Belgian Development Cooperation takes up the challenge

8 projects of Belgian Technical Cooperation to achieve the Millennium Development Goals

Belgian Development Cooperation takes up the challenge

MILLENNIUM GOALS

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Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

8 themes: Millennium Development Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Eradicate extreme poverty and hunger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Achieve universal primary education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Promote gender equality and empower women . . . . . . . . . . . . . . . . . . . . . . . . 10

Reduce child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Improve maternal health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Combat HIV/AIDS, malaria and other diseases . . . . . . . . . . . . . . . . . . . . . . . . . 16

Ensure environmental sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Develop a global partnership for development . . . . . . . . . . . . . . . . . . . . . . . . . 20

Recommendations of the Millennium Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

CONTENTS

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BELGIAN TECHNICAL COOPERATION

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The tsunami catastrophe, which claimed over 280,000 lives and left millions homeless, demonstrated how solidarity too can become a global phenomenon nowadays.

This unparalleled natural disaster, which was watched virtually live by TV viewers around the world, led to a turning point in the history of international humanitarian aid.

In the space of a fortnight, 75 states, both the rich and the not-so-rich, collected 800 million dollars at the UN’s request as a first instalment of emergency aid. Meanwhile, millions of members of the public, feeling a sense of responsibility, demonstrated their generosity by donating unprecedented sums of money.

But this spectacular humanitarian crisis experienced through the power of television should not lead us to overlook all those other crises. Crises which do not receive media coverage, since in many cases they are inaccessible, yet which claim millions of victims every year.

I am thinking in particular of the crises with which Africa is afflicted, such as famines caused by the desert locust and other factors, or tragedies such as those in Sudan and the Great Lakes region, where over three million lives have been lost in recent years.

I am also thinking of all those Southern countries, in Africa, Asia and Latin America, which cannot experience sustainable development without the support of the international community.

This is why, in 2000, at the Millennial Session of the United Nations General Assembly, 189 heads of state and government leaders jointly undertook to halve world poverty by 2015.

To achieve this goal, they set eight common objectives, known as the Millennium Development Goals, which range from ensuring primary education for all children to taking measures against famine and combating AIDS and tropical diseases, and also include empowering women and establishing a global development partnership.

Belgium has been doing its part towards the accomplishment of these objectives by earmarking 0.5% of its GDP for development aid, putting it eleventh in the world ranking of donor nations.

It has also undertaken to further increase its support for development by devoting 0.7% of its GDP by 2010 to the achievement of these development goals, which offer the prospect of stabilising and pacifying the world by reducing migratory tensions.

Last year, the world spent 1,000 billion dollars on arms, 300 billion on export subsidies and just 60 billion on world development …

Without being guilty of naïve pacifism, I believe that the world will be an infinitely more stable and peaceful place when the relative proportions of these three figures have been substantially adjusted.

Clearly, all things are interconnected.

It is foolish to imagine that we can have peace without development, any more than development can be achieved without peace.

This is what makes development a highly political issue that can only be tackled with a global approach.

Today, five years after the Millennium undertaking, the task still seems insurmountable; yet I am convinced that, through the fervour of solidarity of which the world has shown itself capable, it can be achieved.

ARMAND DE DECKER

Development Cooperation Minister

FOREWORD

At the dawn of the new millennium (2000), the international community fi rmly decided to take action to combat poverty. For the fi rst time, the 189 member countries of the United Nations undertook, in the Millennium Declaration, to achieve eight objectives by 2015. These are known as the Millennium Development Goals (MDG).

The Goals are not new. What is unique in the history of development cooperation is the general consensus which has been established as regards the practical results to be attained and the agenda to be followed. Every country has to take steps. The developing countries have a responsibility to undertake a policy of reforms and to strengthen governance so as to release the creative energy of their people and attain the fi rst seven MDGs. However, they will not succeed in this without receiving further contributions from the developed nations in terms of aid and obtaining fair trade rules and debt relief (MDG 8).

Belgium is making an active contribution to the achievement of the Millennium Development Goals. Since 1999, it has undertaken to increase the fi nancial resources set aside for development cooperation annually so as to attain at least 0.7 % of GDP by 2010 at the latest.

Through this report, Belgian Technical Cooperation, the executing agency of Belgian development cooperation, wishes to explain its work on the ground. Eight projects, selected from among around 260 projects in progress in 2003, depict the day-to-day work of men and women fi ghting against poverty in the world.

MILLENNIUM DEVELOPMENT GOALS

Themes888Themes8Themes

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BELGIAN TECHNICAL COOPERATION BELGIAN TECHNICAL COOPERATION BELGIAN TECHNICAL COOPERATION

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1 - Eradicate extreme poverty and hunger

2 - Achieve universal primary education

3 - Promote gender equality and empower women

4 - Reduce child mortality

5 - Improve maternal health

6 - Combat HIV/AIDS, malaria and other diseases

7 - Ensure environmental sustainability

8 - Develop a global partnership for development

MILLENNIUM DEVELOPMENT GOALS

MILLENNIUM GOALS


1 - ERADICATE EXTREME POVERTY AND HUNGER

Democratic Republic of Congo: local food security project to take structural action as regards the regional economy

In the port of Kinshasa1

A barge glides among the countless wrecks scattered throughout the port of Kinshasa. Unloading can begin. Around 2000 tonnes of corn grown in the province of Bandundu, upstream, are to be distributed, through humanitarian organisations, to the most vulnerable population groups in the capi-tal: abandoned children, AIDS orphans, those displaced by war, etc. There are esti-mated to be over 30,000 street children in Kinshasa, many of whom spend the night in the cemeteries. “This specifi c initiative, supported by Belgian cooperation, aims fi rst of all to encourage local corn produc-tion, all of which is sent to the capital, as the Bandundu villagers tend to eat manioc instead”, explains project leader Jean-Marie Ngaleko. “This increases the income of these poor peasant farmers, so they can equip their home, by a cart or a bicycle and, above all, send their children to school - one of the most urgent challenges facing our country”.

Halve the proportion of people whose income is less than one dollar a day

Halve the proportion of people who suffer from hunger

A new approach in Rwanda: Belgian cooperation is working on the seed sector

To ensure basic food security in Rwanda, Belgian Technical Cooperation is working out a research and production project for basic seeds.

Eighty fi ve per cent of the population of Rwanda live from agriculture. This is mainly subsistence farming. However, the plots of land, passed on by inheritance, are becom-ing smaller and smaller and can no longer meet the needs of a family. This means that there are two options: importing the food-stuffs that are lacking or increasing agri-cultural productivity. By entrusting Belgium with the task of reconstituting the country’s vegetal genetic capital (destroyed by wars), Rwanda can make use of this country’s leading-edge experience in tropical agri-culture. The main goal of this new project, which is to start in 2005, is to increase the food security of millions of small-scale producers in Rwanda by making available

to them high-quality seed that is suited to the local agronomic conditions and cli-mate, through a production and market-ing sector entrusted to private players. Initially, this involves updating suffi cient varieties to meet all demands and ensuring that more people have access to improved seed (to promote better productivity). How-ever, other elements are also involved: it is risky to focus exclusively on the seed aspect, without considering fertiliser, pes-ticides and their availability. Downstream, the size of the market and its conditions of access must be assessed. This is therefore a multi-facetted project which, at the end of four years and with a budget of Ð 6 mil-lion, should enable Rwanda to contribute towards the food security of its people.

1 Extract from the article entitled Congo- Au fi l du fl euve, published in Le Vif/L’Express on 1 October 2004- Olivier Rogeau

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Food aid for vulnerable population groups

Start-up: 2002/2003 – 2003/2004

Duration: 1 year in each case

Belgian budget: € 1,000,000 per operation

Goal: To reduce poverty by providing food aid for vulnerable population groups and encouraging corn production at a fair price.

Bringing supply and demand together

Seventy per cent of the people of Congo currently face food problems. Para-doxically, the country has the resources needed to feed the entire population.

In Bandundu, a corn-producing region 300 km from Kinshasa, small producers face two major difficulties in selling their produce. On the one hand, the very low price they are offered does not enable them to live decently or invest in their working tools. On the other hand, the conditions for reaching the capital are made very difficult by transport prob-lems and damaged or badly maintained tracks. At the other end of the chain, in Kinshasa, thousands of street children, AIDS orphans or people displaced by war and ‘vulnerable adults’ all depend on any aid available to survive.

The Belgian cooperation project is based on the initiative taken by a local rural development organisation (the NGO BUACO) to improve food security for the poorest people in Kinshasa whilst at the same time creating an outlet for the small-scale producers of Bandundu. In practical terms, 10,000 small-scale pro-ducers are offered an incentive price for their harvest. This price enables them to live and organise their production under better conditions. Grouped together in cooperatives, they receive support from BUACO, which helps them plan

their harvests and arrange transport to 85 intermediate locations by lorry and inland waterway as far as Kinshasa. In the capital, 47,000 people receive food aid in the form of local corn.

Working structurally to ensure a long-term impactStarting with this small project, Bel-gian Technical Cooperation is seeking to have a structural impact on rural development throughout the region. This approach goes far beyond emer-gency food aid. It involves local people actually implementing the mechanisms themselves. By ensuring that all those concerned participate directly (local authorities, NGOs, the private sector), Belgian public aid aims to have a long-term impact since it is in the interests of everyone. Tracks are being maintained again so that the corn can be taken to the river. Thanks to the fair price they are offered, the farmers are able to look to the future, plan their harvests (corn production in the region has increased by 178%) and even set aside a sum for health care and education costs. Finally, the beneficiaries in the streets of Kin-shasa no longer face malnutrition on a daily basis.

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TESTIMONIAL

To what extent are the people of Congo faced with the problem of hunger?Decades of poor governance and a series of armed conflicts have plunged the Democra-tic Republic of Congo (DRC) into a complex humanitarian crisis. Many fields and farms in the east of the country have been abando-ned and agricultural output has fallen subs-tantially. In March 2003, the DRC was one of 25 African countries suffering from a serious food shortage in the FAO classification. In ten

years (between 1990 and 2000), the number of undernourished people more than doubled, from 15 to 32 million. Twenty-seven per cent of households in the Congo only have one meal a day.

Where did the idea for the project come from?First of all, we set up an informal group made up of representa-tives of the Directorate-General for Development Cooperation, the Belgian NGO Solidarité Socialiste, its Congolese corres-pondent BUACO and Belgian Technical Cooperation. The group worked for almost a year before putting its proposal to the Bel-gian government, which accepted it : food aid would be based on local purchases of foodstuffs rather than on food imports as had been the case until then, through the United Nations World Food Programme using Belgian funds. For me, Belgian food aid here is one of the most appropriate strategies for indirect sup-port for the agricultural sector.

What results has the project achieved so far?The list of results achieved is considerable. I will only mention a few significant points here. First of all, we have enabled 10,000 peasant farmers to sell their corn under good conditions (at twice the normal price). Corn growing has revived and is beco-ming firmly established in the region. The producers’ income has improved substantially, enabling them to make economic choices, such as the purchase of bicycles, cement, solar panels or sheet metal houses, or to opt for social expenses (construc-tion of a school and health centre). The villagers have started maintaining local roads again. What’s more, food aid has rea-ched 47,000 vulnerable people in Kinshasa.

Was it easy to persuade the peasant farmers of Bandundu to grow corn when they tend to eat manioc instead?The peasant farmers were already producing corn, but on a small scale, as a vegetable. Once they had been made aware of the situation, they were quickly persuaded to invest in corn as a profit-making crop. As regards their eating habits, these have basically not changed. They eat mainly chikwanga, prepared from manioc. However, some families are already eating fufu, which is prepared from a mixture of manioc flour and corn.

KEY PROJECT DATA:

Patrick Kakwata, technical assistant

K a t a n g a

Sud-Kivu

Nord-Kivu

Maniema

H a u t - C o n g o

E q u a t e u r

Kasai-Occidental

Kasai-Oriental

BandunduBas-Congo

Kinshasa

MILLENNIUM GOALS


2 - ACHIEVE UNIVERSAL PRIMARY EDUCATION

Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full

course of primary schooling

Education policy in MaliSince 2001, Belgium has been support-ing PRODEC, the ten-year programme for the development of education in Mali. This is an ambitious programme which concerns all levels and types of educa-tion. PRODEC defi nes Mali’s priorities in the fi eld of education and bears witness to the government’s wish to provide rapid responses to existing problems. The main goal is to increase the quality of primary, secondary, higher and vocational educa-tion. Mali faces a host of diffi culties at the moment: there are not enough schools, the economic and social situation is such that children are sent out to work or girls are registered at school less often than boys. Other aspects of the programme concerns the use of mother tongues com-bined with French or teacher training.

Generally speaking, the programme aims to restructure the educational system by means of decentralisation, dialogue and

consultation between the governments of the donor countries.

Budget aid, a new instrument for global action Over the past few years, Belgian Techni-cal Cooperation has been developing its expertise in the fi eld of budgetary sup-port. This type of aid includes not only the fi nancial aspect (funding develop-ment programmes in the partner coun-try), but also ongoing political and tech-nical consultation with the government on the progress made.

In the case of PRODEC and the part-nership framework signed between the Mali minister in charge of education and the 15 technical and fi nancial partners, Belgium is one of the members (along-side the World Bank and other bilateral cooperation agencies) that is funding

the programme through targeted budget-ary aid. The partnership framework acts as a guarantee for means of cooperation and consultation.

Consequently, the authorities in Mali are in control and encourage a global approach by requiring technical and fi nancial part-ners to complement one another and be consistent and by seeking to harmonise procedures. To implement activities, an ongoing political and technical dialogue is established with the Mali government. Monthly meetings are held, backed up by theme-based meetings (access, qual-ity, management/decentralisation, infor-mal education and vocational training) so that the project can be followed up and the work managed properly. These meet-ings contribute towards strengthening the institutional capacities of the Ministry of Education and increasing its sense of responsibility.

Mali: a new instrument for large-scale action in education8

Bamako

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TESTIMONIAL

Do you think all children in Mali will have access to primary school by 2015?In Mali, the gross level of schooling in the first cycle rose from 58.1% in 2000 to 67 % in 2003 and 70 % in 2004. The net level of schooling in 2004 was 53.4%. This is forecast to stand at 83% in 2015.Despite these increases and the note-worthy progress made, the goal will

only be attained if economic growth is such that the fam-ily income enables each family to send all its children to school. This also requires a rise in budgetary spending and increased awareness on the part of parents of the importance of education for children.

What makes PRODEC an important programme?Bringing substantial budgets into play enables the Ministry of National Education to plan and implement the first phase of the programme in full. This means that continuity of action is assured and supervisory bodies are being put in place. The gradual harmonisation of proce-dures between the partners enables the Ministry to save time and monitor its budget. The partnership framework is very dynamic. During meetings of the theme-based commissions and at the monthly meeting, the quality of the interventions is discussed and, if necessary, improved. The only slight problem is that it sometimes takes a little too long to obtain the consent of all the partners.Joint missions are replacing individual missions per agency and leading to the preparation of a checklist validated by everyone, including the findings and recommendations for the next six months.

What exactly is your role?My role mainly involves following up the programme and Belgian public aid. My constant presence with the partners to obtain lasting agreements and facilitate technical meet-ings takes up a great deal of my time. In order to ensure a balance between the partners and the Ministry, Belgium assured the presidency of the technical and financial part-ners for six months. As an advisor on the subject, I helped set up the multi-sector and inter-ministerial commission on vocational training, which was subsequently formal-ised.

How does your role differ from that of a ‘traditional’ Technical Assistant?As regards programme follow-up, the main difference between the work of a traditional technical assistant and my work concerns the extent of the intervention and the partnership framework. Above all, I defend the interests of the Ministry of National Education and the partnership framework and not only that of Belgium.As there are many partners, there is a real risk that the technical content of the debates will become more com-plicated. Generally speaking, the quality of the debates is very high and participants have to master the subject fully. Moreover, it is essential to be able to communicate with the decentralised structures and schools in terms that they understand.

A gradual approachPRODEC consists of three phases: Pro-gramme d’Investissement Sectoriel en Education (PISE - programme for sec-torial investment in education) PISE1 (2001-2005), PISE 2 (2006-2008) and PISE 3 (2009-2010). At the end of the first phase, the project is in the process of making a transition to a new educational system, new management methods and more efficient primary education.

To back up this process, Belgian Techni-cal Cooperation has delegated a techni-cal adviser locally, whose follow-up role

is vitally important. He attends all the technical meetings and, as a resource person on the spot, he makes sure that the interests of everyone are taken into account (trade unions, Koranic schools, vocational and technical training, etc.) and that the programme involves the Ministry of Employment and Vocational Training and the decentralised struc-tures (local authorities).

PRODEC - Programme Décennal de Développement de l’Education

Start-up: 2001

Duration: 3 years (Phase 1), extended by one year

Belgian budget: € 6,9 millions

Total budget: € 130 millions

Goal : To provide general support for the Mali national programme for the development of education

Alexis Hoyaux, technical assistant

KEY PROJECT DATA

MILLENNIUM GOALS


3 - PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all

levels of education no later than 2015

The story of Sopheak 1

Sopheak, who is 14 years old, is the orphan of a military father killed by a mine when she was still a baby. She is the second in a family of four girls being brought up by Sophat. Her elder sister has already left the family’s poor straw hut to go to Siem Reap where she dances in the big hotels. The three younger ones still remain, including Cham, the youngest, who is ten, and 13-year-old Mao. “I want my daugh-ters to go to school so that they can get a good job and have a different life to me”, their mother hopes. Sopheak nurtures a childhood dream: she wants to become a tourist guide at the site of Angkor, which she grew up beside.

Every morning, after getting up at dawn to help her mother, she sets up a rickety stall facing East Mebon. Mao and Cham soon join her, their arms loaded with cakes prepared by Sophat, as well as a supply of coloured fruit. The 3000 riels 2

that this trade brings in every day are not enough to guarantee the family its two daily meals, let alone to enable the ado-lescent to go to secondary school. This year, the grant which she receives (along with her sisters) from Belgian Techni-cal Cooperation means that she can go to the fi rst year of the secondary school in the village of Ta Koh, in the Banteay Srei district, to the west of Siem Reap. The 90 dollars taken annually from the social fund set up by Belgian Technical Cooperation to help the poorest of the poor, is enough to pay for school sup-plies, uniforms and the precious bicycle without which Sophat’s children would have to give up going to school. “The head of the primary school in our village spoke to me about this programme. It’s an opportunity for my daughters”, says their mother, bowing her thanks. Out of the 639 students at Ta Koh, 43 of them benefi t from the BTC grant.

A ‘customised’ project for girlsThe Cambodian government shows a very clear political will in terms of promoting equality between the sexes. This is directly refl ected in the schooling policy, which lists this equality as a priority. To promote access to school for girls, the strategic plan involves recruiting female teachers and educational staff, integrating the ‘gen-der’ component in the plan, setting up and assessing projects, and increasing aware-ness among families and the community.

The Basic Education and Teacher Training Project (BETT), set up by Belgian Techni-cal Cooperation in the provinces of Siem Reap, Otdar Meanchey and Kampong Cham, is fully integrated into the national strategy in Cambodia. Its main goals are to improve the quality and facilitate access to basic education, and it includes a series of measures intended directly for girls.

1 Extract from the article by Frédéric Loore of La Libre Match - 16 th of February 20052 4000 riels equals $ 1

Cambodia: the integration of girls is the priority10

PHNOM PENH

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3 - PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

Basic Education and Teacher Training project in the provinces of Siem Reap, Otdar Meanchey and Kampong Cham (BETT)

Start-up: 2003

Duration: 3 ans

Budget: € 8,750,000

Goal: To improve the quality of basic education and promote fair access for girls and boys.

To promote access to basic education for all children, this very ambitious project includes the construction and rehabili-tation of schools (500 classes). An initial pilot school has been set up. It will be used as a model for the construction of others (including a boat school on Tonle-Sap lake). In these new schools, par-ticular attention is paid to hygiene and separate toilets are provided for girls. The second measure to promote access involves grants for the children of the poorest people. The project encourages children from the poorest families so that they do not abandon their schooling during the year and their parents so that they do not discriminate against girls. Consequently, 60% of the 1200 grants distributed this year are deliberately intended for girls.

The project’s second goal concerns the quality of education through teacher training and educational staff. For girls in particular, the project fosters the

recruitment of female teachers who act as models for pupils and reassure par-ents. The teaching staff, made aware of the importance of integrating girls into schools, endeavour to give them confi-dence in themselves and to avoid repro-ducing stereotypes linked to male and female roles. In teaching institutions, the refurbishment of dormitories makes it easier for female students to register.

BETT is a model for the integration of the ‘gender’ component at all levels, right down to the composition of the team allo-cated to the project.

TESTIMONIAL

What is the position of girls in Cambodia?Equality between girls and boys in edu-cation is one of the government’s priori-ties. However, despite the real political will and action programmes that have already started up, there is still a long way to go before Cambodia achieves equality between the sexes in primary and secondary education. The country

currently has to cope with disparities at all levels. Eight out of ten men aged over 15 can read and write, while the figure among girls is only six. There are between 10 and 20% more boys than girls in primary schools. In general, girls start school later and are more likely to give up their schooling, often before they get to secondary school. Very few of them reach the higher level.

What results has the project already achieved?In one year, results can be seen at various levels. First of all, we have increased awareness among local and pro-vincial education officials of the problems linked to equal access for all to school. We have developed a database and tools to select the locations of future schools and the ben-eficiaries of our grants. A special programme, the “double poverty targeting strategy” enables us to choose them. We have set up local committees to administer the grants and we have selected the 1200 beneficiaries for this year. As regards building schools, an initial pilot experiment has been set up and we have decided on the sites where the next classes are to be built.

In your view, what are the project’s strong points?For me, the main priority is to involve the community, to ensure the participation of all stakeholders, the decen-tralisation of decision-making, partnership and coordina-tion with the Ministry of Education, Youth and Sport and the other international partners. However, I also think it is too early to draw conclusions in terms of impact. The schools still have to be built and grants have to be followed up. We learn from the situation on the ground that the grants programme has an important effect on both poor girls and boys, but it is still too early to generalise.

Iris Uyttersprot, technical assistant

KEY PROJECT DATA

MILLENNIUM GOALS


4 - REDUCE CHILD MORTALITY

during pregnancy or childbirth. However, it is estimated that almost two-thirds of these deaths could be avoided if these children had access to vaccinations and better hygiene, which emphasises the importance of local health services that can at least meet this demand. In other words, all projects providing support for the development of health services have a direct impact on infant mortality.

The project in support of the devel-opment of the health districts of the department of Dosso in Niger, while focusing on the improvement of health services as a whole, includes several aspects that are linked to infant mor-tality. Amongst other things, it aims to increase the percentage of children who are vaccinated, construct new health centres for very remote population groups, create an evacuation service for seriously ill children and provide better care for sick children in hospitals. More specifi cally, initiatives have been taken to increase the number of doctors in the area. Nursing staff have been trained so

as to improve diagnosis and care for infec-tious respiratory illnesses and malaria, for example. A special effort has been made to cover as many equipment structures as possible required to ensure curative and preventive activities.

Improving access to care is the fi rst step towards improving infant mortality levels but, in a longer-term vision, other sectors have to be taken into account.

Acting in parallel on all frontsIn Dosso, Belgian cooperation promotes synergy between the health project and other Belgian public aid initiatives in the region.

Alongside the support for the development of the health districts, Belgian Technical Cooperation has implemented two com-plementary projects: one to supply drink-ing water and one to increase women’s income. These interventions, the common aim of which is to improve the living con-

Reduce by two thirds the under-fi ve mortality rate

12

Inverting the trendThe level of mortality among children aged between 0 and 5 years is a good indicator of the level of development of a country. The poorer the country, the higher the level of infant mortality.

Thirty years ago, one child in fi ve in the world died before his or her fi fth birth-day. Since then, infant mortality has fallen sharply in many countries. How-ever, from the 1990s onward, this rate of decline slowed down in Niger, and in other countries that are amongst the poorest in the world.

Developing integrated health servicesThe fi rst few years in a child’s life are extremely diffi cult. Respiratory infec-tions, diarrhoea, measles, malaria, HIV/AIDS and malnutrition are the cause of most deaths. To this should be added the number of babies who die in the fi rst few months due to complications that arose

Niger: A multi-dimensional approach to improve child health

Niamey

13

ditions of the people, also contribute towards the fight against infant mor-tality. In the case of the drinking water project, the direct aim is to bring down the rate of mortality by reducing the risk of hydric diseases such as diarrhoea and cholera, particularly among young children aged 0 to 5 years. The sec-ond project, by increasing the financial resources of women, serves to improve children’s diet and make it financially easier for them to receive health care. The synergy between the three projects is only the first step in a more integrated approach.

Aiming for a more strategic approach with the Health Development Plan From 2005 onwards, the BTC’s various health projects in Niger will give way to a single integrated programme spe-cifically designed to form part of the Health Development Plan, which itself is integrated into the strategic approach

adopted by the Ministry of Public Health. The Health Development Plan is sched-uled to last five years and bears witness to a more global vision of the health system, planning for synergies between all aspects of the programme. This involves both pro-viding institutional support for the Ministry of Public Health, research and training for health professionals, the national hospital in Niamey (orthopaedic/traumatology) and urban health in Niamey, while continuing to contribute towards the development of the Dosso health district.

Structured as a ‘programme’, Belgian aid must make it possible to considerably improve the quality of and access to health care for the people of Niger, by guarantee-ing the coherence of the national strategy.

TESTIMONY

What are the precise goals of the Health Development Plan as regards infant mortality?Infant mortality in Niger currently stands at 274 ‰ and the new Health Develop-ment Plan aims to reduce this by 25 % by 2009. This « modest » goal is due amongst other things to the fact that between 1992 and 1998, infant mortality in Niger only fell from 323 to 280‰, that the past engenders caution and that the reduction in infant mortality does not depend solely

on the way the health system performs, but also on other factors such as socio-economic conditions, instruction, food resources linked directly to climatic conditions, etc. The reduction in infant mortality is therefore also linked to a considerable extent to the results of the Poverty Reduc-tion Strategy Paper in general.

What is special about the new Health Development Plan?The Health Development Plan is a very ambitious pro-gramme spread over four years, with a budget of € 11 mil-lion. It is the result of a group effort by all the technical and financial partners who have worked in a concerted fashion from the outset. As part of a programme approach involving real joint management, it is now up to the Niger government to take on the role of coordinating the various partners. The Health Development Plan comprises inno-vative aspects: for the first time, in a health programme, the issue of malnutrition is tackled. Special emphasis is placed on maternal health and infant health.

Niger is still one of the poorest countries in the world. How does cooperation fit into this context?Niger is a country that is cruelly lacking in both financial resources and human resources. For instance, there are only 250 doctors for 12 million inhabitants.Niger is developing slowly, but this does not mean that our efforts are in vain - on the contrary. The efforts we have made in the Dosso district over the past 30 years are rec-ognised and Belgium has become the ‘leader’ in the health sector in Niger. However, development is a long process and will take place over the decades to come. Now more than ever there is a need to invest in aid for Niger, which must remain a priority country.

Support of the health districts of the department of Dosso

Start-up: 2001

Duration: 4 years

Budget : € 6,801,000

Goal : To develop and improve the health services in Dosso

Paul De Munck, technical assistant

KEY PROJECT DATA

MILLENNIUM GOALS


5 - IMPROVE MATERNAL HEALTH

Reduce by three quarters the maternal mortality ratio

Dying to give lifeEvery year, 500,000 women die as a direct consequence of a pregnancy or childbirth. Ninety-nine per cent of them are in developing countries. While most health indicators in these countries have improved over the past two decades, lit-tle change has so far been seen in the fi eld of maternal mortality.

According to the United Nations Popu-lation Fund (2003), the countries with the highest ratios of maternal mortality are in Africa. For instance, in the year 2000, 1564 mothers died per 100,000 births in Kenya, 1408 in Tanzania, 1258 in Rwanda, 1135 in Mali and around 900 in Burundi, Mozambique and Uganda, to mention only a few countries in which Belgian cooperation is an active force. In Belgium - by comparison - the rate stood at 10 deaths per 100,000 live births.

Why do mothers die? Haemorrhages, infections, pregnancy com-plications and diffi cult childbirth lie behind over 60% of maternal deaths. Indirect causes such as anaemia, malaria or cardio-pathy are also responsible for a fi fth of these deaths. In developing countries, around 60% of pregnant women are anaemic, reducing their chance of survival and that of their baby. Moreover, 13% of deaths are the con-sequence of high-risk abortions which are provoked either by the women themselves or by unskilled persons using dangerous techniques, without any hygiene.

However, the main cause of a high level of maternal mortality is the lack of access to appropriate health care for both geographic and fi nancial reasons. In the world as a whole, only 56% of births are assisted by qualifi ed health personnel. In sub-Saharan Africa, this proportion falls to 38%. In the developing countries, access to hospitals is still very random for most rural people and many of these hospitals are not capable of dispensing essential care, in particular sur-gery and blood transfusions.

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A new effective method : Unmet Obstetric Needs (UON)

In several of Belgium’s partner countries, the UON method, which is coordinated by the Insti-tute of Tropical Medicine in Antwerp, is proving to be a very interesting approach. Starting from the principle that health services can do more for lower-risk maternity, it is based on statistics from hospital registers. District by district, region by region, the difference between the number of women who should have benefi ted from a major obstetric intervention and those who actually did so is being mapped out. Steps are then taken to increase awareness among the local community. In villages where everyone remembers the stories of women who died the previous year, they think about what should be done to avoid such cases occurring again this year. The solution comes from the community itself. In some cases, they decide to organise a tontine fund so as to have ‘emergency money’. In other cases, they appoint a driver and a vehicle responsible for taking women to hospital quickly if the need arises. Each case is different and requires an appropriate solution. In countries where maternal mortality is high, the UON method, which is simple and not very costly, is bringing changes both at national and at local level, with a commitment from the entire community.

Kenya: improving maternal health by targeting young women

Nairobi15

Finally, the inequality of the sexes means that women often have too little control of economic resources in the household, and of the right to take decisions, even when it comes to their own health.

A global approach To combat maternal mortality, Bel-gium’s health policy aims to strengthen health systems as a whole. As the main cause of maternal mortality remains the geographic and financial inacces-sibility of care, the approach adopted by Belgian Technical Cooperation con-sists of providing high-quality, close and accessible care. In the long term, real progress will be measured not only by improvements in the area of health, but also by the improved position of women in society, more adequate nutrition and high-quality education.

Priority for young peopleThe Belgo-Kenyan reproductive health project in the Makueni district pays par-ticular attention to the health of adoles-

cents, who are most vulnerable in child-birth. Young girls aged between 15 and 19 run twice the risk of dying in childbirth than those who have reached the age of 20. However, in Kenya, half of all women have a child before they are 20.

The projects aims to provide ongoing train-ing for health personnel in the district in the use of new methods and techniques. One particular aspect concerns increasing awareness among young people and sexu-ally active women to limit the transmission of HIV/AIDS. They are encouraged to use reproductive health services via a centre for young people. The project is making the use of family planning methods more widespread in the community and among nursing staff.

TESTIMONY

Can you explain the results of the project so far?Over the past five years, the rate of mater-nal mortality has fallen from 590 to 414 deaths per 100,000 live births. Thanks to training, the quality of health services has improved, the number of consultations has increased and the number of obstet-rics cases recorded by the district hospital is rising. Beyond these positive figures, the strength of the project lies in the real partnership that exists between the local technical

team, the Ministry of Health and Belgian cooperation. The local team is now able to train, equip and supervise its health officials. Increasing awareness in various groups of the community, beginning with mothers but also targeting young people, has borne fruit and helped demystify AIDS, for example, or encouraged men to become involved with reproductive health services.

How has the new family planning service been accepted by the community?Although family planning is widely accessible, there remain cultural barriers to consultations. Assessment has shown us that the service was used almost exclusively by women, hence our desire to increase awareness among men.

What is the biggest difficulty facing Kenya as regards health?Basic health care services first need to be improved in terms of human resources, which are cruelly lacking at the moment. Training health officials, providing reproductive health equipment and increasing awareness in the com-munity of the urgent need for obstetric health care are all paths we will have to follow if we are to ensure that the national reproductive health policy works more effectively.

Reproductive health in the Makueni district

Start-up : 2001

Duration : 4 years

Budget : € 2,608,000

Goal : To improve the situation as regards reproductive health among the population by targeting in particular young people, pregnant women, small children and sexually active people

Béatrice Ndarugirire, technical assistant

KEY PROJECT DATA

MILLENNIUM GOALS


6 - COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES

Have halted by 2015 and begun to reverse the spread of HIV/AIDS

Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

Supporting the national policy

Malaria is a major health problem in Rwanda. Young children, pregnant women and the rural population are its fi rst victims. Fighting malaria remains a priority in the country, particularly as the problem has shown signs of worsen-ing over the past few years. The disease has become more aggressive owing to increased resistance to the cheap anti-malaria drugs most frequently used, such as chloroquine. Over-population is pushing people to move from the hills to the plains which are warmer and invaded by mosquitoes. What is worse, mosquitoes can now survive at an alti-tude of 2000 m instead of 1500 m pre-viously, owing to the greenhouse effect. Another element also plays a part: the extreme poverty of the people who can-not meet the cost of curative care and mosquito nets.

As part of its national policy, the Rwan-dan Ministry of Health has set up a pro-gramme known as PNILP, Programme National Intégré de Lutte contre le Paludisme (Integrated National Pro-gramme for the Fight against Malaria). Through the PNILP Support Project, Belgium is providing fi nancial and tech-nical support for the Rwandan Ministry of Health to ensure that its actions are sustainable. Besides Belgium, other fi nancial backers include the WHO, UNICEF and the Global Fund.

Acting at all levelsAs a major health problem, malaria jus-tifi es the development of an integrated vertical programme in basic health care. PNILP acts at every level in the organisation of the health system so as to create synergy between the various actions. From the central level (Min-istry of Health, university hospital), to

the outer level (socio-medical centres and small hospitals), the projects plans actions to reduce malaria-related mortality and morbidity.

From central level… The assistance provided by Belgium at cen-tral level primarily takes the form of train-ing provided for PNILP staff and support for the programme’s activities. A technical committee meets every six months to coor-dinate, plan, manage and supervise PNILP activities and strengthen the organisation. Belgian Technical Cooperation supports the process of moving to new treatment for simple cases of malaria and plans practi-cal training courses for doctors and staff at health centres to help them deal with seri-ous cases of malaria.

16

Rwanda: institutional support to combat malaria

Kigali17

…to the outer levelIn the regions and districts, the pro-gramme aims first and foremost to improve the quality of the care provided. Patients are treated with new, effective and less expensive drugs. Preventative measures concern the entire rural pop-ulation, with particular attention paid to the most vulnerable: pregnant women and children aged under 5. Groups of women and volunteers from associa-tion such as the Rwandan Red Cross take care of distributing mosquito nets impregnated with insecticide at a very low cost - $ 0.30 - to the entire popu-lation, even in the most remote areas. Courses of treatment are administered to pregnant women in the second and third months of their pregnancy. These IPT courses (Intermittent Preventive Treatment) enable them to fight anae-mia and give birth to larger babies.

Epidemiological surveillance is carried out through watch sites scattered all over the country. They help to detect immediately and even prevent epidemics and to react promptly. They are also used to collect demographic data. Finally, one important aspect of the project involves inform-ing and increasing awareness among the population of the risks of malaria and the means of protection.

TESTIMONIAL

PNILP is a budget support programme. What is the cooperation between Bel-gian Technical Cooperation and the other financial backers like?Belgium provides technical and financial support for the division of the Ministry of Health that deals with PNILP. The Rwan-dan State is contributing € 1,208,000 and the Belgian State € 2,830,000 for the period 2003-2006. By fitting in with the national health policy set out by the Min-istry in November 2000, the Belgian sup-

port is fully integrated into existing structures.

One of the goals of PNILP is to decentralise the fight against malaria. What practical measures are you taking to achieve this?We work through local associations, such as groups of women, the volunteers of the Rwandan Red Cross or local health professionals, who distribute mosquito nets impregnated with insecticide to the most remote areas. We increase awareness among communities of the risks of malaria and of the existing means of protection.

What results have been achieved since the programme started?Our support focuses primarily on advice for politicians, which is now very concrete. In terms of care, we have trained health officials and supplied the people with anti-malaria drugs. As regards prevention, we have distrib-uted 300,000 mosquito nets. In addition, we have set up 11 watch sites which enable us to follow malaria-related morbidity and mortality in these various areas.

What results are still anticipated?We have precise objectives for 2005 :• 60% of pregnant women and children under five will

sleep under a mosquito net, which means we will dis-tribute one million mosquito nets.

• 60% of pregnant women will receive IPT (Intermittent Preventive Treatment)

• all epidemics will be detected thanks to the watch sites.

Walli Van Doren, technical assistant

Support to the integrated national programme for the fight against malaria

Start-up: 2003

Duration: 3 years

Budget: € 2,609,000

Goal: To reduce mortality and morbidity due to malaria by 20% in three years

KEY PROJECT DATA

MILLENNIUM GOALS


7 - ENSURE ENVIRONMENTAL SUSTAINABILITY

Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources

Halve, by 2015, the proportion of people without sustainable access to safe drinking water and sanitation

By 2020, to have achieved a signifi cant improvement in the lives of at least 100 million slum dwellers

Fountain keepers and water counters1

In the village of Sate Wally, a three-hour drive from Dakar, water can be bought from a fountain twice a day: at 8 o’clock in the morning and at 6 o’clock in the evening.

For 19-year-old Abingail, life has changed since the drilling carried out by Belgian Technical Cooperation. Water towers are dotted about the bush land-scape and fountains with drinking water have appeared in the villages. “Ding!” Abingail’s money drops into the small pot kept for this purpose… A bowl of water costs CFA 5 francs, or less than one eurocent. The fountain keeper or

‘water counter’ collects the money. She is appointed by ASUFOR, the association of borehole users, that is all the people of the village. Abingail opens the taps twice a day and sells water to the users. She turns back to her work: “A good fountain keeper has to be dignifi ed, to know who is who, and to have a good memory”.

Ensuring sustainable access to drinking waterThe Kaolack, Fatick and Djourbel regions are in the groundnut basin in Senegal, where the situation is deteriorating and the people becoming poorer. One of the reasons for this is the decline in rainfall. Sustainable access to drinking water is inadequate there. There are not enough

wells and the wells that do exist are often in poor condition or do not work. In the best cases, drilling makes it possible to reach deep zones using pumps. In this rural area where the people are scattered, water is essential for development (domestic use, for the animals, for the local economy) and contributes, amongst other things, towards preventing the exodus from rural areas to the capital. Installing a water point in a village not only improves the living condi-tions and health of the villagers, but also creates true dynamics and new economic opportunities.

In many cases, however, such investments are out of reach of the fi nancial means of the community. Most of the high cost there-fore has to be borne either by the Govern-ment or by external aid. In both cases, the aid is supplemented by contributions from the villagers.

1 Extract from the article by Marielle Van Camp, Vers l’Avenir, 4 /12/20042 The average monthly salary per person is around EUR 60

Senegal: larger quantities of drinking water18

Dakar 19

In the case of Senegal, the Ministry of Agriculture and Hydraulics launched a huge programme to reform the urban drilling management system in 1997. Belgium decided to support this move by contributing to the fulfilment of an initial project that aimed to make operational 22 drinking water supply systems in the Kaolack and Fatick region. PARPEBA is continuing to establish rural hydrau-lic structures, backing up the national strategy.

Improving water qualityThe main problem facing the region in terms of water quality is the high level of minerals, particularly fluorine. In some places, the rate exceeds the acceptable limit and risks being harmful to health by causing dental fluorosis (changes to tooth enamel causing yellow or brown stains or, at higher concentrations, the loss of teeth) or bone fluorosis char-acterised by hyper-calcification of the bones.

To deal with this, the project has signed a cooperation contract with the Poly-technic College at the University of Dakar with a view to developing simple, inexpensive and reliable technology to reduce the fluorine content of drinking water adapted for use on a family scale.

Backing up the project at local levelOne important element in the project involves setting up associations of bore-hole users (ASUFOR). These committees, which consist of representatives of all the social groups in the village, agree on a price at which water will be sold at each water point. The money collected is used to maintain and repair the pumps.

With the help of local NGOs, the project also includes social sessions designed to explain the water management system and encourage all the villagers to sup-port it. This involves increasing awareness of issues of hygiene (how to carry water without risk of contamination, how to keep it, etc.), basic literacy training (keeping accounts) or planning (maintenance of the appliances).

TESTIMONY

What is significant about the approach chosen by the project?I think the project succeeds in increasing the sense of responsibility among the peo-ple through the ASUFORs that take care of managing the infrastructures put in place. Gradually, they acquire management tools and ensure that what they have acquired will last. Selling water creates jobs and involves women at all levels.

Who are the greatest beneficiaries of this project?The rural people are the greatest benefi-ciaries. Women, who use most water, now have time for other activities. Cattle breed-ers also benefit, to water their livestock.

Is the financial participation of the people enough to guarantee good water point management in the long term?The financial management of the ASUFORs is sufficient to guarantee that the equip-ment will be maintained and amortised. In addition, the project provides assist-ance for the ASUFORs with accounting and financial management.

Improve and reinforce water points in the groundnut basin (PARPEBA)

Start-up: 1st phase: 1998 2nd phase: 2003

Duration: 5 years (for each phase)

Budget: 15,000,000 € (for phase 2)

Goal: To provide sustainable access to drinking water for 260,000 people in the Kaolack, Fatick and Djourbel regions

THE PARPEBA PROJECT TEAM

KEY PROJECT DATA

MILLENNIUM GOALS

8 - DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT

Develop further an open, rule-based, predictable, non-discriminatory trading and

fi nancial system

Belgium: measures to promote fair trade20

A commercial partnership for a fairer systemThe fi nal goal of the Millennium Decla-ration is directed at rich countries and encourages them to take effective steps to develop a real partnership with devel-oping countries and help them achieve the fi rst seven goals.

One of the axes chosen by Belgium is to promote fair trade, “a trading partner-ship, based on dialogue, transparency and respect, with the aim of achieving greater fairness in world trade” .

Fair trade is an ideal instrument for developing a worldwide partnership and fi ghting poverty. In the South, this involves working with marginalised pro-ducers and workers by reinforcing their organisations while in the North public opinion is made more aware of fair trade and the market is developed.

Four special instruments…To promote fair trade, Belgium has asked Belgian Technical Cooperation to implement the new Fair Trade Cen-tre programme for the promotion of fair trade in Belgium. This involves four spe-cifi c instruments:

> Fair Trade Week

A huge awareness campaign has been held in October every year since 2002. All players in the sector (including Maya Fair Trading, the Oxfam Magasins du Monde, Oxfam Wereldwinkels, the Fair Trade Organisation and Max Havelaar) join forces to encourage as many con-sumers as possible to opt for fair-trade products. Special offers and campaigns in the various sales networks, a media campaign, events sponsored by famous people, the participation of businesses and institutions, etc., are all events that make this particular week ‘the’ fair moment of the year, the opportunity to make progress on the Belgian market.

> The fair trade transactions guarantee mechanism

Fair trade transactions are often charac-terised by pre-fi nancing of 50 to 60% when orders are placed, with the balance paid when the goods arrive after quality control. However, this procedure may involve risks (non-delivery of products in circumstances such as natural disasters, war, strike in the transport sector, theft, etc.). To cover these risks, Belgian Technical Cooperation has set up a guarantee system covering prefi -nancing activities. In practical terms, the mechanism takes the form of an insurance policy taken out by BTC with Ducroire/Del-credere. For small-scale producers, the implication is direct: less risk for importers means more orders for them.

> The fund for the promotion of fair trade products

To make fair trade an effective tool in the fi ght against poverty, marginalised produc-ers must be put in a position in which they can engage in long-term economic activ-ity, amongst other things by developing new products or improving existing prod-

1 Extract from the offi cial defi nition of the international fair trade movement FINE - 2001


QUITO

21

QUITO

ucts. With this in mind, Belgian Tech-nical Cooperation can support various activities, including market surveys, the creation of new products, improvements in the quality of existing products, the introduction of quality control systems, producer training (in management, mar-keting, etc.), participation at trade fairs and, finally, “company matching”, which puts producers and importers directly in contact with one another.

These activities, financed to a maximum of 75%, are all ways of helping which may prove decisive for producers.

> The Fair Trade ObservatoryThis instrument covers the management of surveys on the sector and its environ-ment. The observatory will gather all use-ful information (Internet site, newsletter) and circulate it among businesses, insti-tutional buyers and public associations.

In Manabi, Ecuador, BTC supports the families of small-scale coffee producers The coffee market is the world’s second largest raw material market after oil. Every year, six to seven million tonnes of coffee are harvested. Seventy per cent of coffee is produced by 25 million

small-scale producers, most of whom are poor. Over the past five years, the price of coffee on the world market has reached a dramatically low level. Farm-ers are often forced to sell at a price that does not even cover their production costs. Many end up withdrawing from the activity.

To counter this phenomenon, Belgian Technical Cooperation is setting up a project to support small-scale cof-fee producers in Manabi. This project involves 3500 families who have joined together to form an organisation in order to respond better to market requirements. Together, the producers have decided to modernise the produc-tion and transformation of their coffee. The project provides technical support to improve the quality of their coffee and helps them gradually convert their con-ventional production to organic meth-ods. By meeting international fair trade criteria (FLO standards), the organisa-tion manages to sell its coffee at a bet-ter price, enabling it to invest within the community. A credit fund has been set up to finance productive investments. At the same time, the project includes plans to develop profitable activities as an alternative to coffee.

TESTIMONIAL

To what extent do you think your project can contribute towards bet-ter market access for small-scale coffee pro-ducers?One of our main goals is to reinforce the spirit of entrepreneurship in the organisation of small-scale coffee producers. The support we provide is not only administra-

tive, but also strategic, to position products on the regional, national and international market. Together, we strive to make the products more competitive, to expand the internal market, and to diversify the various distribution channels.

What solutions does the project include to help small-scale producers out of the crisis?We are encouraging producers to improve the quality of their coffee so that it can be positioned in market niches, such as that of fair trade products. At the same time, we are plan-ning to reduce the areas set aside for coffee, while aiming for improved profitability thanks to the use of new techniques.

How have producers received the project?Right from the outset, producers’ organisations and a series of local non-governmental organisations were involved in defining and setting up the project. The success of the pro-ject depends largely on this responsible and efficient invol-vement.

Where is the project situation in the context of the Ecuadorian market?The commercial coffee chain in Ecuador is very fragmented and is run by a limited number of exporters and industria-lists who are more interested in quantity than quality, which explains the poor reputation of Ecuador coffee on the world market. In this context, we are running directly counter to the traditional tendency in Ecuador by putting forward the con-cept of fair trade.

Guy Castadot, Resident representative of BTC in Ecuador

KEY PROJECT DATA

Support to the families of small-scale coffee producers in Manabi (Ecuador)

Start-up : 2004

Duration : 4 years

Budget : € 4,500,000

Goal : to improve coffee production and strengthen the local coffee producers

2 Fair trade Labelling International

MILLENNIUM GOALS

United Nations call for swift action on Millennium Development Goals

In his report “Investing in Development”, which was presented to UN Secretary-General Koffi

Annan on 18 January 2005, American economist Jeffrey Sachs emphasizes the importance of the

year 2005 as a turning point to achieve the Millennium Development Goals. The practical solutions

exist. The time has now come for action. All that is needed is action. The Sachs report describes

the way forward, including ten key recommendations that need to be implemented as soon as

possible in order to achieve these goals.

Recommendation 1Developing country governments should adopt development strategies bold enough to meet the Millennium Devel-opment Goal (MDG) targets for 2015. We term them MDG-based poverty reduction strategies. To meet the 2015 deadline, we recommend that all coun-tries have these strategies in place by 2006. Where Poverty Reduction Strat-egy Papers (PRSPs) already exist, those should be aligned with the MDGs.

Recommendation 2The MDG-based poverty reduction strat-egies should anchor the scaling up of public investments, capacity building, domestic resource mobilization, and offi cial development assistance. They should also provide a framework for strengthening governance, promoting

human rights, engaging civil society, and promoting the private sector. The MDG-based poverty reduction strate-gies should

> Be based on an assessment of invest-ments and policies needed to reach the Goals by 2015.

> Spell out the detailed national invest-ments, policies, and budgets for the coming three to fi ve years.

> Focus on rural productivity, urban productivity, health, education, gen-der equality, water and sanitation, environmental sustainability, and science, technology, and innovation.

> Focus on women’s and girls’ health (including reproductive health) and education outcomes, access to eco-nomic and political opportunities right to control assets, and freedom from violence.

> Promote mechanisms for transparent and decentralized governance.

> Include operational strategies for scale-up, such as training and retaining skilled workers.

> Involve civil society organizations in decisionmaking and service delivery, and provide resources for monitoring and evaluation.

> Outline a private sector promotion strat-egy and an income generation strategy for poor people.

> Be tailored, as appropriate to the spe-cial needs of landlocked, small island developing least developed, and fragile states.

> Mobilize increased domestic resources by up to four percentage points of GNP by 2015.

22


23

Recommendation 5Developed and developing countries should jointly launch, in 2005, a group of Quick Win actions to save and improve millions of lives and to promote eco-nomic growth. They should also launch a massive effort to build expertise at the community level.

The Quick Wins include but are not lim-ited to:

> Free mass distribution of malaria bed-nets and effective antimalaria medicines for all children in regions of malaria transmission by the end of 2007.

> Ending user fees for primary schools and essential health services, com-pensated by increased donor aid as necessary, no later than the end of 2006.

> Successful completion of the 3 by 5 campaign to bring 3 million AIDS patients in developing countries onto antiretroviral treatment by the end of 2005.

> Expansion of school meals pro-grams to cover all children in hunger hotspots using locally produced foods by no later than the end of 2006.

> A massive replenishment of soil nutrients for smallholder farmers on lands with nutrient-depleted soils, through free or subsidized distribu-tion of chemical fertilizers and agro-forestry by no later than the end of 2006.

The massive training program of commu-nity-based workers should aim to ensure, by 2015, that each local community has:

> Expertise in health, education, agri-culture, nutrition infrastructure, water supply and sanitation, and environmen-tal management.

> Expertise in public sector manage-ment.

> Appropriate training to promote gender equality and participation.

Recommendation 6Developing country governments should align national strategies with such regional initiatives as the New Partnership for Africa’s Development and the Caribbean Community (and Common Market), and regional groups should receive increased direct donor support for regional projects. Regional development groups should:

> Be supported to identify, plan, and implement high-priority cross-border infrastructure projects (roads railways, watershed management).

> Receive direct donor support to imple-ment cross-border projects.

> Be encouraged to introduce and imple-ment peer-review mechanisms to pro-mote best practices and good govern-ance

> Calculate the need for official devel-opment assistance.

> Describe an «exit strategy» to end aid dependency, appropriate to the coun-try’s situation

Recommendation 3Developing country governments should craft and implement the MDG-based poverty reduction strategies in trans-parent and inclusive processes, working closely with civil society organizations, the domestic private sector, and inter-national partners.

> Civil society organizations should contribute actively to designing poli-cies delivering services, and monitor-ing progress.

> Private sector firms and organiza-tions should contribute actively to policy design, transparency initiatives and, where appropriate, public-pri-vate partnerships.

Recommendation 4International donors should identify at least a dozen MDG «fast-track» coun-tries for a rapid scale-up of official development assistance (ODA) in 2005, recognizing that many countries are already in a position for a massive scale-up on the basis of their good governance and absorptive capacity.

RECOMMENDATIONS


> Middle-income countries should also seek opportunities to become provid-ers of ODA and give technical support to low-income countries.

Recommendation 8High-income countries should open their markets to developing country exports through the Doha trade round and help Least Developed Countries raise export competitiveness through investments in critical trade-related infrastructure, including electricity, roads, and ports. The Doha Development Agenda should be fulfi lled and the Doha Round com-pleted no later than 2006.

Recommendation 9International donors should mobilize support for global scientifi c research and development to address special needs of the poor in areas of health, agriculture, natural resource and envi-ronmental management, energy, and climate. We estimate the total needs to rise to approximately $7 billion a year by 2015.

Recommendation 10The UN Secretary-General and the UN Development Group should strengthen the coordination of UN agencies, funds, and programs to support the MDGs, at

headquarters and country level. The UN Country Teams should be strengthened and should work closely with the interna-tional fi nancial institutions to support the Goals.

> The UN Country Teams should be prop-erly trained, staffed and funded to sup-port program countries to achieve the Goals.

> The UN Country Team and the interna-tional fi nancial institutions (World Bank, International Monetary Fund, regional development banks) should work closely at country level to improve the quality

Recommendation 7High-income countries should increase offi cial development assistance (ODA) from 0.25 percent of donor GNP in 2003 to around 0.44 percent in 2006 and 0.54 percent in 2015 to support the Millen-nium Development Goals, particularly in low-income countries, with improved ODA quality (including aid that is har-monized, predictable, and largely in the form of grants-based budget support). Each donor should reach 0.7 percent no later than 2015 to support the Goals and other development assistance priorities. Debt relief should be more extensive and generous.

> ODA should be based on actual needs to meet the Millennium Development Goals and on countries’ readiness to use the ODA effectively.

> Criteria for evaluating the sustaina-bility of a country’s debt burden must be consistent with the achievement of the Goals.

> Aid should be oriented to support the MDG-based poverty reduction strat-egy, rather than to support donor-driven projects.

> Donors should measure and report the share of their ODA that supports the actual scale-up of MDG-related investments.

24

Special thanks to the sectoral and thematic experts of BTC and the staff members of the 8 projects concerned.

Editor: Carl Michiels - Coordination, editing: Marie-Christine Boeve, Guido Couck

Translation: Thierry Pirard, IGTV, Alicia Pabón

Photographs : Layla Aerts, Jacky Delorme, BTC, cover : Wereldmediahuis, Gie Goris

Design : www.concerto.be

This report was printed on non-chlorine bleached 100% recycled paper.

BELGIAN TECHNICAL COOPERATIONPublic-law company with social purposes

147 rue Haute – 1000 Brussels

T +32 (0)2 505 37 00 • F +32 (0)2 502 98 62 • E [email protected] • www.btcctb.org

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Belgian Development Cooperation takes up the challenge