Presented by Clinton Global Initiative
Fragile but forgotten: Why are the countries most in need of development and climate finance the least likely to get it?
Also in today’s edition: We have the latest on the mpox outbreak, which has derailed a major public health gathering in Africa. Plus, the World Bank wants people to not only live longer but also better.
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Neglecting the neediest
It’s a double blow — or insult, depending on how you look at it: Some countries are not only dealing with the ravages of climate change, they’re also dealing with the ravages of conflict. In many ways, they need the most aid, but they’re actually getting less than more stable countries.
That doesn’t sit well with David Miliband, head of the International Rescue Committee, who said part of the problem is the conventional wisdom that aid needs to go through national governments. Civil society groups should not allow this thinking to dissuade them from providing conflict-afflicted, climate-vulnerable countries the help they desperately need, he said during a recent appearance in London, where he warned that the reliance on national governments is “failing” these countries.
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“Climate and development finance often flows where it is easiest to deliver — from national governments in stable countries. Staggeringly, the more fragile the country is, the less climate finance it gets,” Miliband said.
He specifically criticized World Bank guidelines that governments should be bypassed only “in exceptional circumstances,” arguing that they contribute to a “disjointed and incoherent” aid system.
“In fact, World Bank funds are often allocated to these conflict-affected states, but they’re not dispersed. The spend rate is about 50% even of money that’s been allocated,” he told the Chatham House think tank — because those in need are “beyond the reach of government’s control or influence.”
But it doesn’t have to be this way. Miliband pointed to the example of child immunization — where IRC is helping Gavi, the Vaccine Alliance deliver jabs to 2.5 million hard-to-reach children in Sudan, South Sudan, Ethiopia, and Somalia — and called for the same approach to climate funds.
“Instead of the World Bank saying that in exceptional circumstances they’ll work outside national government, it should become much more the norm to have a range of different ways, working through civil society.”
My colleague Rob Merrick reported on what else Miliband said. One thing the IRC chief was conspicuously mum about? Staffing cuts at his organization and the hubbub over his $1.25 million salary.
Read: ‘Incoherent’ aid system is ‘failing’ conflict states, Miliband warns (Pro)
ICYMI: IRC poised to shed 1 in 9 UK staff amid funding crisis
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Fighting the resistance
Pandemics and diseases such as mpox strike fear in many people. But there’s a metastasizing health scourge that tends to fly under the radar even though it contributes to millions of deaths per year.
It’s antimicrobial resistance, or AMR, which happens when antimicrobials such as antibiotics are no longer effective against bacteria, viruses, fungi, and parasites.
“If AMR spreads unchecked, many infectious diseases will become untreatable, reversing a century of progress in medical practices,” according to a new report by the Africa Centers for Disease Control and Prevention and the African Union’s InterAfrican Bureau for Animal Resources.
That report is being published in the lead-up to the U.N. General Assembly as part of a push to convince world leaders to commit to reducing AMR mortality by 10%, inappropriate human antibiotic use by 20%, and inappropriate animal antibiotic use by 30% — all by 2030.
“If left unaddressed, AMR will drive much of Africa into extreme poverty and cause significant annual losses in Gross Domestic Product,” the report warns.
Deaths from antimicrobial resistance already surpass those from malaria, HIV, and tuberculosis in Africa, my colleague Sara Jerving writes. By 2050, as the African population is expected to double, AMR-associated deaths could rise to 4.1 million annually.
Read: The African Union crafts a continental position on AMR ahead of UNGA
ICYMI: Is the fight against antimicrobial resistance finally gaining traction?
The Nordic model
Shifting gears back to the evolving mpox threat, the World Health Organization announced on Friday that Bavarian Nordic’s vaccine has become the first mpox vaccine to be added to WHO’s prequalification list.
Sara tells me that this is a process the agency uses to ensure medical products meet global standards of quality, safety, and efficacy. This type of approval is critical in ensuring countries without the regulatory capacity to approve the vaccine independently can still use it — and it’s a necessary step for organizations such as Gavi and UNICEF to procure it en masse.
WHO recommended that in places with limited supply, which is currently the reality in Africa, health workers could administer one dose to a person as opposed to two, though there’s a need to collect data on safety and efficacy in these cases. The agency also said Bavarian Nordic’s vaccine can be used “off-label” in children, pregnant women, and immunocompromised people in circumstances where the benefits outweigh the risks.
There have been more than 26,500 confirmed and suspected mpox cases in Africa so far this year, but there have been significant delays in speeding vaccines to the continent.
“We now need urgent scale up in procurement, donations and rollout to ensure equitable access to vaccines where they are needed most, alongside other public health tools, to prevent infections, stop transmission and save lives,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said.
In other mpox news, Africa CDC has decided to postpone its flagship conference — scheduled to be held in Morocco in November — because the Pan-African public health agency is busy co-leading the continental response to the outbreak with WHO. “Africa CDC is now concentrating all its efforts and resources on combating this devastating Mpox outbreak,” it wrote, adding that a new date for next year will be announced at a later time.
Related: What you need to know about mpox vaccines (Pro)
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Living longer and better
Development stories can be uplifting, but more often than not, they’re depressing. After all, we’re staring down a skyscraper-tall wave of crises, from disease and war to climate change and debt distress.
But one undisputedly positive achievement is that people everywhere are living longer.
In fact, by 2050, 1 in 3 people will be over 60 years old, according to the World Bank, calling it “a triumph of development” and noting that over 60s are the fastest-growing demographic across the planet. But aging comes with its own set of problems, and the anti-poverty lender thinks we can do a better job of keeping more people alive even longer — and better.
So it released a “healthy longevity” report to lay out strategies governments can take to improve health — especially when it comes to noncommunicable diseases — reduce poverty, address gender inequity, and enhance productivity in low- and middle-income countries.
If governments take bold action, the World Bank says low- and middle-income countries could save 150 million lives and extend millions more. And that translates into benefits for everyone. “Saved health care costs, healthier lifestyles, increased workforce productivity, and lower public expenditure on social services would also generate enormous economic value,” the report says.
Related: Yes, there's a youth bulge, but the global south is also getting older
In other news
The U.S. announced it will provide $202 million in aid to Bangladesh to spur economic growth and support institution-building in the country. [Reuters]
Typhoon Yagi has left more than 320,000 people displaced and at least 100 people dead in Myanmar, as the country’s ruling military junta appeals for aid. [BBC]
This year is shaping up to break the record set in 2023 and be the deadliest year for aid workers, as nearly 200 humanitarians have been killed so far in 2024. [The Guardian]
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About the author
Anna Gawel
Anna Gawel is the Managing Editor of Devex. She previously worked as the managing editor of The Washington Diplomat, the flagship publication of D.C.’s diplomatic community. She’s had hundreds of articles published on world affairs, U.S. foreign policy, politics, security, trade, travel and the arts on topics ranging from the impact of State Department budget cuts to Caribbean efforts to fight climate change. She was also a broadcast producer and digital editor at WTOP News and host of the Global 360 podcast. She holds a journalism degree from the University of Maryland in College Park.
