What Do You Need to Actually “Do Development Differently?”

By Karl Hofmann, President and CEO, PSI

Thinking about development differently and adapting it to our times: DEVEX has been driving this conversation for years, and Raj Kumar’s recent book, The Business of Changing the World, added new perspectives. 

Now, The New York Times has editorialized  about “decolonizing development” and the need to change the paradigm faster.

We agree.

Yes, white saviorism is a design flaw in much of development programming. It constitutes blinders to what is actually happening in many countries in the Global South, where a middle class is growing strongly, private capital and remittances far outweigh Official Development Assistance, and domestic resource mobilization (through host government taxation) is at the center of the debate. 

Having more Global South voices in the driver seat of development policies and decisions is also widely recognized as necessary and long overdue.

For any large institutional funder (say, USAID or the UK’s FCDO), having an aid recipient government speak clearly and confidently about its own development priorities, and driving the deployment of official development assistance, is ideal.  Likewise, having representative community voices define what is best for investments in a community, to lift it up and address problems, is also ideal. But it’s still too rare.

So, what’s an international NGO with decades of experience in this work to do at this time of choosing and change?

For us, democratizing and strengthening development includes these truths:

Language does matter. For PSI, with 50 years of experience on the development end of the humanitarian-development spectrum, our founders’ mindset never saw those we’re working for as beneficiaries or recipients, but as consumers. Health consumers with choices and the power to decide how best to use scarce resources for healthy lives. If we do our job well, we make those decisions easier for our consumers.

Work locally. In addition to our national offices, where 98% of our employees work, PSI works with hundreds of sub-recipients and partner organizations, many of them national NGOs and businesses in the countries where we work, to achieve the health impact we collectively aim for.  Former USAID Administrator Raj Shah had an objective of 30% of USAID funding going to local and national partners.As the Times notes, we are still short of that objective. But at PSI, we are now at about 21% and growing.

Working through partners carries risk for all those who are entrusted with spending taxpayer funds. But funders can make the process easier by simplifying compliance rules and embracing true gain-sharing financing schemes, where those doing the work can benefit by doing it more efficiently than planned.

Align and support the health ministries where we workFor one thing, we need their permission to do our work. And, if good health policy choices are going to underpin healthier societies, then policymakers need to drive the change. We are working with health ministries, for example, on implementing their visions for self-care, something the World Health Organization sees as critical to faster progress toward Universal Health Coverage, and also a set of interventions that seems tailor-made for an age of pandemics. More healthcare technology and decisions directly in the hands of consumers? This is power in their hands, not ours.

Work toward financial sustainability while maintaining impact.  Donors are rightly concerned about never-ending expectations of funding; shouldn’t programs evolve and shouldn’t the need for subsidy decline? In many cases, yes. Over the past decade for example, PSI’s condom programming across dozens of countries has shifted to be 70% self-reliant, depending on the contributions of consumers to sustain the programming when donors have pulled out. Our social enterprise work is meant to capture and grow this magic, particularly where donor funding and subsidy is increasingly smaller, targeted and strategically leverages the power of markets and consumers to solve their own challenges.

Network our standards.  Our funders hold us to high compliance and performance standards. We hold ourselves to internal standards that are just as demanding. No matter how PSI is implementing — whether through a branch office structure, alongside a national NGO we created, or with a partner NGO that is a member of our global PSI network — standards and expectations of performance are common across the board. And we are aiming for these standards to be upheld through peer review rather than just central direction.

Decolonizing development? Democratizing development? Or simply running a responsible, socially minded business in the 21st century? A modern global enterprise should be delivering value to consumers, to stakeholders, and to society as a whole.  That’s the future for the next 50 years of PSI.

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