Breakthroughs in Development

Speech by Dr Ngozi Okonjo-Iweala

August 2, 2017

Madeleine K. Albright Global Development Lecture

Aspen Institute, Aspen, Colorado, USA

 

 Opening remarks

  • I am delighted to be here today. I am extremely honoured to have received this recognition and been invited to give this year’s Madeleine K. Albright Global Development Lecture. It is daunting to follow in the footsteps of such esteemed speakers as Paul Farmer, Helen Clark, Mary Robinson and Rajiv Shah. Let me pay a special tribute to Madeleine Albright, the inspiration for tonight’s event. Madeleine, you are an icon and an inspiration to us all.
  • As some of you may know I have lived most of my life between two great nations, Nigeria and the United States. Both are my home and both very dear to me. Yet in so many ways, they couldn’t be more different. In coming here tonight it struck me that, despite the enormous differences that exist between these countries, in terms of culture, wealth and resources, some of the greatest challenges they will face in the coming decades will nevertheless be the very same.
  • I’m talking about those laid out by the Sustainable Development Goals and the Paris Climate Agreement. Both agreements clearly set out the challenges of the 21st Century and beyond, and provide a universal framework with targets to address these challenges, which apply to all nations. I don’t think we’ve ever had a time in history where our development goals address not just developing countries but also developed countries. Rich or poor, all nations, we are in it together. To me, this is a pretty significant breakthrough in development in and of itself.
  1. Introduction
  • Within this context, it seems clear to me that to solve these challenges and reach these targets will require significant breakthroughs and it is this that I would like talk about tonight. The breakthroughs I want to talk about centre on technology. Despite the potential benefits technology can offer, historically breakthroughs have often had a negative impact on poor people. Since the industrial revolution, if technology wasn’t putting people out of work, it was endangering them through hazardous working environments or long-term exposure to pollutants.
  • It is true that technology is still displacing the working poor in many countries. But it is also true that it once would take decades before those at the bottom of the economic ladder could access technology—even though often they had the most to gain. That is now changing—today a global shift is underway that is seeing the quality of life for millions of the poorest people radically improved by breakthroughs, and in some cases they are even the first to benefit from this technology.
  • And what is so extraordinary is that, from this, a fascinating synergy has emerged. Because while technology is now helping to drive development, development is also helping to drive technology.
  • This is taking place for two reasons: innovation and scale. The first is that the challenging nature of the development problems we need to solve are such that they require a high level of innovation. Technological innovation is occurring in so many spaces all over the world: this is helping to push the boundaries and lead to genuinely new solutions. The second is scale. Roll out a technology across developing countries and you not only unlock new markets—US$ 12 trillion of untapped potential in low-income countries in the SDGs alone—but also that technology can be put through its paces on a scale that is not normally easy to achieve. Scale is something I am particularly focused on as a big development challenge, since we all know how to do good projects and programs, but oftentimes fail to scale them to target the large numbers of poor people in need.
  • So with regard to scale and technology, we have seen what can happen with renewable energy. For decades, investment in wind and solar power has been dwarfed by fossil fuels. But the need for clean off-grid and on-grid energy solutions and the energy deficit in poor parts of the world, particularly Africa, is now spurring development of renewables: from the solar powered fridges that are now appearing across Africa to keep medicines and vaccines safe, to Narendra Modi’s commitment to generate 40 percent of India’s energy through solar by 2022. New markets are emerging in the South that are helping provide the renewables revolution with a new and much needed impetus, from which we all stand to benefit. Renewable sources of energy currently account for over 22 percent of global energy production, reaching over 100 million people. This figure is projected to reach 26 percent in 2020, and developing countries will make up two-thirds of this renewable energy expansion[1]. There is an explosion in innovation in renewables, and tapping of the off-grid market. I am the co-Chair of a small company, Lumos, that has come up with an off-grid solar solution to power SMEs and has a mobile payments application. This is so important because it gives businesses in rural and peri-urban areas hope that they can operate sustainably and create jobs.
  • Over 55 percent of people on my continent have no access to electricity,[2] so this innovative breakthrough in electricity gives me hope that poor people can be reached at scale and given access to a service capable of truly transforming their lives, enabling children to study at night, welders and carpenters to work, women to leave behind back-breaking household work, and community health workers to store vaccines.
  1. Identity
  • The need for scaling up innovative solutions for development also applies to identity technology. Currently one in three children under the age of five does not formally exist, because their birth was not registered. This means technically they have no legal status. It is a major problem that can see individuals disfranchised and denied access to education, health, and the ability to vote. The problem is that in poor countries, the archaic paper-based methods used to certify births, deaths and marriages, make it too easy for people to slip between the cracks.
  • With 86 percent of the world’s children now getting access to routine immunization, more children have vaccination cards than birth certificates. So, one solution is to start treating vaccination cards as de facto identity cards. One project called MyChild is doing precisely this and attempting to reach even more children by helping countries transition from paper to digital.
  • At first glance it looks like a typical paper booklet on which healthcare workers can record health details about the child, such as vaccinations, deworming, or nutritional supplements. But each booklet contains a unique identification number and tear-out slips that are collected and scanned later. This means that even if a child’s birth hasn’t been registered, a unique digital record will follow them through childhood. Developed by Swedish start-up Shifo, this system has been used to register more than 95,000 infants in Uganda, Afghanistan, and the Gambia, enabling health workers to follow up either in person or through using text reminders to parents.
  • But the biggest identity project of all time is India’s Aadhaar biometric ID system. In just seven years, Nilekani and his team have been able to cover 90 percent of India’s 1.3 billion population. Using just a unique ID number, much like a social security number, and by scanning their finger or iris, this system gives citizens an identity that has opened up the potential for access to services that were previously not available to them.
  • The biometric identity system will enable government to restructure and improve its social safety net and subsidy system to better target poor people at scale. It will provide a platform for digital payments, and some are even talking about its use in a Universal Basic Income (UBI) system. In short, it provides the opportunity for India to bring development solutions that eradicate poverty. In Nigeria, during my time in government, we saw the opportunity to follow a similar path through the National Identity Card project in partnership with Mastercard. [Show your card.] The idea was to develop a biometric platform that would facilitate government-to-people transfers, financial inclusion, and the building of a strong, targeted safety net.
  • Of course, such systems still come at a cost, but the beauty about biometrics is that they can more than pay for themselves by helping to prevent or stop corruption. When I first became Finance Minister in Nigeria in 2003, I found very weak systems, processes, rules and regulations in our public financial management system. Virtually all transactions were cash-based. There was nothing on a technological or electronic platform, meaning that if I wanted to pay the wage bill of a Ministry, we did it in cash transferring monies to the Ministry’s bank account for payments.
  • To compound matters, there was no clarity on the number of civil servants on the payroll. Ministries would send differing numbers each month, sometimes making the wage bill and recurrent government expenditures high, and unpredictable. The cash-based transactions and lack of firm payroll numbers left room for manipulation and corruption. Unscrupulous civil servants in collusion added phantom workers to the payroll and collected their paychecks. This phenomenon was known as ghost workers. Ghost workers even retired to become ghost pensioners!
  • I was horrified to see the corruption in government caused by the absence of a financial management system. With the President’s support, I requested the World Bank and DFID to help; USAID also pitched in.
  • With the support of about US$ 92 million in concessional loans from the World Bank, we set about building an electronic payments platform for the federal government, the Government Integrated Financial Management Information System, or GIFMIS. We set up a biometric system to capture and identify all civil servants and pay them directly to their accounts, and eventually pensioners too, with a system known as IPPIS—Integrated Personnel and Payroll Information System. We also developed the Treasury Single Account (TSA) so that the Ministry of Finance could have an overview of all government accounts.
  • These three systems resulted in much stronger financial management institutions. By 2015, we were able to weed out over 65,000 ghost workers, saving the government over US$ 1.1 billion in fraudulent payroll costs.
  • Ultimately, introducing these kinds of digital ID systems benefits everyone. Using biometrics to include those left out or weed out those who would be corrupt is a social good that benefits all.
  • SDG 16 requires all 193 member countries to ensure that everyone has a legal form of identity by 2030, with the aim of helping safeguard the rights of millions of marginalized or disenfranchised people. In light of this, this kind of technology is a necessity if we are to stand a chance of meeting that target. It will make governments stronger and more accountable, and significantly aid financial and social inclusion.
  • This is especially important for women. In many parts of the world, large numbers of women are unable to take control of their finances because they lack the basic documentation to open a bank account. Globally, 42 percent of adult women do not have a bank account, and according to the 2014 Global Findex study, this number rises to 70 percent in sub-Saharan Africa. That’s more than one billion people! Providing women with a digital identity not only helps to address this gross inequity, it also has a very important role to play in empowering them. When I hear of the Fintech revolution, I am excited because I am convinced that the combination of biometrics, mobile phones, and digital payment platforms, when properly applied can truly empower women and girls, and not only speed them out of poverty but also set them up to create wealth and create jobs. Look at what is happening with the Safaricom M-Pesa revolution in Kenya, now used by 96 percent of households. A recent study[3] by Georgetown and MIT professors showed that M-Pesa helped an estimated 185,000 Kenyan women move from subsistence farming to entrepreneurial activities, lifting their families out of poverty. Just this May in Ahmedabad, I visited the women of the Self Employed Women’s Association (SEWA). There are 2.5 million of them, and their leaders told me many are using mobile money transfers through M-Pesa to run their businesses.
  1. Women and Girls
  • Let me now switch to health. Another technology that is revolutionary for women, one I care deeply about, is the HPV vaccine for girls that prevents cervical cancer. Currently, this horrific disease kills 266,000 women every year, or roughly one every two minutes. The vast majority of these deaths (85 percent) are in developing countries because there is a lack of screening and treatment; or where this is available, the cost of puts it out of the reach of most women. If left unchecked, the number of cervical cancer deaths is expected to continue to rise, exceeding maternal deaths, and reaching 416,000 by 2035.
  • With the help of new medical technology, the human papillomavirus (HPV) vaccine, and thanks to Gavi, the Vaccine Alliance—of which I am Board Chair—our hope is that it won’t come to that. Just two shots of this vaccine provides protection against the virus that is responsible for the vast majority of cervical cancer cases. Yet, up until a few years ago this vaccine was beyond the reach of women and girls in poor countries.
  • In 2013, Gavi, took steps to make the HPV vaccine available and affordable to the poorest countries at just US$ 4.50 a shot. Here in the US, a single shot can cost more than US$ 100. This had two dramatic effects. First, the response from countries applying for the vaccine has been unprecedented. Governments were only too aware of the devastating impact cervical cancer can have on the individual, the family and community, cutting down women in their most productive years.
  • But in addition to this, we saw that the market shifted. Previously, poor countries were not viewed by manufacturers as viable markets for this vaccine. But now, 28 countries have introduced the vaccine with support from Gavi, and counting. So far, one million girls have been vaccinated, saving over two thousand lives. In the next few years, our ambitious objective is to vaccinate 40 million girls in the medium term and save 90,000 lives.
  • Interestingly, all this has also helped stimulate innovation, which brings us to the other way in which development is driving technology. HPV vaccination is most effective on girls who have not yet been exposed to the virus. This means they must be vaccinated before becoming sexually active, ideally between the ages of nine and 13. So unlike most other childhood vaccines, which are mainly given to infants, HPV vaccines require dedicated immunisation sessions, and these are now serving as an entirely new kind of platform for reaching adolescent girls with other health services, such as reproductive education, menstrual hygiene, deworming, nutrition checks, vitamin shots and general check-ups.
  • In fact, with mosquito season upon us, it’s also worth mentioning that if, or when, a Zika vaccine becomes available it will most likely have to be delivered through the HPV platform as it too will ideally need to be given to girls before they become sexually active.
  1. Drones
  • On the subject of vaccines and health, let me give you another interesting example where we have breakthroughs and where development is driving innovation. That is with the use of drones. Originally developed for military applications, there is now also a burgeoning consumer drone market for hobbyists. But somewhere between these two successful markets, a fledgling drone delivery sector has been trying to take-off. But despite the hype we have still yet to see pizzas or Amazon drone delivery services take flight.
  • Yet last year, while the Federal Aviation Administration was still scratching its head over drone regulations, the Rwandan Government fully embraced the technology and launched the world’s first autonomous drone delivery service. And no, it is not for pizza! In partnership with US drone company Zipline, as well as UPS and Gavi, this nationwide service was created to deliver medical supplies, such as vaccines, blood, etc. across the country. As you all know, Rwanda is a hilly or mountainous country, and the cost is prohibitive for building infrastructure to reach all villages. The drone service means those living in difficult-to-access places can get health services that save lives at a cost-effective rate for government. With up to 150 deliveries a day, this service allows the government to centralise supplies in its capital Kigali, reducing waste and improving efficiency. For people in remote, rural districts in need of a blood transfusion or vaccines for their children, the waiting time has been cut from four hours to just 20 minutes.
  • And this is just the beginning. New drone companies are springing up, developing ever more sophisticated technology for humanitarian applications. This will continue to improve our ability to solve major development challenges in accessing those hardest to reach communities, and in doing so, continue to stimulate innovation in drone technology.
  1. Global Positioning Services
  • Finally, let me turn to the last technology I’d like to talk about, which is also transforming development. This is data—or “big data” to be precise. One of the great frustrations in development has been getting reliable data upon which we can act. But now by using novel approaches, applying sophisticated data analysis to a very broad range of “hyper-local” data sources, companies like Fraym, an 18-month-old start-up in McLean, Virginia, are demonstrating that it is possible to find gold in those data mines. Using around 200 different data sources, which includes anything from household surveys to geospatial satellite data, Fraym’s algorithms can identify and cluster a vast range of different types of demographics in developing countries.
  • For example, this has already been used in Tanzania to help an off-grid energy company pinpoint the best locations with the most latent demand for off-grid energy, based on population density, proximity of schools, cellphone towers and households.
  • Similarly, the technology could equally be used to identify different demographics to better target development, whether it’s through unemployed men and women in rural areas, pregnant women, or unvaccinated children.
  • While this has many commercial applications, such as helping P&G target areas in Nigeria where mothers are using diapers, it is also already benefitting the development agenda. By identifying which big companies are operating in areas of difficult-to-reach or unimmunized children, Gavi is now able to target potential private sector partners with whom to team up to solve access to immunization problems.
  1. Conclusion
  • So, while it is true that the greatest challenges of climate and development are in need of technological solutions, through scale or innovation, or both, it is worth remembering that this can often be a reciprocal relationship. Tonight, I have just scratched the surface with a few examples. Moving forwards we are already seeing other breakthroughs in biotechnology, food technology, agriculture, rapid diagnostics and others that can also help us solve big the problems of improving health, equity and inclusiveness, creating wealth and eradicating poverty. As Nelson Mandela once put it: “Poverty is not an accident. Like slavery and apartheid, it is manmade and can be removed by the actions of human beings.” It seems appropriate then to apply a manmade solution, technology, to solve manmade problems.
  • Thank you very much.

 

 

[1] International Energy Agency 2015 http://www.iea.org/newsroom/news/2015/october/renewables-to-lead-world-power-market-growth-to-2020.html

[2] World Energy Outlook 2016 http://www.worldenergyoutlook.org/resources/energydevelopment/energyaccessdatabase/

[3] Tavneet Suri and William Jack, “The long-run poverty and gender impacts of mobile money,” Science, 09 Dec 2016: http://science.sciencemag.org/content/354/6317/1288