David Miliband: Today’s refugee crisis demands an aid revolution.

Every day in my work at the International Rescue Committee, I hear stories and see evidence of how vulnerable people in desperate straits around the world are not getting the help they need. The scale and complexity of current humanitarian needs are increasingly out of step with the resources, policies and practices available to meet them.

A series of events this year offers the chance to encapsulate and enact reforms that make a material difference to the lives of the people we and other humanitarian agencies seek to serve. In May, there was the first ever U.N. World Humanitarian Summit, which the U.N. secretary general boldly committed to "fundamental reform." There are successive U.N. and U.S. government-sponsored summits in September on migration and refugees. There is the election of a new U.N. secretary general, also in September, who will take office in January 2017, when there will also be a new U.S. president. These are vital opportunities to bring new hope and dignity to some of the most vulnerable people in the world.

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Much humanitarian action is genuinely heroic. The work of staff members of the United Nations and nongovernmental organizations, not to mention the efforts of those afflicted by conflict and disaster, is remarkable. But more heroism is not an adequate response to the scale of humanitarian suffering; instead we need to update our thinking about what humanitarian action is and how it can be delivered.

There is a need for better aid, not just more aid. The guiding light of reform should be the idea of turning humanitarian action from a mission-driven but fragmented sector of activity to a high-performance and dynamic system. Speeches, articles and books often talk interchangeably of a humanitarian sector and a humanitarian system. In fact, a sector and a system are not the same. A sector is a diverse group of organizations, each with a different focus, operating on the basis of shared principles. A system, for example a judicial system, by contrast, is directed toward shared outcomes, not just shared principles; it has agreed metrics of success, not just multiple measures of activity, and a commitment to inform all practice with objective evidence on what works rather than a generalized belief in sharing positive experience.

The obvious objection to trying to harness diverse activity into a single system is that bureaucracy and hierarchy would triumph. My argument is the opposite. A system with clear goals, a dedicated evidence base and the right financial incentives would be better able to adapt to and even anticipate change than the current sector. Such a system will need to break out of the categories that currently constrain us: emergencies versus protracted crisis, humanitarian relief versus sustainable development, helping people survive versus helping them thrive. These are meaningless categories to individuals and families coping with crises. Changes in the wider world have left these distinctions behind. It is time for public policy to do so, too.

The Context of Crisis

The current scale of human displacement is staggering. Over 60 million people, split two-to-one between internally displaced people and refugees, are now fleeing for their lives. In 2014, only 1 percent of the world’s refugees were able to return home. Old conflicts are continuing, from Somalia to Afghanistan, and new wars are starting, from Syria to South Sudan. One in every 122 people on the planet is fleeing conflict. Over 40 percent of the world's extreme poor live in conflict or fragile states.

This is what creates the case for more aid. Despite the fact that fragile states produce 60 percent of the world's displaced and host nearly half of the world's displaced and 43 percent of the world's extreme poor, they receive just 30 percent of total overseas development assistance. As the U.N. High Level Panel on Humanitarian Financing recently said, "Never before has the world been so generous towards the needs of people affected by conflicts and disasters, and never before has generosity been so insufficient."

It is more than plausible that the humanitarian effort is underfunded to the tune of $15 billion (the figure given by the U.N. High Level Panel). But while $15 billion would be very welcome and would make a real difference, it would not solve the problems that exist. The organic growth of the humanitarian sector over 70 years—spurred in recent decades by the creation of the U.N. Office for the Coordination of Humanitarian Affairs, the entry of Gulf state donors and the growth of a private sector role—has not kept up with the needs of the people.

The mismatch is not just one of resources. It is also one of concept, institutions and mindset. And the mismatch is likely to grow if the likely context going forward is taken into account, from growing climate risks and economic imbalances to the deep trend toward flight and urbanization, the reticence at best on the part of most wealthier countries to accept refugees and the continued pressure on humanitarian finance at a time when there are increasing pressures on domestic budgets.

In the face of these facts, there is a range of necessary responses. One is to reinvigorate international action for conflict prevention and response. Another is to raise more resources. These are very important. But I focus here on what we are trying to achieve, how we can achieve it and how we can finance it.

Collective Outcomes

The humanitarian community has always embraced fundamental principles of action. The principles of independence, neutrality, impartiality and humanity are important every day in our work—protecting our staff and supporting our beneficiaries. But unlike our “development” counterparts, we have yet to define limited and specific results to guide our programs and investments and to measure progress and performance.

Over the past few years I have argued that the absence of a limited set of agreed-upon outcome measures prevents the humanitarian community from operating like a proper system, with a clear focus of activity and effort. As a result, energy is wasted, accountability is undermined, responsibility is dispersed, a silo mentality is reinforced and the divide between people and institutions who consider themselves to be working on “development” rather than “humanitarian” issues is reinforced.

Outcomes, measured by meaningful indicators and context-specific targets, are not a magic cure, but they are the starting point for a serious attempt to build a system that effectively and accountably meets the needs of people displaced by conflict.

It is therefore significant that the recent U.N. report “One Humanity” mentions "collective outcomes" not 10 or 20 times but 60 times. It rightly calls for "agreement on collective outcomes that are strategic, clear, quantifiable and measurable” and says that “over a multiyear horizon [collective outcomes] is ultimately how we transcend the humanitarian-development divide."

Collective outcomes need to specify the improvement we want to see for the conflict affected and displaced: not just numbers of children in school but whether they have literacy and numbers skills. In countries where needs most outpace resources, we need to agree on the most pressing changes that our shared activity must achieve. Setting targets for improvements in the situation of displaced populations that are both ambitious and feasible will motivate all of us to be more disciplined in our interventions. Measuring our progress together will help all of us improve accountability to beneficiaries and incentivize collaboration. In essence, these targets would form the bedrock of a systemwide performance framework.

The task of the U.N. Meeting on Refugees and Migration in September is to agree to the details. I offer three points to inform this process. First, there should be some clear priorities for collective outcomes relating to health for those displaced by conflict, to education for children displaced by conflict, to protection from violence for women and children displaced by conflict and to economic well-being for those displaced by conflict.

Second, the indicators to measure these outcomes need precision and care if they are to have the requisite effect. In education, for example, whether a child has access to education should be indicated not simply by an enrollment rate demonstrating that she is signed up for school but by attendance and participation rates, signaling that she indeed was able to go to school and participate for a minimum number of hours needed for learning.

Third, the power of this approach comes in the word collective as well as in the word outcome. That is because, at the moment, different donors ask implementers to measure different indicators. This means that even if one donor simplifies reporting requirements, it does not have the intended effect of easing the burden on implementation in a material way. For example, the International Rescue Committee in Ivory Coast is required by a combination of donor, host country and internal management demands to track over 1,200 indicators weekly and monthly. This information is time-consuming and costly to collect and not well used to drive programming. So collective outcomes need to be a discipline on donors to drive out wasteful information-collection in favor of harmonized and effective accountability.

Follow the Evidence

Focusing on outcomes is the first part of the battle for effective aid. The second is making sure we have the evidence necessary to choose and prioritize interventions that work.

Since 2006, the I.R.C. has completed, or is in the process of conducting, 66 research studies, including 29 impact evaluations, across 24 crisis-affected countries and in the United States. But while there have been over 2,000 rigorous evaluations of programming in stable countries in the last 10 years, we have seen only 100 in conflict settings. And in the absence of a strong evidence base, the humanitarian world is relying on assumptions, experience and intuition rather than research founded on fact or evidence.

Evidence-based interventions have much to offer to improve outcomes. For example, the use of community committees as a means to keep children safe is a common intervention, but there is little evidence that these committees are effective. On the other hand, targeted programs for parents and caregivers have been shown to reduce violence and promote children's healthy development in high-income and stable countries. The I.R.C. has now tested a family-based approach in Burundi, Thailand and Liberia and set a new standard for effective practice.

A commitment to the use of evidence needs to have five components. First, donors and implementers need to agree on what the evidence says about how to achieve desired outcomes. Second, outcomes need monitoring to measure change from different interventions. Third, we need to generate causal evidence through impact evaluations to inform program design. Fourth, we know that evaluation and evidence alone will not necessarily achieve system breakthroughs. If we want to sustain a system that is evolving, we need to allocate risk capital for research and development to vary and test what works and push for breakthroughs in innovation and research and development. Finally, funding needs to follow the evidence. Programs with high levels of impact need to grow, while those without need to shrink.

The humanitarian community stands to gain from aligning behind what works and, where we do not have evidence of what works, investing in evidence generation. This takes us directly to the third part of reform: finance.

The Cost of Aid

Funding requested through humanitarian appeals has swelled by 660 percent since the United Nations Millennium Development Goals were announced in 2000. The rise in actual funding over the same period has been 366 percent. Various aspects of the financing system are out of sync with the modern reality of humanitarian need. Refugees are displaced on average for 17 years, but the I.R.C.'s median grant length is 11 months. The attendant accountability systems are multiple, overlapping and divergent, all with their own costs. Aid dollars sometimes follow a circuitous route to the beneficiary, from the donor to the United Nations to an international implementing partner to a local organization.

The High Level Panel on Humanitarian Financing has raised the standard for a more efficient and effective financing system. It is vital that its insights are turned into daily practice.

For donors, that means embracing a shift to predictable multiyear funding dedicated to clear outcomes for affected populations. It means funding measurement, evaluation and evidence-generation at appropriate levels. It means pooling funds across agencies (humanitarian, development) and sometimes across sectors (health, education for women and children) to make sure money is targeted on people's needs and not on organizational mandates. It means a harmonized reporting framework that cuts the costs of managing grants.

For implementers, N.G.O.’s and the United Nations, it means one thing above all others: open books. Transparency is essential for the trust that comes with outcome-oriented funding over longer periods. But obviously the agenda goes beyond that to include more extensive cooperation at the local level: to embrace client voices and choices in program design and delivery and to upgrade our own human resources and compliance systems.

One test of the financial system will be the measurement of cost efficiency and cost effectiveness. We are convinced that by better understanding the cost of different programs in different places, we can dramatically increase the number of people who benefit.

We know from research in Kenya that while there is good evidence that a number of programs can improve children's literacy, they vary widely in cost-effectiveness. According to a review by the economist Patrick McEwan, an investment of $8,900 could upgrade the reading skills of 100 students by 20 percent if the money were spent on computer-assisted literacy instruction. But the same amount of money could get the same result for 423 students if spent on performance incentives for teachers, and for 695 students if spent on remedial tutoring. In other words, with the same amount of funds, we can achieve the same outcome for six times as many people.

Within the sector, cost is widely recognized as important. U.N. appeals often state the "cost per beneficiary," and N.G.O.’s, like my own, report on the percentage of donated funds that go directly to programs. For example, we say, accurately, that 93 cents of every dollar given goes directly to programs and services.

While it is a step in the right direction, this form of reporting has significant limitations. It assumes that low administrative costs are equivalent to efficiency. A more meaningful analysis would be to look at the cost-efficiency and cost-effectiveness of specific programs. A cost-efficiency analysis compares the cost of a program to the outputs it achieves (for example, cost per latrine constructed, or cost per family provided with cash assistance), while a cost-effectiveness analysis compares the costs of a program to the outcomes it achieves (for example, cost per diarrheal death avoided, cost per increase in nutritional status).

The truth is that better costing of aid has the potential to save and improve more lives. But the multiplier effects of costing will be realized only when the sector is able to behave like a system. This means having a common methodology for costing that allows cost figures to be compared across agencies, systems that help to automate calculations so they can be done quickly and consistently, and common indicators that we are striving toward.

Everyone expects N.G.O.’s to call for more aid. If we call together for better aid, then we are really doing justice to our beneficiaries.

The Way Forward

There are good grounds for believing that there is an emerging consensus about what should be done to reform humanitarian aid. Yves Daccord, director general of the International Committee of the Red Cross, put it well: “As humanitarian organizations and their leaders strive to remain relevant and effective in this dramatically changing environment, carrying out ‘business as usual’ is clearly not an option.”

It is vital to acknowledge the widespread skepticism about whether there is sufficient unity of leadership in this diverse sector to deliver change. We are a donor-driven sector, and the main donors have wide areas of agreement. But they still run different systems. The United Nations is coordinator, implementer, fundraiser and donor, but each U.N. agency has a different mandate, and so a different set of incentives. The implementing N.G.O.’s are funded to deliver programs, not to exist, and so are in a constant battle to raise core funds.

My own view is that this change has to be led by the donors. They have the money; therefore they have the leverage; therefore they have the responsibility. If they remain fragmented, focused on inputs, not outcomes, and siloed in their thinking, then the sector will remain fragmented and siloed as well. Overcome this inheritance, harmonize their efforts, put the beneficiaries at the center, and the extraordinary commitment of all the players could build a humanitarian system worthy of the name.

 

Related Coverage:

Who is Responsible for Refugees? by David Hollenbach

How One Syrian Refugee Family is Seizing the Opportunity for a Future in Italy, by Gerard O'Connell

The Somali refugee crisis reaches a crescendo in East Africa, by Kevin Clarke

Comments are automatically closed two weeks after an article's initial publication. See our comments policy for more.
Margi Sirovatka
1 year 3 months ago
Based upon the sub-heading of Miliband’s article, I looked forward to a good read. I had recently viewed the film “Poverty, Inc.” that put forth what I assumed was the same message. However, my enthusiasm for Miliband’s message waned by the end of the first paragraph. Did I read that “needs are increasingly out of step with…policies”? Should “needs” be in step with policies, or should it rather be vice versa? I withheld judgement and continued to read and continued to be disappointed. Miliband, a politician and CEO of IRC, focuses on the concept of “collective outcomes” and apparently suggests that the United Nations is the primary appropriate entity to draft, implement, and monitor desired outcomes. He mentions U.N. summits, meetings, Millennium Development Goals, and the High Level Panel on Humanitarian Funding. To the common sense reader, images of a tangled web came before my eyes. Isn’t there royalty on the High Level Panel? Do the academics, the politicians and the royal families really know how to determine the “best outcomes”? In May 2012, I attended an excellent Lumen Christi Institute event. Reinhard Cardinal Marx spoke on his vision for a global social market economy. During his talk, my eyebrows raised as I listened to his waffling as to how to make this vision a reality. I listened again today to Kevin Murphy’s rebuttal (http://www.lumenchristi.org/moral_economy/) to Cardinal Marx and was reminded that focusing on outcomes, as imposed by governance authorities, leads to the law of unintended consequences. “Better aid”? Who determines what is “better”? CEOs of large non-profits with $600,000 salaries? The 15 large donors who contribute 98% of the core resources for the U.N. Population Fund? Oh, and how does a non-profit organization’s “mission” come into play…will reproductive health “outcomes” include injectable contraception? Hmmm…neo-colonialism? Margi Sirovatka Bozeman, MT

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