Some more or less random thoughts today:

An organization called the Centre for Global Development publishes an annual index measuring the rich countries who show the highest commitment to alleviating poverty in developing countries. In addition to the amount of money spent on aid, the index evaluates seven policies, including openness to migrants, policing sea lanes and selling arms to unsavory regimes (for which a country loses points). Who comes out on top? The Netherlands, with Denmark, Sweden and Norway close behind. Of the 21 countries listed, the U.S. finished 13th. Japan was last. This is an interesting and seemingly effective method of evaluation insofar as it looks beyond the amount of money donated and looks at the broader picture.

The situation in Darfur is going from bad to worse. The Sudanese government has refused to allow the UN to assume responsibility for the African Union forces stationed in Darfur. This comes on the heels of the government's refusal to agree to the more robust UN peacekeeping force approved earlier this year. So long as China and other countries continue to sell arms to Sudan and rely on oil exports from there, it seems nothing much will happen to alleviate the suffering in Darfur. Amnesty International U.S. has issued a "Call to Action" in an attempt to mobilize its members in support of the people of Darfur. See www.darfur.amnesty.org.

Commentators have been assessing the state of the battle against HIV/AIDS in the wake of the International Conference on AIDS held last week in Toronto. The emphasis seems to be shifting from treatment to prevention. While we must not abandon those who already have contracted HIV or have AIDS, it seems clear to me that prevention is the only way to address this in the long run. A vaccine would be wonderful, of course, but one seems very far off. Less complex preventive methods, such as diaphragms and other cervical barriers that can be used with microbicide gels and creams seem to be promising. Interestingly, men who are circumcised are far less likely to become infected. In addition, some studies are showing that using antiretroviral drugs on a prophylactic basis may prevent reduce the likelihood of infection, too.

If not one more person worldwide became HIV positive ever again, we would still face an enormous cost of treatment using current treatment methods. This is because the ARVs simply suppress the virus but do not eliminate it from the body. Thus, pending new treatments, every person who is HIV positive must receive ARV treatment for the rest of his/her life. Do we have to do this? Yes. Can we afford it? Yes. But the cost is enormous and grows daily.

Of course, providing effective HIV screening and treatment is fraught with difficulties. In South Africa, for example, there is such a negative stigma associated with being HIV positive that people will refuse treatment rather than admitting their condition to themselves and others. A recent article in the New York Times explains how pregnant women with HIV sometimes refuse nevirapine, which can help prevent transmission of the virus to their babies, so that no one will know that they are HIV positive. This personal and societal denial is incredibly sad. But it exemplifies the challenges faced by those on the frontlines of the battler against this disease.

I want to follow-up briefly on a point I have made in previous posts. That point was that all too often international consultants and organizations think they can provide meaningful assistance to developing countries quickly, without truly understanding the country and its problems and without involving the people in fashioning solutions to those problems. According to an article by A. Lin Neumann in the most recent Far Eastern Economic Review, this is precisely what happened in East Timor. A Timorese journalist who worked with the World Bank and the UN told Mr. Neumann that: "The international advisors who swooped into Timor failed to understand the depth of the political rivalries that existed in the country." An unnamed UN official is quoted as follows: "There needs to be a serious rethinking about how this kind of assistance works. Too often the decisions about what needs to be done are taken by international consultants who have little or no knowledge or understanding of the country concerned and with no serious consultation with that country's citizens." Precisely my point.

After six long weeks I am finally getting back to this. Summer has not been conducive to blogging for some reason. Its not even that hot here in Seattle. Anyway...

I have added a link to another great organization called Care to Give. Their mission is primarily to build wells to bring clean water to people in the hill country of Viet Nam. They are also trying to build schools. Please consider a donation.

The election in the Congo has finally brought more much-needed attention to the humanitarian catastrophe there. I was astonished to read that nearly 2 million children have died in the Congo in the past several years (from a total of 4 million deaths overall) due to war, disease and malnutrition. Eastern Congo is still very unstable, with warfare continuing unabated. In an of-ed piece in the July 28 NY Times, a journalist writes that he witnessed a massacre in April that was carried out, in part, by UN "peacekeeping" troops. Some 25-34 civilians were killed.

The UN calls the situation in the Congo the equivalent of a tsunami every week. In some ways, this is Rwanda all over again. (In fact, many of the fighters are Rwandan Hutus.) The world pays close attention to the Middle East (with good reason) but, again, little heed to the condition of millions of people in a resource-rich country the size of Western Europe. How do these things happen?

I have been reading a novel called "Acts of Faith" by Philip Caputo. Set primarily in southern Sudan, it is the story of the interaction of NGOs and missionaries with the Sudanese People's Liberation Army, the Nuban people of southern Sudan and, to a lesser extent the Sudanese regime in Khartoum. The book, which I heartily recommend, has made me think more about how best to pursue international development and the people who can do so most effectively. In so doing, I came across a quote from a book called by "The Prince of the Marshes and Other Occupational Hazards of a Year in Iraq" by Rory Stewart. (I have not read this yet--the quote is from a review of the book.) Here is the quote: "The best kind of international development seemed to be done by people who directly absorbed themselves into rural culture and politics, focused on traditional structures, and understood that change would always be very slow." This makes a lot of sense. In my limited experience, solutions imposed by outsiders who do little more than fly in and fly out rarely work. First, one cannot possibly understand the situation "on the ground" without spending time there. What may have worked in one country may have absolutely no chance of success in another. Second, one cannot expect to simply dismantle and replace structures and traditions that have been in place for decades or perhaps centuries. One must usually try to incorporate changes into the traditional practices. Finally, patience is critical--the consultant who thinks she can fix complicated, long-standing problems in a few weeks or months usually fails.

Finally, a few words about a recent study of the extent to which the $12 billion spent by the World Bank since 1990 on education in developing countries has borne fruit. The analysis was done by the Independent Evaluation Group and is summarized in an article in the July 15 edition of The Economist. According to the study, there has been significant improvement in the number of children attending school but the quality of education has not improved anywhere near as much. Donors and governments are good at funding the construction of schools and the purchase of school supplies but not so good at improving the quality of education. This suggests there is still a shortage of qualified, adequately paid teachers. The article reports on a successful strategy for improving the level of instruction in India. In some districts, high school graduates (who had no teacher training beyond the two weeks provided by the program) were hired to help students who were falling behind. The results were very encouraging and the cost was low as they "children's friends" as they were called were inexpensive. This strategy may warrant further application elsewhere, depending of course on the availability of local teachers, funding and other local conditions.