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The Best Mother’s Day Gift of All

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 11-17, we will be featuring the important role of mothers and partnerships in Global Health.

B. Ryan Phelps serves as Medical Officer for PMTCT and Pediatric HIV, Office of HIV/AIDS. Photo credit: B.R. Phelps

By far, the best Mother’s Day gift I’ve ever seen was given to another child’s mom. It was in Swaziland and I was working in an HIV clinic as a consulting pediatrician. The mom’s name was Nomcebo. What she received was a simple bit of news: “Your baby is not infected with HIV.” She was told that her baby was protected by the HIV medicines she had taken during her pregnancy and during breastfeeding. She was told that her baby was HIV-free because she had come to clinic for her refills, and taken the drugs religiously. The mother’s eyes, wet with tears, were set on the sleeping baby in her arms. She was smiling, and whispering softly, over and over, the words “thank you.” Then she paused, looked up, and said: “Tell them thank you.”

Every day, around 1,000 babies are born with HIV, and there is a growing recognition that we can decrease that number to near zero. In other words, we can virtually eliminate pediatric AIDS. We can give children like Nomcebo’s a healthy start.

The implementation toolkit to assist countries as they scale up universal treatment strategies. Photo credit: Interagency Task Team

USAID, through the U.S. President’s Emergency Plan for AIDS Relief
(PEPFAR), is working closely with the World Health Organization, the
Centers for Disease Control and Prevention, and other international
partners to do just that. Through more progressive policies that help
ensure that all pregnant mothers get access to lifelong HIV therapy,
countries throughout Africa, Asia, and Latin America are increasing
mothers’ access to once-daily, lifelong antiretroviral drugs that will protect
their babies from infection. Such treatment decreases the risk of HIV
transmission to the child from ~40 percent to less than one percent. These
drugs also protect against the spread of HIV to other adults, as well as
keep mothers healthy so that they can care for their children.

Over a dozen countries are in the process of developing and rolling out universal treatment strategies for pregnant women, and USAID continues to work side-by-side with ministries of health toward the goal of an AIDS-free generation. To further bolster this technical support, USAID recently helped in the creation of an Interagency Task Team implementation toolkit to assist countries as they scale up these strategies.

In Swaziland, when Nomcebo said, “Tell them thank you,” she was looking directly at me. Besides Nomcebo and her baby, there was nobody else in the exam room.

I said that I would.

So…if you are reading this, there is a mother in Swaziland who thanks you. By supporting USAID and PEPFAR, you have helped give Nomcebo (and hundreds of thousands more) one of the best Mother’s Day gifts imaginable.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Harnessing the Commitment & Energy of Diaspora Communities to Transform Development

Rajiv Shah serves as Administrator at USAID

Earlier this year, I had the opportunity to meet a Syrian-American trauma surgeon who told me about the multiple trips he had taken to Syria with other doctors to help remove shrapnel from the bodies of children.

As I listened to him share these devastating experiences, I knew that his story reflected the tremendous contributions of Syrian-Americans to the humanitarian response. Every day, at great risk to their own lives, they were caring for the injured, training doctors in triage and medicine, and helping deliver lifesaving medical supplies throughout Syria.

Whether we’re talking about the struggle for freedom in Syria or the fragile–but remarkable–transition happening in Burma, we know the diaspora community has a uniquely important role to play in addressing the challenges of today and shaping a brighter future for tomorrow.

Last year, global remittances topped $534 billion—more than 5 times U.S. official development assistance. So often the result of long hours and sacrifices, these contributions mean so much more than their monetary value. They mean the chance for a child to afford her school uniform. The chance for a young man to take out a loan and open a business. And sometimes, they make the difference between life and death – when they allow a family to buy food in tough times.

We are determined to work together to ensure the each dollar saved and each dollar transferred can make a lasting impact. Through our Development Innovations Fund, we’re partnering with a major Filipino bank, a Filipino education NGO, and a group of researchers from the University of Michigan to pilot a financial innovation called EduPay. The tool allows overseas individuals to pay school fees directly to educational institutions in the Philippines, instead of channeling the funds through an informal trustee. The tool also goes one step further by enabling you to monitor the student’s attendance and performance so you can be sure you’re supporting a quality education.

Whether saving money to send home, building a business from the ground up, or partnering with us in response to a crisis, the commitment and energy of diaspora communities holds the potential of transforming developing countries around the world. Through a partnership with Western Union, we’re helping support diaspora leaders who have a great idea to start a business, but need the resources to get it off the ground. Since 2009, the African Diaspora Marketplace has provided grants to 31 companies, totaling more than $2.2 million.

At USAID, we’re increasingly focusing on providing a platform to connect problem-solvers everywhere to the greatest challenges of our time. We call it “open-source development,” and it reflects our desire to harness the creativity and expertise of a much broader development community. Through our new model of development, we aren’t focused on our solutions. We’re focused on yours.

To learn more about the Global Diaspora Forum or to learn how to partner with USAID, the State Department, and the private sector, please visit: http://diasporaalliance.org/.

Join conversation on Twitter (@USAID) using #2013GDF.

U.S. Provides Wheat to Fill Urgent Food Gaps in Syria

An Arabic translation is available.

As part of our nearly $510 million in humanitarian aid to help those affected by the crisis in Syria, wheat recently provided by the United States will feed more than one million people in Syria for four months.

The 25,000 metric tons of wheat donated to the United Nations World Food Program (WFP) will be milled into flour and distributed to vulnerable families across Syria’s 14 Governorates through WFP as part of a monthly food ration. In addition to the 25 kilogram bag of flour that is being provided in these monthly food kits, families receive vegetable oil, pasta, bulgur, canned pulses and sugar.

An American ship arrives in Beirut, Lebanon with enough wheat to feed more than one million people affected by Syria’s ongoing crisis. Photo credit: WFP/Laure Chadraoui

The U.S. remains the largest donor of food assistance to Syria through WFP, contributing nearly $125.5 million in emergency food assistance since the conflict began more than two years ago. This most recent wheat contribution—worth more than $19 million—will provide much-needed bread for families in areas of Syria where access to humanitarian aid has been most constrained by the conflict and where there are severe shortages of bread.

“We are very grateful for this timely contribution from the United States which will allow us to supplement our food rations with wheat flour especially in the areas where families are struggling to get their hands on bread, a staple part of their diet,” said Muhannad Hadi, WFP’s Emergency Coordinator for the Syria crisis.

WFP, with support from the U.S., is working to reach 2.5 million people across Syria and approximately 300,000 Syrian refugees in Jordan, Lebanon, Turkey, Iraq and Egypt.

Visit our website for more information about USAID efforts in Syria

Video of the Week: Maura O’Neill Previews the 2013 Global Diaspora Forum

Starting today, USAID and the State Department will co-host the third annual 2013 Global Diaspora Forum. The world’s largest gathering of diasporans, this year’s forum “Where Ideas Meet Action” aims to recognize, celebrate and inspire the work of American diaspora communities with roots from around the globe to contribute to the development of and diplomatic relations with their countries of origin.

Learn how USAID continues to expand and strengthen its engagement with diaspora communities in order to achieve development outcomes. Visit the website to watch online.

Throughout the forum, content will be live tweeted from @DiasporaIdea and @USAID. Join the conversation on Twitter using #2013GDF.

Malian Midwife Champions Respectful Care for Pregnant Women and their Families

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 11-17, we will be featuring the important role of mothers and partnerships in Global Health.

The man brings his pregnant wife into the health center and is confronted by the irritated midwife who raises her voice: “I’m too busy, what do you want? Go outside, this is no place for a man!” Later, the man returns for news about his wife’s condition and is promptly told to “go back and sit there.”

This role play session about abuse and disrespect in maternity care was part of a training in Burkina Faso sponsored by MCHIP. Through role play, MCHIP trainers demonstrated to doctors and midwives what not to do when attending to their patients, as disrespectful treatment of pregnant women and their families is all too common in health facilities around the world. This is especially true in developing countries, where doctors and midwives often lack basic infrastructure, supplies, manpower, or even awareness about patients’ rights to be treated with dignity during birth.

Pregnant woman with companion at the renovated maternity ward in Bobo Dioulasso, Burkina Faso. Photo credit: USAID

Training participant Haoua Ba had never heard about respectful care until this MCHIP training, even after 22 years as a midwife in Mali. Haoua and about 30 other midwives, pediatricians and obstetricians are known as Africa “Champions” (or advocates) for improving maternal and newborn health by promoting up-to-date knowledge, practices and attitudes in their countries and region. Mali is one of 10 key African countries—along with Benin, Guinea, Kenya, Liberia, Madagascar, Senegal, South Sudan, Uganda and Zambia—where the MCHIP Africa Champions Program is being implemented over two years (2011-2013).

MCHIP maternal and newborn health trainings have always emphasized “women friendly care,” for example by introducing skills checklists with which providers are evaluated on their ability to provide respectful care. However, given the prevalence of disrespect and abuse—in Africa in particular—and the lack of knowledge about this issue, Africa Champion trainers developed an entire training module devoted to this topic. In this 1.5 hour session, a facilitator helps training participants understand during group discussion that there is evidence that key components of respectful care, such as involving a woman in her care, will make the birth experience go more smoothly for both the woman and the health care provider.

Haoua described how this training session taught her to respect pregnant women and their families by greeting them politely and continually informing them in a soothing voice about everything she is doing. And since the training last year, Haoua has seen a big difference after putting into practice these new skills.

“When you show respect, it really facilitates things,” she said. “If you calmly tell the woman what to do and explain things her, it comforts her. And word gets around so women know who is going to treat them well and they request that midwife when they come into the hospital.”

After participating in three Africa Champions maternal and newborn health trainings on innovative, lifesaving practices, Haoua is uniquely positioned to transfer these lessons learned. She plans to do so with both staff and student interns at the busy Referral Health Center in Bamako, Mali, where she also works as a midwife with 22 other midwives and three gynecologists. In fact, one of her primary goals as a Champion is to help strengthen the health center team by promoting evidence-based care. She described how she and one of the doctors will organize trainings about twice a month on a particular theme and have attendees practice on mannequins under their supervision to ensure they are correctly using their newly acquired skills and knowledge.

Importantly, Haoua has taught her colleagues that a woman should be allowed to have a companion by her side during the birth, which is a central tenant of respectful care. Having a loved one present provides women with essential comfort and support during the birth process, especially when the health center staff are busy or overworked. Evidence supports this practice as one that can help to shorten labor and increase normal outcomes.

A pregnant woman who must give birth without the company of a loved one or who must lie on the floor because there are not enough tables, without the privacy of a curtain, is not receiving respectful care. But even in the worst conditions, said Haoua, “if you have the will to do things well, you can help women.”

She is a perfect example of how the USAID-funded Africa Champions program is helping to prevent the untold suffering of women during one of the most vulnerable but extraordinary times in their lives.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

USAID in the News

Food Aid Reform

In an op-ed published in the Chicago Tribune, USAID Administrator Rajiv Shah, Secretary of State John Kerry, and Secretary of the Department of Agriculture Tom Vilsack explain “our hallmark food assistance program has not evolved with the times.” President Obama has proposed a number of reforms that could help the U.S.  “feed up to 4 million more hungry people every year” while reducing costs. From purchasing locally-sourced food to using electronic payments, the officials say such strategies can help the U.S. “carry out its development mission more effectively and efficiently – not to perpetuate dependency, but to advance human dignity.”

In an editorial, the Chicago Tribune says it considers the current Food for Peace program a “terribly expensive and inefficient system. We’re pleased to see the Obama administration make a run at changing that… the administration has proposed a modest reform that can save money and feed more people.” The editorial continues,  “Food aid can help to lift developing nations out of poverty, promote political stability and economic growth. It must be structured efficiently to achieve its objective. Reforming food aid would enable America to do justice to a large taxpayer outlay – and to save lives.”

USAID, Swedish Ministry for International Development, and African Development Bank launch Agriculture Fast Track at World Economic Forum

Business Day Live reports, the “fund – called Agriculture Fast Track – is the first of its kind and marks a new approach to development aid by western donors, that aims to promote economic growth through commercial agriculture.” In short, “Agriculture Fast Track’s purpose will be to fund some of the front-end costs of developing agricultural infrastructure, such as scoping, project design and feasibility studies, with the aim of leveraging private funding to commit to the projects.”

Harvest, Meet Market: How a New Fund Will Accelerate Agricultural Infrastructure in Africa

Since 1964, the African Development Bank (AfDB) has worked with African countries to develop their economies and progress socially.

This week, with AfDB and the Government of Sweden, we launched a first-of-its-kind effort to expand this progress and growth. The Agriculture Fast Track will encourage private sector investment in agricultural infrastructure projects to advance food security in Sub-Saharan Africa. In doing so, it supports Africa’s agriculture transformation agenda.

Incentivizing investment in agriculture

Historically, the private sector hesitated to invest in agriculture in Africa—and for good business reasons. Investing in agriculture has inherent risks, including drought, crop and livestock diseases and fluctuating crop prices. Agriculture projects can have high start-up costs because systems and facilities must be developed before they can begin making a profit. Given these challenges, it can be difficult for African countries and their development partners to create lasting improvements in food security.

That’s why we are so excited about renewed efforts to tackle these challenges in order to catalyze private investment that can spur economic growth while reducing hunger and undernutrition. Following the lead of African nations, efforts like the New Alliance for Food Security and Nutrition have coupled tough regulatory policy reforms with private investment commitments in agriculture. African leadership has driven these efforts forward, with governments undertaking transparent market-oriented reforms that encourage private investment and reduce barriers to agriculture-led economic growth.

USAID, the African Development Bank, and the Government of Sweden launch Agriculture Fast Track Fund for infrastructure projects in Africa. Photo credit: USAID

Bridging the last mile

But the last mile linking farms to markets still needs to be strengthened.

Smallholder farmers in Africa are some of the poorest and hungriest people in the world. And while the world has worked to reach them with the tools, skills and knowledge they need to increase their crops, farmers also need infrastructure.

Agriculture infrastructure reduces the risks farmers face—for instance by providing irrigation so farmers don’t rely solely on erratic rainfall to water their crops. It also provides ways for farmers to get their harvests to markets (and buyers, and ultimately to tables) quicker, like on nicely paved roads, and helps preserve harvests longer, using electricity and modern preservation and processing facilities.

The Agriculture Fast Track addresses this challenge head on. It is the first and only fund exclusively focused on infrastructure for agriculture and food security. As a New Alliance deliverable aimed at addressing barriers to agricultural development, it defrays front-end development costs and risks the private sector is unwilling to shoulder alone.

Operationally, the Agriculture Fast Track will fund technical assistance for public and private sector organizations seeking to create agricultural infrastructure projects. By providing grants for activities like scoping assessments, feasibility studies, market analyses, and social impact investments, the Agriculture Fast Track will help create a pipeline of projects able to garner the private capital needed to start and complete them.

Learn more

Along with our colleagues at AfDB and the Government of Sweden, we’ve developed a variety of materials for you to learn more about Agriculture Fast Track and the vision we have for it.

The Power of Mobile Technology to Save Lives

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 1-10, we will be featuring the role that Science, Technology & Innovation plays in Global Health.

The development field has been exploring for years ways to harness the power of technology to benefit those in need, especially mobile technology, which can reach people in remote areas who need food, health, education, and other assistance quickly and well.

A health worker refers to her mobile phone for information while making a house visit. Photo credit: World Vision

Health is an area in which the benefits of mobile technology are obvious. One initiative World Vision is especially proud of is our mobile health (mHealth) projects  in 13 countries. Our mHealth projects leverage the ubiquity of mobile phones to deliver information to, and receive information from, patients and caregivers and can address a broad range of scenarios, including announcements, targeted messages, appointment reminders, medical records for patients, treatment reminders, training and tools for front line health workers and volunteers. Key mHealth principles that have been integrated into current and planned projects include: 1. Align closely with Ministries of Health and their partners; 2. Work in partnership with other funders, developers, and implementers to build on and add to global learning; 3. Design to meet the needs of local users but also provide the basis for maturing the evidence base; 4. Be initially affordable yet based on sustainable costing models and scalable technology; 5. Be respectful of data governance issues; 6. Utilize and strengthen government and partner information systems; 7. Emphasize coherence and quality of approach and program/project management; and 8. Favor open source solutions and emerging global standards.

To support mHealth, World Vision has strategically partnered with the Bill & Melinda Gates Foundation, Grameen Foundation, and Dimagi to create and deploy a World Vision version of the Gates-funded MOTECH Suite (MTS), a sustainable, scalable, open source mobile solution. MTS provides a set of capabilities encompassing five key functional mHealth areas: Behavior Change & Demand Generation, Managing Patient Data, Improving Worker Performance, Last-Mile Supply Chain, and Patient Adherence. This partnership allows World Vision’s funded mHealth projects to utilize a common, yet customizable, field-tested mHealth tool.

MTS was piloted in World Vision’s Afghanistan mHealth project (USAID-funded Child Survival Health program 2008-2013), and the evaluation results are encouraging:

  • significant improvement between intervention and control groups in any antenatal attendance (20 percent),
  • skilled delivery at a health facility (22.3 percent),
  • having a birth plan that included improved coordination with the health facility (12.6 percent),
  • saved money and arranged transport (12.9 percent)
  • knowledge of two or more pregnancy danger signs (12.9 percent).

A volunteer health worker refers to her mobile phone for information while making a house visit. Photo credit: World Vision

In World Vision’s Mozambique mHealth project (Gates-funded Grand Challenges 2010-2012), MTS research results indicated that pregnant women in the project’s intervention area had a higher likelihood of accessing antenatal care, prepare better for birth, and have their births assisted by a skilled provider. They were also more likely than those in the control group to know about signs of pregnancy complications and to seek care at a facility for that complication.

The advantages of the shared framework of MTS are numerous, from minimizing software development, operations, and support costs, to making available the source code, best practices, learning, and other assets to the global community to avoid duplication, and ultimately, save more lives. As World Vision rolls out MTS in additional countries and regions, we’ll analyze the complexity and economics of this versus other models, the interface with national Ministries of Health systems, impact, and sustainability.

Deployments of WV’s global version of MTS have begun in Sierra Leone, Uganda, and Zambia, with others to follow in Tanzania, Sri Lanka and India by this August. World Vision aims to increase geographical mHealth reach within these countries while enhancing MTS functionality at the community level. The focus is on creation of a solution that is globally deployable, meeting at least 80 percent of functionality needs for each project, and further customizable for each context. A key characteristic of this effort is collaboration with Ministries of Health and intentional efforts to forge public-private partnership agreements with mobile network operators and other potential private sector partners. This model has already effected notable reductions in duplication of effort and overall costs at the global level, as well as for each project.

Initiatives like MTS are the way forward for NGOs to impact the global health field, including reducing incidence of malaria, improving maternal and child health, and improving child nutrition. Read more about World Vision’s mHealth projects.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Earth Matters Workshop Helps Nepali Journalists Link Environment to Socio-Political Dialogue

Given Nepal’s high vulnerability to climate change, one might expect reporters like Mangal Man Shakya, a veteran investigative journalist and chairman of Nepal’s Wildlife Watch Group, to find great demand for his environmental stories. Unfortunately, that isn’t the always the case.

“It has been a long time since I saw an investigative environmental report in the Nepali media,” Shakya said as he spoke at a recent “Earth Matters Workshop” for journalists in Kathmandu. Although many Nepali leaders recognize the need to take action on environmental issues, the preeminence of political and economic stories often means reporting on climate change and conservation gets buried on page 6. The environmental stories that do get published are typically limited in scope, rather than in-depth and linked to broader political, economic, or health issues.

Recognizing the media’s critical role in raising public awareness and influencing public policy, USAID, in partnership with WWF Nepal, organized a media Earth Day workshop called “Earth Matters,” designed to help journalists understand how environmental issues can be linked to broader socio-political issues in Nepal and produce content with more in-depth analysis. The workshop, organized through the USAID-funded Hariyo Ban (Green Forests) Program, invited Nepali journalists to engage with some of the nation’s top conservation experts, high-ranking policy makers, veteran media professionals, and an award-winning journalist from the United States, in sessions that often took on a press conference format.

Former Parliamentarian and Politician Gagan Thapa joined the “Earth Matters Workshop” to discuss the environmental issues and challenges in the Constituent Assembly and reiterated the important role media plays in raising public awareness and influencing policy discourse and action. Photo credit: Fungma Fudong, USAID Nepal

The 12 participants, selected from a large pool of applicants, shared the common challenges they face not only in accessing resources to pursue environmental reporting, but also in getting buy-in from newsrooms that do not care for, or do not understand, the country’s environmental issues. Such challenges make it even more important for journalists to link environmental stories to political and economic issues, which tend to receive greater coverage.

Speaking at the workshop, former Member of Parliament’s Natural Resources and Means Committee Gagan Thapa reiterated the influence that good reporting can have on policy: “Often, it was the media that brought many issues to our attention,” he said, discussing the relationship between reporters and the Parliament and Constituent Assembly. He added that, with Nepal’s current lack of a Parliament, it is all the more important for environmental reporters to be bold and vigilant.

“Environment issues are at the heart of Nepal’s socio-economic present and future problems and solutions, and it is high time Nepali politics recognizes this,” Kashish Das Shrestha, well-known environmental writer and moderator of the workshop, said. “An informed and responsible media is critical in helping to shape the political discourse accordingly.”

By the end of the workshop, one of the 12 participants had produced a radio show on the devastating effects of mining and deforestation in Nepal’s mid hills for Image FM 97.9, one of Nepal’s largest stations, and also published an article on the story. Another participant had produced a radio report for the Community Information Network, which includes more than 100 community radio stations throughout Nepal. These reports are just few of the bright sparks lit by the workshop.

In the second phase of the workshop, participants will head to the field to conduct research in the areas where Hariyo Ban operates. This interaction with those most affected by environmental issues is expected to inform and expand environmental media coverage. The workshop culminates on World Environment Day, June 5, when all participants—Hariyo Ban Champions—will share the work they have produced based on the workshop and field research.

USAID’s Hariyo Ban program has, since 2011, helped Nepalis prepare for and adapt to climate stresses. Hariyo Ban is a cornerstone of President Obama’s Global Climate Change Initiative in Nepal and is implemented by a consortium led by World Wildlife Fund (WWF). Other consortium members include: CARE, the Federation of Community Forestry Users in Nepal, and the National Trust for Nature Conservation.

Glass Half Full in this “Almost Revolution”

Larry Garber serves as deputy assistant administrator for Policy, Planning and Learning

Last week I participated in two panel discussions organized by the Carnegie Endowment for International Peace that addressed two important development issues: 1) “Closing Space for International Assistance,” a roundtable discussion that included over 20 participants from various U.S. Government agencies, implementing partners, and think-tanks; and 2) the role of politics in the work of development agencies as described in a new book Development Aid Confronts Politics: The Almost Revolution.

USAID confronts the issue of closing space in a number of different country settings. Recently, Agency efforts have catalogued the diverse and creative Mission responses to the problem under the rubrics of prevention, adaptation, and continuing support. In addition, we have engaged implementing partners–both those involved in Democracy, Rights and Governance and in more traditional development sectors–and donor counterparts regarding the challenges we all face.

The second panel discussion involved the launch of a new book by Tom Carothers and Diane de Gramont, entitled Development Aid Confronts Politics: The Almost Revolution. As I stated in my remarks at the launch, the book is a must-read for all USAID staff, whether they are in policy making or operational positions, and whether they are based in Washington, D.C. or serving in the field.

The book describes how the development community shifted over a period of 50 years, from a generally apolitical, technical orientation during the 1960s, 70s and 80s to a recognition in the 1990s that both political goals and political methods are essential for achieving development results. The book acknowledges the progress that many donor agencies, including USAID, have made in introducing democracy and governance programs into their portfolios and in encouraging robust political analysis as part of their strategy and project design processes.

Carothers and de Gramont include many examples from USAID. There is an extended quote from the 2010 Ethiopia Country Development Cooperation Strategy (CDCS) (PDF), which forthrightly describes the “competing objectives of engaging and assisting Ethiopia as a high profile example of poverty and vulnerability to famine, and addressing the major challenges and constraints to democratic space, human rights abuses and severe restrictions on civil society.” There is also a wonderful quote from a Mission Director serving in Africa, who extols the virtues of political economy assessments and “insists that all newcomers read the report as part of their briefing materials.”

And yet, the authors conclude that this transformation is only an “almost revolution.” I share their view that the glass is half full, yet also hope that the book will motivate a profound debate within the broader development community as well as USAID regarding the proper relationship between politics, political methods, and political goals on the one hand, and an emphasis on the achievement of traditional development results on the other hand.

Let the debate begin!

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