Isobel Coleman

Democracy in Development

Coleman maps the intersections between political reform, economic growth, and U.S. policy in the developing world.

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Combating Obstetric Fistula

by Isobel Coleman
An Ethiopian woman sits on her bed inside a clinic for obstetric fistula in Bahir Dar on March 10, 2007 (Eliana Aponte/Courtesy Reuters). An Ethiopian woman sits on her bed inside a clinic for obstetric fistula in Bahir Dar on March 10, 2007 (Eliana Aponte/Courtesy Reuters).

Today is the first International Day to End Obstetric Fistula. To be honest, I was not very familiar with the tragedy of fistula until about a decade ago, when I met the remarkable Dr. Catherine Hamlin, who has devoted her life to treating the problems of fistula in Ethiopia. More on her work below, but for those of you who don’t know what this terrible condition entails, I refer you to the UNFPA explanation: Read more »

Missing Pieces: Cash for the Congo, Health Shocks, and More

by Isobel Coleman
A woman carries a gardening tool on her head while heading to work in the fields at Bukima, just north of the eastern Congolese city of Goma, August 19, 2010 (Finbarr O'Reilly/Courtesy Reuters).

In this edition of Missing Pieces, Charles Landow reviews stories on Afghanistan, the Democratic Republic of the Congo, Indonesia, and Mongolia, as well as a scholarly paper on health. Enjoy and have a great weekend.

Cash for the Congo: Starting in 2007, the Tuungane program in the Democratic Republic of the Congo “funded classrooms, clinics, and other investments in 1,250 villages,” which had to form elected committees to plan and execute projects in consultation with villagers. More recently, in what the Financial Times calls “an acid test of whether Tuungane had helped to promote effective village institutions,” an evaluation project gave cash to Tuungane and non-Tuungane villages and examined their process for spending it. Tuungane’s impact on improving governance appears minimal. In both groups, almost equal proportions of villages used elections to choose committees to spend the funds. The average amount of money that went missing was “nearly identical in treatment and control areas” as well. But even if Tuungane’s effects on governance were limited, it is heartening that the UK’s Department for International Development, which funded Tuungane, has allowed such a rigorous study of its work. Read more »

Missing Pieces: Education and Health in Pakistan, Poverty in Haiti, and More

by Isobel Coleman
A health worker administers a polio vaccine to a child during a nationwide drive against the disease in a hospital in Islamabad, Pakistan, August 8, 2007 (Faisal Mahmood/Courtesy Reuters).
In this edition of Missing Pieces, Charles Landow reviews two scholarly works, as well as news on Haiti and a range of development innovations. Enjoy the reading and the holiday weekend.
  • Education and Health in Pakistan: While better educated parents are known to raise healthier children, the role of each parent and the exact reasons for the correlation remain unclear. A study in World Development seeks to clarify the issue. Using a survey of almost 1,200 households in two provinces of Pakistan, the authors find that a mother’s level of schooling significantly affects children’s height and weight. However, only a father’s education impacts immunization. The authors speculate that fathers may guide certain health behaviors, “particularly if they require travel to a health clinic,” while mothers govern “day-to-day decisions” that affect “longer-term measures of health such as height and weight.” But it is not parents’ “education per se” that drives better child health. Instead, the authors find that immunization responds to fathers’ health knowledge (rather than overall schooling). Mothers’ impact on height and weight, meanwhile, seems driven by their health knowledge and “empowerment within the home.” Based on these findings, the authors write that “policies aimed at achieving better health awareness and knowledge” might give Pakistan the biggest development boost. Read more »

Missing Pieces: Kim’s Vision, Zimbabwe’s Farmers, and More

by Isobel Coleman
Jim Yong Kim, the new President of the World Bank Group, speaks to the press as he arrives for his first day on the job at the World Bank Headquarters in Washington, DC, July 2, 2012 (Jason Reed/Courtesy Reuters).
In this edition of Missing Pieces, Charles Landow covers topics ranging from global health to emerging market growth, with stops in Zimbabwe and Latin America. Enjoy!
  • Kim’s Vision: In a speech and interview this week, World Bank president Jim Yong Kim made clear that he sees deep connections between poverty and health. First, in remarks at the International AIDS Conference, Kim called for using the lessons of the AIDS movement to combat poverty, including through partnerships, openness and transparency, and “applying AIDS knowledge and resources” to broader challenges like health insurance and human capital. In an interview with the Guardian, Kim said that his past work with Partners for Health “was really always about poverty.” As he put it, “we’ve always believed that investing in health means investing in the wellbeing and development of that entire community.” CFR’s Laurie Garrett offers a sobering take on the fight against AIDS in a interview. Read more »

Missing Pieces: Global Growth Prospects, East Africa’s Farmers, and More

by Isobel Coleman
Trucks unload shipping containers from a cargo ship at Qingdao port in Qingdao, China, September 2, 2011 (Courtesy Reuters).
Charles Landow reviews IMF forecasts, a study on cash transfers, and reports on East Africa and Indonesia in this edition of Missing Pieces. Enjoy the selection.
  • Global Growth Prospects: The IMF released a sanguine but sober World Economic Outlook last week. “Weak recovery” should take hold in advanced economies while developing ones “remain relatively solid,” the Fund says. But “recent improvements are very fragile.” The U.S. economy is projected to grow at 2.1 percent this year and 2.4 percent in 2013; the Eurozone is forecast to contract 0.3 percent before resuming growth of 0.9 percent. These figures are all up slightly from the IMF’s previous forecast in January. Asia is set to remain the fastest-growing developing region, with China projected to expand by 8.2 and 8.8 percent this year and next. India should grow by 6.9 and 7.3 percent, lagging the region as a whole. Sub-Saharan Africa is forecast to keep growing at just over 5 percent per year. Read more »

Agriculture in Egypt

by Isobel Coleman

A farmer shows cotton on a farm in Qaha, north of Cairo in September 2011 (Amr Dalsh/Courtesy Reuters).

Agricultural is the third largest productive sector of Egypt’s economy after manufacturing and mining, which includes oil and gas. It represents 14 percent of overall GDP, but directly employs at least a third of Egypt’s labor force, and indirectly employs many more through the processing and transportation of agricultural products. Nonetheless, Egyptian agriculture has long been neglected by politicians. Cotton production has dropped over 75 percent from 1972 to 2009, and the amount of arable land (2.4 percent of Egypt’s territory) has hardly budged in that time. Read more »

USAID in the 21st Century

by Isobel Coleman

I recently hosted Ambassador Don Steinberg, Deputy Administrator of USAID, at an on-the-record CFR meeting to discuss the broad transformation underway at USAID. (You can view above a brief video interview that was filmed after the meeting.) This ambitious reform effort, called USAID Forward, is intended to reposition USAID as an “innovator” in global development, and also to establish a “relentless focus on results.” After years of decline (declining staff, declining expertise, declining reputation), USAID is adding personnel (850 new hires in the past 2 years), bringing experts in-house, gaining clarity around seven core priorities (food security, global health, climate change, sustainable economic growth, democracy promotion, humanitarian assistance, and conflict prevention), and introducing better measurement and evaluation (M&E) systems. Steinberg was optimistic about USAID’s ability to succeed in this transformation, although he spoke candidly about intensifying budget pressures, the imperative of convincing Americans that USAID can be “good stewards,” the rise of new actors in development (US official development assistance last year was roughly $30 billion, but private philanthropies donated some $36 billion to international development), and the ongoing cultural challenges involved in shifting the mission of this large bureaucracy (frankly, it’s hard to push innovation and risk-taking in a structurally risk-averse organization). Read more »

World AIDS Day: The Role of Religion

by Isobel Coleman

A Buddhist monk waits to pray at a World AIDS Day commemoration in Colombo, Sri Lanka on December 1, 2011 (Dinuka Liyanawatte/Courtesy Reuters).

Since the first cases of AIDS came to public attention in 1981, the virus has claimed over 25 million lives worldwide. Preventing HIV transmission and providing care for the 34 million people living with the virus remains one of the foremost public health challenges of our time. Even in communities with high rates of HIV/AIDS, the virus is still too often a source of deep social stigma, dissuading those infected from seeking help. Although combating the spread of AIDS requires coordination and support from all sectors, key stakeholders have often exacerbated the epidemic. In South Africa, former President Mbeki’s rejection of the basic scientific consensus on AIDS led to an estimated 343,000 otherwise preventable deaths from 1999 to 2007. While religious leaders are unusually well-placed to provide followers with guidance about this preventable disease, they have in many cases contributed to the epidemic by denying the importance of condoms in HIV prevention and contributing to the stigma that AIDS patients already confront. Read more »

An AIDS-free Generation

by Isobel Coleman

A health worker holds up a blood sample at hospital that provides treatment for HIV/AIDS patients in northern Vietnam in November 2010 (Nguyen Huy Kham/Courtesy Reuters).

In a speech on Tuesday at the National Institutes of  Health, Secretary of State Hillary Clinton  called for countries to work together to establish “an AIDS-free generation,” meaning virtually no children are born HIV positive, they would have a far lower risk of HIV infection when they become teenagers than they do at present, and where people who become infected with HIV are prevented from developing AIDS and from spreading the virus. These ambitious objectives seemed impossible not long ago, but recent scientific advances make the notion of an AIDS-free generation conceivable. In the speech, Secretary Clinton proposed three main HIV/AIDS interventions, all based on successful clinical trials: voluntary medical circumcision for men, drug treatment for  infected pregnant women to prevent HIV transmission to the infant, and antiretroviral drugs for recently infected patients to reduce the risk that their sexual partners will contract HIV from them. Nevertheless, although the vision of an AIDS-free generation is tremendously exciting, generating sufficient funding for AIDS treatment and prevention remains a daunting task. At present, worldwide AIDS spending is about $16 billion each year. Even if only half of the 34 million infected individuals receive drug treatment by 2015, that would require worldwide AIDS spending to grow to $23 billion. Given the current state of the global economy, the challenges of increasing government contributions loom large. Read more »

Missing Pieces: Kyrgyzstan, China in Africa, and More

by Isobel Coleman

Kyrgyz President Roza Otunbayeva casts her ballot during the presidential election at a polling station in the capital Bishkek, October 30, 2011 (Sultan Dosaliev/Courtesy Reuters).

Charles Landow offers a selection of news and scholarly work in this week’s edition of Missing Pieces. Enjoy and have a good weekend.

  • Kyrgyzstan’s Election: Former prime minister Almazbek Atabayev won Kyrgyzstan’s presidential election on Sunday. He will take over on December 31 from Roza Otunbayeva, who has served as caretaker president since an uprising toppled the previous regime last year. As Voice of America explains, this will be the first voluntary transfer of power in Central Asia since the collapse of the Soviet Union. Sunday’s polls were decidedly imperfect, according to the OSCE. But “observers overall assessed the voting positively”–a solid outcome in a country torn apart after last year’s uprising, as this report from the International Crisis Group shows. The Economist explains that Atabayev will need to repair lingering ethnic tensions, as well as combat organized crime and boost the economy. The new president is seen as friendly to Russia; he pledged on Tuesday to close the U.S. air base at Manas, a crucial supply post for the war in Afghanistan, when its lease expires in 2014. Read more »