Thank you Professor Furness. I’m very grateful to you and to the Royal College of Pathologists for hosting this evening’s event. I’ve been hugely looking forward to delivering this speech and will extend time for questions.
Elsewhere in this magnificent building is a room dedicated to Edward Jenner, a man who has arguably been responsible for saving more human lives than anyone else on the planet. And all because he helped to spearhead a vaccine against smallpox.
In a few days’ time countries - led by Britain and by our Prime Minister - will gather, along with charities and businesses, to pledge to vaccinate hundreds of millions of children across the poor world. The passion and commitment of Jenner lives on today in our determination to make deaths from preventable childhood illnesses a thing of the past.
Ladies and Gentlemen, it’s now a little over twelve months since I took office as Secretary of State for International Development. It’s been a year of urgency, optimism and action.
I was clear from the very outset that under my stewardship DFID would embrace a relentless focus on results. I think that after 12 long months DFID officials will testify that I have been true to my word.
This evening I want to set out our vision for international development and explain why I have insisted on this emphasis on results. By spending time getting right the why, the what, the where and the how of development, I believe that the ensuing results have the capacity to add up to something far more significant - something that can transform communities, societies and economies.
We see examples of this happening all over the world. They give us cause for hope and I will talk about some of them later on.
Let me be clear: my vision is not about accountancy and bean-counting; it’s about changing the world. It’s about being:
- smarter in how we spend money
- sharper in our focus
- tougher in our approach
- more inclusive in our partnerships.
It’s a vision:
- that is rooted in evidence and evaluation
- that subjects DFID - and its partners - to rigorous and ongoing scrutiny
- that ushers in a new culture of radical transparency.
A vision that sees us focusing on results and - yes - going after the hard wins too. One that sees us working in the toughest places but always tailoring solutions to specific needs and contexts, something that we will be even better equipped to do with our strengthened in-country teams.
Don’t be misled into thinking our focus on results means we’ll avoid doing the harder things just because they’re difficult to measure. It doesn’t and we won’t. If it costs twice as much to educate a child in a conflict country as it does in a stable one, it’s still good value. We will be guided by what we can achieve not just by how much it costs to achieve it.
Why, Where, What, How, Who
It’s because we’ve spent time getting the basics right that we’re able now to hone the results that will produce that change. So let me begin tonight by telling you where we’re up to with those basics, with the why, where, what, how and who of the past year.
So first, WHY is the Coalition Government so clear about the vital nature of what we’re doing in development? It’s because development is both morally right and in our national interest.
It is a stain on all our consciences that a girl born in South Sudan today is more likely to die having a baby than to complete primary school. When we know what life - and death - is like for over a billion people living on less than 80 pence a day, and we have the wherewithal to do something about it, then yes, I do believe we have a moral imperative to do so.
But if the moral case were not enough we also know that whether you’re talking about tackling conflict, addressing climate change, building global economic stability or helping the most vulnerable populations, international development is one of the best means we have of protecting UK security and prosperity. It’s also one of the most cost-effective. As the Prime Minister said last month:
“…these countries that are broken like Somalia, like Afghanistan - if we don’t invest in them before they get broken we end up with the problems; we end up paying the price of the terrorism, of the crime, of the mass migration, of the environmental devastation…. If we’d put a fraction of what we’re spending now in Afghanistan on military equipment into that country as aid and development when it had a chance perhaps of finding its own future, wouldn’t that have been a better decision?”
So said our Prime Minister. They are my sentiments exactly.
Turning to the WHERE. The Bilateral and Multilateral Aid Reviews have been completed and their findings are being implemented. They have allowed Ministers to take a strategic, informed view about where to focus our efforts in order to achieve the greatest impact. And to recognise the relative success of many countries that are coming out of poverty themselves.
So, over the next four years UK bilateral aid will be concentrated on 27 rather than 43 countries, amongst the poorest countries in the world, where the need is greatest. And whether we channel funds through multilateral agencies, or indeed through NGOs or others, we will expect the same rigour in results, transparency and value from them as we do from ourselves.
We are withdrawing aid from those countries that have succeeded in pulling themselves out of poverty. And we will continue to take this approach, celebrating when countries make the transition to self-sufficiency and supporting them through this process. Aid is a means to an end not an end in itself.
Britain will continue to be a beacon of support at times of humanitarian need - the floods, earthquakes and conflict-generated crises that plunge thousands into sudden need. But our response will now be informed by the review that Lord Ashdown led at my request earlier this year, allowing us to maintain our reputation as a world leader in times of disaster.
So next, WHAT will we work on? UK aid will focus on those issues that can lead to the greatest transformation, whether it’s girls and women, conflict, wealth creation, climate change or innovation.
And my litmus test for HOW we will work? In whatever way delivers the best results.
This doesn’t just mean working with in-country governments, it means working with new partners, with foundations, citizens, the private sector, emerging powers - in short with anyone whose support complements our own efforts.
We have become much more joined up with the rest of Whitehall, a central player in policy decisions that affect poor countries, whether through the National Security Council, the International Climate Fund or in our close working with other Government departments.
We’ve taken the bold step of opening our actions up to external scrutiny, promising - and delivering - a radical new agenda of transparency and accountability, and I’m delighted to see the Chief Commissioner of the Independent Commission for Aid Impact here tonight.
We’ve made it easy for people to understand what we’re doing - publishing clear, simple data that’s easy to understand. Not only can the British taxpayer see what we are doing but so too can the people our aid programmes are intended to help. Whether it’s a British person sitting in Manchester or a Kenyan sitting in Kisumu, any individual can hold us to account - and tell us if they think we’re getting it wrong.
We want to build evaluation processes into our programmes from the outset so that we can learn which interventions work best.
So, in summary, in just one year we’ve got the UK Aid Transparency Guarantee and the Independent Commission for Aid Impact up and running and we’ve started to embed evaluation throughout DFID’s work. That is no mean feat.
We’ve taken a fresh look at our response to key challenges such as malaria and maternal health, publishing frameworks that shine a spotlight on what is needed and what works.
DFID country offices are now trying out innovative approaches such as cash-on-delivery aid, cash transfers and participatory budgeting that put more power and choice into the hands of local people and communities.
And, within DFID’s London office we’ve set up a new team and charged it with galvanising the entrepreneurial spirit of the private sector in the poorest countries. We are injecting private sector DNA into DFID’s bloodstream, promoting the dynamism and know-how that often exists in the private sector, marrying DFID’s traditional development expertise with business instinct to generate opportunity, jobs and prosperity.
CDC, the Government’s Development Finance Institution, has published a brand new business plan with an inspiring mission to be a pioneering investor in the poorest places of the world.
Each of these reforms is necessary and important - and all have been achieved in just one year.
And finally, WHOM will we help? The simple answer is that we will focus on the poorest and the most vulnerable. On women and girls, including those who, because of the conflict in which they live, lose out twice over.
Taken together, these cornerstones - the why, where, what, how and who of our approach - will allow us to be smarter and more effective in spending taxpayers’ money. We know what we want to achieve, we will measure how well we’ve achieved it, and we will learn the lessons when we could have done better.
Of course, I know there are some people here who say that my focus on results, transparency and accountability is turning development into a numbers game.
They suggest that it will encourage us to indulge in a host of evils: to focus narrowly on the easy wins, to adopt ‘one-size-fits-all’ methodology, to take simplistic views of complex societies, and to mortgage long-term change for short-term gains.
It is this critique that I want to address head-on tonight.
I put it to you that our focus on results will allow us to deliver the individual, incremental changes that will lead to deeper, more sustained change. Change that will transform whole countries - in our lifetime. We will address the difficult, thorny issues in development, not just pursue progress on the so-called ‘low hanging fruit’.
Our approach will be flexible and differentiated, recognising local realities and contexts. We will work to understand and go with the grain of change in complex societies, rather than attempting to impose rigid blueprints.
We will shine a spotlight on effectiveness and good governance and build up the democratic institutions which will ultimately allow countries to float free of development assistance. We will do what we can to address the structural inequalities that rob the poorest and most vulnerable of control in their lives and a say in their societies. And we will strive for long-term transformative impact, as well as concrete, observable improvements in human lives today.
I do believe these aims are compatible with a results focus. Indeed, they are part of it. Because it is through results that we will secure the underpinning to:
- propel economic growth
- make governments accountable to their people
- put more power into the hands of girls and women
- promote peace and prosperity and
- address the challenges of climate change.
These are the fundamentals of development and what we are working flat out to achieve. Let me try to illustrate this with real-life examples which give a flavour of the kind of things which can transform our world. I could give you examples on contraception, nutrition, low carbon technology and many more. But let me pick just four for now.
Results for Change
I’ll start with health, an area where we’re going to see some particularly strong results.
The sad irony is that much of what needs to be done here is so straightforward.
Vaccinations, for example, are proof positive that well-spent aid transforms lives. When I visited a vaccinations clinic in Karachi last week the mothers’ faces told the whole story: their children, like ours, now have the opportunity to escape polio and other preventable diseases and pursue healthy, full lives.
Next week, the UK will host the GAVI replenishment conference. With the right financial resources GAVI can vaccinate around a quarter of a billion children and save four million lives.
Imagine that for a moment. A quarter of a billion children. We wouldn’t spend a second tolerating a single death from malaria or diarrhoea in this country. Why should we tolerate it elsewhere?
The UK will be making a strong commitment to the GAVI conference and I call on others here and now to do the same.
It not only saves lives. It reduces acute and long-term illness. It prevents decades of disability. I’m thinking here, for example, of the paralysis that so often blights the lives of polio sufferers or the deafness that can accompany pneumococcal infection. Immunisation is also cost-effective.
- Families avoid the costs of hospitalisation
- Women are freed from long-term caring for the sick
- The crushing burden on doctors and nurses is reduced
- Resources are liberated to invest in clinics and drugs
- Healthier children are better nourished and educated, and so earn higher wages as adults.
There is another benefit too. Many poor people rarely see a health worker. A good immunisation programme draws people into contact with a professional. This professional can also distribute bednets, give Vitamin A supplements to children, advise on contraception, test for HIV, and schedule follow-up visits.
Of course, an essential part of getting this positive reinforcement off the ground is to ensure there’s actually a health professional to go to and that’s why a large part of our work is, and will continue to be, helping countries to develop their own healthcare systems in a way that suits their needs and contexts.
As in Odisha where DFID helped the Government of India to set up mobile health clinics, reform salaries and promotion systems and contract in private doctors. These relatively simple measures helped to reduce the number of vacancies for badly-needed rural doctors by 58% in the space of just one year.
So, you see what I am getting at. This simple result - one ordinary jab - can bring a host of other benefits, for the family, for the health system, for the economy. This is what economists call a multiplier effect. I call it a miracle. The miracle of a result changing our world.
2. Education for Girls
Next, I want to look at education.
Consider this simple fact: in some parts of Africa, half of all girls are married by the time they reach the age of 15.
Girls who marry at this age are more likely to drop out of school. They also put their health at risk. Compared with women in their twenties, mothers aged between ten and 14 are five times more likely to die from childbirth, while those between 15 and 19 are twice as likely.
Conversely, when a girl receives seven or more years of education she typically marries four years later and has 2.2 fewer children.
But early marriage doesn’t have to be inevitable, as the results of a pilot project supported by the Nike Foundation in northern Ethiopia has shown.
That project helped a whole community to come together to explore the consequences of young marriage.
And the result? Over the course of the 18 month pilot, not one of the 376 participating girls married. Instead, they stayed in school. British aid - working in partnership with the Nike Foundation - will now help 200,000 girls directly, and many more indirectly, to delay their marriages and to stay in school.
And over the next four years we’re going to get another two million children - half of them girls - into school in Ethiopia.
The cost? Just £20 a head. And the facts? Equally compelling. One extra year’s schooling can increase a girl’s earnings by ten to 20%. Earnings that she will plough back in to the family unit, ensuring that her children have better, more nutritious food and are more likely to attend school themselves.
In turn, this leads to better jobs, higher wages, increased taxes, more effective public services.
A truly virtuous cycle - what the Nike Foundation calls “The Girl Effect” - that drives and sustains deeper, transformative change. By preventing poverty from passing from one generation to the next, stopping poverty before it starts.
- Wealth Creation
Now, thirdly, we come to wealth creation.
I could spend the whole evening giving you examples of the transformative impact of wealth creation but I’m going to focus on just one: EasyPaisa, the branchless banking service that’s bringing financial services within reach of some of the world’s poorest people in Pakistan.
EasyPaisa builds on the runaway success of M-PESA, a mobile phone-based system piloted in Kenya by DFID and Vodafone.
And let me make something clear. I’ve seen the reports that imply that EasyPaisa is simply a convenience measure. That somehow we’re just making life a bit easier for the busy elite in Pakistan.
Nothing could be further from the truth. We’re talking about people who’re existing on 80 pence a day. Who don’t have any access to the most basic financial services. Who can’t open a bank account, who can’t insure against the risk of a bad crop or a sudden illness. Who can’t do any of the things that we do day in and day out and on which our very economy relies.
In fact, right now, less than half of the adult population of Pakistan has access to a bank account. But in future, thanks to EasyPaisa up to 3 million more people - amongst the poorest people in the world - will be able to use their mobile phone to pay bills and transfer money to their families. As I witnessed in Karachi just ten days ago where I saw a young nurse using EasyPaisa to send £27 home to her dad.
And as they become familiar with using the technology - and as the transferring banks become used to their new customers - they will be able to open savings accounts. They will be able to start and sustain small businesses, creating jobs, contributing to the local and national economy and stimulating that growth that helps pull the country and its people out of poverty.
The implications are enormous. If you’re a small-holder with no access to a reliable power supply, you can finally afford to make small payments on a solar panel. At last, you can cook more nutritious food. Your children have light to do their homework. They get better jobs as a result.
By changing lives we can change the world.
Finally, it’s sometimes said that a spotlight on results pushes governance and politics into the shadow. Nothing could be further from the truth: what is good governance if it is not ensuring that politicians and local officials are held accountable for delivering the results that people demand?
Healthier, wealthier and better-educated citizens can make all the difference if they know what is being delivered in their name. And as Nancy Birdsall of the Center for Global Development has argued, the incentive to produce monitored results may be exactly what politicians need to prioritise delivery, try out new approaches, and tackle bureaucratic constraints.
In Bangladesh, we are working with the government to open new and inexpensive channels for people to access their legal rights. This system has brought justice within the reach of poor people - the landless labourers, the slum dwellers, the very people who often need it the most.
68% of women surveyed said that there had been less violence and abuse within the home six months after mediation was complete. And just under £1.3 million worth of assets have been returned to poor people - most of them women.
The balance of power will also shift, meaning that poor people are safe to accumulate wealth and live their lives free from violence.
I’ve spoken this evening about how we’ve laid the foundations for a new results-based approach. And whether through the examples I have set out tonight, or the countless transformative results we achieve in all our areas of work - I hope I have illustrated why I believe that’s the right direction for us to take.
But there’s one other thing I want to touch on before ending.
When I was appointed to this job a year ago, I said: “Promoting wealth creation and development around the world is about so much more than just giving aid. We will harness the full range of British government policies - including trade, conflict resolution and environmental protection - to contribute to our progressive vision of a more prosperous, sustainable and secure world.”
One year on, I can point to a number of specific examples to show that this is exactly what the Coalition has done:
- Whether it’s the White Paper on trade that the Government published earlier this year, which has development concerns and arguments at its core
- Whether it’s the Strategic Defence and Security Review, which has made tackling the causes of conflict - which destroys the lives of poor people - an absolutely central plank of the Government’s approach to the world, complementing the astounding work of our brave armed forces of which we are so proud
- Or whether it’s our action under Chris Huhne’s leadership, to drive forward climate negotiations and lock-in gains for the poorest countries.
But we want to go further.
Our ambition is to do much, much more than simply make Britain’s bilateral aid more effective - important though that is.
Our ambition is to do more, even, than to drive a fundamental reform of the whole global aid system. Not just holding others to account for the commitments they’ve made to the developing world and not just bringing in new donors - but making global aid radically more effective, transparent and responsive to the needs of poor people.
Let me be crystal clear. Our ambition is to use every tool in the Government’s armoury to promote development. We are helping to build a new DFID, much closer to the centre of decision making, playing its full part within a joined-up Government - and in turn, shaping and influencing the whole of Government policy to be development-friendly. DFID as a grown-up Department of State for Development, not just a narrowly-focussed unit for administering aid well.
I’ll be saying more about this later this year when I will set out more detail of that vision.
So, right now, my number one priority is for us to start delivering the results that will change the world.
Because as I have shown this evening, I believe results not only transform individual lives - as a cumulative force they transform societies. Those same results lie at the heart of our vision for international development and, in turn, at the heart of our response to national and to global challenges.
As those challenges have become more sharply defined over the last decade our expectations have increased. Yet, few of our aid instruments and approaches have been refreshed to meet those higher expectations.
And that’s why I was determined that the changes I introduced at DFID would not be mere cosmetic adjustments but deep, structural reforms that would enable us to deliver what is needed over the next decade.
The effect of some of these changes will not be felt overnight. It will take time for the full impact of transparency, the aid watchdog and our investment in rigorous evaluation to trickle through. But we will be in a much better place for it by 2015 or by 2020.
DFID is not alone in embracing this vision. Sweden, the Gates Foundation and USAID are amongst those who share some of our thinking and are joining us on this journey.
Indeed, I believe that scholars will look back at the changes that we and our colleagues are making and see them as the start of a new paradigm across the development community. A paradigm:
- that focuses with laser-like intensity on results
- that places evidence above ideology
- that welcomes external scrutiny, embraces radical transparency, opens its doors to fresh ideas and to new partnerships
- a paradigm that injects the dynamism of the private sector into its DNA
- that acts as a critical friend to its partners
- that directs aid on the basis of performance
A paradigm in short, that we can hand to the next generation. A proud and enduring legacy.
Like my friend, Bill Gates, I’m an impatient optimist. I’m restless. I want to use this brilliant machine - the sheer power of Britain’s development efforts - to change the world. I want to use other parts of Whitehall to help us do that. This is why I have an obsession with results. I want to achieve more every day. I want to encourage our international partners to do the same. So that development as a whole is more effective because of UK leadership. Like the Prime Minister I think that Britain does stand for something in the world.
And as the Deputy Prime Minister has said:
“Let future generations look back and say that they inherited a better world because - at this critical moment, at this difficult moment - we did not shrink from our responsibilities.”
Ladies and Gentlemen, this is the most exciting time to be working in development in the UK. Our results agenda will take development up a gear. Our credible leadership on the international stage will be a beacon to others. And our new culture of radical transparency will allow the world to judge us by our actions rather than our words.
As Disraeli, whose picture hangs in my ministerial office, once said we are not creatures of circumstance, we are its creators. We must all be ready to take up that challenge.