Challenging the ideological deficiency in the existing Aid narrative is essentially dependent on how we accord attention to the existing shifts in the interests of global economic power centers, and power imbalances rooted in imperialism- that is perpetuating the misdiagnosed fundamental dynamics of capitalism in the multilateral trading system that has quite often acted as a tandem to direct the route of trade
By Michael Ssemakula
Human Rights Research Documentation Center (HURIC) & People’s Health Movement
Development Cooperation: Concerns and Emerging Challenges
The challenges surrounding Aid and overall support towards the health, humanitarian and development programs of the south, sets in another significant conversation on the notion of aid especially its flow- through the far-old outdated narrative of aid coming from the bloc [1] of “first world capitalist” states to the poor-est and low-est wage countries.[2] The question remains, who has access to these resources? Why Aid flows predominantly from one side of “philanthropic stream”, mainly from ex-colonial monopoly and north partnership financing initiatives? [3] Who has access to this stream? How is the Aid system in the multilateral trust funds and groups structured to reduce systems of aid that are “parallel” to local systems [4] which is one of the Paris Declaration [5] priorities. What is the role of proximity to these Aid resources between the south and north divides? How effective is aid in impacting the livelihoods of the recipients besides being used largely for influencing the macro-economic policies of developing countries? [6]
Challenging the ideological deficiency in the existing Aid narrative is essentially dependent on how we accord attention to the existing shifts in the interests of global economic power centers, and power imbalances rooted in imperialism- that is perpetuating the misdiagnosed fundamental dynamics of capitalism in the multilateral trading system that has quite often acted as a tandem to direct the route of trade.
Thousands of policy analysts and advice-givers commend for aid as a catalyst to harness the global development agenda, health and development transformation in the economic growth stages of nations- from traditional economy to the age of high-mass-consumption- but is aid the ultimate solution? Who demystifies the misleading purported “persuasive thought” of “fair” trade that is acting as a blindfold in promoting neoliberalism syndrome in the world economy ruining fragile economies and fueling dependency through aid.
Echoing back on the historical reality, and the contemporary reality that suggests a required model shift in aid drawn for its coverage and effectiveness; that is aid flowing from north to south- to universal coverage through global public investment, where all countries should contribute to Global Public Investment according to their ability, and all can benefit from it according to need. [7] Circumstances have changed over time and this is a manifestation of the fact that developing nations are no longer a homogeneous boat of “poor” countries but instead are extremely differentiated in their capacities and needs [8]. Historically Aid was coiled in the dominant narrative of rich countries helping poor countries to develop [9]. This traditional model of development and health assistance has been superseded by a more complex reality of aid in response to new prevailing conditions, new global players, and new mechanisms for aid delivery.
In the recent Kampala initiative workshop (November 2019) “cooperation and solidarity within and beyond aid” civil society activists from diverse professional and experience backgrounds met in Kampala to examine the notion of Aid, dominant narratives about aid and charity emanating from the global North (the rich states helping the “poor” states- and in particular from many NGOs), establish a democratic civil society space and structure of independent, critical-thinking activists and organizations across Southern and Northern boundaries and address the failures and shortcomings of “health aid” and its actors and practices.[10] But how can we change this narrative with the existence of funding mechanisms and systems of these new players operating differently from and parallel to the country policies and structures?
In the current global development evolution both in north and south, the progressive development and health cooperation among the partnering agencies and states through bilateral, multilateral and aid trust funds like the Global Financing Facility of the World Bank Group have become more and more essential joints in financing for health. All these are multiple mechanisms that have been designed to channel aid to the high priority areas, but how can we strengthen coordination to prevent distortion of national policies and structures through these funding modalities? Most significantly how governments in low- and lower-middle income countries can transform how they prioritize and finance their health [11] without necessarily drifting away from their country health strategies, plans and programs because of the enthralling “big monies” promised by big agencies to support new areas that are far-divergent from the country original strategic plans?
Aid can be a propulsion to strengthening health systems, but also its intended purpose and achievements can remain “imaginary” if power imbalances remain unchecked, one-sided and firmly ingrained in decisions made by aid agencies. The current narrative on aid reinforces power imbalances, and through Kampala initiative, civil society recognized that the framing of the language in aid is still problematic and inadequately represents the reality. This is detrimental to strengthening policy coherence and the normative values of aid and solidarity among the aid actors especially the intergovernmental agencies.
Moving forward, the complex mix of approaches interweaved with new global instruments for delivery designed to reshape rules and policies and strengthen coordination and corroborative efforts (such as the Global Action Plan-GAP on healthy lives and wellbeing) in health financing and development among the existing and new institutions and funding models, have served as an imperative tandem of shifting development paradigms in health, thriving on the assumption of what is purported to work best for the aid agencies’ systems. But little grip of attention on what works best for the in-country systems. With the increasing diversity of approaches and aid streams, the development cooperation space now faces a blend of multiple exciting opportunities to expand funding, however this raises difficult questions about how to forge meaningful and effective partnerships,[12]shared ownership, mutual accountability, deliverable results, and harmonization of processes as guiding principles of the Paris declaration.[13]
References
[1] First, Second and Third World, https://www.nationsonline.org/oneworld/third_world_countries.htm
[2] Ecological modernization: World Bank’s ‘impeccable’ logic of pollution trade, Lawrence H. Summers
[3] Turbulences in Uganda’s Global Aid Construct: Is the Contemporary Aid Effective Enough to Transform Uganda’s Health System to Achieve UHC? By Michael Ssemakula; http://www.peah.it/2019/03/6553/
[4] https://en.wikipedia.org/wiki/Aid
[5] The Paris Declaration on Aid Effectiveness
[6] The Effectiveness of Foreign Aid on Economic Development in Developing Countries: A Case of Zimbabwe (1980-2000)
[7] GLOBAL PUBLIC INVESTMENT Five paradigm shifts for the future of aid: Jonathan Glennie, Principal Associate, Joep Lange Institute; September 2019
[8] Building a Foundation for Better Development Cooperation: CGD Development Leaders Conference 2019
[11] https://www.globalfinancingfacility.org/introduction
[12] Building a Foundation for Better Development Cooperation: CGD Development Leaders Conference 2019
[13] The Paris Declaration on Aid Effectiveness
[14] “Beyond aid” – the Kampala Initiative, https://www.medicusmundi.org/beyond-aid-the-kampala-initiative/