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Getting to Scale
How to Bring Development Solutions to Millions of Poor People
By LAURENCE CHANDY, AKIO HOSONO, Homi Kharas, JOHANNES LINN BROOKINGS INSTITUTION PRESS
Copyright © 2013THE BROOKINGS INSTITUTION
All rights reserved.
ISBN: 978-0-8157-2419-3
Excerpt
CHAPTER 1
Overview: The Challenge of Reaching Scale
LAURENCE CHANDY, AKIO HOSONO, HOMI KHARAS, AND JOHANNES LINN
The challenges of global development can be counted in millions, if not billions: 2 million preventable infant deaths a year from pneumonia and diarrhea, 61 million children out of school, 850 million malnourished people, a billion people living in city slums, 1.3 billion people without access to electricity, 1.5 billion people living in conflict-affected states, 2.5 billion people without access to formal financial services. Meeting these challenges hinges on finding sustainable solutions that can have a transformational impact on the lives of millions of the world's poorest people.
Developed countries have, by definition, solved these problems. These countries are identifiable by both their superior level of income and the institutions through which their societies and politics are organized, which enable their living standards to be sustained. Over the last half century, a handful of countries have succeeded in making the transition from developing to developed, and the hope is that many more will do so in the next.
However, such transitions are extremely hard to pull off. Using past performance as a guide, it would take nearly 6,000 years for the poorest countries to reach the level of income currently enjoyed by the United States of America. Similarly, improvement in the capacity of poor countries to deliver basic public services to their citizens is proceeding at a glacial pace. Extremely optimistic estimates, using the performance of the fastest-improving countries as a yardstick for what is possible, suggest that the waiting time to eradicate extreme poverty and deprivation should still be measured in generations. For instance, were Haiti to somehow adopt the rate of progress in government quality of the twenty fastest-improving countries in the world, it would be another twenty-six years before it reached the current standard of Malawi.
To speed up this process for today's poor countries would require a recipe for development—something that after years of looking has not yet been found, and maybe never will be. Countless studies have been undertaken examining what countries such as Japan and Korea did to advance so quickly. But it is quite another thing to translate these studies into a meaningful plan for today's poor countries. This explains much of the skepticism around foreign aid. If the role of aid is to encourage countries to grow faster and to accelerate up the development ladder, then it is easy to conclude that the mission has been a failure and is probably futile.
There is an alternative and more hopeful view. It submits that there is much that can be done to address global development challenges without altogether altering the trajectories of poor countries. A number of targeted solutions have been found that can solve specific challenges: vaccines and water treatment to prevent child death; conditional cash transfers to nudge parents to encourage school attendance; micronutrient supplements and the promotion of breastfeeding to vanquish malnourishment. These solutions can permit poor countries today to overcome many of the deprivations associated with their low levels of income and to improve the lives of their people.
To succeed, however, these solutions need to be scaled up to reach poor people everywhere. Herein lies the problem.
Reaching Scale
There are certainly examples of scale being reached in a developing country context. Mexico rolled out its Oportunidades program, a conditional cash transfer scheme, to all of its regions, reaching around one-quarter of the entire population with cash incentives designed to improve health and educational attainment among poor families. Brazil dramatically reduced poverty with its Bolsa Família program, which today reaches 12 million families. Indonesia's Kecamatan Development Program provides grants to half of all villages in the country for small infrastructure projects chosen by the community. Oral rehydration therapy, introduced by UNICEF, has almost halved deaths from diarrhea, cholera, and related diseases. Long-lasting insecticide-treated bed nets have dramatically reduced malaria. China has initiated vast poverty reduction programs, including those affecting millions of poor farmers of the Loess Plateau.
Yet these examples are the exception as opposed to the rule. Many development solutions create more of a whimper than a wave. This is surprising when one considers that scaling up is at the core of the development model that donor agencies purport to follow. They regularly develop pilot projects with the supposed intention of replicating or expanding successes, or handing them over to developing country governments to do the same. But only a small share makes it beyond a pilot phase. This is why donors are more likely to report one-time, localized success stories than examples of transformative wide-reaching progress.
Even when a dedicated effort is made to transition from pilot to program, scale is rarely achieved. The use of fuel-efficient cooking stoves in India, for example, has proceeded very slowly. Ten years after their introduction through the National Improved Stoves Program, improved stoves accounted for less than 7 percent of all stoves in use.
We believe this deserves a full inquiry. Remarkably little is understood about how to design scalable projects, the impediments to reaching scale, and the most appropriate pathways for getting there. Despite its centrality to development, scaling up is rarely studied in its own right and has undergone little scrutiny. Scaling up has been treated as something that occurs spontaneously and organically when successful development interventions are identified rather than as a challenge in and of itself.
This book is about increasing the number of people who are assisted through development programs so they can be counted in the hundreds of millions and in a time frame that is measured in decades rather than centuries. It asks what could be done to improve living conditions in poor countries in a way that is financially affordable and technically feasible. It is the contention of this book that scaling up is mission critical if extreme poverty is to be vanquished in our lifetime.
Already, the idea of accelerating poverty reduction is taking root among development practitioners. This is evidenced by the Millennium Development Goals (MDGs), which are expressed in terms of the pursuit of results at scale, reflecting the desire to transform lives and to bring about far-reaching, sustainable change. In 2011 the international development community congregated in Busan, Korea, at the High Level Forum on Aid Effectiveness, to discuss how approaches to development need to change if accelerated results are to be achieved. The outcome document for the meeting concludes, "We recognize that progress has been uneven and neither fast nor far-reaching enough.... We reaffirm our commitment to scale up development cooperation ... scaling up our support of development results ... scaling up the use of triangular approaches to development cooperation ... and scaling up of efforts in support of development goals." Easier said than done.
But perhaps such pledges are not so unrealistic. What if scaling up was being held back by some well-defined obstacles, which could be overcome through a dedicated effort? This claim has become associated with two schools of thought.
The first can be caricatured as a West Coast "Silicon Valley" perspective. It puts its emphasis on finding innovative technological solutions to development challenges through scientific advances and visionary entrepreneurship. F
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Excerpted from Getting to Scale by LAURENCE CHANDY. Copyright © 2013 by THE BROOKINGS INSTITUTION. Excerpted by permission of BROOKINGS INSTITUTION PRESS.
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