The debate raging on between Microsoft guru, Bills Gates and
the world celebrated microeconomist, Jeffrey D. Sachs of the Earth Institute at
Columbia University touches on the core of Global Health. (Refer to Uganda’s The Independent
magazine: Why Jeffrey Sachs matter by
Bill Gates and; Why Bill Gates gets
it wrong by Jeffrey Sachs – May 31, 2014). These debates provide an
indictment for the millennium village projects – a brain child of Jeffrey Sachs
in his quest to end poverty in Africa. In reality, this debate is an indictment
of all foreign interventions that have been conceived from western capitals or institutions and imposed on Africa.
Here, Bill Gates reiterates the critiques of the Millennium
Village Project contained in a book by Vanity Fair writer, Nina Munk titled The Idealists: Jeffrey Sachs and the Quest
to End Poverty (Published by Random House Inc, NY). The book reads very
easily as a narrative in a novel but not as one of those methodological and
glossy text books.
The debate between these two philanthropists is much welcome
in the world where transparency and imperialist agenda appears transposed. No
doubts, both men have used their influence and resources very generously to
better the causes of humanity and to liberate Africa from its sorry conditions
of persistent hunger, ill-health and poverty. Having dished out over US$28.6
billion in grants payout so far, Bill Gates is perhaps, the most committed
person in the world, in this struggle against dehumanizing conditions in Africa
and elsewhere – and that is where his leadership in Global Health matters.
Given the much negative evaluation that the MVP is
attracting, one needs to fully understand the problems with such programs. While
they are ethically sound, well intentioned, meticulously executed and located
in places where they are most needed, they fail to deliver on their ultimate
aims and objectives and instead exacerbate those same problems they are
intended to resolve or rectify!
The MVPs were designed to improve living conditions in
villages and to bridge the gap in social services where governments in those
countries have failed. MVP went about into populations building health centers,
schools, libraries, teaching modern farming methods, providing health
education, distributing mosquito nets, drugs, providing immunization services, and
extending communication systems in countries such as Malawi, to end isolation, in
Dertu (Northern Kenya) where Ms Munk found it to be of no essence, they constructed
markets - and did more.
Furthermore, the MVPs are a welcome intervention for theory
testing, but it ends at that. The lessons that Jeffrey Sachs and his colleagues
should have learned about Africa and such impositions are numerous. The WB/IMF
imposed the much dreaded structural adjustment programs which, instead of
uplifting African nations from debts, it achieved the exact opposite effect. Thereafter,
every program, whether by the EU, US or China imposed on Africa have continued
to defy sustainability and collapsed the moment the dollar support is ended.
As scholars and global health leaders, the main areas of
concerns before any investment is implemented should be about locals’ buy-in
and sustainability. Often, these philanthropists do not pay much attention to
any of the crucial factors such as cultural fit of their programs and the fact
that human societies are not homogenous, that so each program requires
customizing. Failure to include diversity in these theories, from a non western
calibration is also the beginning of their failures.
Interestingly, for an economist like Dr. Sachs, he fails to
understand the complex nature of poverty, its various tenets and
manifestations. In general, he makes it appear that the nature of African
poverty has eluded many in the Western capitals.
This explains why Western-prescribed solutions appear to
address universal poverty as experienced in the West – deprivation. An
influential analysis of rural poverty in Africa was well articulated by Patrick
J. Muzaale in the Journal of Social
Development in Africa in 1982. In his seminal work: Rural Poverty, Social Development
and their Implications for Fieldwork Practices, Muzaale explicates different
typologies of poverty and those that are specific to rural Africa. The MVP
experience is perhaps the major lesson that Bill Gates and Jeffrey Sachs can
use to teach the western world about the complex nature of poverty in Africa.
Lastly, I commend the efforts of Nina Munk. Had she not been
diverted with the obsession to critique the MVP too early, she could have done the
most relevant work for the success of MVPs. Her initial intentions to capture
the voices of the underprivileged recipients of the MVP whose inputs were
excluded and yet were crucial. Without these voices, the MVP project will
remain experimental and will collapse the moment the MVP dollars dry out like
all other projects before it.
END
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