ABU DHABI/NEW YORK – For a child, receiving a vaccine takes just a moment (and perhaps a few tears). But such moments are crucial for getting children off to a healthy start in life, and for advancing progress on global health and development goals.

Along with Mohamed bin Zayed bin Sultan Al Nahyan, Crown Prince of Abu Dhabi, we attach great importance to the world’s first global summit, being held this week in Abu Dhabi, aimed at ensuring that all children have access to the full benefits of vaccines.

Vaccines protect people for a lifetime. They are one of the most cost-effective investments we can make to improve our world. Vaccines have eradicated smallpox, pushed polio to the verge of eradication, and saved millions of children from measles, diphtheria, tetanus, and other deadly and disabling diseases. Thanks in large part to the power of vaccines, the number of children dying before the age of five has fallen from 20 million in 1960 to 6.9 million in 2011, despite a large increase in global population.

Disease saps the greatest asset that any country possesses: the energy and talent of its people. This is an especially harsh loss for poor countries seeking to gain a foothold in the global economy. But when children are healthy, families are freed from the burden of costly medical care, allowing them to spend more on food and education. Healthy children attend school more regularly, are better able to learn, and become more productive adults. New research shows that vaccines improve cognitive development in children, raise labor productivity, and contribute to a country’s overall economic growth.

Yet more than 22 million children lack access to the basic vaccines that people in high-income countries take for granted. These children live in the poorest and most remote communities, where the risk of disease is highest. A child born in a low-income country is 18 times more likely to die before reaching the age of five than a child in a high-income country.

Ending this inequity is at the heart of history’s largest and most successful anti-poverty push – the Millennium Development Goals.

The eight MDGs were adopted in the year 2000, when leaders meeting at the United Nations agreed to cut extreme poverty and hunger by half, fight disease, improve water safety and sanitation, expand education, and empower girls and women. There have been remarkable gains, but there is still much to do – and fewer than 1,000 days of action left until the 2015 deadline.

Raising global immunization coverage will speed progress toward the MDGs and generate momentum toward a successful post-2015 development agenda. The World Health Assembly, representing the World Health Organization’s 194 member countries, has endorsed a shared vision – known as the Decade of Vaccines – of a world free from vaccine-preventable diseases, with the full benefits of immunization reaching all people, regardless of who they are or where they live.

Eradicating polio will be a milestone on our path to realizing this vision. With a new, comprehensive plan to be introduced at the Summit, the world will have a clear roadmap for creating a polio-free world by 2018. The plan works hand in hand with our overall efforts to raise immunization coverage against other diseases like measles, pneumonia, and rotavirus. Indeed, we are seeing how strong immunization systems protect our gains against polio and provide a platform for reaching the world’s most vulnerable mothers and children with new vaccines and primary health care.

If we are successful, by the end of the decade we will save more than 20 million lives, prevent nearly one billion cases of illness, and save almost $12 billion in treatment costs alone. And, in the process of freeing people from the burden of disease, we will unlock immeasurable human potential.

The MDGs and the Decade of Vaccines prove that focused global development objectives can make a profound difference. They show the power of partnerships that bring together the United Nations, governments, development agencies, civil society, foundations, and the private sector.

Over the next 1,000 days and beyond, our progress will be measured by what we have done to improve the lives of the poorest and most vulnerable members of the human family.

Let us start by recommitting ourselves to realizing the shared vision of a world in which all children get a fair start in life with the protection of vaccines. This generation will thank us – and so will many generations to come.

* Ban Ki-moon is Secretary-General of the United Nations. Bill Gates is Co-Chair of the Bill & Melinda Gates Foundation.

The African National Congress, which has governed South Africa since the end of apartheid, is in serious trouble. Unfortunately, the country may not be far behind.

In 1994, the ANC – widely credited with ending decades of white minority rule – came to power with a near-monopoly on political legitimacy among the country’s black majority. Together with President Nelson Mandela’s moral authority, this status helped the party to accommodate a wide range of interests and establish a stable economic order without losing the support of poor black voters, many of whom fell outside that order. Although supporters’ expectations were high, so was their patience – a dynamic reinforced by the ANC’s liberation mythology and early successes in expanding housing, electricity, and social grants.

Nearly 20 years later, this patience has worn thin. While poverty has decreased slightly since 1994, inequality has vaulted upward, fueled by extreme unemployment, state incapacity, corruption, and affirmative-action policies skewed toward the upper reaches of the economy (not to mention the pernicious legacy of apartheid).

Rapid urbanization has increased the number of people living in settlements surrounding the country’s major cities, where deprivation is especially stark and government malfeasance is more widely felt. Meanwhile, a new generation of “born free” South Africans are not swayed solely by the ANC’s historical credentials, especially with youth unemployment near 45%.

As a result, the ANC’s monopoly on legitimacy is loosening. Although still electorally dominant, the party’s parliamentary representation has dropped below the two-thirds threshold required to change the constitution. And, if the 2011 local elections are any indication, its popular backing continues to decline (the ANC won just 63% of the vote). Meanwhile, growing apathy and discontent with the scope and pace of economic change has substantially reduced voter turnout.

Beyond the ballot box, violent, inequality-driven protests are on the rise, as citizens step outside the ANC and its affiliates to demand economic improvements. There has been a boom in so-called “service-delivery protests” in the settlements surrounding urban areas.

Last year’s wave of wildcat strikes in the mining sector – which precipitated the infamous “Marikana massacre” – ended up shaving 0.5% off the country’s GDP growth in 2012. Recent labor unrest on wine farms in the Western Cape reflects the same dynamic. While violence and instability have long marred the informal sector – witness the country’s high crime rate and frequent attacks on foreign traders – they are becoming more common in the formal sector as well.

These structural, “bottom up” pressures will continue to weigh on South Africa, making 2013 another year fraught with political risk. President Jacob Zuma’s sweeping re-election as ANC president at the party’s December conference was a defeat for the most radical factions, and will foster a more decisive government than the country had in 2012. But the ANC leadership will alienate leaders and constituencies from the very same areas where protests and strikes are most common, including Gauteng, Western Cape, swaths of Eastern Cape and Free State, and mining communities in North West and Limpopo.

Government efforts to control provincial spending will exacerbate tensions, as will the growing influence of Zulus in Zuma’s ANC. Retrenchment and shutdowns at gold and platinum mines –as well as the expiration in June of wage agreements in the gold and coal industries – will almost certainly spark more labor unrest, especially considering the growing rivalry between the ANC-aligned National Union of Mineworkers and the more militant Association of Mineworkers and Construction Union.

Given that the ANC’s overwhelming priority is to maintain political dominance in the 2014 elections, the party will be tempted to win public support through increased spending and statist policies, rather than implementing critical structural reforms that investors demand. Although the ANC dismissed proposals to nationalize the country’s mines, its embrace of “strategic state ownership” has brought further policy uncertainty to the sector while paving the way for a weightier government presence in related industries like energy and steel.

Similarly, the party’s endorsement of the pragmatic National Development Plan and the election of popular labor leader-turned-billionaire Cyril Ramaphosa as Deputy President are unlikely to stem the risks that it now faces. The NDP’s most urgent proposed measures – more flexible labor laws, education reform, and rationalizing local government – will be watered down by vested interests and weak governance, while its (otherwise welcome) emphasis on expanding infrastructure will be undermined by political favoritism and corruption.

Ramaphosa’s respectability will undoubtedly provide the party (and the scandal-plagued Zuma) with some badly needed cover. But the ANC government will still have to focus on short-term measures and patronage in order to shore up its electoral support. Without these steps, continued bouts of social unrest may well shake investor confidence more than unwelcome policies do.

The ANC no longer has sufficient credibility with poor South Africans to ask for continued patience in achieving “a better life for all.” It is no longer 1994, and Zuma is no Nelson Mandela.

Project syndicate

Hosted by Liberian President and Nobel Peace Prize laureate Ellen Johnson Sirleaf, Indonesian President Susilo Bambang Yudhoyono, and British Prime Minister David Cameron – take place, the nearby Sahel and the Great Lakes region continue to be plagued by violence and conflict. Indeed, large-scale displacement of people and unspeakable human suffering are occurring in many African countries (not to mention in Syria and elsewhere), threatening to reverse the continent’s unprecedented economic progress during the last decade.

The Panel (of which I am a member) must seize the opportunity presented by the Monrovia meeting to contribute to a global development agenda that addresses the vicious cycle of conflict and poverty that hampers economic activity and undermines human well-being.

For more than a decade, the Millennium Development Goals, which expire in two years, have provided the framework for international development cooperation, with a focus on combating poverty worldwide. In developing a new, comprehensive follow-up agenda, global leaders should recognize that, although the MDGs have enabled millions of people worldwide to escape illiteracy, disease, and hunger, their overall impact has been inadequate, particularly in fragile, conflict-ridden countries. World Bank statistics show that no conflict-affected low-income country has achieved a single MDG, reflecting the framework’s failure to address problems caused by organized violence and insecurity effectively.

That is why the post-2015 agenda should be centered on peace, security, and freedom from fear. It should aim to make justice and prosperity a reality for everyone. And it should reflect the understanding that development is impossible without peace, just as peace is impossible without development – and that lasting peace and sustainable development are impossible without respect for human rights and the rule of law.

Furthermore, as the Monrovia meeting’s theme, “National Building Blocks for Sustained Prosperity,” suggests, post-2015 global development initiatives should emphasize support for national efforts to achieve strong, stable, long-term prosperity. Strategies that would help countries to overcome domestic insecurity and conflict, transform their economies, and, ultimately, meet their potential include strengthening governance institutions and the rule of law, ensuring multi-stakeholder participation, and guaranteeing that all citizens have equal access to justice. International support for such efforts would mean giving African leaders and stakeholders the opportunity – and the responsibility – to eliminate underdevelopment and boost prosperity.

Moreover, while poverty eradication will remain a paramount concern after 2015, the focus must shift from national averages to local disparities. Measures must move beyond overall social needs to bolster progress in productive job-creating and income-generating sectors. And strong efforts must be made in conflict-affected countries to promote reconciliation and prevent the revival of violence.

Given Liberia’s recent success in post-conflict reconstruction and human development, following a 14-year civil war, it is a fitting setting for the Panel’s deliberations. Since 2003, domestic vision and commitment, together with international support, have enabled Liberia to hold democratic elections, reintroduce some essential public services, reestablish a public-finance management system, and make progress in addressing endemic corruption, rebuilding public institutions, and reconstructing national infrastructure.

The Panel should view Liberia’s ongoing efforts to secure peace, maintain stability, and initiate economic and social transformation as a blueprint for successful post-conflict transition. Other inspiring models can be found in Rwanda, Mozambique, and Sierra Leone.

The Panel is committed to creating an ambitious, coherent, and practical proposal for a sustainable global development agenda. The process will be open, inclusive, and transparent, and will be informed by the opinions and experiences of experts and stakeholders representing young people, women, the elderly, and the disabled, as well as legislative, academic, and inter-governmental actors. The Panel will also take advantage of extensive online and offline efforts to engage with people worldwide and gain insight into the future that they envision. Their perspectives will enrich efforts to develop an agenda that addresses their priorities.

In a world roiled by conflict, development efforts will always fall short. The post-2015 global development agenda must take a comprehensive approach, combining poverty-reduction measures with peace-building initiatives and strategies for economic transformation. In this way, global leaders can begin to lay the foundations for prosperity, justice, and sustainable development worldwide. Future generations are counting on it.

Project syndicate

With rapid economic growth have come more prosperous consumers – and vice versa: 45% of Africa’s total GDP growth in the 2000’s (before the financial crisis erupted in 2008) came from consumer-related sectors of the economy. It is expected that, by 2020, more than half of African households – almost 130 million – will have discretionary income to spend (or save), up from 85 million today.

Moreover, Africa has the world’s fastest-growing population – and the youngest, with more than half under 20 years old, compared to 28% in China. The United Nations estimates that the continent will account for more than 40% of global population growth through 2030, with the working-age population expected to surpass that of China by 2040.

Given these trends, the continent’s consumer industries are expected to grow a further $410 billion by 2020 – more than half the total revenue increase that all businesses are expected to generate in Africa by the end of the decade. But, for many companies entering Africa or seeking to expand there from a local base, the challenge now is to obtain a better understanding of the market and its consumers.

In one of the first studies of its kind, the McKinsey Africa Consumer Insights Center surveyed 13,000 individuals from 15 cities in ten of the continent’s 54 countries in 2011 and 2012. The ten countries – Algeria, Angola, Egypt, Ghana, Kenya, Morocco, Nigeria, South Africa, Sudan, and Tunisia – accounted for 81% of Africa’s private consumption in 2011. But, throughout the continent, market opportunities for consumer-facing companies are concentrated more in cities than in particular countries.

Indeed, with 40% of its population living in cities, Africa is more urbanized than India (30%), and nearly as urbanized as China (45%). By 2016, more than 500 million Africans will live in urban centers, and the number of cities with more than one million people is expected to reach 65, up from 52 in 2011 (on par with Europe and higher than India and North America).

This development is critically important for consumer companies. Urban household spending in Africa is increasing twice as fast as rural spending, with urban per capita incomes, on average, 80% higher than those of countries as a whole.

Befitting the continent’s strong macro trends, the survey found a high degree of optimism among urban African consumers: 84% of respondents expect their households to be better off in two years. Sub-Saharan Africans are the most optimistic – 97% of Ghanaians, for example, expect to be much better off in two years. (For North Africans, however, that figure drops to only 10-15%, which is unsurprising given the uncertainty generated by the region’s recent political turmoil.)

Overall, consumers are increasing their spending across most retail categories. Up to 30% of the more optimistic consumers in some countries say that they are shopping more frequently and purchasing new and more expensive products. And half of all respondents claim to make daily sacrifices to save for major expenditures.

This suggests that companies offering cheap, poor-quality, unbranded products are unlikely to succeed in the long term. For apparel consumers, for example, quality is second only to price when choosing a store, and second only to fashion when choosing a specific item. And, in both North and Sub-Saharan Africa, brand loyalty is strong, averaging 58%.

But quality and brand must be delivered at the right price. Even though Africans value brands and product quality, affordability remains crucial. To succeed, companies should work to reach consumers’ price points through a combination of product reengineering (such as removing low-value-added features), smaller package sizes, and low-cost operating models.

Moreover, timing is crucial when choosing where to play. Demand for consumer products typically follows an S-curve. As incomes rise, categories reach a takeoff point where demand accelerates by 3-5 times. At higher levels of income, markets become saturated and growth slows.

Different products and categories enter the “hot zone” at different moments: those with low price points, such as snacks and beverages, typically take off relatively early; beauty products somewhat later; and luxury goods, such as branded fashion, later still. Not surprisingly, in most African markets, few categories have entered the slower-growth “chill-out” zone.

This is where understanding opportunities at a city level is vital. Country-level planning and resource allocation is still the rule for most businesses operating in Africa, resulting in inefficient allocation of human and capital resources. By creating detailed profiles of the most promising urban opportunities, companies could target their investments more effectively.

Identifying growth hot spots is only the start. Substantial differences among and within Africa’s countries imply the need for a much deeper and finer-grained understanding of consumer preferences and affordability profiles by product category. Likewise, many markets are still in early stages of development, and must be built through concerted consumer education and trial.

Here, Africa’s youth merit special attention: the survey found that the 16-34 age group already accounts for 53% of income in urban centers. Young people’s consumption habits are quite different from their elders’. They are more than twice as likely to search for information online and to seek products and stores that reflect the “right image.” They are also more educated, with 40% of 16-24 year olds having completed high school, compared with only 27% of the 45-and-older group.

These characteristics point to a major change in African consumption habits as this cohort ages, its incomes increase, and its behaviors and decision criteria become the societal norm. Many companies – particularly multinational firms accustomed to old and aging populations in the advanced countries – will have to adapt accordingly.

Project syndicate

As drought becomes increasingly common, farmers worldwide are struggling to maintain crop yields. In the United States, farmers are experiencing the most severe drought in more than a half-century. As a result, global corn, wheat, and soybean prices rose in July and August, and remain high.

But the severe dry spell parching croplands across the US is only the latest in a global cycle of increasingly frequent and damaging droughts. In Africa’s Sahel region, millions of people are facing hunger for the third time since 2005. Lack of rain in the region and volatile global food prices have made a bad situation worse. Indeed, it is the world’s poor – particularly those in rural areas – that suffer the most from these combined factors.

This does not bode well for our future. By 2050, global food production will have to increase by 60% to meet demand from a growing world population with changing consumption habits. To ensure food security for all, we will have to increase not just food production, but also availability, especially for those living in developing countries. That means breaking down barriers and inequalities, building capacity, and disseminating knowledge. In Africa, smallholder farmers – who provide 80% of the sub-Saharan region’s food – need infrastructure for agricultural development, including irrigation and roads, as well as better market organization and access to technology.

The International Fund for Agricultural Development sees enormous potential in Africa’s agricultural sector, which experienced 4.8% growth in 2009, compared to 3.8% in the Asia-Pacific region and only 1.4% in Latin America and the Caribbean. Given that agriculture amounts to roughly 30% of sub-Saharan Africa’s GDP, and accounts for more than 60% of employment in most African countries, the sector’s development could reduce poverty in the region substantially.

Not only in Africa – in countries like Burkina Faso and Ethiopia – but also in emerging countries like China, India, and Vietnam, experience has repeatedly shown that smallholder farmers can lead agricultural growth while stimulating broader economic development. Small farmers, both women and men, are Africa’s biggest agricultural investors. And agriculture-driven GDP growth is more than twice as effective in reducing poverty as growth in other sectors.

But African farmers encounter significant barriers to achieving their potential. On average, they apply less than 10 kilograms of fertilizer per hectare, compared to 140 kilograms in India. Furthermore, less than 5% of agricultural land is irrigated, and improved crop varieties are rarely used.

Agricultural development efforts should, therefore, focus on promoting the growth and sustainability of smallholder farmers and small rural businesses. This requires a more supportive regulatory environment, technical assistance, as well as connections to suppliers, distributors, and finance providers.

Countries that are experiencing significant agricultural growth, such as Brazil and Thailand, have benefited from public-sector investment in research and infrastructure development. We should consider not only how to improve the ability of smallholder farmers to grow food; we also must strengthen their ability to participate in markets, while improving the way those markets function.

Moreover, sustainable investment linkages between smallholder farmers and the private sector are needed. By enabling farmers to increase their output and incomes, smallholder-inclusive private investment can bolster economic growth and food security. Finally, farmers’ organizations, which are crucial intermediaries between producers and corporate investors, must be involved in the formulation of plans and policies aimed at agricultural development.

A vibrant rural sector can generate demand for locally produced goods and services, thereby stimulating sustainable employment growth in agro-processing, services, and small-scale manufacturing. Such opportunities would allow young people to thrive in their rural communities, rather than being forced to search for work in urban areas.

Africa can feed itself. But that is not all: With knowledge, technology, infrastructure, and enabling policies, smallholder farmers in Africa and elsewhere can drive sustainable agricultural development, contribute to global food security, and catalyze economic growth worldwide.

WASHINGTON, DC – Last year, the international community recognized one of the worst humanitarian tragedies of recent times unfolding in the Horn of Africa, and moved in to ameliorate the widespread famine there. Now, poor rains, crop shortages, and continuing conflict could cause millions to be plunged back into life-threatening levels of hunger and malnutrition.
Emergency assistance is crucial in this fragile time; but it is not enough. Only if the agricultural sector’s fundamental inadequacies are addressed can the region truly escape famine’s blight.
Africa is endowed with 60% of the world’s unused arable land and millions of dedicated farmers. They simply need the tools, infrastructure, and competence to unlock the continent’s tremendous agricultural potential. There is no reason – and no excuse – to leave the survival of millions to unpredictable weather conditions. Rather, countries must take control by drastically improving efficiency and productivity.
To be sure, progress has been made. Some African governments have reduced regulatory barriers to private-sector investment in agriculture. And some are implementing risk-management and hedging tools to shield farmers from drought and flood, and poor consumers from the food-price volatility that such disasters cause. For example, the Global Index Insurance Facility insures Kenyan farmers against drought or excessive rainfall.
Such initiatives foster the flow of resources into agriculture – both for the agribusinesses needed to feed Africa’s growing cities, and for smallholders who need better seeds, fertilizer, and market roads. Although more developed regions have been taking such measures, they are not yet standard practice in Africa.
The continent’s agricultural sector is further hindered by low skills, a dearth of innovation, weak infrastructure, little funding, and lack of access to land, land titles, and lender security. But, given the right tools, all of these problems are solvable.
For example, in order to finance reform, local banks need incentives to expand credit. That could mean access to specialized credit bureaus and rating agencies, risk-sharing facilities targeting smallholders, and advisory services to provide capacity-building and education.
These banks also need direct support. For example, the International Finance Corporation is investing $25 million in Zambia National Commercial Bank to increase access to finance for small-scale entrepreneurs and rural agribusiness companies, which account for a significant share of Zambia’s economic output.
Moreover, innovative financing techniques – such as structured trade finance, warehouse receipt finance, and supplier finance – are already in place or being developed. Under the Global Warehouse Receipt Program, for example, farmers may use produce stored in depositories as collateral for loans.
Smallholder farm-mechanization models are also needed to improve efficiency and increase yields. Farmers could be grouped together to pool their production and negotiate a favorable offtake agreement to monetize future sales, then use the receipts to lease equipment, such as tractors.
Water is another major constraint on food production in some regions. Most affected countries are working to increase supply by developing new sources of ground and surface water, using wastewater from nearby urban areas, harvesting rainwater, or reusing agricultural drainage. Meanwhile, some countries are focusing on reducing demand, through improved management and innovative agricultural techniques, such as precision and drip irrigation.
Africa also needs better infrastructure in order to boost food output. Limited access to electricity means that cold storage is lacking; poorly maintained roads slow down old vehicles; and inefficient ports often leave food to rot on the docks. Production is meaningless if fresh products do not make it to market in good condition and at a reasonable cost.
Finally, Africa’s transformation into an agricultural powerhouse must be based on inclusiveness and environmental sustainability. Investments should ensure an equitable division of benefits between producers and consumers, and include smallholder participation and linkages to markets for inputs and outputs. And investors must account for the interests of host countries, local communities, and the environment – an approach that is both good and good business.
Long-term food security in Africa is possible. In fact, it is only the first step on the road to a booming agricultural export sector for Africa. By acting now, African and international leaders can ensure not only the continent’s food security, but also a prosperous, inclusive economy.

* Thierry Tanoh is Vice President for Sub-Saharan Africa, Latin American and the Caribbean, and Western Europe at the International Finance Corporation, a member of the World Bank Group. (Project syndicate)

This act of solidarity – unprecedented in human experience – led to revolutionary advances in promoting health care as a human right. The Global Fund to Fight AIDS, Tuberculosis, and Malaria, along with the United States President’s Emergency Plan for AIDS Relief (PEPFAR), quite literally changed the course of history. Programs directly supported by the Global Fund have saved nearly eight million lives since 2002 – an average of more than 4,400 lives every day.

But, while much has been accomplished, much more remains to be done – and the Global Fund needs at least $2 billion to reverse a funding freeze that is in place through 2014. So the world now plays a waiting game to see whether governments will step up and fill the gap.

To be blunt, many of the world’s largest economies are not fulfilling their financial pledges to the Fund. Their politicians cite budget constraints and the need to prioritize domestic programs over fighting diseases that disproportionately kill the world’s poorest.

My country, Rwanda, has been a recipient of Global Fund grants since 2002. Just 18 years ago, our society was torn apart by a brutal genocide that killed more than one million people. Today, Rwanda is a peaceful country full of promise and hope, with one of the world’s fastest-growing economies.

With Global Fund support for our national institutions, we have achieved universal access to lifesaving antiretroviral therapy for people living with HIV, and we have stabilized HIV prevalence at around 3% of the population. Similarly, Rwanda’s tuberculosis program has become a model for Africa, and all Rwandan families now have access to insecticide-treated bed nets to prevent malaria, contributing to an 87% drop in cases during the last seven years.

Integration of services for infectious diseases and primary care has contributed to some of the steepest declines in child and maternal mortality ever observed. And, as life expectancy in Rwanda continues to climb (from below 30 in 1995 to 55 in 2010), we are now taking action against non-communicable diseases such as heart disease, cancer, and diabetes. The flexible, country-owned support provided by the Global Fund has been crucial to our success.

My country is living proof that investing in health is not only the right thing to do, but that it can also create virtuous cycles that promote security and development. In fact, after receiving Global Fund support for years, Rwanda recently made its first donation of $1 million to the Fund.

Unfortunately, infectious diseases are far from under control around the world. Less than a quarter of the world’s children living with HIV have access to treatment, and up to a million people still die of malaria each year. And, alarmingly, only one in six patients with drug-resistant tuberculosis currently receives proper treatment. Moreover, reports of “totally drug-resistant tuberculosis” have recently emerged from India.

Policymakers would do well to remember that it only takes one airplane flight for such a pathogen to go global. Infectious diseases neither respect national borders nor conveniently follow economies into recession. History has shown that retreating from the fight against an epidemic can lead to a renewed plague that is immune to our best drugs, requiring far more expensive measures to control.

Our choice could not be clearer: either we resolve to answer the call of history and provide the Global Fund with the resources that it needs, or we allow political lassitude to undermine a decade of progress and consign untold thousands to preventable deaths. Investing now, on the other hand, would pay off in the long term: just $6 billion more per year for the AIDS response today would save more than $40 billion in averted treatment costs alone over the next decade.

Today, the Global Fund stands at a crossroads. The international community’s regard for the health of the world’s poorest in the face of financial uncertainty will be a standard by which history measures not only our ability to stand together in weathering economic upheaval, but also our capacity for justice.

Now is the time for donor countries, including middle- and low-income countries, to rise to the challenge and ensure that the Global Fund has the resources needed to accept new grant applications as soon as possible. The costs of inaction are morally – and economically – untenable.

KILGALI – Ongoing unrest between rival military factions in the eastern Democratic Republic of Congo (DRC) has triggered a predictable barrage of innuendo, fabricated leaks, and outright lies regarding Rwanda’s role. It began ten days ago, with a single BBC story on a leaked United Nations report that was said to prove Rwanda’s involvement, but did nothing of the sort (as the source of the leak admitted within days).

As if on cue, this was followed by Human Rights Watch, which paraded an even less credible set of allegations – including the risible claim that a Congolese rebel was seen by an unspecified number of unnamed witnesses at a bar on the Rwandan side of the border. Like the UN report, there was not a shred of material evidence to back up the Rwandan conspiracy – it relied on anonymous witness testimony and nothing else – but it gained a good deal of coverage anyway.

Finally, the DRC government added its voice, but once again failed to present any evidence beyond hearsay. Unfortunately, this is a well-worn path in this region whenever internal turmoil in the DRC threatens to spin out of control. The DRC must have known that its hyped-up claims would reach an audience that had been warmed up by the bogus UN and Human Rights Watch reports. The desire in some quarters to promulgate a war narrative easily outweighs the obligation to establish a credible basis for one.

Beyond fending off this latest round of exasperating claims, Rwanda is involved in the DRC crisis in one other concrete way. At last count, more than 12,850 Congolese citizens have made their way across the border into Rwanda following the recent outbreak of hostilities. The refugee situation, while tense and challenging, remains manageable, thanks to cooperation between the United Nations High Commission for Refugees and the government of Rwanda, alongside the World Food Program, the World Health Organization, and other partners. Meanwhile, many more Congolese have been displaced to other neighboring countries and within the DRC’s borders, fleeing the too-familiar drumbeat of conflict.

Too many observers have entirely forgotten the central role of the Democratic Forces for the Liberation of Rwanda (FDLR) in fomenting almost constant crisis in the region since fleeing into the DRC from Rwanda after the 1994 genocide, during which its members killed more than one million ethnic Tutsis. It has been widely reported, including by the UN’s Office for the Coordination of Humanitarian Affairs, that the FDLR is taking brutal advantage of the current unrest. The reports of mass rapes, looting, and slaughter in the DRC at the hands of these unrepentant génocidaires echo with a chilling familiarity throughout the region.

Unfortunately, these real-life horrors barely rate a mention in recent media coverage, which has focused instead on false allegations against Rwanda. And Human Rights Watch is not alone in ignoring the FDLR, whose escape to the DRC was all but facilitated by the international community in 1994, and which has never wavered from its intention to finish what it started. In its eagerness to deliver high-profile scalps to The Hague, the UN Organization Stabilization Mission in the DRC (MONUSCO) has lost sight of its original purpose, which is to quell the FDLR threat.

As the International Crisis Group recently noted, the credibility of the UN mission, whose mandate is currently under review by the Security Council, is on the line. Far from enabling security, many in the region believe that MONUSCO has emerged as a destabilizing influence – a bureaucratic behemoth, fixated on its own survival and institutionally motivated to profit from instability. As long as this remains the case, it cannot possibly play a constructive part in building sustainable peace and prosperity.

Rwanda plays no role in internal disputes within the Congolese military. As this current situation plays out, the government of Rwanda will focus its efforts on treating those who seek refuge in our country with the dignity to which they are entitled, and will take the necessary steps to facilitate their safe passage home when the time comes.

Citizens of Rwanda and the DRC have suffered long enough through conflict. It is time to reap the dividends of a sustainable peace: expanding cross-border trade and commerce, shared infrastructure, and greater economic integration. This is the path that we have pursued since 2009 – and people on both sides of the border demand that we do not stray from it.

Project syndycate

The critics of foreign aid are wrong. A growing flood of data shows that death rates in many poor countries are falling sharply, and that aid-supported programs for health-care delivery have played a key role. Aid works; One of the newest studies, by Gabriel Demombynes and Sofia Trommlerova, shows that Kenya’s infant mortality (deaths under the age of one year) has plummeted in recent years, and attributes a significant part of the gain to the massive uptake of anti-malaria bed nets. These findings are consistent with an important study of malaria death ratesby Chris Murray and others, which similarly found a significant and rapid decline in malaria-caused deaths after 2004 in sub-Saharan Africa resulting from aid-supported malaria-control measures.

Let’s turn back the clock a dozen years. In 2000, Africa was struggling with three major epidemics. AIDS was killing more than two million people each year, and spreading rapidly. Malaria was surging, owing to the parasite’s growing resistance to the standard medicine at the time. Tuberculosis was also soaring, partly as a result of the AIDS epidemic and partly because of the emergence of drug-resistant TB. In addition, hundreds of thousands of women were dying in childbirth each year, because they had no access to safe deliveries in a clinic or hospital, or to emergency help when needed.
The critics of foreign aid are wrong. A growing flood of data shows that death rates in many poor countries are falling sharply, and that aid-supported programs for health-care delivery have played a key role. Aid works; it saves lives.

In 2000, Africa was struggling with three major epidemics. AIDS was killing more than two million people each year, and spreading rapidly. Malaria was surging, owing to the parasite’s growing resistance to the standard medicine at the time. Tuberculosis was also soaring, partly as a result of the AIDS epidemic and partly because of the emergence of drug-resistant TB. In addition, hundreds of thousands of women were dying in childbirth each year, because they had no access to safe deliveries in a clinic or hospital, or to emergency help when needed.

The United Nations’ member states adopted the Millennium Development Goals in September 2000. Three of the eight MDGs – reductions in children’s deaths, maternal deaths, and epidemic diseases – focus directly on health.

Likewise, the World Health Organization issued a major call to scale up development assistance for health. And African leaders, led by Nigeria’s president at the time, Olusegun Obasanjo, took on the challenge of battling the continent’s epidemics. Nigeria hosted two landmark summits, on malaria in 2000 and on AIDS in 2001, which were a crucial spur to action.

At the second of these summits, then-UN Secretary-General Kofi Annan called for the creation of the Global Fund to Fight AIDS, TB, and Malaria. The Global Fund began operations in 2002, financing prevention, treatment, and care programs for the three diseases. High-income countries also finally agreed to reduce the debt owed by heavily indebted poor countries, allowing them to spend more on health care and less on crippling payments to creditors.

The United States also took action, adopting two major programs, one to fight AIDS and the other to fight malaria. In 2005, the UN Millennium Project recommended specific ways to scale up primary health care in the poorest countries, with the high-income countries helping to cover the costs that the poorest could not pay by themselves. The UN General Assembly backed many of the project’s recommendations, which were then implemented in numerous low-income countries.

Donor aid did start to rise sharply as a result of all of these efforts. In 1995, total aid for health care was around $7.9 billion. This inadequate level then crept up slowly, to $10.5 billion by 2000. By 2005, however, annual aid for health had jumped another $5.9 billion, and by 2010, the total had grown by another $10.5 billion, to reach $26.9 billion for the year.

The expanded funding allowed major campaigns against AIDS, TB, and malaria; a major scaling up of safe childbirth; and increased vaccine coverage, including the near-eradication of polio. Many innovative public-health techniques were developed and adopted. With one billion people living in high-income countries, total aid in 2010 amounted to around $27 per person in the donor countries – a modest sum for them, but a life-saving one for the world’s poorest people.

The public-health successes can now be seen on many fronts. Around 12 million children under five years old died in 1990. By 2010, this number had declined to around 7.6 million – still far too high, but definitely an historic improvement. Malaria deaths in children in Africa were cut from a peak of around one million in 2004 to around 700,000 by 2010, and, worldwide, deaths of pregnant women declined by almost half between 1990 and 2010, from an estimated 543,000 to 287,000.

Another $10-15 billion in annual aid (that is, roughly $10-15 more per person in the high-income world), bringing total aid to around $40 billion per year, would enable still greater progress to be made in the coming years. The MDGs for health could be achieved even in many of the world’s poorest countries.

Unfortunately, at every step during the past decade – and still today – a chorus of aid skeptics has argued against the needed help. They have repeatedly claimed that aid does not work; that the funds will simply be wasted; that anti-malaria bed nets cannot be given to the poor, since the poor won’t use them; that the poor will not take anti-AIDS medicines properly; and so on and so forth. Their attacks have been relentless (I’ve faced my share).

The opponents of aid are not merely wrong. Their vocal antagonism still threatens the funding that is needed to get the job done, to cut child and maternal deaths by enough to meet the MDGs by 2015 in the poorest countries, and to continue after that to ensure that all people everywhere finally have access to basic health services.

A decade of significant progress in health outcomes has proved the skeptics wrong. Aid for health care works – and works magnificently – to save and improve lives. Let us continue to support these life-saving programs, which uphold the dignity and well-being of all people on the planet.

Project Syndicate

NAIROBI – In Kenya, there is a running gag that sums up how far away the Turkana people live from the rest of us. When a Turkana man leaves for the capital, Nairobi, the joke goes, he tells his family, “I’m going to Kenya.”

In recent weeks, ever since Kenya’s government announced that oil had been discovered in the Lake Turkana basin, more jokes have emerged. A picture of unidentified happy, half-naked black children I had seen on my Facebook friends’ profiles many months ago began circulating again, this time with the caption, “Discover Oil in Turkana…No More Dry Skin.”

At first, I chuckled at the jokes. As a Maasai, I have heard every Kenyan joke about how “uncivilized” my people are, so I was happy that someone else was in the spotlight for a change. But when I saw a photo of a topless Turkana woman doctored to look as if she were breastfeeding a white baby, my attitude began to change.

The creator of the picture was implying that now that oil has been found in northwestern Kenya, Western oil workers will descend on the region and impregnate Turkana women, perhaps against their will. A British company discovered the oil, and, thanks to allegations that British soldiers raped hundreds of Kenyan women from 1965 to 2002, our former colonial master’s reputation isn’t good. But if the rights of the Turkana end up being violated, it will be Kenyans, not the British, who will bear the blame.

The Turkana people are, as the joke suggests, as far away from Nairobi as one can be without being foreigners. For this reason, we know very little about them. In schools, we learned about them only within the context of the Leakey family’s decades-long work excavating the Lake Turkana basin in search of fossils of humans’ ancestors. This could be one reason why Kenyans have historically looked at the Turkana people as archaic beings, millennia away from “civilization” and with different needs from most of the country.

The lack of adequate infrastructure in the Turkana region is evidence of this. Unlike the Maasai, the Turkana inhabit a region that, until now, was of little or no value to the country. There are no wild animals to attract tourists, and, although the Turkana, like the Maasai, have preserved their indigenous culture, they are not renowned around the world, perhaps because of their distance from Nairobi.

Indeed, Turkana is one of Kenya’s most neglected districts. Whenever there is a famine, chances are high that Turkana will be affected. Gado, a renowned cartoonist for one of Kenya’s leading newspapers, summed it up best, depicting a jubilant Kenyan President Mwai Kibaki leading a pack of bureaucrats and dogs in suits to Turkana to announce to the people, “Rejoice! We have discovered oil!” A Turkana woman asks him, “And when will you discover water?”

In addition to famine, the Turkana people have endured decades of raids by cattle rustlers from neighboring Ethiopia and Sudan (now South Sudan). Still, Kenya – which has been actively involved in peacekeeping operations in the Horn of Africa region and beyond – has not seen that as a good reason to protect Turkana.

The discovery of oil presents Kenya with a rare opportunity to end the Turkana community’s marginalization. Discussion of how the oil exploration and extraction will proceed needs to start now, and the health of the environment surrounding the Turkana people must be paramount.

“Pastoralists and indigenous people often rely heavily on their immediate environment for their livelihoods,” says Ikal Angelei, the director of Friends of Lake Turkana, which has been opposing the construction of Gibe III, an Ethiopian dam that threatens to reduce the amount of water flowing to the lake. Angelei says, “My fear is that if the oil exploration and drilling happens without community participation, and goes against the communities’ expectations, there is a great possibility of conflict.”

Africa’s numerous resource-driven conflicts validate Angelei’s concerns. Some of the precautions that she suggests to safeguard her people’s welfare include establishing a regulatory body that fosters transparency in contract negotiations; balancing oil production with conservation of the area’s unique biodiversity; enforcing high standards of corporate responsibility; and regulating land sales to prevent conflicts. Finally, the government should ensure that Turkana people are trained to understand and participate in the new sector.

If Kenya approaches oil exploration and extraction in Turkana the way my Facebook friends have, and fails to implement these common-sense recommendations, a few years from now Kenyans might be sorry that oil was ever found. Indeed, Kenya could end up with a conflict similar to the one in Nigeria’s Niger Delta, where local people took up arms to fight the oil industry’s degradation of their environment.

Unfortunately, the foundation for such a conflict has already, sadly, been laid. Many people in the Lake Turkana region are already armed with AK-47s and other weapons originally intended for protection from cattle rustlers. If Kenya’s government fails to protect the Turkana from the oil companies as well, its people might well start shooting.

* Juliet Torome, a writer and documentary filmmaker, was awarded Cinesource Magazine’s first annual Flaherty documentary award.
Copyright: Project Syndicate, 2012.
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