The case for a regional approach to localization

While the localization debate has focused on the need to shift power from international NGOs and institutions based in the global north to those in the global south, little has been said about the role of regional organizations in aiding a more locally led approach to development. Pape Amadou Gaye led IntraHealth, an international health NGO based in North Carolina, United States, with a focus on family planning, reproductive health, and human resources for health for 15 years. After stepping down in 2020, Gaye returned to Senegal, his home country, and founded a new NGO, the Baobab Institute, aimed at supporting the push toward localization in West Africa. “I felt that one of the requirements for success was the assurance that there are strong institutions and individuals in the field, especially for Francophone West Africa, where there is a dearth of institutions. It’s a region that has not really gotten much attention in terms of resource allocation,” said Gaye. In a conversation with Devex, Gaye shared how the Baobab Institute aims to strengthen local organizations in West Africa, why a regional approach might be one of the missing pieces in the localization debate, and the mindset changes needed in order to make locally led development a reality. This conversation has been edited for length and clarity. How did your experience leading a global health INGO for many years influence your views on the need for locally led development? I've come to the conclusion, I and many others, that the current global development model that we're using is no longer fit for purpose. I think it's fair to say that we've made great progress toward reducing extreme poverty, maternal mortality, child mortality, and the list goes on. But there are new challenges in the field, and there is an appetite for doing things differently. Yet we continue to use the same model of development we've used for the last 50 years. I think there is a lot of expectation that we could do development better by involving local actors more than we have so far, and there is a movement toward making sure that the center of gravity is shifted much closer to the field. What is Baobab Institute’s approach to strengthening local organizations in West Africa? Currently, our focus is on efforts we had started as IntraHealth to strengthen family planning and reproductive health in this region. We have a big focus on what’s called the Ouagadougou Partnership, which [comprises] nine French-speaking West African countries, an initiative which is now 10 years old and was supported by many donors. It has become a good platform, in my view, for doing work in the region. As one of the cofounders of the partnership, we are committed to using that platform so that we can build on the multiplier effect and touch several countries at the same time. Where we've landed right now is in three major areas that we think are extremely helpful for the region. We think that having a mechanism to support financing, especially of front-line workers, is going to be extremely important. There is financing going on, but the model favors working directly with government, and it takes a while for the money to trickle down to where it needs to be. So we pitched this idea to the Gates Foundation that having a locally run fund that people can apply to could make a big difference in terms of scaling up tested approaches. The foundation responded favorably to that and gave us a three-year pilot grant. The idea is to turn this into a catalytic fund that could also be a pooled fund for donors. We also want to focus on training because even if we believe that there's a lot of unlearning to do, if you have a good learning platform, you can promote new approaches to doing things. And then we think that digital health is going to be key to everything that we do to modernize the current health system. Do you see this regional approach to localization as a stepping stone to a more direct funding approach, or as a model for localization that we should be considering in its own right? Ideally, we would get to a point where everybody's comfortable about funding directly who they want to fund and so forth. I think we're far from that reality at the moment. Right now, many countries are not able to even spend the money that's available to them. The infrastructure is just not there yet. Many of the countries [in the region] are also too small, and it really doesn't make sense to have separate kinds of activities. I think a regional approach to localization is not being talked about enough, and I think that's one of the missing pieces. But as countries mature, as their systems develop or their governance capabilities improve, then I think direct funding makes a lot of sense. And it continues to do so because a lot of work you want to do with governments has to match with government programs, so I’m all for that. In your view, what does a shift to locally led development look like and what changes would you like to see that would help enable this shifting of power? I would like to see international organizations reorganize themselves, so that there is truly a shift in the center of gravity. There is no reason why you should continue to have the major decision-making positions based in the U.S. or in Europe. I worked for almost all of my career for an international organization. And by the time I retired, all of the major functions, the executive team, and all the vice presidents were still based at headquarters. I think we should be courageous enough to say we could move some of these key positions to the field. There are also roles that are better played in the global north. Advocacy to [donor] governments — like to the U.S. or to the U.K. — should continue to be done from the U.S. or from Europe, because, frankly, it makes more sense in terms of proximity. But advocacy to local governments obviously should shift to the region. I would like to see a lot of the way we design these projects be more reflective of more participation from local actors. That we reduce the number of projects that are all conceived and just need to be implemented [locally]. I think we can go from that, to maybe a concept that is fully fledged and fully developed in the region or in the countries, with better participation of local actors. Global development so far has been conducted in this global framework of actors who are both from high-income countries and middle- and low-income countries. In my opinion, locally led development does not mean countries just working on their own with their own resources and their own technical expertise. I think it’s very important to maintain an environment where there is generosity and openness to aid. What message or advice would you want to share with other regional or locally led organizations? There is some work to be done from local actors for localization to happen. I think there needs to be a change in mindset. People truly have to believe that we can do it, and we can carry on these new tasks and perform up to the standards. There are a lot of people like me, who might be from the region, but who were trained in the United States, and molded a certain way. As a CEO of a large NGO, making good money, with good benefits, it's not easy to give up. But I do think it does take that courage to make sure we're not part of the problem we're trying to solve. And that can only be done by individual assessment, by introspection, by looking at how may I be contributing to perpetrating the same thing I'm trying to change? The localization agenda is not coming at the best time, because the economy is very tough for a lot of these countries. No one is even talking about the amount of debt that these countries have or about debt forgiveness, yet we're talking about localization and putting people in the driver's seat. And so we do need a level of realism. It's not an easy task that is being asked. And we should not be naive to think that there is a recipe that you can just quickly apply. It's really long work, because we are talking about changing a whole model, changing our whole system. And we're going to see the results little by little. Dig into Roots of Change, a series examining the push toward locally led development. This is an editorially independent piece produced as part of our Roots of Change series. Click here to learn more.