Outcomes-based financing: Possibility and promise in global health


Outcomes-based financing: Possibility and promise in global health


Addressing the Gap between Relief and Development

Elizabeth Ferris
Elizabeth Ferris
Elizabeth Ferris Former Brookings Expert, Research Professor, Institute for the Study of International Migration - Georgetown University

October 24, 2007

Thank you very much for the opportunity to participate in today’s public meeting of the Advisory Committee on Voluntary Foreign Aid and for the opportunity to comment on the recommendations made by the Working Group on Humanitarian Assistance. I do so from the perspective of someone who has worked on humanitarian issues primarily at the international level.

Nancy Lindborg, President of Mercy Corps, has laid out the 4 recommendations of the Working Group to USAID:

  • Maintain an emergency fund
  • Fund humanitarian assistance programs through core budgets
  • Create a clear strategy and funding mechanisms for transitional programming
  • Ensure a strong capacity within USAID

All four of these recommendations make good sense and they are all issues which are also being discussed internationally. The first two are intended to strengthen the ability of the US government to respond to emergencies more quickly and flexibly. Given the increasing number of natural disasters as well as the likelihood that new conflicts will emerge in the future, this capacity is sorely needed. Similarly, changes in the UN’s Central Emergency Response Fund (CERF) at the international level represent an attempt to increase both the speed and the flexibility of international funding in emergency situations.

I’d like to offer a few more comments on the last two recommendations in light of the current humanitarian landscape.

In spite of hundreds of articles, countless speeches and numerous conferences, the gap between relief and development (or refugee aid and development as it was called in an earlier generation) is still far from being overcome.[1] After conflicts are over, the expectation is that development actors will play the leading role in addressing the needs of the affected population, but this just doesn’t seem to happen naturally. Particularly in our work with internally displaced persons, we hear from development actors that ‘IDPs are a humanitarian issue, we don’t work with them.’ But there are many cases where displacement continues – either after conflicts have come to an end or because the conflicts are ‘frozen’. While the humanitarian agencies move on to more recent crises, development agencies aren’t prepared to see displacement as a development challenge. The lack of an adequate transition has a high human cost. Lives are put on hold because of this gap.

In 2004, the UN Development Group (UNDG) issued guidance on durable solutions for displaced persons,[2] noting that “durable solutions for displaced persons have been approached in an ad hoc manner. The needs of displaced people are often not incorporated into recovery and development plans, and, in some instances, displaced persons have been presented as a burden, hampering progress toward development, rather than as a potential asset.”[3] The guidance note emphasizes that preventing displacement and integrating IDPs are development challenges and that “integrated approaches are critical in ensuring the sustainable socio-economic reintegration and rehabilitation of displaced populations and their host communities through participatory, community-based and self-reliance oriented approaches.”[4] Ideally, the needs of IDPs and their host communities should be included in country development plans.

  • The guidance note indicates that there are several gaps to including displaced persons in integrated planning, including
  • Institutional gaps as different operational styles and cultures exist among different international agencies and government institutions
  • Financial gaps as funding is often for either emergency or development assistance
  • Temporal gaps with a particular gap emerging after emergency assistance begins to subside and before long-term development activities begin
  • Different program processes and budgeting cycles, particularly as development actors generally use multi-year planning cycles while humanitarian agencies use shorter time perspectives.[5]

While these gaps are descriptive of the international level, I suspect that they also occur on the national level. In any event, these gaps need to be addressed and I hope that USAID – and particularly through the F process – will develop a comprehensive strategy and additional capacity to transition assistance programming effectively from relief to development. As this comprehensive strategy is developed, I would suggest that you also follow – and encourage – the relatively new Cluster Working Group on Early Recovery, under the leadership of the UN Development Program. Established as part of the humanitarian reform initiatives, the Working Group consists of 19 UN and non-UN members. Early Recovery is defined as “recovery that begins early in a humanitarian setting and is guided by development principles. This is achieved through a multi-dimensional process – encompassing livelihoods, shelter, governance, environment, and social dimensions, including the reintegration of displaced populations – that stabilizes human security and addresses underlying risks that contributed to the crisis.”[6] At this stage, it is too early to tell whether the Early Recovery cluster will be able to overcome the difficulties in managing the transition from humanitarian assistance to long-term development. If this challenge is taken seriously, it means changing the way governmental, non-governmental and intergovernmental agencies work. It is simply easier for staff in a given agency to come up with a solution on its own – even if it means duplicating efforts undertaken elsewhere or if other agencies have more expertise in a given area – than to work with other agencies. Changes in culture are always harder to implement than structural changes.

The second issue I’d like to comment on is the working group’s recommendation to ensure a robust capacity within USAID to respond fully to humanitarian crises without over-reliance on military capacity. As Nancy has pointed out, there are times when the military’s logistical capacities are needed, and there were few quarrels with the provision of food drops for victims of the Pakistani earthquake or, for that matter, when US troops marched into New Orleans. But I believe that the growing military involvement in humanitarian work during conflicts is weakening humanitarian principles.

Humanitarian principles of neutrality, impartiality, and independence emerged 150 or so years ago with the development of the Red Cross movement and have been recognized by governments and non-state actors alike. There is something very special about having organizations whose mission is to help people in need – regardless of their politics, religion, or nationality. Those principles have been eroding in recent years for lots of reasons. Governments try to use humanitarian assistance to support political objectives. Humanitarian organizations sometimes compromise their principles or make ‘unsavory deals’ in order to continue their operations.[7] Accusations in certain parts of the world that humanitarianism is a Western concept jeopardize the lives of humanitarian workers. The very principles of humanitarianism are under strain. When military forces carry out humanitarian work, they do so in support of a military mission. That’s the way it should be. But while ‘winning hearts and minds’ may make good political sense, it is not based on humanitarian principles of neutrality, impartiality and independence. Given the preponderance of US power in the world, the impact of US military involvement in humanitarian assistance is huge. I strongly support the working group’s recommendation on the need to give USAID a more robust operating budget to ensure that it and other civilian agencies have the capacity to respond fully to humanitarian issues. When we lose humanitarian ideals, we are losing something very precious.

[1] See for example, Robert Gorman, ed., Refugee Aid and Development: Theory and Practice, New York: Greenwood Press, 1993. Jeff Crisp, “Mind the gap! UNHCR, Humanitarian Assistance and the Development Process,” New Issues in Refugee Research, Working Paper no. 43, Geneva: UNHCR, May 2001. Alexander Betts, “International Cooperation and the Targeting of Development Assistance for Refugee Solutions: Lessons from the 1980s,” New Issues in Refugee Research, Working Paper no. 107. Geneva: UNHCR, September 2004.

[2] UNDG, “UNDG Guidance Note on Durable Solutions for Displaced Persons (refugees, internally displaced persons, and returnees), 2004. See: http://altair.undp.org/documents/5239-UNDG_Guidance_Note_on_Durable_Solutions_for_Displaced_Persons_-_English.doc

[3] UNDG, Guidance Note, p. 1.

[4] UNDG, Guidance Note, pp. 1-2.

[5] UNDG, Guidance Note, p. 6.

[6] IASC Cluster Working Group on Early Recovery, “Background Paper for CWGER Workshop, 8-9 June 2006,” UNDP: April 2007, p. 3. http://www.undp.org/bcpr/iasc

[7] See for example, Larry Minear and Hazel Smith, eds., Humanitarian Diplomacy, New York: UN University Press, 2007.