health worker ever before. But if we use a disease-specific frame and leave it at that, we will have wasted a tremendous of effort and money.

So this is one of the powerful pieces of using the women and children's health frame is that we need a whole series of capacities and capabilities to not only get out to that village once to stamp out one disease, but to be able to engage that population, for the first time in most cases, with the public health system. And what do we do with that?

The idea, when you're talking about the numbers of affiliated staff in InterAction, I was floored when the head of BRAC -- how many in the office know what BRAC is? I'm just curious. This is a -- that's not bad, about half of you. One NGO in Bangladesh that has 120,000 people -- women, poor women -- on its payroll reaching a tremendous part of the Bangladeshi population and that model is now in 14 different countries starting from the most unlikely of places, Bangladesh.

So here we have an infrastructure that's building. Do we want to use that for one purpose or for a multiple --

WORTHINGTON: They're an InterAction member now, so-to-speak.

ORR: Ah, excellent.

(Cross talk.)

ORR: So now you can double the number people you have.

WORTHINGTON: -- exporting NGOs from the south to the north.

FOSLER: Yes, sir?

QUESTIONER: Yeah. I'm Charlie MacCormack, the CEO of Save the Children. My question is for Bob Orr. Given this much more complicated, multi-stakeholder process that Sam described, what can be and should be the role of the U.N. in kind of pulling it all together? You know, at Save the Children we really look to Davos and the Clinton Initiative and Allen and Company (ph) and so on and so forth, as the venues where we can really pull together our partnerships with corporations and foundations and media and so on and so forth, because the U.N. wasn't set up, the entrepreneurial and results-oriented and media-oriented and so on and so forth. So hats off for as much as has been done, but is the U.N. able to kind of play that role in this new system and if not, what's the package that would allow all the players who want to be responsible and move forward and more coherently do that?

ORR: So Charlie, I think first thing, hats off to you and Save and to Kate Hunt and Care. And I see many of you in the audience here today that made some of the most dramatic commitments against this strategy. And I will tell you when I said we're creating a positive cycle, I mean you were. You have bid up these governments. You have bid up these companies and I think it was the energy coming, quite frankly, out of the non-profit sector, out of the NGO sector, which started to create a race to the top here. And I don't say that lightly. And so, the energy came from the base on this one. It didn't start with the leaders on this. It started from the base and the leaders heard it and grabbed onto this, because this looked like a political equation that was a winner.

On the issue of what the U.N. can do. I think the secretary-general is committed to this for the long term because we have intentionally used the Office of the secretary-general to bring this to a leaders' level. But this has to be done at exactly the level you described, specific partnerships, specific delivery vehicles for new things in need places that none of us have ever really reached before, and opening the doors here. We have a number of governments that said they're ready to work with NGOs and companies that have said they were nervous about that before. So we're not going to advocate this space, but the one thing the secretary-general said was, we're not going to replicate things that exist. This is not an opportunity for the U.N. to kind of colonize the space. In fact, we want to make all the different venues out there more efficient and effective.

But the one area that I think we can help a lot with is the coordination on the ground. U.N. country teams are in virtually all the countries. We're talking about with technical capacity, with reach back capacity, the headquarters and we've underutilized that in the past. But it is going to be your folks on the ground with our folks on the ground with your folks on the ground. It is going to be the on-the-ground folks that have to pull all this together. And I think that the secretary-general will be channeling what comes out of that on-the-ground experience straight back to the leaders' level. To say, we're on track, you're on track or we need more of this or more of that.

So I think in terms of using the leverage of his office and the political weight that this strategy has created, I think really we need to just take what your people are doing on the ground and others and then feed that back in and adjust course as needed.

WORTHINGTON: Let me on this one, just say I think this is a space the U.N. really does need to step in, because when you're engaged in the humanitarian enterprise and the nation states not functioning the NGO community to, you know, Haiti, you know, sort of $1.3 billion from the U.S. down there, you have thousands and thousands of staff. You're managing that enterprise within the U.N. system at the highest level.

The moment it goes to the development sphere, this thing called sovereignty kicks in and you end up with a degree of discomfort, of non-state actors, corporations and so forth. And since the end game is ultimately aligning state and non-states, private and for-profit actors in the development enterprise, it is difficult to create that if governments are uncomfortable.

And now it's an interesting tug-of-war with various governments saying, no, we don't want these non-state actors -- whether they're corporations or NGOs -- at the table; others saying, yes, we do. And to some extent, the neutral broker able to pull that off is the U.N. And of course, then of course, the U.N. being owned nation states has its own challenge. But I see that as a particular opportunity for a space that -- at least for nonprofits -- we can't fill without help.

FOSLER: Another question? Yes.

QUESTIONER: Hi. I'm -- (inaudible) -- U.N. Foundation.

A few of you have mentioned what happens after 2015 -- or at least alluded to it -- and I just wanted to press you a little bit more on that.

What happens after 2015 -- assuming that we don't meet the MDGs? Do we have another set of MDGs? What do they look like, what are the lessons that we've learned from this first iteration? And what happens to the U.N.'s credibility on this if we're not going to achieve them?

Thank you.

ORR: We've been assiduously deferring that question until after the summit, so thank you for putting me on the spot right after.

All joking aside, I think it was a very important unified message that we had to send that we are focused on 2015 right now, because there's no doubt we could start kind of letting our belt out any time now and say, you know, ah, we'll start dieting later; we'll get to that issue later.

But I think we will have to build into the next couple years some serious strategic engagement among all these communities about what a post-2015 world looks like, because if we just keep singing the anthem "until 2015" and then we're not there, it would be pretty natural for there to be a political falloff and a political fallout on this.

But I think if we stay focus on what we've learned and drive towards 2015, but then build over the next couple of years an understanding of what happens, you know, from 2015 on, I think we can take the power of driving to that artificial deadline and then roll it over into the real world where there is no artificial deadline in 2015 and 2016 is, you know, not that different looking than 2015.

So that needs to start happening now. But I think given the kinds of commitments we've just seen, we need to stay on the path of 2015, even as we build that conversation. And I mean build it across all these constituencies -- not a kind of a strict U.N.-intergovernment negotiation two years from now to say we're going to set a new set of goals. I think this really has to come out of the fabric of the kind of partnerships that are making this work right now.

I think the NGOs, the companies, the foundations and the international organizations -- as well as the governments -- have to be a part of that conversation for it to be real.

FOSLER: One final question -- oh.

COOPER: I just had something to add, which is what we're looking at is trying to look at the principles of aid effectiveness that have existed over the last 40 or 50 years and incorporate them first in the Millennium Challenge Corporation, and I think more broadly now being embraced by the administration. But it's basically a strategy that's focused on the long term. And it's about a focus on economic growth and making sure that we're creating environments that are conducive to investment and conducive to private-sector firms becoming engaged in these markets.

And it's a focus on some of the other principles that we talked about earlier with regard to selectivity and country ownership and really trying to put those into practice and learning the experiences of those aid-effectiveness principles.

But also, perhaps most importantly, is the focus on results and making sure that we're holding ourselves accountable and that we're holding our partner countries accountable for results. And what that means is if we're not achieving the results that we're seeking that we have to make changes and we have to make midcourse corrections and we have to think about, how can we do things differently?

But we have a dedicated focus on economic growth. We're focused on these other aid-effectiveness principles and we think that this is the foundation for the future of development assistance. And so 2015 is the short-term goal, but we think these principles are built to last and we think that the whole focus of the strategy is on sustainability.

WORTHINGTON: The frame behind all this -- just to jump in here -- is one of human rights. And it's the shift from political rights to social and economic rights. And all the conferences -- starting with the National Conference of Population Development 1993, all the big gatherings that are focused on how do you solve these problems have ultimately led back to one or other of the core human rights principles that the U.N. is built on.

And I think the next step -- if we're able to do this -- would be able to tie some set of goals and direction associated with the social and economic rights that underlie -- or the foundation on which the MDGs sit.

FOSLER: Yes, sir. Back here.

QUESTIONER: Colin Mack (ph) -- (inaudible) -- University and Columbia University.

Thanks to all of you for this presentation. My question is directed to all of you: Do you think we have the institutions and people to make it possible to measure the effectiveness of the programs oriented towards millennium development goals?

I'm concerned that we don't have the institutional infrastructure, because a large part of the world has not been censused in the last decade or two; and I'm concerned that a major portion of the research staff of the statistical offices of the developing countries were trained in the '70s and they're retiring now; and we are not investing in the human resources and capacity to know whether we are or are not achieving our goals.

I thought the global pulse project was a great idea, but without a statistical office to design sample frames and analyze the data and publish the results and discuss what it means, you're on very thin ice.

So are we investing adequately in people and institutions so that we know -- so we have instruments on this space ship.

WORTHINGTON: Yes to your general observation and no, we're not investing.

FOSLER: (Laughs.) I thought this was going to be a short answer.

WORTHINGTON: To be fair, I used to say this and we'll see where the new investments in USAID go, but for many times I would say well, the U.S. NGO community has more evaluation capacity than the U.S. government does. I think we're still there where the nonprofits in the U.S. have more capacity to assess and evaluate.

We have a partnership interaction with (triple-IE ?), we've created it at MIT and looking at a number of universities -- actually, with Rockefeller engaging on learning within the NGO community. And yet, all learning has a long, long way to go.

But the overall statistical frame within which we work has not had the level of investment it needs. And our ability to tell the story tends to be reduced to project-based data and effectiveness around projects. And we know we can be effective on projects. What we don't know and we have difficulty validating with outside different tools -- whether it's, you know, baselines and so forth -- is impact scale, without getting into simply anecdotes.

ORR: On the investment side of this, I think your point is extremely well taken. And what's interesting about the global pulse is it will only truly work if it's able to link together not only existing statistical capacity -- both of governments and of NGOs and others.

And this is a big, new space here, because information sharing of data is heavily constrained by government decision making. And if governments are willing to work with us to cross some of those boundaries -- they've been less willing to before -- they could actually learn a lot more a lot faster. And if they want to help their populations -- and we've heard from a number of major governments, they do want to help their populations and they're willing to look at these issues, we actually could provide a lot more to them and they to us.

We surveyed the U.N. system. We had 39 different early warning capacity mechanisms before the global pulse was created. We said, we don't want to create one more. We don't need a 40th, thank you very much. What we need is to link these usually sector-specific mechanisms. We have the food, we have the children under five, we have all these different constituency and disease oriented and specific mechanisms. We need to knit it together. We need to get the kind of agreements in place in the MOUs such that a government statistical capacity could be built by this and supported by this and vice versa, not replaced.

Just because we have (handholds ?) out in the field in Africa, that doesn't mean we can afford to disinvest in statistical capacity. And you said, also very importantly: analytical capacity to use this. It's not a lack of data we have. It's a lack of usable data that we can crunch down to make into good policymaking. And that, I think, is going to be important.

One last observation on this: Just straight from this meeting I'm heading back to the U.N. for -- we're launching the Global Fund's third replenishment tomorrow and tonight is the reception for all of the ministers in town.

If we have a mechanism like the Global Fund, which is pumping out not only huge amounts of money, but there are systems linked to now a multilateral capacity like the global fund, we're learning a lot coming back from that. So we actually have a level of organization that we didn't five years ago.

So we need to take what we do have, use that, fuse these pieces together, because if we just start investing in national, statistical offices, we could drop hundreds of billions of dollars very quickly. But if we're smart about it, we may get a lot more bang for our buck on the data that we have.

COOPER: I would say that the president's new policy has made a commitment to focus on monitoring and evaluation and to put real resources behind that and to strengthen USAID with regard to a focus on monitoring and evaluation.

The Millennium Challenge Corporation, since its founding seven years ago, has been built around the idea that we have to do rigorous monitoring and evaluation. So a dedicated portion of our budget has gone to monitoring and evaluation and we take that very seriously -- from design all the way through impact evaluation. We look at results; we look at not only outputs, but outcome -- outcomes and ultimately, the impact. And so it's something that's really baked into our DNA and it's something we take very seriously.

And the way that we do this in partnering with our partner countries is that we create something called the Millennium Challenge Account in each of our countries that we're working with. And that is an in-country staff that gets hired of country nationals who both help to design, but implement our projects. And a component of that MCA in each of our countries is monitoring and evaluation staff.

And so the monitoring and evaluation staff and the economists in Washington are very much focused on training these MCA, MNE staff so that they, in country, are able to have the capacity to do monitoring and evaluation and impact evaluations -- not only during the term of our compacts -- our aid packages -- but moving beyond so they have the capacity, after we stop our engagement in the country, so they have the capacity to continue to do that once we -- once we leave.

FOSLER: Well, this has been a fabulous session for me. I've learned a tremendous amount. I thank each of you -- wonderful expertise and commitment from each one of you.

And thank you all, again, for coming on a perfectly foul night. But it's a great session and actually, one where you rarely hear -- our question not withstanding -- more positive than negative. So I actually walk away with some optimism.

So thank you all. (Applause.)

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