Georgieva takes over IMF, PEPFAR cuts funding for Kenya’s blood transfusion services, and WHO takes stock of setbacks in eradicating Guinea worm. This week in development:
The U.S. International Development Finance Corp. has fallen victim to America’s dysfunctional budget process, as the new institution missed its target launch date of Oct. 1. Instead of passing new budget bills — which would have stood up and funded the highly-lauded DFC — U.S. Congress once again resorted to a continuing resolution until Nov. 21, which will buy more time for budget negotiations. A few of DFC’s supporters had attempted to persuade lawmakers to include language in the continuing resolution that would have allowed the institution to launch, but those efforts fell short. The agency’s new CEO, Adam Boehler, tells Devex that the delay merely gives his institution more time to prepare before its operations kick into gear. For Boehler, that means strengthening ties between DFC and other development agencies including the U.S. Agency for International Development, advocating for greater room to make equity investments, and ensuring the agency is adequately staffed to deliver on its mission. A remaining question as lawmakers negotiate the terms of DFC’s budget is how the agency’s equity investments should be scored. Currently, these investments would be treated similarly to grants and counted as budget losses, even though DFC’s supporters argue they are likely to generate returns — a fact that other countries with development finance institutions tend to recognize in their budget allocations.
Kristalina Georgieva has officially taken the reins as managing director of the International Monetary Fund — and the World Bank has chosen a long-time staffer to assume her former responsibilities. Georgieva, who was selected by the IMF’s executive board on Sept. 25, arrived at the institution for her first day on Tuesday. Global development advocates are eager to get a sense of Georgieva’s goals and priorities at IMF, given her deep background in development issues. Previously CEO of the World Bank and commissioner for international cooperation, humanitarian aid and crisis response at the European Commission, Georgieva, who is from Bulgaria, pointed out that she is the first IMF chief to come from an “emerging market.” World Bank President David Malpass has opted not to appoint a new CEO, but instead to elevate Axel van Trotsenburg, who had been acting in that position since Georgieva’s departure, to the position of managing director of operations. Previously, van Trotsenburg led the successful replenishment of the bank’s fund for low-income countries, the International Development Association, and will now oversee the operations of its two main lending arms — IDA and the International Bank for Reconstruction and Development.
The U.S. government has severed support for Kenya’s blood transfusion services, a long-planned transition that has nonetheless left health providers worried about whether the government will be able to deliver services on its own. The U.S. President’s Emergency Plan for AIDS Relief provided about $1.4 million for blood safety activities in Kenya last year, and about $468 million in funding and technical assistance between 2004 and 2016. The Kenya cuts are part of a broader effort to transition blood transfusion activities to host governments, according to a PEPFAR spokesperson. Health workers tell Devex they are worried about the government’s ability to take over these services in the short-term. “There will be a lot of confusion and people running helter-skelter,” said Dr. Rowena Njeri, medical superintendent of a sub-county in Murang'a County, in central Kenya. “It’s only going to get worse. We are predicting an increase in mortality over maybe the next year until the government gets their heads together.” Others hope that PEPFAR’s decision to pull support for these services would compel the government to make the necessary budget commitments to sustain them.
The World Health Organization has pushed back its target date for eradicating Guinea worm from 2020 to 2030, in response to a series of troubling complications that suggest the debilitating disease will be more difficult to defeat, according to Nature. Among the biggest problems is the high rate of infection among dogs in Chad, which health workers have been so far unable to explain. The parasite, which causes excruciating pain and often disability in those it infects, was not previously known to circulate among animals. Researchers believe that having nearly ended transmission between humans, they are now seeing it perpetuated through dogs. Combined with surveillance challenges in conflict-affected states such as Mali, Sudan, and South Sudan, the first-known cases in Angola, and a surprising handful of infections among baboons in Ethiopia, the surging cases of infected dogs has forced people committed to eliminating the parasite to reassess. “We are being realistic and down to earth,” Dieudonné Sankara, who heads WHO’s eradication effort, told Nature.