Viewpoint: Why Is the United States Letting Its Best Foreign Aid Tool Fall Apart?
Tuesday, June 23, 2015
Gown shop owner Jill Andrews is probably not who you would have picked to solve one of the U.S. Agency for International Development’s (USAID) most pressing problems during the Ebola crisis in West Africa. After all, the Baltimore dressmaker typical day is spent helping soon-to-be brides look “a glass of milk,” as she told the Washington Post. But after responding to an email advertising a challenge (complete with prize money) to help USAID update the so-called “moon-suit” – the protective equipment that medical personnel wear to avoid infection while treating Ebola patients — Andrews became part of a team of experts charged with updating the gear for Liberia’s stifling climate. The problem they were facing was that, in the West African heat, medical personnel could only function in these suits for 20 minutes at a time; in addition to which, contaminated suits were clumsy to remove. But with her help, Andrews’s team developed a suit that not only fit better and was easier to take off, but could be worn three times longer.
At a time when the Defense Department was on its way to spending nearly a billion-and-half dollars to respond to the Ebola crisis, the USAID program fixed a critical glitch by dangling prizes of $100,000 to $1 million to folks who could offer creative (and cost-effective) solutions for healthcare workers on the front lines of the Ebola crisis. Meaning that while the soldiers were in the headlines, America’s most effective and inexpensive agency arm for handling crises of this kind was working to much greater effect with much less fanfare. That’s because these civilian development and humanitarian aid professionals prefer to build local capacity instead of dependency. But USAID’s own capacity is on the cusp of crisis: its staff is divided between veterans who are aging out and greenhorns, with too few in the middle.But USAID’s own capacity is on the cusp of crisis: its staff is divided between veterans who are aging out and greenhorns, with too few in the middle. From the standpoint of national capacity, America has a development donut. And it’s a problem that so far has gone all but unnoticed by policymakers or the public.
The U.S. response to Ebola is a good example of why this matters.
Six months after the response was in full sway, the forces of Operation United Assistance, according to the New York Times, wound up treating only 28 patients at two of the 11 units they had built. Given the total military costs, that’s about five million dollars per patient. The emphasis on constructing treatment centers may have made for good media optics, but it turned out to have much less impact than less expensive, more nimble measures USAID and NGOs took on the ground to halt the outbreak, among them public outreach and education. For one-fifth of that single-patient cost, the kind of public-private crowdsourcing initiative to fix a critical wardrobe malfunction, for instance, proved far more effective.
The “Fighting Ebola Grand Challenge,” launched in December 2014, is only one of many under USAID’s new Grand Challenge for Development program, a new business model featuring community-based, public-private approaches to foreign assistance as opposed to more conventional, top-fed, state-building programs. Also last fall, in partnership with Volvo, USAID launched work on 10 academies to provide industrial skills training to hundreds of students each year from Morocco, Côte d’Ivoire, Senegal, and other countries. This part of the Middle East and North Africa Investment Initiative is aimed at disenfranchised youth, who are most vulnerable to recruitment by dark and illicit networks.
At the same time, with Shell Foundation and Berytech, USAID began investing in job entrepreneurial capitalization designed to create thousands of sustainable jobs through small enterprises in Iraq and Lebanon, both of which are under a heavy burden from the influx of Syrian refugees and the threat of the Islamic State. Then, in April, the agency revealed a multiyear plan to drive down the price of medicines and increase delivery speed, enabling millions more patients to be treated for the same cost. So far, these innovations — which cost in the millions compared to the billions the Pentagon spends to go after the threats emerging from those same problems in the same places — have scored reasonable successes. But the small scale of the wins shrinks in comparison to the challenges.
Part of the problem is money.