Partnerships elevate Africa’s development successes

On this episode of Foresight Africa, hosted by Landry Signé, Gargee Ghosh, president of Global Policy and Advocacy at the Gates Foundation, explains why collaborative, context-specific, and innovative solutions elevate development success across Africa.

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[music]

SIGNÉ: Hello, I am Landry Signé, senior fellow in the Global Economy and Development Program and the Africa Growth Initiative at the Brookings Institution. Welcome to the Foresight Africa podcast, where I engage with distinguished leaders in policy, business, academia, and civil society to share their unique insights and innovative solutions to Africa’s challenges while highlighting opportunities to advance engagement between Africa, the U.S., and the global community. You can learn more about this show and our work at Brookings dot edu slash Foresight Africa podcast.

Today, I would like to introduce Gargee Ghosh, president of global policy and advocacy at the Gates Foundation. Brookings receives generous support from the Gates Foundation, which helps make the work we do possible. I’d like to reiterate Brookings’ commitment to independence and underscore that the views expressed today are solely those of the speaker.

Gargee Ghosh leads the Gates Foundation’s work in international, political, and economic affairs, overseeing relationships with governments, international organizations, advocates, and philanthropic partners worldwide.

Thank you so much for being here today, Gargee.

GHOSH: Landry, thank you for having me. It’s great to see you. Great to be here.

SIGNÉ: Fabulous! Gargee, you have had an impressive career in both the public and private sectors with roles at Google, McKinsey & Company, the Center for Global Development, and the United Nations prior to taking on your role at the Gates Foundation. Can you share your personal journey and what has inspired you to create a so impactful career in development?

[2:39]

GHOSH: Thank you for asking. I feel I’ve come home to the issues I care most about, issues of poverty, inequality, progress, what helps some countries and families rise up quickly and continue on the trajectory to prosperity and growth and why some countries and families get stuck.

It took me a while to find this place where I think I can have so much impact on those questions but in a way, it was written from the beginning. My parents emigrated from India. They moved to Canada in the ‘60s.

SIGNÉ: Wow.

GHOSH: And they had many things going for them. Both their families had invested in education. So they landed in Canada with exactly $200 in their pocket. But they had education, they had their health, they had many of the ingredients you need to succeed.

But their story is one that shapes a lot of the work I do today. My mom was the only surviving sibling of five children. With the language I have now, I know that some of my aunts and uncles, one died of tetanus, one who actually is alive today was one of the later cases of smallpox in India.

SIGNÉ: Sorry.

GHOSH: I saw the burden of poor health on families and the drag that has. But that was 1950’s India and it boggles the mind that that could still be true for families in parts of the world.

So as I said I feel now with the skills I have as an economist and the role that I sit in, I feel I’m getting to work on a set of issues that are core to who I am and what I believe in in the world.

SIGNÉ: Fantastic, thank you so much for sharing, Gargee. In your current role, you coordinate development policy and ideas amongst government, multilateral governmental organizations, and civil society organizations. Given the diversity of needs across Africa, can you provide some examples of ways in which African governments can work together to meet their development needs?

[5:01]

GHOSH: Well, let me start reflecting on why this kind of role exists at the Gates Foundation to start with. Gates is a private family foundation. This year, we’re turning 25. So you may think that is very young or very old, but we’ve been—

SIGNÉ: Happy anniversary!

GHOSH: Thank you. And we are, in our core, really focused on bringing the best innovation in the world to bear on these intractable problems, right? That’s not a substitute for hard work for building systems, but a way I think about it is relentless incrementalism is important, it makes progress, but there are certain problems where innovation can also help you jump further ahead.

HIV, for example. You have to do the work of treatment and coverage and building health systems that work. And we should be looking at the cutting edge science to think about a cure and whether that cure is possible in our lifetimes. So the Foundation tries to think about both. I think our comparative advantage is actually in that innovation space.

Now, why would an organization like that need a policy function, a government relations, a partnerships function? And you know this very well, but for us it was a realization that none of those great innovations has impact without the scale, the enabling environment, the commitment of government. Government as essential but not alone. So government working with industry, working with philanthropy, community leaders, religious leaders. We’ve learned time and again, whether it’s acceptance of vaccines or understanding the power of digital public finance, that all of those stakeholders need to be part of the story from the beginning, right?

SIGNÉ: Absolutely.

GHOSH: And that’s where my group comes in. And we have team members in my division that think really early on about what is the product or space we’re working in and how do we engage with community health workers, religious leaders, of course government procurement systems or essential medicines list so that there’s early awareness and a kind of coalition building to introduce a new combination vaccine or a new drought tolerance seed.

And for me, it’s been incredibly powerful to see the difference it makes to have government commitment or not. And, quite simply, we can’t do it without governments who are committed to putting their voice and policy power to making progress.

You know, if you think about primary health care, for example, if you think about agricultural productivity, when we have the commitment of governments—my boss, Bill, was in Ethiopia today, he’s going on to Nigeria—when we work with the Nigeria Governors Forum to build their commitment to understand their priorities with respect to the role of digital and economic growth. That’s when we can come in and make a difference. And we have the products, they have the systems, the political will to make the difference.

SIGNÉ: I really like how you highlight the critical importance of agency, especially from the government, with whom you are partnering on the continent. So, Gargee, as we approach the 2030 deadlines for the Sustainable Development Goals, Africa is noticeably behind on many of the goals, including in such areas like job creation, climate adaptation, and hunger reduction. What efforts need to be made for the continent to reach these goals and how can non-governmental organizations can support in this process?

[9:36]

GHOSH: Two things come to mind. First, I would really love to see a continent-wide—customized for, as you say, the diversity of situations—but a continent-wide discussion about how progress can be accelerated. For example, on maternal health. This is an area you and I both know tends to be very stuck. For many years, we used to say, oh, we can’t make progress on maternal health until health systems and economic growth kick in. Let’s not accept that. Let’s say that is not a good enough answer.

Some of the work we have been doing recently suggests that very simple innovations—a surgical drape that has a cup attached to it where you can measure the amount of blood loss from a woman during childbirth, turns out, in the heat of the moment, healthcare providers are not very good at measuring how much blood is being lost. And that simple gauge of saying, okay, when you hit this level, so many milliliters, you automatically provide this protocol of medicines, anti-hemorrhage medicines. That drape, Landry, is a couple of dollars. We think it could be a dollar within a short amount of time.

SIGNÉ: Amazing!

GHOSH: Let’s catalog the best buys in maternal health and nutrition, the set of things we’re committing to, and let’s get those introduced and scaled up as fast as we can.

I think sometimes we live at that high level of saying, oh, those goals are so massive, we’re so behind, we can’t do anything. Come on, let’s break it up into things we can do. And I think those best buy lists that become the must introduce, must incorporate, actually provide a pathway to making progress. So that’s one, I think, just really focusing on where we can make progress, where money can be very well spent.

[11:29]

The other, of course, is the financial environment, which is more dire on more fronts today than even if you and I were talking about a year ago or three years ago. So a couple of years ago, we would already have been talking about the debt burden that many African countries are facing. We would already been talking about restructuring and, you know, needing to make progress there. Of course, now we’re talking about not the gradual transition from aid, but a massive cliff that many countries are facing, especially in the areas I work in, health is deeply affected. And we can talk about it in the U.S. context, but there has been cuts to aid from so many different governments—the UK, France. And so I think now many countries are facing this scissor effect where the ability to raise domestic resources is constrained at the same time that they’re dealing with aid cuts.

So you probably did this too, but during the IMF/World Bank Spring Meetings, I had the chance to sit down with finance ministers from some of the countries where we work deeply, you know, Ethiopia and Nigeria, and they are, of course, saying, look, we know we need to be independent. We want to finance our own development. This cliff is super painful. And so how overnight we take on the domestic financing, this is the conundrum.

So today we’re thinking about, okay, how do you make every dollar stretch furthest through these best buy lists in maternal health and nutrition? And how do we create a plan to finance those best buys in the very near term? Can we plug gaps with debt swaps and while we get the more systemic pieces rolling, like progress on domestic resource mobilization, like shoring up aid where we can. So you know one it has to work, as you know very well, on multiple fronts right now to keep progress going.

SIGNÉ: Fabulous. I really love how you are emphasizing the critical importance of speeding up technological innovation but also scaling up the already existing one, connecting with financing and in order to make a monumental difference and thinking holistically including at the continental level. Thank you so much, Gargee.

So your work has focused on regions beyond Africa, as well as throughout your career. What lessons can Africa learn from other regions of the world that may be useful in reaching their development goals? And similarly, what lessons can other regions also learn from Africa?

[14:28]

GHOSH: Hmm, great. Well, one thing you learn very quickly working around the world is how much local context matters, so I’m very cautious to import lessons across borders. Having said that, what I see now is a really exciting transition from thinking about development pathways through the lens of what Western Europe or the U.S. did to actually having a multiplicity of countries in the Global South that can exchange views and can talk about real-life situations that they are dealing with.

So one of the really exciting areas of work for us has been trying to facilitate more South-South cooperation, conversation. One of the areas where we’ve seen a huge interest in that is in digital public infrastructure. So I think you and I probably share a view that digital infrastructure needs to be part of the common modern understanding of infrastructure. There’s roads and connectivity, and there’s a digital infrastructure: ID, data, consent. Because so much of the modern economy, jobs, livelihoods will require digital connectivity.

So digital public infrastructure is a place where India, for example, has been at the forefront. They had their initial investment in Aadhaar, the ID program, that over the past years has become the base layer of a stack that includes payment systems and now use cases that are beyond what you and I would have conceived of at the beginning. So I was there not too long ago and what you see is, so farm credit is something around the world. It’s very hard, very expensive for farmers to access credit at the time that they need. So, being able to offer that digitally through secure payment systems with online credit scoring. And digital means the cost structure allows for much smaller unit sizes.

Now, you look at what a farmer sees on their phone. And there are companies competing to offer, not onerous, but fair market rates to farmers or cooperatives. And, you know, the use cases go on in education and healthcare workforce, support structures, et cetera.

Now, what we have seen, and we’ve been able to help facilitate is exchange between the architects of the Indian system and the planners in Indonesia and increasingly in Africa who are trying to think about how to adapt that for their own context. The adaptation is critical, right? because every government will take a different view on single ID structures, on how they want to structure their payment systems, but the richness of the exchange between countries who are wrestling through these problems live is really unique and we are told uniquely helpful.

And you see, you know, in Africa, of course, you have the early adopters. We could talk about Rwanda as a great example. We could talk about Kenya, digital finance.

SIGNÉ: Absolutely.

GHOSH: But now you’re starting to see Togo leapfrogging and using digital payments at first to extend their social payments, social protection payments. They used it during COVID to expand their reach. So this is now not the work of a few early adopter countries, but starting to be the currency, if you will, of how governments are thinking about building their modern citizen support and modern economic infrastructure.

SIGNÉ: I really love, Gargee, how you are providing numerous illustrations related to digital and emerging technologies, and many of those cases are also made in my second to latest book, Africa’s Fourth Industrial Revolution, where I identify many of the emerging technologies and how they are transforming various areas, whether in the primary, secondary or tertiary sectors, the countries which are leading the way, and you name some of them, as well as the strategy to leverage, to scale up, and ensure success.

Gargee, Africa has many assets that it can leverage to achieve its economic and development goals such as critical minerals, large youth population, and entrepreneurial and innovative workforce. Where has the continent or specific countries on the continent been successful thus far in advancing development goals and what aspect of your economies do they need to embrace to capitalize on these successes for additional progress?

[19:52]

GHOSH: Landry, I’m so glad you mentioned the book and I will add to my own plug to the book because I think your ability to get specific about what that fourth industrial revolution could mean is really important and exactly what we need now.

SIGNÉ: Thank you so much.

GHOSH: You’re welcome. Okay, great. So I see your question very much through the work we do at the Gates Foundation. And for me, the opportunity is to think about growth in a way that includes everybody. So there are many people out there, many economists who will advise on growth strategies and job creation strategies. What we try to do when we join that table is to think about what it means for families, income groups, parts of the population who might otherwise be left with the trickle-down effect of economic growth.

So who are those? We could talk about women often and the work women do as being neglected in high-level growth strategies.

SIGNÉ: Absolutely.

GHOSH: We could talk about farmers, the engine of both nourishment and the job source for so many people across Africa who maybe are left out in the conversations about growth that tend to focus more on what is the manufacturing pathway to growth and development.

So we really spend our time thinking about, well, let me give you an example, the intersection, women farmers.

SIGNÉ: Yes.

GHOSH: How do we create more productivity at the farm level so that is a viable source of income, a desirable job, a contributor to economic growth? And we think about that at a few levels. First, you see the theme from an innovation lens. A lot of these smallholder farmers are at the front of the line dealing with even small changes in weather patterns, right? And the productivity is not so robust that you can deal with three extra days of drought—

SIGNÉ: —absolutely—

GHOSH: —or an extra week of rain. So how do we, we’re using basic crop technologies to think about how we develop lower water use staple crops—cassava, maize. And this is going to make a big difference when it’s rolled out at scale.

But then, how do we also reach women farmers with extension services, with more up-to-date weather. We talked about credit before. So there’s a package of services now, some that use digital or other technologies, others that are just about good old-fashioned policy targeting—

SIGNÉ: —absolutely—

GHOSH: —that can collectively lift the economic contribution of this group that is often left out of growth conversations. So for me, success would be a refreshed focus on growth, which we absolutely need now, jobs-led growth, but in a way that includes all parts of society.

SIGNÉ: Wonderful! And throughout much of your career, you have worked in roles that stress the need for partnership to achieve progress. Why are partnerships so important for development, Gargee?

[23:35]

GHOSH: So I started my career as an economist, and you may have had a similar evolution, but it didn’t take me long to notice that economic theory is rarely followed in practice.

SIGNÉ: Absolutely.

GHOSH: And you very quickly start to think about politics and stakeholders and interests in the execution of priorities that look simple on paper. An example that I speak to from the Gates Foundation experience, we do some support on anti-smoking work as part of our health program. We do that in partnership with Bloomberg Philanthropies, who’s a major contributor in this area. And you know very well that one of the hardest things to enact has been tobacco taxes. And if you look at it from a health perspective, it’s simple. It’s straightforward. Why would you not want to disincentivize a bad for health and use every policy tool at your disposal to do that?

But you just scratch under the surface once, and you realize, okay, well, there’s a revenue dimension. You have to find the right balance of smoking cessation and revenue generation. Oh, there is a jobs dimension, because tobacco farming is a source of employment and income for a population. Now you’re starting to think about, okay, the right answer has to take into account all of these interests and stakeholders, and that’s what’s gonna be achievable.

And more and more in our work, it’s clear that we need to bring those stakeholders around the table to achieve what might be a common cause but often worked at from different perspectives. So whether you think about it as how do you build trust in health technologies? Vaccines and facility-based birth? Those are deep norms, some religious, some cultural, some familial—it’s not gonna be addressed by the Gates Foundation coming in with a new technology.

So we’re spending a lot more time today thinking about how we achieve impact in ways that are ingrained in how communities and countries want their society to be working. And that has been a really enriching part of our work at the Foundation. If you think about impact and work backward, you’re almost always working with partners.

SIGNÉ: Fabulous! I always like to end each interview by asking the guest two questions. First, building on your work and experience, what is one piece of advice you would give to African or global leaders, policymakers to ensure the best outcome on the continent?

[26:45]

GHOSH: Great. I would pick up on a theme we were talking about a few minutes ago, which is to find where we can make progress and put your shoulder against it. Sometimes when you think about development or growth or continental challenges, it’s easy to become overwhelmed. The aid situation, the debt. Let’s not accept that as a reason to be paralyzed. And I think there are so many areas in health, in agriculture, in education, where we have the ability to make progress. And time is ticking for the kids, you know around the continent. So let’s lean into the things we can make progress on.

SIGNÉ: Amazing. I really love that to focus on the areas where we can move the needles. And given your successful, very impactful career, Gargee, what advice would you give to youth and specifically girls hoping to follow in your footsteps?

[27:48]

GHOSH: I love that question. I would advise really thinking about and dreaming big about where you want to be. Where do you see yourself making contribution? And work backwards from there to think about who are the people that can mentor me along the way? What are the skills I need to build. How do I create step-by-step the opportunity that helped me achieve that vision. Having said that, I did not have a 10-year plan, but I did know sort of the field I wanted to be working in, and that really helped me find and build a community around me who were supporting me and lifting me up through every step.

SIGNÉ: Long-term vision and hard work, step-by-step, to achieve the great goals.

GHOSH: You said it.

SIGNÉ: This is incredibly powerful. Gargee, we are so grateful that you accepted to join us today. We are grateful for the support of the Gates Foundation and, as you mentioned, of your boss, Bill Gates.

[music]

And thank you so much for supporting us. And thank so much for joining me today.

GHOSH: Thank you, Landry, it was a pleasure to speak with you.

SIGNÉ: I am Landry Signé, and this has been Foresight Africa. Thank you, listeners, for joining me today.

The Foresight Africa podcast is brought to you by the Brookings Podcast Network. Send your feedback and questions to podcasts at Brookings dot edu. My special thanks to the production team including Fred Dews, producer; Nichole Grossman, Dafe Oputu, and Nicole Ntungire, associate producers; Gastón Reboredo, audio engineer; and Izzy Taylor, senior communications coordinator in Brookings Global.

The show’s art was designed by Shavanthi Mendis. Additional promotional support for this podcast comes from my colleagues in Brookings Global and the Office of Communications at Brookings.