Let's take at face value the Prime Minister's announcement that he wants the G8 to make maternal and child health in poor countries a priority. Heaven knows it should be. Despite some real progress over recent decades, women and children continue to die in huge numbers from conditions that, to some extent, can be easily and inexpensively prevented and treated. It's both a tragedy and a scandal.
If Stephen Harper is serious, I believe there are a number of lessons that can be learned from the many years in which good people have already been trying to meet this challenge. As it happens, I have some experience here, since in the past decade I've written a series of reports on these issues, usually focusing on Africa, for the United Nations, the African Union and for Unicef in Africa.
And that's the first lesson. The Prime Minster must not think he's just discovered America. All kinds of efforts have been attempted for decades to improve maternal and child well-being globally. Those involved have included the United Nations, UN agencies, NGOs, the World Health Organization, government aid organizations like CIDA, and governments and civil society groups in poor countries. But as the ongoing crisis demonstrates, results have been distinctly mixed. That's why so many Canadian NGOs have been urging the government to make this issue a priority.
I could fill this column with the lofty titles of conventions, charters, plans of action, reviews of plans of action, calls for action, calls for accelerated action, special assemblies, ministerial declarations, formal statements of principle – all aimed at improving maternal and child health. Evaluations have often been surprisingly frank in pointing to disappointing results and helpful in suggesting the reasons.
As a result, in virtually every conceivable area related to the well-being of women and children, there are detailed plans of action and recommended policies and programs outlining exactly how commitments can be implemented. As well, across all poor countries there are countless dedicated NGOs, civil society organizations and local community groups already active in these areas. It would be an unforgivable error if Mr. Harper doesn't learn from these many experiences and work with these dedicated groups.
He must begin by acknowledging that his government has a real credibility gap in this area, not least the abrupt way he's introduced the subject.
A Tanzanian expectant mother lays on the floor as she and others pack a maternity ward while waiting to deliver their babies at the Temeke hospital in Dar-es-Salaam, Tanzania, on October 2, 2007. — 2007 AFP
We have real expertise on the subject right here in Canada. But much of it is held by NGOs and CIDA staff whom Mr. Harper and his government clearly hold in low regard. Last summer, International Co-operation Minister Bev Oda attacked her own department in a remarkable interview with Embassy Magazine in Ottawa. She complained, for instance, that CIDA did not have a single health specialist whom she could consult regarding a proposed new health project. As Ottawa University Professor Stephen Brown commented, “This statement came as quite a shock for the five or more health experts at CIDA.”
In what Prof. Brown also called “an even more shocking statement,” Ms. Oda claimed that CIDA employees and its NGO partners only looked at how much could be spent, not what results would be achieved. “In fact, CIDA and the organizations it funds are required to use a tool known as ‘results-based management.' As minister in charge of CIDA for almost two years, she has to be aware of this.” If the Prime Minister wants his brand new initiative to have credibility, this kind of malicious undermining of those whose help he needs most must immediately stop.
There are other issues in the aid department, both for Canada and its G8 partners. The first is that they never give as much aid as they promise or live up to the commitments they earnestly make. It's getting hard to recall all the G8 meetings in recent years that have promised far more aid, to Africa especially, than they ever deliver. (Watch what happens to the pledges to Haiti over the next few years.) And not a single member of the G8, including Canada, has ever come close to delivering on the promise that 0.7 per cent of GDP would go to aid. Beyond that, we must not forget that large chunks of so-called aid fail to reach poor countries at all. In reality much of it goes to purchases at home, administration, consultants and the like. That kind of “aid” helps us far more than it helps them.
