Strategic 1

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This pr oject w as made possible thr ough Cooper at iveAgr eement Number HRN-A-00-96-9006 betw een t he US Agency

f or Int er nat ional Development and Tulane Univer sit y

L I N K I N G C O M P L E X E M E R G E N C Y R E S P O N S E A N D T R A N S I T I O N I N I T I A T I V EL I N K I N G C O M P L E X E M E R G E N C Y R E S P O N S E A N D T R A N S I T I O N I N I T I A T I V E

CERTICERTI Cr isis and Tr ansit ion Tool Kit

Strategic Framework for Crisis Prevention ,

Mitigation and Transition :

Link ing Relief to Development in Africa

Dra f t

Prepared for USAID/AFR/SD

Apr il 2000


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TABLE OF CONTENTS

In t roduct ion: Rat ionale for Cr is i s Prevent io n, Mi t i gat ion and Recovery andTransition as a New Analyt ical Domain for Policy Analysis andProgramming in Sub-Saharan Africa (SSA). 3

Conceptual Framework for Cr is is Prevent ion, Mi t igat ionand Recovery/ Transition 5

Immediate Causes: Natural Hazards, Epidemics, and Conflicts 7

Underlying Causes: Ecology, Underdevelopment and Inappropriate Development 8

Phases of Crisis 13

The Temporal Dimension of Crisis 13

Why Tradi t ion al Approaches to Af r ican Development are no LongerAppropr iate 14

Conceptual Gaps 14

Programming Inefficiencies 16

An Outdated Political and Organizational Framework Within the Development Industry 16

CPMR Approaches and Strategy 17

Principles of Linking Relief and Development 18

The Central Role of Public Health and Human Security 21

Performance Monitoring of Interventions Across the Crisis Life Cycle is Critical 22

Systematic Mechanisms for Identifying Information Gaps and Disseminating Best Practices 23

Summary of a Strategy for Crisis Prevention, Mitigation and Recovery/Transition in SSA 24


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Humanitarian relief and disaster planning are integral to sustainable development. Manmade and natural disasters

can wipe out years of development in a matter of minutes. The costs of clean-up, reconstruction, and adjustment

associated with large-scale natural disasters can impose burdens on a national economy that persist for years. War,

famine, and environmental damage can undermine development for decades to come. Annual losses from natural

disasters now equal the total of official development assistance, so investments in prevention and mitigation promise asignificant financial and strategic return.

USAID Strategies for Sustainable Development, April, 2000

Rationale for Crisis Prevention, Mitigation andRecovery/Transition as an Important Analytical Domain forPolicy Analysis and Programming in Sub-Saharan Africa (SSA).

Introduction

Although very recent economic and political events give reason for optimism, SSA

remains a region in crisis. In the majority of countries development progress has beenslow as is reflected by both human and economic indicators. In addition, SSA recentlyhas experienced the highest frequency as well as the most serious consequences ofdisasters than any other region. The situation was well summarized by the AfricaRegional Director of the World Health Organization who remarked recently that the veryhazards and vulnerabilities that originate the Regions disasters have been the targets ofmore than thirty years of development, their persistence can be taken as a testimony toas many failures and as a consequence, out of a population of more than 744 million,734 million live in countries that are considered to be disaster prone.

The massive loss of lives, livelihood and infrastructure is clear in the cases of the recentcatastrophic emergencies in Rwanda, Somalia, Mozambique, Sierra Leone and Liberia.

While quantitative information on the economic costs of disasters are elusive because ofthe varied types of costs and poor financial information, available information shows thateconomic outputs of countries are reduced during major disasters and that availableresources are consumed to mitigate impacts, in the case of drought-related famine; or tosupport military costs in the case of conflict-related disasters. Specific studiesundertaken by UNICEF (1985) suggest that the impact of conflict and destabilization insouthern Africa approached 25-40% of GNP annually. In countries directly involved inconflict, this percentage was much higher. Military expenditures alone exceeded 50%during the period of active conflict. Although natural disasters such as drought arefrequently less costly, even in relatively developed countries such as Botswana,government expenditures on relief varied between 14-18% of total governmentexpenditures during the drought of the 80s (Buchanan-Smith, 1994). In Zimbabwe, the

1992 drought lead to a 25% reduction in the volume of economic output (Benson et al.,1994).

Crisis has eroded development investments in SSA. The frequency of disasters and theircosts have dramatically increased during the past decade. International donor outlaysfor disaster assistance to SSA increased nearly nine fold between the mid 80s and mid90s, while development budgets have stagnated or declined. In 1998, the United StatesAgency for International Development (USAID) spent more than 35% of its assistancepackage to SSA on emergencies.


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A review of officially declared disasters during the past 25 years (those recorded by theOffice of Foreign Disaster Assistance (OFDA) illustrates the changing character ofdisasters and crises in SSA. Although disasters due to the natural hazards of drought,pests and flooding have always been a recurrent threat to African development; morerecently, in the wake of the cold war, armed conflict has resulted in a dramatic increase

of Complex Emergencies (CEs). CEs are disasters characterized by political instabilityfrequently combined with problems of food insecurity and health threats that lead tomassive population migration.

Epidemic threats also are more critical to the development of SSA than anywhere else inthe world. Although SSA accounts for only 10% of the worlds population, it contributesmore than 20% of the worlds global burden of disease (World Bank, 1993). Unlike otherregions, the majority of SSAs disease burden is the result of infectious and parasiticdiseases, which makes it unique in the world. The underlying risk of infectious andparasitic diseases can act as catalysts of far more consequential epidemics in this thanother regions. The interaction between HIV and Tuberculosis is an obvious example.Populations with high levels of HIV infection are also at increased risk of epidemics

caused by many infectious agents.

Natural disasters, epidemics and conflict-related disasters have occurred morefrequently and with greater negative consequences in Africa than in any other region(see Figure 1). Epidemics and conflicts are far more frequent in Africa than anywhereelse. Even in the area of disasters caused by natural hazards, Africa registers thehighest numbers of declared disasters in the first half of the decade.

Figure 1- Worldwide Disaster Incidents 1990-1994 (Source: OFDA Database)

Africa Asia

Central America

Other

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Confl ict

Natural

Epidemics

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Disaster T es b Re ion 1990-1994

This context of disasters and underdevelopment has given rise to the need for acrosscutting analytical domain for policy analysis and programming. We have termedthis analytical domain Crisis Prevention, Mitigation and Recovery (CPMR). Strategies toachieve CPMR emphasize the multi-dimensional nature of crises in SSA and theintimate linkages between disasters and development. Also important is the need to


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examine and more carefully characterize the life cycle of crises and the temporalaspects of their evolution so that interventions can be dynamic and responsive to therapidly changing needs of affected populations.

Effective CPMR has important implications for policy, programming and theorganizational aspects of international development. Two basic approaches are central

to improved CPMR in SSA. One is better integration and complementarity of relief anddevelopment interventions (linkage between relief and development). The second ismore effective regional and national programs to address the question of crisisprevention in SSA in the areas of conflict, epidemics and natural hazards.

This paper develops a strategic framework for crisis prevention, mitigation, and recoveryin SSA. Specifically, it 1) provides a conceptual framework illustrating the phases ofcrisis within which CPMR can operate, 2) reviews current approaches and strategies todealing with crisis, and 3) puts forth a rationale for CPMR.

Conceptual Framework for Crisis Prevention, Mitigation and

Recovery/ Transition

Understanding the nature of crises in SSA is aided by an analytical framework thatdistinguishes the various causes of disasters and crises (see Figure 2). The immediatecauses of crises (see Figure 3) are natural hazards such as drought, flooding, pests,earthquakes; epidemics, such as cholera, measles, meningitis, ebola and HIV/AIDS;and armed conflicts such as those that gave rise to the CEs in Sierra Leone, Sudan,Burundi, Liberia, Ethiopia, Somalia, Rwanda, Angola, and Mozambique among others.Crises may or may not result in disasters depending upon the efficacy of interventionsdirected at mitigating the effects of exposure of populations to the immediate crisisthreats.

The underlying causes of crises are those that give rise to the immediate causes or actsynergistically with the immediate causes to produce massive population movementsand to profound loss of life and livelihood. It is important to note that, with the exceptionof earthquakes and catastrophic floods and droughts, crisis threats in the developedworld rarely result in such serious outcomes that external disaster assistance is needed.In order to understand the policy and program implications of CPMR, it also is useful todistinguish the phases of the crisis lifecycle and the different time trajectories of crisesand disasters; there are both slow and rapid onset crises that have different implicationsfor appropriate response.


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Figure 2- The Causality of Crisis and Complex Emergencies

Underdevelopment

Vulnerability

Crises andComplexEmergencies

NaturalHazard

Epidemics

Conflict

PopulationMovements

InternationalFactors

Figure 3- Categories and Immediate Causes of Crisis.

Immediate Causes of Crisis

Prevention

Recovery/

TransitionMitigation

Response

Epidemics

Confl ict N a t u r a l

H a z a r d s


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Immediate Causes: Natural Hazards, Epidemics, and Conflicts

In spite of their relative frequency and the large numbers they affect, natural disasters inAfrica have resulted in very few deaths in recent years a reflection, in part, of improvedearly warning and more effective response. Natural disasters are responsible for 28% of

disaster-caused deaths recorded by OFDA from 1970 to 1994, while they accounted57% of all those affected by disasters and 66% of all disaster-related homelessness ordisplacement. Drought accounts for over three-quarters of those affected by naturaldisasters in Africa and nearly all natural disaster-related mortality. Ethiopia, Chad,Botswana, Burkina Faso, Kenya, Mozambique and Mauritania are among the countriesin Africa reporting the highest frequencies of drought related events.

Although no more frequent than natural hazards, for most of the 1970 to 1989 period,infectious disease epidemics claimed the greatest number of lives (Figure 4). This is theresult of interactions among these immediate causes. Only since 1990 have conflict-related disasters overtaken epidemics as the major cause of disaster-related mortality.Yellow fever, cholera, and meningitis traditionally are among the diseases most often

cited as the source of epidemic outbreaks in the region. Measles, malaria and dysenteryare the major killers of children who are refugees or displaced as the result of anyimmediate threat. Recently, outbreaks of emerging diseases such as the ebola andlassa fever have also warranted serious concern and significant responses from theinternational community. Drug resistant malaria and Tuberculosis as well as HIV/AIDSare slow onset crises that have dramatic effects on the impacts of other immediate crisisthreats. Slow onset crises interact with other crisis threats, such as conflict and forcedmigration to escalate the spread and ferocity of epidemic diseases.

Figure 4- Mortality by Disaster Type 1970-1994 (Source: OFDA Database)

90-9485-8980-8475-79

70-74Natural

Epidemic

Conflict

0%

20%

40%

60%

80%

100%

Percentage of Total Mortality by Type of DeclaredDisaster Over Time

Currently, conflict-related crises represent the most serious threat to developmentalinitiatives in SSA. CEs claimed millions of lives during the 1990s. They resulted inmassive losses of human and physical infrastructure in Liberia, Democratic Republic ofCongo, Sierra Leone, Somalia, Rwanda, Burundi, Chad, Mozambique, Angola andUganda. Many other African countries remain on the watch lists of international donors,


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even though active crisis is not apparent. Even where conflicts are now abated,numerous countries are in a dynamic but fragile state of transition. They remain at risk ofregressing into active conflict.

Underlying Causes: Ecology, Underdevelopment andInappropriate Development

The close correlation between disasters and underdevelopment is now well understoodby the development community. What is more, disasters and underdevelopmentcombine to create a vicious circle of human misery that is difficult to break. The CentralIntelligence Agency (CIA) recently completed a study that illustrated this relationship at aglobal level. In an attempt to identify risk factors for conflict crises, a meta-analyticapproach compared various development indicators between countries that recentlyexperienced severe conflicts and those that did not. This analysis identified threesignificant predictors of conflict disasters. These were infant mortality rate, openness toexternal trade, and democratization.

SSA has the highest infant and child mortality rates in the world (see Figure 5). It also is

disfavored in terms of international trade and democratization. Figures 5 to10 show thatin terms of social development and economic growth, SSA countries, and particularlythose experiencing recent crisis compare very unfavorably to other developing countrieson several of these. In SSA both underdevelopment and inappropriate developmentprovide a context ripe for disaster. Political instability, poverty and economic insecurity,poor and eroding social services and environmental degradation have undermined thelivelihoods of millions in the region. Population movements associated with conflicts,disasters and economics strain fledgling economies in those parts of the region whereeconomic progress is beginning to get underway.

While the 90s have shown some improvement in the economic performance of mostAfrican countries, progress is a new development and it is modest. As recently as 1989,

the World Bank completed a study entitled Sub-Saharan Africa: from Crisis toSustainable Development. In this extensive study, the region was singled out asexperiencing developmental losses, as indicated by any indicator chosen to measuregeneral societal development. The report concluded thatAfricas deepening crisis ischaracterized by weak agricultural growth, a decline in industrial output, poor exportperformance, climbing debt, and deteriorating social indicators, institutions, andenvironment (World Bank, 1989).


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Figure 5- Infant Mortality Rate in Selected African Countries and LowIncome Countries (Source: World Bank)

Figure 6- Total Fertility Rates in Selected African Countries and LowIncome Countries(Source: World Bank)

Infant Mortality Rate

020406080

100120140160180

Angola

Burkina

Faso

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urundi

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eroon

Cent.AfricanR

epublic

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wanda

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nzania

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ganda

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ambia

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1980 1997

Total Fertility Rate per 100,000 Live Births

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OfCongo

Eritrea

Ghana

Kenya

Mozambique

Niger

Nigeria

Rwanda

SouthAfrica

Sudan

Tanzania

Uganda

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Zimbabwe

LowIncomeCountries

1980 1997


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Figure 7- Average Changing in Per Capita Food Production for SevenAfrican Countries Now Suffering or at Risk of Humanitarian Crisis 1979-1992(Source: FAO)

Figure 8- Primary School Enrollment as a Percentage of Age Group inSeven African Countries Now Suffering or at Risk of Humanitarian Crisisand in Low-Income Countries(Source:World Bank)

0%

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ercentageofAgeGrou

Tanzania Sierra

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Rwanda Somalia Sudan Ethiopia Burundi All Low-

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SSA Low-

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1970 1991

- 7 . 0 0 %

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AnnualChangeinPerCapitaFoodProductio

Ta n za n i a S i e r r a L e o n e R w a n d a S o m a l i a S u d a n E t h i o p i a B u r u n d i M o z a m b i q u e


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Figure 9- Annual Percentage Growth in Gross Domestic Product forSelected African Countries 1990-1998 (Source: World Bank)

In the early 1990s, three countries posted consistent economic progress. Ghana,Uganda and Tanzania posted per capita growth in GDP of more than 2% annually duringthat period. From 1988-93 investment as a percentage of GDP in sub-Saharan Africawas around 16% - the same as in the first half of the 1980s.

1995, however, marked a turning point in SSA economics. For the first time in twodecades, the International Monetary Fund (IMF) posted positive economic growth in thevast majority of countries in SSA (see Figure 10). There is optimism that this will markthe beginning of a trend. However, given the volatile recent history of the region,guarded optimism is warranted.

Human development, too, lags behind other areas of the world and is projected todeteriorate on the whole. Figure 8 shows that primary school enrollment is low in manycountries. Maternal literacy is the lowest in SSA than in any other region of the world.Some areas, such as the Sahel, can claim only a small percentage of literate mothers.In 1990, the World Bank projected that the numbers of people living below the poverty

line would have grown from 180 million in 1985 to 265 million by the year 2000 aspopulation growth outstrip the rate of economic progress.

The convergence of population pressure, poor health and poor socio-economicperformance is more severe in Africa than in any other region. African fertility is amongthe highest in the world and movement towards the demographic transition has begundefinitively only in Botswana, Kenya, and Zimbabwe all middle-income Africancountries (see Figure 6).

G D P , R e a l A v e r a g e A n n u a l P e r c e n t a g e G r o w t h 1 9 9 0 - 1 9 9 8

- 8 . 0

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Angola

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icanRepublic

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ep.OfCongo

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Kenya

Mozambique

Niger

Nigeria

Rwanda

SouthAfrica

Sudan

Tanzania

Uganda

Zambia

Zimbabwe


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Figure 10- Growth Rates of GDP and GNP for Selected African Countries(Source: World Bank)

Urbanization also will probably facilitate civil unrest when it leads to the growth of a largemarginalized urban poor sector. In particular, population migration patterns and

urbanization are confounding development programs that target rural areas. Althoughthe pace of urbanization had slowed somewhat during the late 80s (Hill et al, 1985),Africans were migrating from rural to urban areas more intensively than in any otherregion of the world. The United Nations estimates that, by 2025, almost 54% of allAfricans will be urban residents (UN, 1995). More than two thirds of southern Africaspopulation will be urban. Only in the eastern sub-region will the minority of residentsreside in urban areas. Urbanization in Africa leads to lifestyle changes that haveprofound impacts on infectious disease ecology and epidemiology.

Other significant population movements are related to migrant workers who move frompoorer, rural areas to more economically active urban areas in the region. Thesemigration patterns have played an important role in the spread of HIV and otherinfectious diseases.

Phases of Crisis

Crises have various phases, each having distinct characteristics and requiringintervention priorities. Prevention, mitigation and recovery/transition are those elementsof crisis programming that have not been seriously embraced by either the relief ordevelopment communities. Before a crisis emerges, early warning and preparednessprograms can prevent and mitigate the effects of crisis threats. When crises have

GDP and GNP Growth Rates for Selected African Countries

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-2.0

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Angola

BurkinaFaso

Burundi

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Cent.AfricanRep

ublic

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had

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ongo

Eritrea

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ana

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nya

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ique

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iger

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eria

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nda

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frica

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dan

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ania

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nda

Zam

bia

Zimba

bwe

GDP -- Avg, Annual % growth 1990-1998 GNP Avg. Annual Growth rate (%) 1997-1998


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become full-blown disasters, response must be professional and compatible with longerterm development objectives, or at least not antagonistic to them. Finally when theimmediate crisis threat has faded, recovery/transition programs must address thespecific needs of populations emerging from crisis. In the SSA context, transitionprograms have posed great challenges, as donors often have not sustained their interestin supporting populations once the immediate threats to survival have waned.

The Temporal Dimension of Crisis

Disasters and crises can be classified according to the temporal dynamics of their onsetand duration. Crises can be either slow or rapid in onset and they can be of varyinglengths in duration. In fact, in each of the major categories of crisis threats there areexamples of this spectrum of progression. Disasters associated with natural hazardssuch as earthquakes and floods are rapid onset disasters; the hazard event and itsconsequences usually occur within seconds, hours, or days. Classical disaster responseprograms are typically implemented to ensure immediate survival of victims; however,international interest wanes as the recovery process unfolds. Droughts are usuallyslower in onset, occurring over months and in the case of major climatic cycles, years.

Droughts and economic shocks associated with famines provide adequate warning toresult in effective mitigation programs.

Epidemic crises provide examples of both rapid onset and very slowly evolving crises.Cholera and other diarrheal diseases can be very rapid (days, weeks) while HIV takesseveral years to develop into a crisis. Again, early warning and surveillance hold greatpromise for prevention and mitigation of epidemic crises. In Niger, USAIDs investmentsin information systems and the development of disaster preparedness plans resulted inthe prevention of an epidemic during the early 1990s, despite the countrys low level ofsocioeconomic development.

Conflict crises and CEs, may be both rapid and slow in onset. In the SSA context,

however, the duration of CEs has been very long, lasting years and decades. Most ofthe contemporary examples of conflict-precipitated CEs have lasted no less than fiveyears. Until recently, there has been no emphasis on conflict prevention/mitigation,despite the fact that academic research points to the feasibility of early warning systemsand promising approaches to preventing the outbreak of violent conflict. At the otherend, the resolution of violent conflict has often marked the departure of internationalfunds needed to ensure rapid transition to development. The absence of necessarypolitical and financial support often results in regression into political instability.

The temporal dimensions of crises have important implications for CPMR. With foresightand good early warning and preparedness, there is great promise for prevention of theall too familiar sequelae of mortality, mass migration and destitution, if the political will to

act exists.

Why Traditional Approaches to African Development Are NoLonger Appropriate

Business as usual will no longer work in the African context for several reasons, outlinedin the following sections. First, the relief-development paradigm loses its meaning as thelandscape of crisis is increasingly frequent, severe and long-term. Second, resourcesare increasingly being diverted from development investment to humanitarian assistancealong, with a general decline in publicly financed development work. Relief interventions


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have been shown to be inefficient at time and sometimes antagonistic to developmentgoals.The organization and political framework of development agencies must berestructured to respond to these changes.

Conceptual Gaps

Traditional developmental approaches have assumed that developing countries are on atrajectory of improvement, depicted in Figure 11. In this case, disasters are perceivedas a temporary disruption to the development process, requiring a particular set of time-bounded, survival-oriented interventions. As a result, development agencies havecompartmentalized relief and development programming as separate and unrelatedactivities. Margaret Buchanan-Smith and her colleague Simon Maxwell (1994) astutelyobserved that for poor people in the developing world, relief and development areinextricably bound together in the complex and day-to-day business of managing riskand securing livelihood. The donor community has created an artificial distinctionbetween relief and development problems.

A similar problem is that contemporary crisis threats, including natural hazards, conflicts

and epidemics are often managed by unidisciplinary or unisectoral programs. This wasone of the reasons that initial early warning systems attempts were unsuccessful. Forexample, the famine early warning system of the 70s and 80s collected and analyzedagro-meteorologic information. Only when population vulnerability and coping behaviorswere factored in did these early warning systems yield effective prevention andmitigation tools.

Figure 11 - Crisis as Temporary Interruption to Development Activity

(Source: Adapted from Peter Walker, ICRC, 1996)

CRISIS

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A second limitation of many donor strategies is the country-focussed developmentemployed by most. Internationally, levels of Official Development Assistance (ODA) areinversely related to poverty and instability (World Bank, 1995). Donors typically focusinvestments on a limited number of promising countries, ignoring their regional context.This pattern of investment has become greatly exaggerated since the end of the coldwar.

Ignoring the regional nature of crisis threats may greatly diminish the developmentalprogress of focus countries. Epidemics, natural disasters, and even the aftermath ofcollapsed states are not defined by national boundaries. Without significant regional andsub-regional strategies to address crisis threats, the progress of individual countries willbe slowed.

Programming Inefficiencies

As the region is increasingly riddled by full-blown disasters, the cost of externalassistance is high and growing. Among all donors, total funding for emergency aid wasestimated at $6 billion in 1995, 10 percent of all foreign aid (OECD, 1995). Figure 12shows the dramatic climb in the value of humanitarian assistance from the U.S. andother OECD member states, from the early 1980s to the mid 1990s. Among U.S.government agencies, the Office for Foreign Disaster Assistance (OFDA) and the Officeof Food For Peace increased cash and food grants for humanitarian relief in Africa four-fold between 1983 and 1994 (Natsios, 1995). In fiscal year 1994, USAID devoted morethan 30% of its total assistance to disaster relief in Africa. In addition, more than 80% ofall U.S.-supplied emergency food aid went to this crisis-afflicted region as well (USAIDAnnual Report on Program Performance, 1994).

While expenditures on disaster relief have been climbing, funding available fordevelopment programs has been stagnant and declining. Because the relief anddevelopment response of international agencies is almost completelycompartmentalized, relief and development interventions are rarely designed to becomplementary. In fact, numerous recent evaluations have shown that they are oftenantagonistic (Duffield, 1994; Buchanan-Smith, Maxwell, 1994). Although the knowledgebase is inadequate to evaluate the quantitative costs of these inefficiencies, it is clearthat complementarity between relief and development interventions is critical in an era ofdeclining public investment in international development.

The Need for Restructuring the Outdated Political and Organizational

Framework Within the Development Agencies and Organizations

The development agencies and organizations are compartmentalized into relief anddevelopment units consistent with the conceptual framework that has ignored thelinkages between disasters and development. Most international agencies areorganized along relief/development or humanitarian assistance/development lines. Theprincipals, modes, financing and procedural requirements of the two are separate anddistinct. Technical and professional expertise often specializes in either relief ordevelopment careers, with little cross-fertilization between professionals who work indisasters and development. The separation is so complete that different organizational


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cultures have evolved (ECHO, 1995, USAID, 1996). While the relief culture is rapidresponse-oriented and flexible, which are desirable qualities; the planning frame isfrequently in the order of days, weeks and months. Interventions rarely involvebeneficiaries in planning, and there is little accountability for population level inputs andprogram efficiency. Development offices, while operating in a deliberate longer termplanning frame, with explicit focus on population impacts and program sustainability,

operate within inflexible bureaucratic planning and management frameworks.

There is a practical consideration also for better integration of development and reliefwork. In most situations that require rapid response to disasters, the organizations thatare immediately present on the ground are the long-term development organizations.They are familiar with the country, region and the people and understand their needs.However, to the extent that long-term development and relief are divorced from eachother these organizations have to respond to relief needs with one hand tied behind theirbacks. This disability can be removed by integrating relief and development in a smoothcontinuum.

Another constraint to the current organization of both donor and host country

organizations is the compartmentalization of sectors within fairly narrow boundaries.Health offices are frequently charged with programming and implementing interventionsto attack problems such as epidemic outbreaks and HIV/AIDS. These sectors frequentlydo not have sufficient analytical breadth and technical skills to address the behavioraldeterminants of these problems. There have, however, been many recent initiatives tomerge offices that address human resource development problems.

Figure 12- Humanitarian Assistance to Sub-Saharan Africa

1970

1972

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1978

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MillionsofDollars

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Source: IFRC, The World Disaster Report, 1995

Value of Humanitarian Assistance in Millions of U.S. $

OECD Member States

U.S.


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CPMR Approaches and Strategy

The new context of crisis in SSA demands fresh approaches by the developmentcommunity. These approaches must take into account the changing face of crisis inAfrica; the multiple immediate and underlying causes of crisis; the intimate relationshipbetween disasters and underdevelopment; the importance of developing approachesthat attack crisis at different stages, consistent with the current landscape in SSA; andapproaches that engage Africans to take ownership of the programs for prevention,mitigation and transition from crisis to sustainable development. The approach, linkingrelief and development, has three objectives:

1. Improved design of long term development programs such that they prevent, ormore successfully address, the short term contingencies faced by populationsaffected by chronic or recurrent disasters;

2. Improved short term disaster response interventions that are compatible with andmaximize potential synergies with longer term development planning, andminimize potential distortions of the development process;

3. Improved transition strategies that reduce vulnerability to crisis and effectivelyleverage sustainable development as quickly and efficiently as possible.

A second element of the approach is that it must consider the ecology of crisis threats,rather than the usual country-driven approaches. This will require regional and crossboarder strategies, such as the Greater Horn of Africa Initiative (GHAI). Conflicts, naturalhazards, HIV/AIDS and other infectious disease threats clearly know no boundaries.Effective strategies must embrace this reality.

Principles of Linking Relief and Development

Table 1 illustrates the chasm between traditional relief and development programming.In recent years, numerous expert and self-study groups have evolved towardsconsensus on ways to close the gap. Principles and operational approaches areemerging. The GHAI Task Forces work to identify the principles for linking relief anddevelopment is illustrative.

First is the principle of local responsibility. Local ownership is key to the ultimate successof CPMR initiatives. Participatory assessment and planning is essential to correct pastpractices of top-down programs that assume affected populations to be passiverecipients of relief (and sometimes development) interventions (Anderson, 1989).

Second is the principle of international responsibility in the areas of accountability andstrategic coordination. All intervention efforts, including relief programs, must be heldaccountable for their population level impacts on survival and livelihood. This signals theneed for an evaluation framework and suitable indicators that span the crisis life cycle,including prevention, mitigation, response and recovery/transition efforts. In addition,strategic coordination of international partners iskey. While coordination at the nationallevel has improved in relief settings, much more must be done at the international levelto ensure that collective and dwindling international resources are effectively used toaddress the needs of populations threatened by crisis.


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Third, relief programs should be designed and operated such that they reinforcedevelopment objectives. This entails figuring in local participation, reinforcing existingcapacities and building them, and protecting the livelihoods of affected populations.

Finally, development programs should be designed to help prevent or mitigate disasterssuch that development progress is not undermined. This can be achieved by more

informed analysis of disaster and development linkages. Identifying the vulnerabilities ofcountries and particular population groups, designing programs to reduce vulnerabilities,and incorporating disaster preparedness into development programs is a first steptowards this end. This has been demonstrated to be effective in recent history,particularly in southern Africa, but also in countries as poor as Niger.

Table 1 - Characteristics of Relief Planning and Longer Term Food SecurityPlanning

Objectives Relief Planning Longer term food Securityplanning

General Immediate relief for a population from inadequateaccess to food, and the threat of exess mortality

Longer term sustainable improvement ina populations access to food, increasingself-reliance to reduce dependence onexternally provided resources

Timescale Short term, urgency Long term, evolutionary

Approach to Planning and Implementat ion

Level of Planning Centralized Decentralized

Style Top down, often hierarchical Bottom up, participatory*

Management Resource intensive, predominance ofexpatriate personnel

Resource extensive, emphasis on indigenousmanagement

Information requirements Specific information on relief need to

direct immediate action who and howmuch Emphasis on early availability ofinformation.

Detailed information on food insecurity: types of food

insecurity, who, and why cumulative process ofinformation collection over time

Information collection Rapid, often formal surveys carried out byvisiting teams

Flexible systems of data collection usuallyemphasizing participation of target population

Role of target population Passive Active, particularly providing key resources **

Source of resources Heavily donor dependent Recipient government and local communitycontributions expected as well as resources providedby donors

Mobilization of resources Rapid emergency procedures forreleasing donor resources

Procedures for releasing funds (both by donors andrecipient government) often require detailed andlengthy processes of appraisal and approval

I n te rvent ionsType Usually standardized, single tracked

activityMultidimensional, varied activities

Profile High Profile Low Profile

Wind ing-up o f Donor Suppor t

Process Emphasis on rapid withdrawal of relief,often abrupt removal of donor supportedstructures and systems

Emphasis on handing over local management andfunding, leaving systems in place*

*Indicates characteristics that are most difficult to achieve in practice


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In order to effectively operate within this framework, however, international, regional, andnational organizations will have to closely examine their own organizational constraintsto effective CPMR. The GHAI study provides an illustrative example of the scope ofreforms that will be needed. Table 2 presents the broad lines of these recommendationsthat include legislative, policy, administrative, procedural, and human resource

development reforms.

Table 2 GHAI Task Force Recommendations for Addressing AgencyConstraints to Linking Relief and Development (Source: USAID)

1. Establish a team, drawn from M, AFR, BHR, G, PPC and other regional Bureaus to establishconcrete, measurable incentives for USAID staff to acquire skills and experience in linking reliefand development. Incentive and training suggestions provided to the Transitions Team have

been numerous and are outlined below. Each one should be given full consideration by theinter-Bureau team:

a. Amend the new Agency Annual Evaluation Form (AEF) to reflect USAIDs commitment

to assisting countries facing complex emergencies or in transition and to furtheringlinkages between relief and development.

b. Encourage all USAID officers with policy and program responsibilities, including seniormanagers, working on or in countries that have substantial humanitarian assistanceprograms or that are considered to be in transition to have at least one AEF work

objective that discusses their role in effectively promoting relief to developmentlinkages.

c. Revise the Agencys staff assignment process to assure bids are reviewed in the

context of placing individuals in varied assignments over their career span that would

include relief, development, transition and graduation scenarios.

d. Create a new backstop category within USAID to enable Foreign Service Officercommitment to careers in emergency/transition work.

e. Develop a linking relief and development course curriculum and require both disasterand development planners in Washington and the field to take this course. Offer thistraining to other U.S. Government agencies and promote similar training for ourimplementing partners (e.g., PVOs/NGOs) to assure they are able to reorient their

operations and philosophies as we reorient ours.

f. Incorporate aspects of linkage training into existing related institutional training

activities, including BHR/OFDAs Disaster Assistance Response Team (DART) trainingand the new cd-rom Development Studies Program.

g. Promote partnering and teamwork across Bureaus, especially through cross training of

designated USAID staff outside of their areas of expertise.


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More Effective and Efficient Regional and National Strategies to Addressthe Important Direct Crisis Threats to the Region

The most important crises facing SSA today include conflicts, epidemics (most notablyHIV/AIDS), and natural hazards. While the international community has long recognizedthe importance of drought as a threat to African food security, there has been far lesssystematic treatment of other natural hazards, such as floods, and more importantly tothe problems of conflict and epidemics. Each of these problems has been dealt withindividually by the development community, when in fact, crises result from theantagonisms that are created when these problems affect the same populations.

While early warning and risk assessment strategies are relatively advanced forprediction of drought, these same techniques hold great promise for epidemicforecasting and for early identification of pernicious conflict. In the SSA context,integration of these types of information systems will improve the forecasting capabilityof these efforts while improving resource utilization by avoiding redundancy.

The problem of conflicts and complex emergencies requires a two-pronged strategy. Inareas of the continent that have been recently affected by CEs, recovery/transitionstrategies are needed that recognize the unique needs of post conflict countries,including re-building civil society through programs that promote psychosocial well beingas well as physical infrastructure building. The needs of post conflict societies are onlynow beginning to be understood and addressed. Much remains to be done in identifyingbest practices to facilitate rapid transition to sustainable development. In many cases,peace is fragile and the window of time available to promote transition may be short.Liberia, Rwanda, and the Democratic Republic of Congo are examples of countries thatremain on the watch lists of the international community.

The second important element of a conflict strategy is early prevention and mitigation.

Clearly, early warning and vulnerability or risk assessment is one key to improvingreadiness. However, another key element is through more effective engagement ofAfrican regional and national organizations in conflict management.

Finally, the international community must increasingly address crises through regionalprograms, such as the GHAI program, while at the same time recognizing the greatdiversity of community settings within crisis affected countries. Somalia providesperhaps the most dramatic example of a country where active conflict, instability andrelative tranquility and prosperity are all occurring in the country. The World HealthOrganization (WHO) has supported some effective regional approaches to theprevention and mitigation of complex emergencies. Regional programs can prioritizeresources to strategic initiatives that reduce the vulnerability of populations to the affectsof war, for example, through a regional immunization initiative. Preventive diplomacyand transition programs that address the most critical causes of complex emergenciesalso may more effectively address the crisis context of SSA.

The Central Role of Public Health and Human Security

Even some of the most astute development economists have concluded that SSA mustsucceed in overcoming its health problems if the continent is to join the world economicorder (Sachs et al, 1999). Using data from around the world, health (especially parasiticand infectious diseases) is an overwhelming constraint to African development. Malaria


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and HIV are perhaps the most important problems; however, infectious diseases aremore commonly prevalent and pernicious in the African setting than any other. Theinternational community increasingly is coming to the realization that healthimprovements are vital to African development, as evidenced by recent trends infinancing. Health is also central to facilitating a rapid transition from crisis to sustainabledevelopment.

It is not surprising that health is both an input to and a yardstick for measuring crisis. InSSA, disasters are generally defined in terms of excess mortality or malnutrition (i.e.,crude mortality in excess of 1/10000/day, or acute undernutrition levels in excess of15%). Unhealthy populations are more susceptible to external shocks, and theseshocks most commonly cause excess mortality through morbidity and malnutrition. Inthis way, unhealthy populations are particularly vulnerable to the immediate hazardsassociated with drought, epidemics and conflicts.

Much can be done to improve the capability of Africans to survive these types of shocksby investing in basic preventive interventions, especially those that reinforce thecapability of Africans to care for themselves and their families. Immunization and basic

communications programs to promote early exclusive breastfeeding, family managementof infectious diseases and STD/HIV prevention are low cost interventions that couldprevent significant mortality in the event of a crisis threat.

Health initiatives also can leverage the development of civil society. Health is a causethat everyone rallies around and it is rarely seen as a competitive domain of interest.Public health programs provide an excellent vehicle for demobilization and the re-establishment of trust between former military and civilian populations. Military can beemployed successfully to provide immunization and the construction of basic healthinfrastructure.

Other innovative strategies include the engagement of the military in combating

HIV/AIDS. As the military has represented a core group facilitating the spread of theepidemic, their engagement in HIV/AIDS prevention is crucial. USAID and the otherorganizations have funded a very successful pan African military alliance for HIV/AIDSprevention, the Civil Military Alliance (CMA). This network provides an opportunity toexpand similar strategies for involving the military in civil society projects.

Finally, dramatic health sector reform is frequently a rare opportunity in the post conflict(recovery/transition) environment. In the post conflict setting, both the physical and thehuman health infrastructure have been destroyed or damaged. While the task ofrebuilding this infrastructure may seem daunting, the opportunity to developed effectivepreventive care-oriented health systems is enormous. Systems can be designed andimplemented according to current international best practices without having to address

the policy and bureaucratic constraints of expensive, ineffective and inequitable systemsof many developing countries.

More recently, the concept of human security has been developed as an overarchingframework for understanding the range of threats to health and well-being. Theinternational community is increasingly convinced of the relevance of this framework tocrisis prevention, mitigation and recovery. Human Security is defined by the UnitedNations (UNDP, 1994) as it means, first, safety from such chronic threats of hunger,disease and repression. And second, it means protection from sudden and hurtfuldisruption in the patterns of daily life, whether in homes, in jobs or in communities.


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Human security provides a conceptual framework for linking the determinants of crisis and development. Current efforts are being made to operationalize the concept in orderto identify the programmatic implications for crisis prevention, mitigation and recovery.

Performance Monitoring of Interventions Across the Crisis Life Cycle isCritical

While traditional development programs have relatively sophisticated evaluationframeworks and indicators for determining impact and efficiency, crisis interventions arerarely subjected to such systematic scrutiny. For example, one of the mostcomprehensive data bases on refugee health and nutritional status, includingobservations for hundreds of refugee camps, reports population-level health-relatedinformation was only available about 10% of the time (ACC/SCN, 1994).

Elaborating such a framework, for the different phases of a crisis life cycle, is the firststep in developing evaluative criteria or measures of effectiveness. During the Somaliacrisis, the American military were particularly struck by the lack of clear performanceobjectives. They initiated an interagency analytical exercise to develop the framework

and indicators. The preliminary results of this exercise are illustrated in Table 3.

Table 3- Suggested Measures of Response Effectiveness for CEs (Source:USAID)

1. Security and levels of violence

number of violent acts against each distribution center

number of violent acts against convoys

fraction of inventory stolen from distribution centers

fraction of inventory stolen from convoys along each key distribution route

fraction of security for the distribution center assumed by the host nation or international agency security guards

fraction of security for the convoy taken over by the host nation or international agency

2. Infrastructure fraction of visual flight rules (VFR)-day capable airfields, by aircraft type

fraction of all key transportation routes that are convoy suitable

fraction of infrastructure repair effort met by host nation or international agencies

fraction of potable water sources re-established

3. Medical and public health issues crude mortality rates

under 5 mortality rates

cause-specific mortality rates

levels of severe malnutrition

4. Agricu ltural and economic issues

market price of staple foods

market price of animals

fraction of land cultivated or used for animal husbandry

household food security


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Systematic Mechanisms for Identifying Information Gaps andDisseminating Best Practices

CPMR is a cross-cutting analytical domain for policy research and programmingstrategies. As such, there are many gaps in our understanding of how to effectivelyaddress crisis threats. It is critical that mechanisms be established for systematicallyidentifying knowledge gaps, best practices, and dissemination of new information. Muchconceptual, analytical and consensus building is left to move this objective forward.Table 4 contains an illustrative list of work to be done as identified by the internationalCPMR network co-sponsored by USAID, several American and European academicinstitutions, and representatives of the PVO community.

Table 4- Areas Where Further Analysis Research is Needed

State-of the art knowledge developed and disseminated on the ways in which developmentprograms can help prevent or mitigate crisis. Guidance developed and expanded on those factors associated with development programs that may

increase the potential for violent conflict.

Guidance developed and expanded on those non-conflict-associated factors that may increase thepotential for causing crisis (e.g. epidemics, drought).

Identifying key approaches for effective preventive diplomacy

Identifying the key factors that make populations resilient to internal conflicts.

Promoting country and sub-regional policies and strategies for epidemic preparedness andresponse. Improved integrated disease control strategies and policies developed.

Effective approaches for epidemic preparedness, early warning and response developed.

Implementation/technical guidelines developed, adapted and tested.

Tools for monitoring and rapid detection of drug resistance and epidemic progression developed.

State-of-the-art knowledge developed and disseminated on the issues that promote rapidtransition f rom crisi s to sustainable development. Guidance developed and expanded on the principles and approaches for linking relief and development.

Guidance developed and expanded on the critical factors and conditions that are required for successfultransition from crisis to sustainable development.

Assessment and evaluation approaches developed and promoted for application in crisis andtransitional situations.

Guidance developed and expanded on tools and methods that can be used for assessing trends,intervention costs, and program impact in crisis and transition situations.

Guidance developed and expanded on program impact indicators or measures of effectiveness that areappropriate for use in crisis and transition situations.

Building consensus on minimal information needed to monitor and evaluate current SSA crises. Includingconflict, infectious disease threats, and population vulnerability.

Building consensus on minimal indicators for evaluating emergency response and transition.

Assessing the impact of disasters on USAID sustainable development countries.


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Summary of a Strategy for Crisis Prevention, Mitigation andRecovery/Transition in SSA

The goal of preventing, mitigating and recovering from crisis in SSA is a great challengeto development in SSA, as the constraints to its success include both the problems ofunderdevelopment within the continent together with the organizational constraints of

international development agencies. However, an international consensus forum thatincluded a broad range of international and African academicians and public and privatesector practitioners was optimistic that the elements of this strategy are indeed the wayahead (USAID, 1999).

In summary, key elements of the strategy include:

Continued development and application of a conceptual framework that recognizesthe multi-faceted and multi-causal nature of crisis in SSA and the overarchingimportance of protecting human security

Strengthening regional and national institutions and networks within SSA to address

crisis threats through cross border programs, sharing human resources anddevelopment information, and making effective use of modern informationtechnology

Forging and fostering new alliances between all sectors of government andconcerned parties, including international agencies, NGOs, the military and privatesectors

Enhancing and accelerating work, through best practices analysis/dissemination,training and policy development to integrate relief and development programming

Leveraging information technologies to facilitate early warning/vulnerability

assessments related to natural hazards, epidemics and conflict; communication andinformation sharing among the African and international community; best practicesidentification and dissemination; and training/capacity-building


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REFERENCES

Anderson, M.; and Woodrow, P. Rising From the Ashes: Development Strategies inTimes of Disaster, Paris:International Relief/Development Project, Harvard, Westview

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Benson, Charlotte and Clay, Edward. The Impact of Drought on Sub-Saharan AfricanEconomies. IDS Bull 1993; 25 (4): 24-32.

Buchanan-Smith, Margaret and Tlogelang, Gabolekwe. Linking Relief andDevelopment: A Case Study of Botswana. IDS Bull 1994; 25 (4): 55-64.

Duffield, Mark. Complex Emergencies and the Crisis of Developmentalism. IDS Bull1994; 25 (4): 37-45.

Educational Concerns for Hunger(ECHO). http://www.echonet.org/

Hill, Allan G. and Macrae, Sheila. Measuring Childhood Mortality Levels: A NewApproach. United Social Statistics Bulletin 1985; 8 (2): 1-14

Natsios, Andrew. NGOs and the UN System in Complex HumanitarianEmergencies:Conflict or Cooperation? Third World Quarterly. January 1, 1995. Vol. 16,p. 405.

OECD. DAC Guidelines on Conflict, Peace and Development Co-Operation, Paris 1997.

Sachs, Jeffrey. Public Health as Part of the Strategy of African Economic Growth.Harvard Institute for International Development, March 10, 1999.

United Nations- ACC/SCN, Update on the Nutrition Situation, 1995, November 1995.

USAID. USAIDs Strategies for Sustainable Development, Providing HumanitarianAssistance & Aiding Post-Crisis Transitions. http://www.info.usaid.gov.

USAID. Office of Foreign Disaster Assistance.http://www.info.usaid.gov/hum_response/ofda/

USAID. Greater Horn of Africa Initiative (GHAI).http://www.info.usaid.gov/regions/afr/ghai/annex_a.html

USAID Annual Report on Program Performance, Providing Humanitarian Assistance andAiding Post crisis Transitions1994.

USAID The Linking Complex Emergency Response and Transition Initiative.Proceedings of The International Consensus Forum on Health and Human Security inConflict Settings. 1999. http://www.certi.org/HarareForumreport/start.htm

Walker, Peter. Linking Relief and Development: The Perspective of the InternationalFederation of Red Cross and Red Crescent Societies. IDS Bull 1994; 25 (4): 107-110.


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World Bank, Washington, D.C. Colletta, Nat, Kostner, Markus and Wiedenhofer, Ingo,1996. The Transition from War to Peace in Sub-Saharan Africa, Washington DC, WorldBank.

The World Bank. World Development Report 1993 : Investing in Health - WorldDevelopment Indicators. Oxford University Press, 1993.

World Bank, Washington, D.C. Data and Resources. 2000. http://www.worldbank.org

Strategic 1

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