We’ve already looked at how Professor Jeffrey Sachs believes small, proven interventions at local level can be “scaled up” - accompanied, of course, by a matching scale-up of aid to pay for it all. What does his UN assignment, the UN Millennium Project, have to say on the topic?

Multiple examples, the report notes, show that scaling-up can work:

  • Vietnam’s success at beating a 1991 malaria epidemic, where free bednets and treatments nationwide tackled the problem quickly
  • Tanzania’s abolition of school fees, and massive investments in new schools and teacher training, increasing primary school enrolment from around 60% to around 90% and achieving gender equality (p34)

But nevertheless, there are real challenges to be faced in scaling-up the MDG interventions: the sheer number of different areas of action; the need to reach millions of people in each country. The report outlines several key factors which are needed to make it work:

  • Political commitment at the top level;
  • Concrete objectives and plans of work, with specific targets and timetables;
  • Delivery systems that are locally appropriate, but also standardised and easily replicable: for example, there are standardised guidelines for Malaria treatment;
  • Substantial funding - Tanzania’s education budget had to more than double to achieve the changes above;
  • Abolition of user fees;
  • Upgrade of infrastructure and increased staffing;
  • Co-ordination of government, NGOs and community organisations, donors, and the private sector;
  • A role for communities in planning and design of services;
  • Close monitoring of progress, with alterations made along the way if needed;
  • Long-term, stable, predictable donor finance.

Governance

Crucial to achieving effective scale-up, of course, is effective governance. But the report is eager to point out that the common phrase “poor governance” has two distinct meanings:

  1. Corrupt leadership, where government has poor or selfish motives, or is run to the benefit of a particular tribe or ethnic group
  2. Weak leadership, where the government’s intentions are good, but its efforts are impaired by lack of resources, technical expertise, or poor management. (p35)

While comment about governance, particularly in Africa, tends to focus on corruption, the report states that “Many of the world’s poorest countries lie closer to this second category.”(p35) In these cases, investment can also be made to improve governance. The following steps can help:

  1. Promote the rule of law with adequately trained, staffed government and legal systems;
  2. Promote political and social rights through human rights assessments of developing country governments;
  3. Accountability, transparency, and participation by all sectors of society, especially the poor;
  4. Promote private sector growth through sound economic policies and management
  5. Support civil society and NGOs as partners in meeting the MDGs. (p36)

This is all pretty top-level stuff, but it gives a clear steer as to the requirements for an effective scale-up of interventions at national level. But is it enough to convince those critics who believe aid is often wasted? We’ll look at some of the criticisms of the report in a few weeks. Of course, it isn’t just problems within developing countries that are currently slowing progress towards the goals. As we’ve already seen, there are also issues with rich countries and their relationships - as donors and as trading partners - with developing countries. We’ll look a little at this next time.


Page numbers come from the Overview Report. You can also see the full 300+ page version, ten key recommendations, or the reports of the individual task forces.

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