 Good afternoon and welcome to USIP to all of you for this event with a good friend and somebody who want to come to respect in a very short period of time, Greg Gottlieb, who's the mission director of USAID in Islamabad. And I'll introduce him formally, but first I want to thank all of you for showing up on what is clearly the best day for an event like this. And usually I have to tell people not to stare outside and look at us because the scenery is very nice. But today we should have opened these things so that you could give it a shot if you wanted. But again, thank you very much. I know it's not the best day, but Greg, it probably says something about your star power. I don't know. Nobody would have come to listen to me in this weather, that's for sure. We're going to give Greg a chance to lay out the framework. He'll talk for about 20 minutes or so. And then I very much want this to be a conversation, if that's okay, rather than sort of a Q&A. And so even if there are comments as we go along, and I'll try and throw in a couple myself, so that we could have a discussion about USAID priorities in Pakistan, why USAID is doing what it's doing, and if any of you have thoughts on other ways of going about this, because clearly this has been a topic that we've talked about over and over again for years now. And I don't think there's a right or wrong answer, but certainly there are views to be heard. Greg is, as I said, the mission director for Pakistan. Before this, he was the senior deputy assistant administrator for the Bureau for Food Security, where he oversaw development activities associated with the Feed the Future program. He's also been mission director in Namibia. Before that, he was senior deputy assistant administrator in the Bureau for Democracy, Conflict, and Humanitarian Assistance, if I can remember that. But he's been in this business for over 20 years, NGO experience, United Nations, U.S. government, of course, within the framework of humanitarian relief. So Greg, it's over to you. Okay. Thank you, Mohi. Pleasure. There are so many people in here that know me from the office that it looks like it's a plant kind of. Even some staff from Pakistan are here. You should be glad we are having an event on the day. Go for it. Thanks for bringing all of them. Yeah, thanks. Well, thanks very much for everybody for coming out. I'm going to talk a little bit about, you know, we have a pretty robust program in Pakistan and it has a number of elements to it. I'm going to talk about a couple of sides of that that are more on the social sector side. But I think in the conversation that we have on this, of course, it will be a wide open conversation and I'm more than happy to engage in the dialogue. So let me just start off. I'll just try to go through this well. With 195 million people, the second largest Muslim population in the world, nuclear weapons, violent extremists that threaten Pakistan's internal security, the region's security and our own security, helping to stabilize Pakistan is very much in the U.S. interest. And the question is how to support Pakistan's process to deepen its own security and long term stability. And most conversations about stability in Pakistan naturally focus on counterterrorism. Many also recognize the critical role of economic development and building stability and the role of international community in part to help Pakistan expand its economy, create jobs and increase incomes. Discussions of ways to address the energy crisis and help Pakistan commercialize its beleaguered energy sector often goes along with this narrative. But what receives little attention is the essential nexus between long term stability and long term development, not only in terms of economic growth and stability but also social sector stability and the ability of the state to provide for the most basic needs of the population. The foundation of physical security has roots in citizens' economic security. Economic security is founded on the ability of the population to actually participate productively in the public sphere. We have a five sector strategy in Pakistan. So our strategy directly supports U.S. foreign policy objectives to promote democratic, stable and prosperous Pakistan and is part of the overall U.S. government five prong civilian assistance strategy. And this includes energy, economic growth and agriculture, stabilization or what's perhaps will be known later as community resilience, I think. Resilience is a very popular term these days. Innovation and health. And energy easily emerges as a top priority of development concern, one that in the past threatened to destabilize the government. Energy shortages reduce Pakistan's GDP by an estimated three to four percent every year. It increases unemployment and inflation and has even caused summer riots in Pakistan's swelteringly hot cities for the past four years. And for these reasons we have made it the top priority of our five sector strategy. Yet all five elements are critical to Pakistan's long-term growth and development. The multi-sector focus was validated when the Prime Minister Nawaz Sharif campaigned and was subsequently elected on a platform to improve and reform four E's that mirrored exactly USAID's top four priorities, economy, energy, education and extremism. And the only missing foundational element of these four E's is a topic that will be one key focus of my talk today, and that is health. Our fifth sector is the focus of a slew of recent reports raising the alarm on a series of failing health indicators and has only renewed our commitment in that area. A global report on ending newborn diseases released by Save the Children last month found that Pakistan has the world's highest rate of first-day deaths and stillbirths at 40 per 1,000 births, worse than even Somalia and Afghanistan. Our own USAID-funded 2013 Pakistan Demographic Health Survey, released by the government of Pakistan just in January, found one in every 11 Pakistani children does not survive to his or her fifth birthday, equaling over 1,100 deaths every day. And Pakistan's most recent National Nutrition Survey reported 44 percent of children below five years of age are stunted as a result of chronic malnutrition. Stunting causes irreversible brain damage after 24 months, lowering a child's ability to learn, reducing school attendance and increasing the risk of failing, at least one grade, by 16 percent. I think it's worth noting also that besides the 44 percent malnutrition, there's also 15 percent acute malnutrition. And so if you want to put that in context, in any emergency of which I spent a few years working on, 10 percent would be considered an emergency level in which you would intervene with a feeding program. So every day in Pakistan, we are far above that limit. So it just tells you the magnitude of the nutrition crisis in the country. So to put more succinctly, if you are a child born in Pakistan, you have the world's worst chance of surviving your first day, a 44 percent chance you won't have enough to eat for the next five years, disrupting your healthy physical and mental development, and a 9 percent chance you won't make it to your fifth birthday at all. As a deputy of USAID's Bureau of Food Security globally, I find these statistics alarming. Our most basic human and American values that we help those in need when we can should be enough of a motivation for us to seek to provide assistance. But there is an underlying economic stability rationale as well. Earlier, I mentioned an estimate by the Asian Development Bank that Pakistan's power shortages were costing the Pakistani economy 3 to 4 percent of its GDP per year. And according to the World Bank and Pakistan's Ministry of Planning, Pakistan's high rates of malnutrition are costing the economy up to 3 percent of GDP, putting it in exactly the same range. Yet we hear far more about lack of energy in Pakistan than malnutrition. Why? Because malnutrition is primarily a problem of the poor, those with the least ability to speak out and make themselves heard. It is only when tragedies such as the most recent in Tar Park are in sinned kill 187 people in a concentrated area over a short amount of time that issuances of poor government are raised. With 44 percent of Pakistani children malnourished and at risk of brain damage, the development discussion is derailed, challenged so fundamentally it becomes premature to talk about education and economic opportunity and sustainability, and the field of opportunity both for those individuals and for Pakistan as a country narrows. That narrowing is dangerous and starts a destructive cycle. Mental incapacitation reduces the benefits of education, poorly educated individuals struggle economically, large numbers of economically struggling and undereducated people are easily manipulated and their frustrations exploited. For violent extremist groups looking for foot soldiers, it is a ready-made population. With the Taliban and TTP in the north of the country, the sectarian groups in Pakistan's Punjabi heartland and the Kweta Shura in the west, and all three groups mixing with criminal elements in the Karachi south, militant recruitment from this population is local, continuous and unsurprising. However, I think we can and are doing something about it. Addressing malnutrition last month, USAID donated 1,300 metric tons of ready-to-use therapeutic food, a vitamin-enriched peanut paste from UNICEF enough to treat more than 80,000 acutely malnourished children in Pakistan, and since 2009, the U.S. has provided over $600 million in food assistance. Our assistance programs address Pakistan's development challenges even before birth with family planning, and Pakistan is the six most populous country in the world and is projected to reach over 300 million people by 2050. Less checked, this more than 60 percent potential increase in the population is expected to acutely challenge all sectors and overwhelm the government of Pakistan's ability to provide basic services. Working with the Pakistani government and NGOs across the country, our health projects have educated families on topics such as birth spacing, increasing demand for family planning services from 64 to 71 percent, and resulting in an estimated 3,000 fewer maternal deaths and 1.7 million fewer unintended pregnancies. And in Pakistan, effective spending on family planning has been shown to reduce the need for spending in other social sectors by a factor of 3 to 1. USAID, however, now supplies 70 percent of all Pakistan's contraceptives. And it's worth noting that the conversation about family planning has become a more difficult one in the country from where it was even 40 years ago. It's much less of a public topic of discussion. So it makes it even more difficult now, despite what we do I think in family planning to really get that message across. So through refurbishing facilities, training midwives, working with community leaders, and increasing the percentage of women who give birth with support from skilled assistants, we've saved 6,500 infant lives and decreased newborn deaths by 23 percent in 26 targeted districts. And even as we help Pakistan face down these health and nutrition challenges, new ones arise. In order to meet the conditions set by the IMF on its $6.6 billion loan, the government of Pakistan has tightened its fiscal belt and reduced development spending drastically so in the social sectors. Because of this reduced spending, our social sector programs gain an even greater importance, and we recognize this with the launch of a new follow on 387 million maternal and child health program. The program will build on the success of our previous health projects and alleviate some of the financial pressure on Pakistan as it undertakes the IMF mandated reforms that will allow its economy to regain a sustainable, upwards trajectory. Let me move on to a discussion I think of on education because it goes alongside very much so a discussion of health. And there's also a direct link between challenges in health and education. And according to our Pakistan demographic and health survey, illiterate women have a fertility rate of 4.4 percent, whereas the rate is 2.5 percent among educated women. The lower fertility rate is important because, again, unchecked, Pakistan's population will overwhelm the government of Pakistan's ability to provide basic services and available resources potentially destabilizing the country. In addition, children whose mothers have no education are half as likely to be fully vaccinated as children whose mothers have more than secondary education. And it's not surprising that better educated people make healthier choices. One of the great benefits of education is that it allows individuals to make better or at least more informed choices about just about everything. And education is particularly important as Pakistan continues to root itself in democracy. To quote President Franklin Roosevelt, democracy cannot succeed unless those who express their choice are prepared to choose wisely. The real safeguard of democracy, therefore, is education. And in Pakistan there are multiple threats to democracy. Democracy can play a role in mitigating or resolving each of those threats. The most obvious threat comes from extremists violently trying to force an anti-democratic system of governance. And while there can be disagreements on the number and type of institutions that churn out extremists, we know they exist in prevalent areas such as FATA, parts of Khayber Pakhtunkhwa, southern Punjab, and Pakistan's largest cities, including Karachi. And in addition to attendees of these institutions, out-of-school children are also particularly susceptible to extremist ideologies. Our education programs are designed in part to help both public and private schools provide an alternative to that kind of indoctrination, to out-compete the extremist institutions and offer a free meal in the facade of religious piety with a substantive education that promotes critical thinking and the skills to earn a livelihood. USAID has already built or renovated 659 schools, primarily in KP, reaching over 130,000 kids. And through the SIN Basic Education Program, we will build 120 schools, support policy reforms to consolidate them, and mobilize community members to manage schools and enroll up to 10,000 girls in target schools. Also, USAID also has provided funding to UNICEF to increase access to primary school for 1.2 million out-of-school Pakistani children, out of a total of 6.9 million out of school. And this brings us to another threat to Pakistan's stability, that's demography. Over 59 percent of the population in Pakistan, or 102 million people, are under the age of 24. And this youth bulge needs employable skill sets, leadership opportunities, access to quality educational opportunities, as well as solid economic prospects. With them, Pakistan's youth bulge can pay a demographic dividend and turn Pakistan into an Asian tiger economy. Without them, Pakistan's youth population has the potential to act as a major destabilizing force and become vulnerable to violent extremist ideologies. According to UNESCO, in a report released in January, if Pakistan were to have inequality and access to education to the level of Vietnam, it would increase its economic growth by 1.7 percent. USAID is seeking to assist Pakistan to create that access to education by awarding 10,000 university scholarships to talented low-income students. But in order to realize the demographic dividend, Pakistanis must receive a quality education that will result in employable skills. A quality education requires quality teachers. So we help design and establish both AA and BA programs for teachers studying primary education in 90 colleges and universities across Pakistan. As a result, provincial governments are starting to require certification from teachers to obtain jobs in public schools, building the roots to upend the deep trend of patronage and poor accountability among teachers in schools. In addition, the program will train 94,000 teachers on how to teach reading effectively. Basic literacy is a foundation for most other learning and higher-level skills. And yet, a majority of Pakistan's children neither finish or drop out of primary-level education without basic reading skills. A first-time national early grade assessment of reading supported by USAID found that 50 percent of children in third grade were below grade level in reading, and by fifth grade, that percentage rose to 60 percent. These data are informing the pedagogical interventions of USAID's reading program, which will help 4 million children in 38,000 schools learn to read, including ensuring that at least 2.5 million students read at grade level by 2018. But literacy alone doesn't go far enough and is only part of the equation. Initial research, we are supporting to inform some of our new programs, especially in vulnerable areas such as southern Punjab and Karachi, show that basic literacy and numeracy are important, but that holistic efforts to ensure young people in vulnerable areas can participate in the workforce require job training and links to viable employment. At the macroeconomic level, broader national-level economic development is also founded on specialized education to build a highly technical professional workforce. As public and private sectors require a trained labor force that meet to create innovative, indigenously-generated solutions to Pakistan's problems, and USAID seeks to promote those kinds of solutions through Centers for Advanced Studies with some of the best universities in Pakistan. The Centers for Advanced Studies will be focused on some of Pakistan's greatest challenges in agriculture, energy, and water, and these educational centers of excellence are based on public-private partnerships and interest-specific networks that will bring together the best minds in academia, government, and the business community to identify and seek applied research solutions to some of Pakistan's most intractable issues limiting the nation's growth. In the long-term, interventions in basic education, workforce development, and higher education help create a more stable future for Pakistan. So in conclusion, addressing stabilization in Pakistan cannot be solved with a singular approach. The complexity and interrelated nature of the challenges facing Pakistan, Pakistan's security and long-term development require complex and multifaceted strategies. Stabilization and counterterrorism are essential elements as are economic investment and investment in infrastructure. Yet the foundation for all of these elements of stability is a stable, healthy, and well-educated population. Long-term stability depends on long-term development, not short-term interventions, and it is time for the U.S. to join other international actors in deepening attention to social stability as a key to long-term national stability and security. Thank you. Thanks, Greg. Before opening up, let me just make a few comments as I promised. You promised you. First of all, I do commend, I think this is a really, I mean, you've taken this with a passion, because in some ways, this is exactly the conversation some of us have been hoping and arguing should take place for years now. And I would argue partly that all of us are guilty of having focused on Pakistan and many other countries, but Pakistan with a very short-term tactical lens. And oftentimes, what we call strategic to me really was one tactic after another. And when you think in tactical chunks, it becomes very difficult to look at long-term stability, because sometimes I feel if you, when you're trying to achieve short-term stabilization, you forget what happens in the long-term, and they're not always together. I mean, sometimes you actually have a disconnect between them. I'm actually glad I didn't hear you say the word hearts and minds in all of this. And I say this as an analytical point, because I think one of the biggest barriers we've had in terms of real long-term thinking is this idea of winning hearts and minds. And I, at least, I don't claim to be a development practitioner, but whatever my academic understanding of this subject tells me and my time in the NGO sector in Pakistan, you ain't buying too many hearts and minds in Pakistan by telling them that we've done a lot of good things. That's a political problem. It's going to be solved some other way. But I think we undermine the development effort if we focus on the hearts and minds rather than the long-term stability that you've just talked about. So I think I'm in complete agreement. I would also argue that both long-term and short-term stability would benefit more if you were to take away even the two paragraphs you had there about terrorism and Kuwait Ashura and whatever else. I think if you educate for the sake of education and make people healthy for the sake of making them healthy, you will come out with a safer Pakistan. And the flowchart may not be as simple to draw. But everything you've said, I would argue that you take away the terrorism piece you should still be doing. And there, in some ways, I have a lot of sympathy for organizations like USAID, but other countries who are doing this. Because the way the AFPAC paradigm played out over the last 10, 12 years, there was very little space to have that discussion. Because too much of it was about tomorrow and the day after. So I'm very glad to hear what I have from you. A few other specific things. One, I'm not entirely clear what your flowchart looks like when you go from health to stabilization. Is it my argument? A healthy Pakistan is a safer Pakistan? Is it that you have a way to tie lesser infant maternal mortality, healthy children to better behavior? Or is it through education that you get there? I wasn't entirely clear. So that would be something to perhaps comment on a little bit more. On youth, this is a subject I've worked on extensively over the past few years. And I would argue that while what you're saying is correct, employment is a major part of that, education is a major part of that, the type of education also matters. So it's not the quantity of education, but it's actually and not even the quality. I would argue the type of education matters. But part of the problem with Pakistani youth, to be honest right now, if I were to bring in my own view, is that they have been socialized in a culture which has got endemic corruption and failure to impose rule of law. And I think I was the last generation in Pakistan and others before me probably could speak better to this. But my parents' generation was a different class. When I grew up in Pakistan, I remember if you came home and said that you had broken the law, done something, you were in trouble for the next five days. I don't want to go how you were in trouble, but you were in trouble. Now I find that when kids in families come home and say, oh, I got ticketed and I gave my license to the policeman rather than bribing him. Then you're in trouble. Why didn't you bribe him and get your license back? Who's going to go and? So I think the socialization part of the youth who have now grown up with an understanding of life, of culture, of right and wrong, which is skewed towards endemic corruption, I think makes a huge problem for people to start talking about civics rather than about politics and political Islam and everything else. Two questions, and then I promise to shut up and open it up. One is you talked about what USAID is doing. How are you coordinating with other donors? Because one of the things I have found in my experience in Pakistan is that if you go and talk to USAID and then the difference of the world and the others, you will find very often that they're working in the same sectors and often doing the same things, and sometimes not even recognizing that there are more overlaps than there should be. And my point is not to say that they shouldn't be overlaps, but what has happened to the idea of the donor coordination group in Islamabad? They used to exist at some point, then disappeared, and I'm not entirely sure where it stands. Do you feel that there's enough coordination and that USAID has picked priorities based on where you think you have a comparative advantage or where you decided we want to do something because it's important? And related to that, the final question is you mentioned the four E's of the Nawaz campaign. I think I know the answer, but I think we need to have. How do you come up with your priorities? Are these priorities that align with the government of Pakistan's priorities? Or are these priorities that you come up with and then try and persuade the Pakistani government that these should also be your priorities, in which case the buying is much tougher to get than if you were to pick four out of their 10 priorities and go with them? So I've taken too much time. Let me shut up here. Maybe you can respond if you want, and then we can open up. Or we can open up. I think why don't we just open up and then we'll answer. That's fine. So if any of you have comments, please, I'll recognize you in the order that I see. The names, please introduce yourself so that Greg knows where you're coming from, and then make a comment or question. The lady here. Lynn Carter, you mentioned that alteration to corruption is almost voluntary, but if you're a poor person living in Karachi, say, or any other urban area where informalization prevails, you don't have a choice. You want to get something done. You need a patriot. You need a group. So you need MQM. You need another party that's going to help you get those services. But for you, Greg, a question about how usage is layering these various interventions and choosing geographic targeting, assuming that even though your funds are large, they're not large enough to cover the whole country. So if we accept your premise, and I very much do, that one needs to work with you holistically, that one sector by itself isn't enough or adequate, how then do you layer health and education and workforce preparation and job placement as a whole package in order to emerge with a young person who's got some critical thinking skills, is able to get and pull the job, et cetera. Well, thanks, Lynn. Part of the programming, I think the way that we've tried to structure it, particularly if you look at Karachi, is we've tried to make some inroads into those most difficult neighborhoods. We've put that together with a program that deals with training, particularly for kids that probably aren't going to go back to school, but you need to have training. And then you've got a larger sort of sinned education program, you've got reading, and you've sort of concentrated it all in an area so you can at least, you can target the kids that are coming into school, you can target the kids that are now out of school, you can deal with the kids that are in the toughest neighborhoods. And as you say, we're only, even as large as our program is, the problem is much bigger than the money that we have. And I do think, and I'll talk, one question, and if I can kind of connect that to something Moïd said, and that is, it's always this question of what do we do with other donors? I mean, there isn't anything that we do or we don't generally, we haven't talked with other donors. And it's not like there are so many donors out there that you couldn't fit them all into our room, our meeting room. You can. There's not that many. There's a few multilateral banks, and then there's a few major donors. So in terms of, like we're doing big education programs in our biggest one, of course, is in SEND, but we're elsewhere. And we're doing quality work in terms of teacher quality, quality of schools. And the Brits are working on a different aspect of that, particularly in Punjab with that government, which is really, I think, picked up on a lot of what they do, which is about keeping kids in school, getting teachers to stay in the schools and teach. So I do think that we actually coordinate quite well with other donors. I think one of the challenges, and I'm sort of riffing off this a bit, but one of the challenges donors have is that headquarters oftentimes has centralized things that they want to do. And so you do bring those out oftentimes in the field. And you say, well, this is what we're going to focus on. And you find sympathetic people. Richard and Vinay are both here, and they were there, and Robin's also here. So people that preceded me in Pakistan. But I do think that, in fact, much of our program was based upon, most is based upon discussions with government about what we were going to do, particularly the energy program. Obviously, the work we've been doing in Fata KP, economic growth, which is a key for them. And now they've even approached us and talked about perhaps expanding the way what we do in education. I don't think there's anything that we're doing that I would say gets shoved down anybody's throat. What I would say is that there's not always the kinds of champions down below that you wish you had to help carry things forward. And also, I don't think I'm speaking out of turn, but to say that we work with some extraordinary people. But once you come down a certain level, that ability, the ability of that staff is a little more limited. So the ability to move these kinds of projects forward, I think impedes what we do. But I do think we, yeah, lower. So at the top, I mean, we have extraordinary people that we work with. But you get farther, well, hey, it works that way in many places. So this is not an unusual problem in any bureaucracy. And we are not guilt-free here, I think, of that, too. So I do think that I think we're in relatively good sync with them, but I'm not sure always that, as I said, there are all the champions that we need or that the champions that we have can necessarily devote the kind of time they need to our particular issue, because they have so much on their plates. So I'll stop. Lynn, quickly. I think exactly the point you're making is the problem. Because it's involuntary, it is no longer about right or wrong. It's a compulsion. And so that's the way you basically normalize yourself in particular cases. And so the discussion about this shouldn't be done is actually receding, because it's become so commonplace. But I would argue that for the elite, it is voluntary. The elite who go out and bribe to get something done, I think a lot of times, it is voluntary. No elite needs to bribe a policeman to get out of a ticket. And there are many, many other instances which I can go. So I think you've got to look at it in a class structure sense as well. Sorry, let me just come this way. Dana. Very related part. The question of donors, not so much coordination, but in terms of China, the country was getting involved with these more assistance oriented projects, so we say non-backable projects. And the other question is that we are seeing certainly that the government of Pakistan, like many governments, is focusing more, perhaps, on trade and investment than aid. And given the sort of political situation in the United States, a bit of isolationism, always difficult, maybe even more difficult problems in terms of budgets, I wonder to what extent are you seeing the program that you're pursuing as connecting with what the government wants to do on moving more to commercial projects, rather than assistance projects for development. How do you connect those sort of the off-ramp and the on-ramp? OK, well, let me address the China question first. You know, in terms of if you look at a kind of a typical donor meeting that gets called, say, on energy or something, which gets used the ADB chairs those meetings. So the Chinese are never there. For them, I think it's fair to say that their approach is a commercial one. They lend to the government, and then they build the dams for them, or they build the coal plant, or whatever they're going to build. So they're not really participants in sort of what we think of as sort of a usual development program. They have a very different approach to it, at least in the discussions that I've had with Chinese counterparts. And they're very honest about it, to say, that's not how we do business. The way we do our business is we do it on a lending basis, not a grant bid. I think that's my phone, actually. So sorry. I didn't mean to. I'm pretty good about turning it off, but not this time. This is getting bad, isn't it? I think Big Brother says you're talking too much. Yeah, no. That's the NSA telling me, hey, Greg, you can't say that. No, that's not what I meant. So they're pretty frank about it, and they're pretty frank about the way they do their business. And you don't generally see them very involved in sort of traditional development side. They look at it as its development through business, really. I guess that's the best way I'd describe it. In terms of the trade and investment, yeah, I mean, it's trade not aid. That's been our mantra there. And a lot of the work that we're trying to do, both on the project side, but also the policy side, I think, is trying to tend toward that. Because of the IMF agreement, one of the things that we have worked on with them is work with the IMF fund is trying to build a better business climate, which is not we're not the only donors doing that. But it is trying to look at what is it that creates a difficult business climate for people to invest. So we look at those kinds of things. Obviously, issues around power, it's a huge issue because it's hard for companies to invest if they want to do manufacturing, and there's not a steady supply of power. But the government, I think, is very clear that this is where this is the direction they want to go. And so we're going to look at those types of issues to help them become more competitive, and whether it's the advice on policy changes that need to take place, work on issues. We've been talking to them about LNG, and there's a big investment in LNG, and that could free them up from the most expensive kind of energy they've been using. So we'll make it easier for their manufacturers to have a more steady stream of energy. So we will look at all those issues. But we'll also look at things like investing in small and medium enterprises to increase that sector, which does about 80% of the hiring in the country. So a variety of things that we're looking at. But that's a very clear message in all the meetings that we've had with them. Yeah, yeah, pleasure. Hi, Nick Kraft, I was previously country director for the World Bank in Afghanistan. I liked your approach, particularly the long term, focus on early childhood development, nutrition. You said 40% of children who are wasted or stunted will never benefit from education. But there's also a structural element in Pakistan, which I think seems more prevalent in other countries, which is to do with the fact that if I'm not mistaken, either 19 or 22 families essentially control many of the, if not most of the resources in Pakistan, you still have an extremely, you still have also an extremely feudalistic system, particularly in agriculture. And while I think what you're doing on education and health is exactly right, looking at the long term, it seems to me that there are some structural issues that may be very difficult to address, but need to be addressed if Pakistan is eventually to move forward. And I'm wondering whether you thought about that, you're gonna do something about it or basically believe this is something that's too difficult, you know, we can't handle this directly. Well, you know, for an development program to I think to deal with an issue like that would be very, that's a difficult one for us to do. But yeah, I mean, we're aware of the differences, particularly between rural areas and the urban areas. I mean, one thing that was a little bit, I think after this election, one thing we heard from people that they thought was pretty hopeful was a lot of the tradition, a lot of the people who'd always been elected to parliament didn't get elected. They, people were, there was dissatisfaction even in some of the rural areas where people didn't get elected. But also there's the issue of some of the rural areas now, particularly in parts of the Punjab that I've heard from some members of parliament that the concern is sort of the beginning to be the mix of a stronger religious element into the politics there. So it's a different kind of traditionalism around the politics. But I mean, by and large, that's an issue that I think we're aware of. I think we know something about how it impinges upon the work that we do, but it's not something we tackle directly. Yeah. Hi, this is Javed Ali Kalloro. I'm here on internship with Voice of America and in Pakistan, I work for Pasantaluja News. I have seen a couple of projects and I have been to FATA for more than three months. I've spent my time there and I've seen your projects, your schools. But unfortunately, I saw the boards and that's it, nothing else. And I interviewed a couple of political agencies even in car, in mamu agency and couple of more agencies. So what they said that, yes, the people come, they cut the ribbon and they just go off and nothing is there, unfortunately. Second thing, it's true that USAID is doing a lot and there's UK-AID a lot. There are some more international donors who are doing a lot for the betterment for the Pakistani people. But have you ever tried to realize the, realize, try to make the government of Pakistan realize that it's not us who has to do everything, it's you who has to do something more. And third and last, you said that there are multiple threats to democracy in Pakistan. Would you please elaborate? Yeah, well, it's hard to comment on any particular individual observation. So it's difficult for me to do that. But we'll catch the perpetrators and punish them appropriately. That's good. I'll answer your question of multiple threats to democracy. I do think that in fact, even in discussions I've had with some members of parliament, I mean, people do regard kind of the intrusion into politics of much more conservative religion, a religious outlook as a real threat to democracy because it's essentially anathema to democracy. And I think that's the way they view it. I think that's one issue. I think the difficulties of an economy that cannot provide makes it, challenges any democratic system because if you think about the governance aspects, where do people go to get what they want? You don't go through a normal, what's the normal chain? You go through what? Just as people were describing, you have to have a patron. So in essence, I mean, there's not a lot that's democratic about that because it's not an even playing field for people. I think in my, some of the countries I've served in, I've been in places where there's been lots of corruption, but I've also been in countries where, in fact, even very poor countries where in fact, nobody was, you weren't greasing anybody's palm to get something done. And I think when that happens, it's everybody goes and looks for a way to get around whatever that system is. But the inequity there of course is, well, people don't, you don't have to pay a tax. You don't pay taxes. So if you look at the low tax rate in the country, it's always a threat to everybody because it's a pretty non-transparent system in terms of how things get funded. So I think there's a number of things that are out there that work against an effective democracy. On the other hand, the election was pretty good. And I think everybody, most people in the room would say, yeah, that was pretty extraordinary that a government, a democratically elected government was succeeded by a democratically elected government. So we look at that and say, that's a very positive course. And the people that we work with in government, I think, are justly proud of it. And I think that the Shreve government is working hard to make this the norm in the country. So I think that's very positive. Can we get the mic? We actually, there's a web. Okay, so Greg, what is your observation? What do you think what sort of system should be there in Pakistan in order to go out the economic issues? Well, I mean, it's, you know, from our perspective, I mean, elected democratic government is the way that is what people show the preference for. And from our perspective, we are very much glad to see it be that way. I mean, an open, transparent form of governance is that allows people to participate is what I think the US is advocated for in all of our democracy and governance programs and at the highest levels of our government. So I don't think there's anything, I mean, what we saw, which is, I think what Pakistanis are justly proud of was, you know, a very good election that showed that the system can work and that can have a system that can carry on and perhaps be more, continue to be more transparent in the future. So, you know, there's every reason to think that it can work, but there are just a lot of pressures on the government now. Yeah. Gentlemen, on the back. Dick can answer a question. Dick Owens, International Relief and Development. Greg, how are you doing? Hey, Dick, good to see you. We implement a stabilization program for you in one part of the country, a longer-term development program in another part of the country. So your presentation today was very positive. We hope you're making that with frequency including with your implementing partners out there because sometimes we feel like we are in boxes because of the five sectors and the sort of regionalization of the program through the regional offices. But regardless where you are, regardless what you're doing, what sector you're working in in Pakistan, that youth bulge slaps you in the face just every time it's there, it's alive, something you have to deal with. We've looked at it for a lot of years. We still don't see that sector that's gonna absorb that industry, there's no silver bullet. What are you and the bank and the government looking at in terms of multiple outlets for that youth bulge that needs to move into something productive? They need education, they need health, they need hope, really. Thanks, Dick, good to see you again. One thing I would say is that even though our programs are pretty large, I mean, we're given the size of the population in Pakistan, we are just one of, we can only focus on so many kids and we're only gonna reach so many. Even some of the statistics I think in the talk, I mean, you think about the number of teachers we've trained or that kind of thing and they're still, that's a long way to go if you're gonna make the change in quality of teachers. But I mean, in terms of youth bulge, yeah, it's a couple of things that we're gonna look at. One is on the economic growth side. So we are shifting our economic growth to looking at small and medium enterprises, mainly because they are, they create about 80% of the jobs in the country, really. So we wanna, we've got a couple of programs, one which is kind of an innovative one with three equity funds where we work with, we partner with three private investment firms to then invest in these companies and identify them. We've done, we're doing youth training, we're doing that in Karachi and we'll do it elsewhere. I think the notion that we're trying to focus on the quality of education, the quality of teachers so that kids get a better start will hopefully be better. But the fact is that without solving a number of the problems, particularly around energy and security, which probably, which limit investment in the country because foreign direct investments is really lagging of late and I know the government's intent on raising it back up. But it's still lagging poorly, very badly. And until that really picks up and there's a lot more investment in the country where people are creating jobs, it's gonna be harder to get those kids into real jobs and even the companies, some of the training institutes we work with, even the best ones will tell you, it's still hard to find their kids' jobs. So there's not a lot of job creation going on and we hope that what we're doing has some impact and we can, by working along with other donors who are doing similar things, at least begin to create some kind of forward motion, particularly in the SMEs. Can you speak in the mic? We've got a web. I would say some of those structural issues that were raised earlier have an impact on willingness to invest, ability to invest and serve as a disincentive to investment and entrepreneurship. The gentleman here, can I just add one sentence, Greg, that yes, of course, the structural problems have to be resolved. But it's with these very problems that the FDI was almost double this, not too long ago. So I think there's still a margin to cash in on even if the structural problems don't get resolved, not to say that they should. Yes, my name's David Katz from the Department of State. A question about the capabilities of the federal government line ministries and the provinces, provincial line ministries. With this new, with Sharif administration, are we seeing any changes in the capabilities of these ministries that are giving you a stronger partner to work with in terms of some of these sectors and with respect to the provinces, are there particular provinces which have gone and made more progress in terms of their line ministries' capabilities? Well, at the federal level, I would say that we've had some pretty strong partnerships with EAD, which is, you know, and the Ministry of Finance, I mean, Minister Darsman is a particularly strong partner. I think everybody would admit in a very effective partner along with many of his staff and we find them to be working with them actually quite good and we work with them on a weekly basis, we're together with them and we find them very effective. Also, we work very closely with Water and Power and also with Minister Iqbal in planning and have found his staff, particularly Minister Iqbal himself, who has been actually one of the real champions for just these issues. I mean, he has been a very forceful voice in highlighting these along with other issues on water and things. So I think we are finding that at certain parts of the federal government, we have very effective, we have very good partners. You know, at the provincial level, I think it's fair to say, at least from what, when I speak with our staff, the Punjabi ministries tend to be the strongest so far. SIND has been, we've had some difficulties, particularly in the education front. We've had a number, a lot of turnover there that's caused us difficulties and slowness, but nevertheless, just in the recent past, we've managed to get funding done that I never thought we'd ever get done on SIND basic education, but we got it done. Richard, yeah, we got it done. And in KP, the new government there actually has, they have tried to be very transparent in the way they deal with the donors, which has been very good for us. I can't really speak to the effectiveness of their line ministries because I, it's not really where I've spent a lot of my time, but they recently, like in KP, actually in one of the ministries, KP actually reduced the number of staff from 110 to 40 in a bid to get rid of dead weight and to be able to focus on what they wanna do. So we look at that and say, okay, that, it's just one example, it doesn't apply across the board necessarily, but in fact, I think it reflects well on what they're trying to do, which is to at least have some kind of, they want a coherent development strategy. It's still sometimes borders on just a kind of a wish list kind of thing, which is oftentimes difficult to respond to if not impossible, but by and large, we're actually encouraged by the way that they've tried to approach development. We're not always happy with the criticism we get from them, but okay, you know. Have a hand. Thank you. Carla Rosa Borges, Creative Associates International. Thank you for your presentation today. It's been a pleasure to talk about what's happening in Pakistan and you said early in your presentation about the state's ability to provide for the citizens, we most recently started talking about the provincial level and the elections that have been occurring and I think there's some energy that's been occurring at the local level. I haven't heard you speak much about what's happening at the local level, especially with local government, strengthening that USAID may be focusing on. What's the direction there? We have been, yeah, you know, there's been a lot of discussion about the local governance parts of the 18th Amendment and rolling that out. I mean, obviously there's a lot of discussion about hopefully what would be upcoming elections in some parts of the country. And we don't have a huge local governance program right now. I think what we do have, however, are programs that work closely with the local agents, particularly in Fatah KP, as you know, that are supportive of what those local agents do. I mean, much of this work that we do through OTI is not branded, which you also know. And it, but we hope that that gives government credit in the eyes of the citizenry. So that's sort of the theory of it. So hopefully over time, as local governments stand up and we think about what we, how we want to work in the future, you know, governance, we know governance is a big issue for us. And it's, we did a lot of work prior to the election and our governance programs shrunk up a little bit. So it's actually an interesting that you raised that. And it's one thing that we're thinking about how we might, you know, what some of our future programming might look like. And particularly targeted at provincial, at provincial and local governance. Of course I would, just to add, I would argue that you could only be successful that if the hosts were interested in strengthening local government, which doesn't seem to be the case right now, energy or no energy. I also want to recognize, because you pointed to him twice, Richard Albright, who was the former assistant coordinator, civilian assistance coordinator at the embassy in Islamabad and is now with USIP and with state as well, I guess I should say. Okay, he's here for, on a fellowship for a year. Can we have a mic here? It's great to see you here, Greg. You know, you were, you started off talking about the really atrocious indicators in maternal child health malnutrition, which is a long-term chronic problem in Pakistan, particularly concentrated in sinned. But I also note that the government, Asanik Bal, the minister of planning, the minister of food security have taken up the issues to some degree after the data that the government put out. And I'm just wondering about the, what's the prospect for some kind of Pakistani government led, and I mean federal and provincial government led coordinated effort to address the long-term problems that have led to this because it's not, the World Bank talks about needing to do a 10 to 15 year program, multi-pronged because malnutrition isn't just one thing. It's incomes, it's water, sanitation, it's land. It's the availability of an employment and it's a whole range of activities. And I'm just wondering about the idea of the prospect of getting a really well coordinated government led program that they buy into that multiple donors can then take pieces of and try to advance this over time. Well, I mean, you're right, Richard, about minister Iqbal. I mean, he has been the most consistent spokesperson for these issues. The recent deaths in Tar Parker have highlighted the issue but they are, they're just merely symptomatic of a bigger problem. I mean, in fact, World Food Program reported on that back in December. So when you talk World Food Program or others, they weren't surprised at all. In fact, it's just the publicity. Some people say this is just the publicity. But I will say that, you know, from my own perspective, I hope, I would love to see that the fact that the prime minister went down to Tar Parker, I'm hoping, I mean, I'm hoping that perhaps he will see this as an issue that's worth exploring. I was, when we released the demographic health survey, it got coverage for about a day and then just faded from the front pages. That's not very encouraging for me when I look at the issue. But as you rightly say, I mean, it's a long-term issue and it's complicated and it's across a number of sectors. So I haven't heard, other than when I've spoken with Iqbal about this. And Nargisetti, she is always, I mean, she always, you know, who's our main, my main interlocutor, she's always very sensitive to a lot of these issues. But I haven't seen anything yet at either a provincial or national level that would lead me to think that there will be soon kind of a national movement unless Tar Parker really, really moves people to the point where they say, you know, we can deal with this. And donors, and the fact is that I think if donors would step forward on something like this because it's, those are pretty, those are shocking figures and they're, and Pakistan has, and it's a country with such great potential. I mean, there's no reason that we should see that. So I hope that there will be something, but I'm not, I'm not, I'm not that encouraged right now. Thank you. Thank you. I'm one of the girls previously with the BBC in Voice of America, but now an analyst in the region. During your conversation, you mentioned Singh, you mentioned Punjab and Kepi Fatah, but you didn't mention Balochistan, where I come from. So my first question is, how do you distribute your funds or projects in Pakistan? But generally in Pakistan, the funds and resources are distributed among the provinces and region based on the population of that region. So in this case, Balochistan gets only 5%. So is it the same formula that you're following or something else? And secondly, what are the biggest challenges in Balochistan? Thanks. Okay. Well, we don't have a formula for how we distribute it geographically. Balochistan, we do have some programs there, but they're not, they're not used. There's some agricultural programs and we use the UN. We don't really have a lot of access there. To be frank, I mean, we can't get permission to even travel there. So we've tried, as Richard and Vinay knows, but we just can't get there. So while I've met with the Chief Minister, who's invited us to go there, we don't, it's very difficult for us to get permission to travel. And as you can imagine, being an American, security issues are a bit, you know, they're there for us. But we would love to do more work in Balochistan and in fact, we've been engaged in discussions recently with some of the UN agencies on working through them because they have access where we don't have access. Nevertheless, I mean, we are doing the construction on the Kalat-Chaman, you know, the Kweta-Chaman Road. We are doing that now. So it's not like we're completely ignoring. Kalat-Kweta-Chaman Road. So we're doing the construction on that road, which I think is, Vinay will know exactly the number of kilometers, but it's about 200 kilometers of road that we're redoing right now. As I can understand, Balochistan can be no-go area for many foreigners, particularly the Baloch region of the province. But this Pashtun region is the same because the province is the North Pashtun and the South Baloch. So is Pashtun, it is exactly the same for you? It's like a no-go area? Well, we don't get much in there either, but we've had a lot better luck with local partners and gaining access there. There have been more local partners we've been able to use who have been able to do programming there. And it's been much more difficult for us in Balochistan. So, but we would really like to get there and if discussions with the UN work out, then we will probably start putting more money in there. Would you like me to give you some suggestion how to get in touch with the local people in Islamat, for example, like identifying some projects because I come from that province. Right. Well, yeah, I mean... I mean, I can identify projects, actually. Even if you can, I mean, the question for us, it's always a question for us of how we finance it, how we do it, but sure, I mean, we are always open to looking for opportunities where we can. Thanks. Okay, I have a comment and I like your approach looking at the long-term and in the same spirit. My name is Fazia Say. I'm a human rights activist from Pakistan, currently based in DC with George Mason University. My comment is about the evolution and provincial autonomy and earlier, because I've been working in this area very closely, and earlier there were a lot of pressures from the donor. Agencies, I'm talking about the larger landscape. Centralized system suits people because flying in and out of Islamabad is easier and going to the provincial offices is a bit difficult. And I know that direct influence of Bill Gates Foundation and some other donors pushed the government to bring back health which was devolved back into, you know, it got tagged onto a federal ministry just to kind of make things okay with the donors, and there has been that pressure. So my comment is just that this was a very positive, long-term directional change from the centralized government to at least provincial autonomy, and then we are hoping there will be a good positive change to the third year. But I'm just hoping that your programs strengthen that long-term direction and not kind of create the environment where it is convenient for the government to centralize again. Well, I mean, it's interesting because when you look at most USAID programs around the world, I mean, we're actually, in most countries, we're pretty centralized. We have a main office in the capital and that's about it. Pakistan is one of the few places other than Afghanistan, where we actually have provincial offices. They are, and my colleague Ed Burgles is here, and Ed was in Peshawar and in Karachi. Unfortunately, for various reasons, we've had to pull back at least our American staff and a lot of our national staff to Islamabad. But we're still down in Sindum, we travel quite a bit, and actually the structure does allow us to focus more on the provincial side of things. And even our guys that work on Fatta Kp, who are mostly pulled back to Islamabad, they only focus on those areas. And I mean, Dick points out one danger of that is that you kind of get siloed a bit. But on the other hand, it enables us to have people who really focus on a region and they're not worried, like in the health sector, they really go to the Ministry of Health in the provinces as opposed to they go to the State Minister who looks after health. So I think actually that you, I think things are going in the direction, a positive direction that you want them to because our guys to get their work done, you know, when we do some work and we build schools in Sind, I mean, the money goes to the government of Sind. So we, or if we're gonna do health, it's gonna go to that ministry. So we're creating that partnership through the flow of money, which is helpful. It's not always easy to manage that if you're in my position, but okay, you know. Viola. Viola. Viola. Viola Ganger here at USIP. You were talking about the potential risks created by the IMF conditions. Have there been discussions with the IMF on figuring out if there's a way to build in or add in some sort of social safety net? Because obviously Pakistan is not the only country facing those sort of issues. What have your discussions been like if you've had any and is there any discussion of trying to amend those conditions accordingly? Accordingly. Well, thanks for that, Viola. You know, really what sort of happened on that side is that in one sense ADB has stepped up in a big way. I think they're gonna put $430 million, the Asian Development Bank, they're gonna put money into the BISP, the BUTO, this is, yeah, income support program. The Brits are also putting money into that. And so in a way that's a counterweight to sort of that reduction of social services that can occur because of the IMF program. And I think it's very conscious on part of ADB to do that because they realized that there's a couple things going on. One, there's been a change of management at BISP that has fostered a discussion of reform there. I mean, even we have been looking at the back at BISP. We were there, we funded it before, we've actually looked at it to make sure to at least take a look at their accounting, but it's looking actually, so there's a lot of money flowing that way and that should dampen down some of the worst effects of it. But you know, I can't tell you exactly what the impact will be on education overall, but there's a substantial amount of money that'll come out of the development portfolio for the next couple of years until they get that. So with, you know, hopefully BISP will make it possible for the worst aspects of it to be tempered. Thank you Greg, I'm Mohamed Hassan from Pakistan Embassy and I would like to thank you and the USAID for being a partner in development with my country. And we really appreciate that the focus area which USAID has chosen, it's really the priorities of the government of Pakistan as well. My question is a question which we often keep asking to ourselves that is how to improve the effectiveness of USAID programming in Pakistan. And in fact, I would like to know your views that what the government of Pakistan can do and what USAID can do to make it more effective in order to make it, you know, relevant. Thank you. Greg, can I, without opening a can of worms, I had one word here which is that word that we struggle with and all of us in the field impact. What is the thinking on how, how far can we go in measuring impact before it just becomes a futile exercise or have there been now, you know, thinking within USAID where you figured out what impact means and how far you want to do it? Yeah, okay. Let me see if I can answer both. So thank you, Mohamed. I wish you could have thrown me that softball earlier on a couple of things, but that's, but thanks. You know, a couple of things that, you know, what we can always, for us, one of the difficulties is we have, we have a pretty substantial turnover on staff because of some of our security conditions. So, you know, what we've been trying to do is to get our staff to stay longer. Now we're up to about more than 50% of our staff now on two-year tours. And I think that that has been one of the areas I think that's affected our ability to do a good work. Ed, how long did you stay there? You know, Ed, six years. So, you know, most aren't gonna stay six, but we're trying to get people to stay longer. First of all, people need to get to know the country better and they need to get to know their counterparts better because those longer, the longer you have a relationship, the better you build it, the better you're gonna do your programming. So I think in that sense, that's one thing we can do. You know, from government side, you know, one of the things I think we can work with government on and we've been trying to do this with Nargis Seti and with Mr. Iqbal. And that is we do need to improve the processing time for a lot of the, like the PC-1 process. It has been a bear for many people. And it's not just the PC-1, but it's what happens even after the PC-1. And it's no different in, you know, at Pakistan than it is in any bureaucracy. The question is, you know, how can we have a conversation about that process? One of the things that we're preparing for Nargis Seti is a rack up of all donor money that is out there. And what is the reasons that that money's not moving? So that's one of the things we hope to work on with her and with Minister Iqbal because we see that there are roadblocks that are there. And if we can identify them in a consistent manner, we can deal them. It's hard to deal with a one-off issue, but it's a lot easier to deal with a consistent issue that affects a lot of donor money because it's in both government's interest and our interest, you know, particularly 35% of our money goes directly into government coffers. And we know that given where we are in foreign exchange, it's important for government. And Minister Dar has made that clear. So we want to make sure that we move the money as fast and consistently as we can. So that would be one of the areas that I look at. And in terms of impact, you know, you know, Lynn actually has done some, MSI has done some very interesting work on impact for us. I think that we, and I could, I would praise MSI for the work they've done, particularly on a lot of our work with OTI because we've been very creative in trying to measure how we've, what kind of impact we've had in particularly parts of FATA. Very difficult to measure. And yet we've managed to get some things, a mix of sort of quantitative, qualitative, you know, measurements, proxy indicators that tell us, you know, things are better. You know, we were talking the other day about SWAT. My driver said, oh, I'm taking my girls to SWAT for vacation over the, you know. And you're thinking, you never would have done that a year ago, but they've lifted the curfew. It's all, everybody's, people are back to going to SWAT as a vacation. Which, even if you use that as my driver as a proxy indicator, you'd say, hey, that's improvement. You know, people are going to SWAT because it was, you know, that's where people wanted to go for vacation. So I do think that we have to, we need to expend a lot of, we need to spend a lot of effort on it. And we've been doing that, I think, with MSI. I think one of the things that has occurred to me that I'd love to be able to do, particularly on some of the things we've done in FATA KP around roads and saying, oh, you know, we built these roads and now trade's going to be better and everything's going to be better because we did this and electricity. But, you know, I would like to propose at one point that we actually build a monitoring and evaluation system that extends beyond the end of the life of a project, which is something we just never do because if we did that, we could for not a lot of money evaluate, okay, is it really having the impact? Because a lot of times you get to the end of your project and you've met your goals, but the goals are not ultimately how it's going to turn out. You know what I mean? We're going to train all these teachers, but you need to track where that went and how it went. So I think, yeah, there's more that we can do on the impact and it doesn't just end with the project. That's great. Thank you, Greg. I know you have to get to your next engagement. Just before I thank all of you and Greg again, this is, of course, part of our series of events on South Asia where we do sort of public events off the record roundtables and we keep filling your inboxes. So please do keep reading those emails and keep coming. We also have some infomercials at the back, a couple of books that we've just put out and some other publications, so feel free to take them as you leave. Also to remind you, since Greg mentioned, the Pakistani Finance Minister, Ishaq Dar will be speaking here on the 8th of April at 3 p.m. So you'll also see that in your inbox, I'm sure. But once again, thank you very much for coming out today in the snow and thanks, Greg, for joining us again. Thank you.