 Hi, good afternoon and welcome to the Center for Strategic and International Studies. For those of you still trickling in, I want to let you know that we still have plenty of Millennium Development Goals t-shirts that we collaborated with our partner, University of Miami on. Feel free to take one for your friends or family while you're here. My name is Andrew Schwartz. I'm our Senior Vice President for External Relations and I'm very, very fortunate that my partners in this, Dean Sam Grogg of the University of Miami and Sanjeev Chatterjee, the Vice Dean are both here. This is, we've been doing this series for about a year now and it just keeps getting better and better and I think we really are able to shed light on some of these crucial issues surrounding Millennium Development Goals. Today we have just a stellar panel and I'd like to let my colleague, Dan Rundy, who's right here, introduce them but thank you again for coming and visit us at Facebook and visit us at CSIS.org. This session will also be up on iTunes and on CSIS.org afterwards if you want to see it again. Thanks. Thanks, Andrew. Great. I'm really pleased to have everybody here. I want to especially thank the University of Miami for hosting this and we're going to be talking today about an underreported issue which is the issue of science and technology and the Millennium Development Goals. I think those of you that are familiar with international development know that science and technology have played a crucial role in advances and to end human suffering, reduce human suffering over the last 50 years. AID was at the forefront of initiatives like the Green Revolution in the past along with private funders such as the Rockefeller Foundation and the Ford Foundation. There's a renewed emphasis in the Obama Administration and under Dr. Shaw with a focus on science and technology and we're particularly pleased to have Alex Deegan, a former colleague who's currently now at AID as the Principal Advisor for Science with us to my right. To my left is a former classmate from the Kennedy School so it's sort of old home week. John MacArthur is the CEO of Millennium Promise which is an initiative that Dr. Jeffrey Sacks has convened around a series of community development initiatives focused on alleviating poverty and you'll hear more about that shortly. And then further to my left is Sasha Kramer who's an adjunct professor at the University of Miami and also is a visiting fellow at the Center for Latin American Studies at the University of Miami based in Port-au-Prince, Haiti. But she's also wearing her hat as Executive Director of Soil which you'll learn quite a lot about I think when she describes what soil is and what they're doing. I think we have a very interesting panel. I'm going to first ask Alex to set the stage on the issue of science and technology. I think what we have here is at the policy level science and technology, how do we harness it? How do we capture learning? How do we mainstream it? And then we have two examples of applied technology both a particular technology in the case of Sasha and in the case of John's organization. We have a series or suite of technologies and how around community development and how various social practices are brought to bear on technology to achieve alleviation of suffering. So Alex, talk to us a little bit about this new emphasis on science and technology. How are you thinking about mainstreaming advances in science and technology into mainstream USAID operations? Well, science and technology is one of four priorities for the administrator. It's part of our USAID forward agenda, which was an attempt to take the PPD, the QDDR and actually start it before those were even issued. It is a hallmark of this administration in terms of restoring science to its rightful place and it's a recognition that development is a technical discipline. And 20 years ago we had a Bureau of Science and Technology. We haven't had a full-time S&T advisor for 19 years. And having Dr. Shaw set out this agenda and working on it, I think is based on the recognition that much as USAID played an important part in sort of the great transformations of the past, whether it be antibiotics or vaccines, that we need to look toward what are the next sort of transformative agents in the future? How can we actually leapfrog ahead and solve problems rather than making just progress? We recognize that 80% of economic growth around the world is through science, technology and innovation and that we have to actually think about building economies of the future rather than building economies of the past and we tend to do so. And it is not about repeating the last 200 years of industrialization but using all of our expertise to help develop, you know, with people on the ground in the developing world, new solutions and bringing in new solvers to the problems that we have. And last week I was actually in California and one of the things that really impressed me was what was being driven by students at Berkeley, Stanford and Santa Clara University and many of the spin-offs that came about that, which was first bringing together sort of medicine, engineering, graduate sciences together with anthropology and the business community to set up sort of new social entrepreneurship companies working with people from the developing world and frequently driven by people from the developing world to take on these challenges that we face as a global community and being able to address them and that has been exceptionally exciting. The other element of it is this is actually a fundamental part of our national security. I mean we're facing a series of global challenges as a community and our previous administration, we went from this idea of American exceptionalism to what was laid out in the Cairo speech which is this idea of partnership and recognizing that thinking about emerging infectious diseases, thinking about water, thinking about climate disruption, thinking about biodiversity loss, thinking about the connectivity issue that divides between those who are connected and are unconnected. How do we actually address these? And what's clear is, you know, we're not just bordered by Canada and Mexico anymore but what happens in other countries, what happens in Antana and Arrivo, increasingly spills on our shores. And we need to address these problems because the nature of the problems are scientific problems, the natures of the solutions require partnership and one of the great things science does is bring us some of that partnership. Just briefly, at USAID, what we're trying to do is part of this science agenda and particularly our focus for this year is around four things. And the first is building capacity back at USAID in terms of science, technology and innovation. And what that means is, you know, first and foremost, rebuilding our technical capacity that we lost when we went from 15,000 people to 2,000 people but actually had to deal with, you know, a substantial increase in the size of our budget. We lost the ability, with the exception of a few bright spots, to recognize success, to understand success. And enhancing sort of the existing expertise that's in the agency, rewarding and celebrating that expertise that's within the agency, creating opportunities for a senior technical career track, creating senior science advisor positions in our bureaus, within our missions is fundamental to how we're actually going to get science back into recognizing that development is a technical discipline. Getting people access to journals, encouraging people to go to conferences, which people were discouraged from doing so. Letting people actually, through procurement reform, have the time to focus on the nature of the problems themselves. Really turning USAID from a piggy bank to actually a development partner with people on the ground with people around the world is fundamental to what I think it will take for success. Second is recognizing everything we do as play space, but we haven't been able to use geospatial technologies, for instance, in what we're trying to do. So when you're thinking about putting an HIV clinic someplace, we should be thinking about disease prevalence, other co-occurring diseases prevalence, population densities, where DFID has their clinics, where the government has its clinics, what the road and transportation network is, and doing that, and actually having that information before we even go into countries, and using that for project evaluation to analysis. I mean, it's not about maps, it's actually about using a systems approach, and that's what GIS is, to development. The third are a series of grand challenges for development that the administrator will soon launch. But it's thinking about really the big problems, the big solvable problems that are in development, and then focusing on critical barriers. So some of the ideas are, if we're looking at child and maternal health, ensuring that all women, at the time of delivery, have access to medical care. What about, you know, as we think about agricultural productivity, how do we increase yields, which have been going down year after year, despite our efforts to invest in increasing those yields, while decreasing our environmental footprint? You know, how do we ensure that all children of three years of education can read? I mean, fundamental issues, how do we ensure that villages and deep rural communities have access to electricity, which is part of the key to actually being able to read? So being able to not only address major challenges as a way of furthering the millennium development goals, but also other problems that, you know, the key characteristic of development is that it's not static. The context in which it occurs changes, the populations change, and development as a discipline continues to evolve. But we tend to take an approach that is sort of very time-based. Lastly, it's being able to recognize that we have a lot of resources we haven't tapped into for a long time. And I'm generalizing, there are very many bright spots at USAID, but, you know, we've spent $148 billion on research, federal government research in our federal science cabinet in this country. We don't use that for development. We should use 20 percent of our federal domestic science agency budgets should be directed toward development-type issues, because, one, the nature of those solutions actually affect Americans at home, that what's happening internationally is frequently a development issue. And two, fundamentally, we can learn things from other places in the world. If we can develop world-class frugal innovations with the help of partners on the ground, then we can actually, you know, reduce the cost of our healthcare systems in America. And thinking about that, the other aspect of it, and we're starting off this, the other aspect of it is empowering people through cooperative research and development. We have a partnership with the National Science Foundation, where NSF is funding American scientists, we're funding developing country scientists, to be able to empower them to have the ability to solve their own problems. Get us out, you know, age should have an expiration date. I mean, we should think about a future of what will it take to get us out of development, fundamentally. And lastly, academia. We really need to re-invite academia as development partners and be able to leverage that. And that's sort of the approach we're taking today. Thanks, Alex. So, Sasha, you, Necessity is the mother of invention, place-based solutions. Maybe you could talk a little bit about soil and how you came to become executive director of soil, and what is soil? Well, I first went to Haiti in 2004, and I had gone just after the coup that happened there. I went as a human rights observer, and I was still working on graduate school, finishing up in California, and I fell completely in love with Haiti, and began going back every month for my last two years of graduate school. And what I found as a human rights observer there was that really the most pervasive human rights abuse in Haiti was poverty, and was the fact that people did not have access to basic services. And one of the services that people didn't have access to was sanitation, and I myself often found that I would need to use a facility and would not be able to find one. And for me, it was a real eye-opener about something that I think that most of the world, people who have access to sanitation, very much take for granted. So that was when I first started thinking about getting involved in sanitation work in Haiti. But when I was looking at poverty and these other basic services that were not available to people, it was clear to me that it was not just a question of sanitation. It was a question of not having access to healthcare, the leading cause of mortality in children under five in Haiti is waterborne disease, and the fact that agricultural production had been declining so much over the last few decades in Haiti. And this was what got me thinking about is there a way to have an integrated approach to sanitation that would not only be about a toilet, but that would also address some of these other issues, like healthcare, like agriculture. And I was studying ecology in graduate school and was very interested in nutrient cycles. And so I had been thinking about nitrogen for a long time and studying fertilizers. And I sort of had one of those moments where I realized there is this incredible link between sanitation and agriculture, because what is coming out in human waste is actually what is causing these public health problems, but if you transform it properly you can really turn it into a resource that can be used to stimulate agricultural production. So in 2005 I visited South Africa and I went and visited some ecological sanitation projects there where they were designing different kinds of toilet systems that could actually transform human waste into fertilizers. And I went back to Haiti and began speaking with some of my colleagues there and people were really interested in this idea of being able to produce a resource locally, being able to take something that was posing a public health threat and transform it into a resource so that Haitian farmers would not necessarily have to be purchasing fertilizer outside of the country, but could actually be producing this for themselves. So in 2006 I co-founded the Organization Soil, which is sustainable, organic, integrated livelihoods. And we primarily focus on ecological sanitation and developing sanitation systems that are culturally appropriate and that also can be used to produce this agricultural resource. So we founded the organization in 2006 and we were working mainly in rural areas at that time. And when the earthquake happened in January of last year I went to Port-au-Prince two days after the earthquake and I took about half of my team with me and initially we were just involved in sort of immediate emergency relief, so getting food to people, getting water. And around March I decided it was time to get back into the business of what we really do, which is sanitation. And we partnered with Oxfam Great Britain to test some of our technologies in the IDP camps in Port-au-Prince. And since that time we built about 200 toilets in IDP camps throughout the city and we've set up three sort of decentralized composting facilities to treat the waste from these toilets. And right now we have over 100,000 gallons of human waste that has been safely converted into compost and we're now working on sort of finding ways to market that resource in order to make these sanitation systems sustainable. And when I first got involved with soil I had these dreams of we're going to build hundreds of thousands of toilets around the country and maybe we'll move to other countries after that. And I found that over the last year and thinking about how are we really going to scale up this technology, we've sort of shifted our focus from saying we're going to go and build all of these toilets to saying the way to really scale up an innovation from the perspective of a small NGO is that what we have to offer is that we can pilot this technology. We can show how it can be effective, show how it can actually be profitable and then the way for it to be scaled up is to pass that on, pass it on to the private sector, pass it on to other organizations, pass it on to the government. And so now when people ask me how many toilets do you plan to build or what country do you plan to go to next, I say really numbers of toilets for me are not the focus. For me what I want to do is work out the kinks in this system so that we can demonstrate the effectiveness of this innovative technology and then pass it on to others who are going to be able to scale it up. So I think that Haiti is where I will stay and until we can demonstrate that this works and I just hope that we can provide a model that can be used by others around the world to bring this to scale. So Sasha you were going to bring some fertilizer with you but you decided that you were going to have a hard time getting it through customs and so the next time we host this event you'll bring some fertilizer. I will come with a prop next time and it is very suspicious looking so I figured I wouldn't actually make it into this event if I came with it but next time absolutely I'll have a sample for you. Good thank you, good. So John you run Millennium, the Millennium Villages Project, we've heard about scale, we've heard about learning, we've heard about innovation, we've also heard about culturally applied or culturally appropriate technology. This must obviously be issues for you at the Millennium Villages Project. Tell us a little bit about it but also tell us a little bit about how you take technology and make it appropriate in the cultural context you're operating in. Great, thank you and thanks to everyone and thanks to University of Miami and CESIS for putting this series together, it's great and really a privilege to be here. I want to also congratulate Alex and Dr. Shaw and everyone at USAID for putting this at the front of the agenda. I think for those of us who are, for lack of better term professionals in this set of circles, it's quite invigorating to see the leadership and I was with Rah Shah last week and just congratulated him then because the notion of momentum around evidence-based policymaking is really taking hold and focusing not just on the evidence but also on what's next, not just where we are and I think that's the spirit of a lot of what all of us are trying to work on is where are we now and then what's coming down the pipeline soon and how can we make the most of that on a systems basis. So I would just maybe want to share some broader framing thoughts first before getting into specifics because I think as we talk about this issue of innovation, I would have four categories of innovation that come into my own mind conceptually and I'm happy to illustrate a couple of them and in the broader discussion follow up. I think one is probably the most overlooked innovation which is the implementation of known technologies. This is a huge gap in the international system and international efforts and they're generally speaking two or three reasons why we don't do more of it. One is lack of financing so as much as money doesn't solve a problem, if you can't pay for the solution it doesn't get solved either and that is a highly under appreciated issue and if we go back to for example, I'll come back to it in a second, the other reason is often people just don't know the evidence across disciplines and so I'm a macroeconomist, I'm maybe a little bit lucky I've actually spent much more time than most macroeconomists thinking about soil nutrient cycles but I know enough to know how little I know and I unfortunately most of my colleagues don't even know how much they don't know because it's not an issue to them. Even in the circumstances where they're looking at say African economic development patterns which are essentially defined in my view and read the evidence by a lot of soil nutrient cycles, a lot of what the agronomic community calls a soil nutrient crisis in much of Africa where the greatest ecological and economic barriers are around extraction of soil nutrients. We don't think about this systematically as a policy community. You could look at the same say around epidemiology and disease control. The public health community had developed a lot of evidence around the role of say mass distribution of long lasting insecticide treated nets years before the economics community caught up with this and that's not a slag on any community in particular but it's just a recognition of how hard it is for people to recognize even at the very sophisticated levels of insight within their own fields the insights that are being developed across fields that apply directly to their own. And so I think we have to understand how much evidence is out there that is simply not being implemented either through lack of awareness or through lack of financing. And if you look at agriculture for example and we've got a lot of momentum around feed the future the African green revolution initiative at a very simple level. I won't get into all the complexity of soil nutrient challenges and and so forth nitrogen cycles but the high yield seed varieties for African agriculture loosely speaking generally were brought to market in the 1980s roughly a generation after the ones from South Asia roughly one to two generations after those for say Korea and Taiwan in the 1920s and 30s. There's actually a scientific history of high yield seeds. There was no financing to support the fertilizer response of seeds and there was no policy mechanism in the 1980s and it's only a generation later that we're actually getting to the practicalities in my read of the evidence of supporting those seeds to be broadly accessible around the world and around Africa and that's why we're seeing the things like the Malawi take off in agriculture. We're seeing many countries start to have massive breakthroughs not through any immediate technical breakthrough but through the basic breakthrough of implementing the technology that was for a long time known in the agronomic community and I just want to underscore how big a deal that is. There's a second set of issues though which I would say are around the integrated challenges of innovation and implementing integrated approaches to any particular innovation. So we were just hearing about sanitation. If you look at something like child mortality in my view the ultimate bottom line measure of poverty does a child make it to their fifth birthday or not. There's no more human consequence of poverty. There are so many factors that go into child mortality. It's not just a clinical service. It's not just an immunization. It's not just the clean drinking water. It's not just adequate nutrition. It's not just is the community health worker there as the clinician there. There's actually a whole suite of things that go into that outcome. The public health community has actually done quite a bit around this but that's just one challenge. If you want to look at the demand and supply side issues that put a kid in school. If you want to look at all the economic and ecological factors that go into ecosystem management. If you want to look at an issue like access to water which is only partially about drinking water especially in areas where the agricultural use of water is vastly increasing hopefully rapidly increasing in many instances and also industrial uses. You have huge system questions in our own work in the Millennium Villages. We're trying to think through with communities how to take what we already know based on the evidence to actually apply local community managed system solutions not with infinite complexity but at least with enough basic framework that there's a lot of local adaptation and application of known technologies with a minimum or a minimum and maximum in our case resource envelope to get those things done. There's a third set of innovations which is what I would call around a particular and I think the most interesting ones are around the very particular focused high-impact technologies and I is an economist-defined technology very broadly. It's skills, it's systems, it's science. So you know the rotavirus technologies are extremely important high-impact technologies around ICT and connectivity are extremely high-impact but we're for example working a lot with community health workers by colleague Matt Berg is developed with our other colleagues this whole child count plus system. There are places that never even had connectivity two years ago where now you have people with primary secondary education acting as community health workers that can do case management on a cell phone. That opens up huge new possibilities but there are design challenges around what's the most effective type of information to collect. How do you in a world where the smartphone is going to be coming just down the pipeline anticipate that technology. How do you capture the simplest things where the broadband is about to come through to and how do you do so in a way that the community has its impact empowerment in a way that is optimal for longevity of any program. That's a whole other category of innovations that we are I think most of the time talking about and it's crucial but it's one of many. The fourth and final one I'll flag for now is what I would call global learning systems. We are in the middle of a revolution of global learning and that's an innovation unto itself in my view. I've been involved with a couple dozen universities around the world in launching a new degree program we call it the master's in development practice which is actually about integrated science for development and the thesis is that in order to be a good integrator of all the insights of the different disciplines you actually need to know the basics of food systems. You need to know the basics of disease control. You need to know the basics of water management. You can't be an expert in all of those things but you at least need to know the basics and what's really interesting isn't just how quickly that idea has taken hold around the world in our own experience, my own experience and how resonant that concept is but how much it's a collective learning effort. We're able to get a couple dozen universities on the same screen through webcams once a week across time zones so they have the same conversation but imagine what that looks like if that community in a rural village or in a slum in Kibera what have you is able to have their own conversation with USAID on a regular basis and also with DFID and the World Bank and the universities and the businesses on the same time. This notion of collective global learning and I would say multi constituency learning across public, private, non-profit, academic sectors is not just the way the world is going but in my view it's also the way the world needs to go in order to solve a lot of these problems and so I just I want to encourage us to think broadly not just about the very specific technical breakthroughs that are happening but all these forms of breakthrough that I see happening and that I think we need to understand is the world gets the world grapples with its complexity but also figures out how to design systems that are innovative in their collaboration and sharing of insights both across disciplines and across communities around the world. Thanks, thanks John. I'm taking away three things from this conversation and I'm hoping that each of you can maybe talk about each of them. One is let's call it passing it on global learning systems how do you learn how do you cross-fertilize and I've got a specific I want to press you on one thing Alex on that another one is on scale how do you achieve scale you reference that I'm going to pass this on to the private sector I'd be very interested to hear about how do you these commercializable because I think this is this I think hasn't come up in the conversation how do you commercialize a technology whether it's a paid a paid toilet we've all used paid toilets in places like Paris or other other various places around the United States where you can do that maybe there's some there's some kind of a we talk about micro utilities in the development community and this is a form of a micro micro utility right and so if that and then I think the other is how do you measure impact measurement and evaluation what does that come in I think especially in this environment where there's less foreign assistance resources or there may be some how do you make the case for your specific innovation or learning in this difficult environment so but Alex I'm going to be slightly wonky for a minute and and talk about prize authority you got something called prize authority which maybe you may want to maybe I'll explain it's having to do with offering a prize for people to come up with a new development innovation and the good news is you have prize authority perhaps the the bad news is it may be only limited to us citizens perhaps I think is maybe you just talk a little about that and why that's important to what you're doing and maybe you talk about how do you and it seems to me that's part of this accelerated learning conversation so the great the the great advantage of prizes is you get generally people investing ten times the amount of the prize and actually try to solve the problem you find the people who tend to solve the prizes don't come from the communities you expect to actually address them you get a huge amount of attention around the prize so you create actually usually you don't end up with one solution you create what is called an ecosystem of solutions and lemur biologists I also like to talk about ecosystems and evolutionary biology but the idea is you don't have one widget you don't have one solution you don't have one system but you have a series of different approaches that can compete and actually deal with the fact that you have different environments different contexts different cultures which these things have to be in there and and you know so so there's a good reason to have it you want to draw attention you want people to focus on a critical barrier you only pay for success so you you know unlike a lot of development you actually only pay for a prize when someone achieves the particular prize and this is used with the Ansari X prize for a spacecraft that is able to go to a hundred kilometers twice within I think ten days very clear definitions we wanted to use prizes as a way of drawing attention to critical barriers is one of many tools so our traditional grant tools to other things where we could brawn the conversation on development that the problem is the American competes act which was just passed in the last flurry of legislation limits it so you cannot apply it to people in the developing countries and that that is actually a real limitation because quite frankly what we want to do this problem that you have we have all sort of talked about of how do you actually find what solutions are out there there are so many great existing solutions how do you actually bring them forward how how do you actually bring sort of knowledge together and you know you have the set of global challenges why aren't you using the entirety of the global community to try to address up and so there is this limitation we're looking at other ways of potentially addressing prizes through traditional grant authorities through partnerships with other other entities that could actually fund the prize will we do the work to to make it a reality but I think it is sort of an exciting concept to be able to focus and to think about you know get people thinking about the particular problem without dictating the solution in advance so private sector scale how do you how you're passing it on talk a little bit about more about that sure I think that one and I'm going to speak mainly about sanitation because that's what I know about but it can certainly be extrapolated to other technologies but I think that one of the issues with sanitation and the way that it has been promoted in the world is that it's often very supply driven and less demand driven so I think that really the key in going to scale is in creating the demand for the service and there is an approach to sanitation which is called CLTS community led total sanitation and what this is is instead of coming in with a with a product or with an innovative technology you really start by doing a social marketing campaign with the community so you go in and you really the first thing is to draw the linkages to connect the dots for people so to talk about for sanitation this would be what does sanitation actually impact to bring to the forefront that link between sanitation and public health and really get people to understand that and to create within communities the desire to have a community where everyone has access to sanitation so it's not just the recognition of the link between your own access to sanitation and your your health but also recognizing that other people in the community who do not have access to that are going to impact your health as well so it creates within a community the desire to come up with solutions to provide sanitation to people so for me as someone who is specifically promoting a certain technology it took me a little while to say okay well even if I'm promoting ecological sanitation I cannot go into a community and say hey we've got this straight great toilet you should try it the first step that you really need to make is getting people interested in the idea of sanitation themselves and then you can provide them with the different options that are out there so I think that really the key to bringing an innovation to scale is first of all to create that that demand by bringing up those linkages with between the different domains of health and sanitation and agriculture and I think that the second part of it is really doing social marketing so you know sanitation is something that people don't talk about very much it's something that is not seen as cool it's not a it's not something that's discussed and something that we're really working on in Haiti right now is making sanitation cool in a way so bringing in you know doing a marketing campaign that involves having celebrities in Haiti talk about sanitation getting it getting it out there and making it something that people say well hey that guy thought that that kind of toilet was pretty cool I'd like to have one in my house as well so in order to in order to make and make your your innovative technology sustainable you have to make people want to have it you have to create a desire to pay for it so sanitation is something that's never going to be free and one of the things that Alex brought up was the idea of you know when do we when do we get out of this is there an end goal in sight for aid and I don't want to create an organization that in order for this technology to continue to serve people our organization is going to need to continuously raise money for it into the future so we really have to think about what are ways that this can be passed off to the communities in which we're working so that we can just demonstrate the technology stimulate the desire for it and the demand for it and demonstrate that it's something that can be profitable so that community groups businesses will want to get involved with this and certainly waste collection in industrialized countries is huge business and so there is absolutely no reason that that can't be the case in countries that have less access to sanitation so from from our particular perspective of sanitation we're looking at social marketing we're looking at creating demand and we're looking at demonstrating a way that this can be profitable so that these implementations will actually be sustained in the future and you don't just go put in 200,000 toilets that later on turn into storage sheds for people because they don't really have a desire to have that technology. John we talked on the phone yesterday about demand driven versus supply driven this has come up this issue we need to create demand you my understanding of how the Millennium Villages program works is you you come to a community or a set of communities you assess what the needs are how do you generate demand for some of the solutions that you're providing I think this is sort of an interesting and some of them are new technologies or how do you and how do you how do you hope get folks to think differently about some of the challenges that they have? I think we have to segment this quite a bit actually because if you look at even the role of the public and private sector just to weave that in I think I'm a big fan of the private sector's ability to innovate generate new technologies solve very market driven problems where the markets are working quite well or even expand the reach of the markets where they can work better the so-called bottom of the pyramid issues in a loose rough cut I generally think of the bottom of the pyramid issues as applying to places that are between one and two dollars a day so they're a little bit liquid there's some cash in the economy and there's a lot of room for entrepreneurialism I think that there's typically very different set of economic dynamics in places that are below a dollar a day which are often pretty much cash-free economies or very illiquid or highly illiquid and people just don't have the resources to pay for things in the same way so I think that's one cut different issues then there's another cut of things that are behavioral like sanitation one of the great examples there are other things where it's about you might not want your immunization program to be based on a purely demand-driven approach and there's a lot of public health where you don't want you know pure voting at the household level does the child vote for whether they want an immunization or does their parent decide for them and do you want everyone basically to have an immunization in order to have the public good effects that come from mass immunization it's a different class of problem actually and what if the innovation might be is about changing what's in the immunization or changing the sequencing of the immunization and I just think it's important to segment that from for example a sanitation problem I think when we look at these scaling issues I don't want us to walk away as much as I'm a great believer in the private sector walk away from the public finance and I feel like we have a bit of cognitive dissonance on this so we don't expect for example a PEPFAR to be financed the US AIDS program very successful to be financed by the private sector nor do we expect the AIDS widows and orphans to get their antiretrovirals through private financing we we understand that they need public financing because they actually can't afford it and that program won't work in the absence of public finance and we don't expect PEPFAR to self-finance within three years that's not our definition of sustainability definition of sustainability is with the ongoing financing does that program still achieve its objectives and does local management work and are the targets being achieved and is this growing in the right way and so I think we need to unpack even how we think of scaling and sustainability in these in a more deliberate way given that frame we see within the Millennium villages all sorts of different issues as one can imagine so there are some places where the farmers had of course seen fertilizer before they might have used it a little bit before they just couldn't afford to buy it or they couldn't afford it at the new prices or it used to be subsidized now it's not subsidized they might know how to do it but they might benefit from the agricultural extension worker just to make sure they're doing the spacing right and you saw we saw many places do very well with just a little bit of a tweak around what was accessible so there wasn't really a big demand problem actually although there was a complementarity issue around how to make sure that the the technical support was there so that they could do it the most effective way you see other issues for example everywhere with mass distribution of bed nets just to stick with that example I think the evidence is very clear that you need to do mass distribution of bed nets that doesn't mean that that solves the entire malaria problem both because you have to break the transmission cycle through medication treatment you have to make sure people know how to use their net you have to make sure they know how to maintain their net you have to make sure that you know in my view you want to keep the price basically zero so you're not creating a secondary market for the net you know all these things are very effective and that means you need a system around it that's not necessarily one could define that as creating demand one could also define that as designing a system that's efficacious there are other things which are about choosing technologies again all these categories so we have to be very careful not to oversimplify any of this like water well what is the type of water source that people want to use what's the technology they want to use what's the one that people want to maintain it's of course not just about the capital investment it's about how to maintain it how to make sure the skill level is there we've seen in some places communities of course have their own choices of what type of water they use in others for example in Southwest Uganda it's very sloppy people didn't really live there 50 years ago there's been mass erosion and they said you know fertilizer not so relevant for us because it just lost and run off anyways water we need water and of course we need to pump the water up the ills so can we find a way to create pumps to get the water and then we'll do our landscape management as our first priority in agriculture so I think these have to be both globally at the country level and at the community level highly iterative conversations here's what's available here's what can be done here's what the community wants to do no conversation has perfect information no conversation has unanimity in any part of life or rarely but there's really a very iterative process to learning into documenting and I think that's why this forward-looking innovation strategy is so important because even if something's your best estimate the first time your best estimate the second time should hopefully be even better and then the not just the solution will evolve but the problem will evolve and I think the more dynamic and segmented an approach we have to these problems with very very collaborative problem-solving the more efficacious again will be in all of it great I and I know there's a very well informed audience so I want to take advantage of the fact that we have some very thoughtful people and see some hands starting to shoot up we have we have a couple microphones I'll ask folks to identify themselves name and with their organization and if they would please keep their question in the form of a brief question as opposed to a statement or speech yeah so the lady in the second row thank you it's on absolutely fascinating panel congratulations this has been really interesting it's our name oh sir sorry Marisa Lino and I'm with Northrop Grumman Corporation and you may all wonder why a defense contractor might be interested in this topic but we are the largest contractor at CDC and we do work with CDC in 40 countries on global health anyway my question is for Alex and it gets to the heart of integrating knowledge and I'm wondering as you look at reforming USAID as the president has announced in the union reorganizing government I'm struck that perhaps the model that Ambassador Holbrook created for Pakistan development where he brought in people from all the different government agencies because the biggest stumbling block when you look at public financing even if it is public private sector that may implement it is how do you get all the various parts together is that kind of a model maybe based on that particular personality can it be repeatable can you do something on a task force basis that that might create the synergies so bringing center bringing various government agencies together so I'm a I'm a big admirer of Holbrook I used to work for Dennis Ross and I was the representative to his office and I'm a deep believer in much of what he did fundamentally absolutely that that is exactly I think the right approach in terms of we have to be more efficient in what we have to do in development we have to make use of every resource we have available to us to provide value to the taxpayers and to provide value to our development constituents the people you know the people in the developing country that we're working for so you know USAID is working right now we are talking to NASA we're talking to NOAA we're you know we're talking to USGS which has huge expertise remote sensing and water and geology you know we are we are building partnerships with all those organizations along with NIH along with USDA fundamentally to be able to to address these problems because they're they're global problems I think I saw a question up here in the front row as well my name is Wellington I'm a venture capitalist in Johannesburg in South Africa I have got economics training and I'm also passionate about development and actually the business that I mean is a result of an introspective debate on what drives economic growth and development and the conclusion that I came to is similar to the focus of the panel today which is that technology is the factor of production that has made the biggest difference in the history of the world economy now I've been listening to you talk about what you're busy with and the views that you've got and it seems to me that your bias is very much towards being a substitute for developing country governments where there is a deficit of transfer payments you know that would in a developed country setting be provided by government you know to the most vulnerable groups and in general economic viability in that section of the community is very difficult to manufacture because you know the reason why they're vulnerable is because you know they don't have money and because they don't they're there's no market there what we've decided to do in our case is to make the developing world also a source of global technologies and my question is I wanted to know whether there is a solution or a form of intervention that you think you can provide to venture capitalists like me I've got four technologies that have proven their potential to be global solutions we have got a ballast water treatment system which is killing microbes in the water that goes into ballast tanks in the shipping industry a 35 billion US dollar industry and we have partnered with the biggest marine repair and maintenance company in the world which is Norwegian despite the fact that we invested only half a million US dollars in the investment demonstrating that actually high value innovation so the question is the question would be well I you know one of the I know that you don't want speeches but one of the points that you've made correctly is how do you identify quality of opportunities well I do have quality opportunities so you know that's the point I want to make maybe we can talk about the rest of them later on but I just wanted to know whether there is an intervention that you've got for things that are genuinely potentially viable can actually grow the economy so that in the future sustainability will be defined as developing countries having the capacity to provide their own transfer payments to the vulnerable groups in their own countries rather than you know aid USAID being an extension great domestic country governments thank you Wellington I actually think each of you could probably take a piece of this maybe Alex why don't you start and I'm hoping also that Sasha I think you talked originally about how you found the technology in South Africa and brought it to Haiti so it sounds as if there are there are pieces about how do you commercialize the technology how do you scale and how do you bring in governments how do you bring in local governments into into this conversation because I think you put your finger on something well it's in which is where where's the local government's conversation and so and also maybe you could talk about how are you supporting commercializing commercializing technology because I think that's also something that Wellington was getting at one is a personal observation so a very good friend of mine at the World Bank that works on science is and I'm not gonna mention his name but is leaving the World Bank to go work for venture capital firms in Silicon Valley who are interested in the developing world and if you talk to to the smart investors around the world the future markets are in Africa you know they are in it is it is where people see the hope and the success and that's where you know the drive for development is gonna come from the second point is recognizing where agent development agencies even what we're trying to create it is what we're calling a modern development enterprise can distort the market and where we shouldn't be acting and how do we actually encourage the venture capitalists and entrepreneurs like yourself and and we're still working on this but one of the mechanisms that that you know my colleague Dr. Moro Neal who's our chief innovation officer and we work closely together is this thing called the development innovation ventures which is intended to be able to take those new developments as new sort of technologies those new ideas from anyone and if they have the potential to reach 75 million people to start off like a venture capital fund to scale them up and that's available now it's rolling applications so that's some of the ways we're thinking about but we also have to be careful of not distorting markets you know which I think aid has the potential to do as well not just USAID but other development agencies just talk also Alex about you have I think part of your office also covers working with local scientists and developing countries as well I mean that's fundamental about how do you actually build up people to solve their own problems and this is why you know through the National Science Foundation are you know one of our premier science agencies you know we want to partner American scientists with developing country scientists so that they're both you know so you're building labs you're creating postdocs you're buying equipment helping individuals just like we do with our scientists be able to address the same set of problems and create world world-class laboratories the other piece of it is thinking about digital libraries and we were successful in doing this in Iraq when everyone told us that it wouldn't work because we created a virtual science library hundred percent of Iraqis have access Iraqi students and all their science ministries have access to it the best part about it was people said well they don't have electricity they don't have internet you and they're not interested in using this and what we found was despite electricity despite internet that people took the challenges and turned them into opportunities and we have 8,000 to 10,000 active users if you don't use it you're kicked off 35,000 articles a month are downloaded 1.2 million or 1.3 million over the course of it and what's even better is we did it at 95% discounts using open source software platforms that were that can be adapted and have been now taken up by other countries and now the Iraqi government pays for it as opposed to USAID or the US government and that to me is a sign of success and it's also a sign that people have a thirst for knowledge in the developing world it you know if you talk to people scientists around the world they're reading abstracts they don't have access to these things you give them the knowledge they will use it and they will want it. So Sasha talk about where has the local government play into what you're doing because I think this is an important point and then how are you reaching out to commercializing your ideas I think this is something else that Wellington talked about he has a series of his ideas but my hope is that at some point you'll you'll find a venture capitalist for for paid toilets. Yes well Wellington I'm very glad that you brought up the issue of government because it's something the role can't be under play like it's something that I may have skimmed over in my initial discussion and I think that certainly when you're working in a country like Haiti where many people are living on such a small income and you're talking about a very basic service like sanitation which actually does cost money that absolutely the government is going to have to be involved and certainly sanitation is subsidized by governments in most countries. So we've been trying to work closely not only with the government water and sanitation authority but also the Ministry of Agriculture to find a way to sort of develop a public-private partnership where the NGO like ourselves would come in we would demonstrate a technology the way in which it works and then there would be certain parts of it which could be operated by the private sector like for instance the collection and transport but then when you look at something like waste treatment this is something that is much better initially run by the government so you're talking about semi-centralized waste treatment plants where it costs a lot of money to get that sort of infrastructure in place and that is money that you're not going to be able to get from your customers who are paying for their toilets. So I think that there is a real need to come up with creative ways that the NGO community the government and the private sector can work together to provide this service and to really ensure that the service is not only available to people who are able to pay for it so there needs to be some thinking about subsidization for people who cannot afford the entire cost of the service and the interesting thing about ecological sanitation is because you're not just providing toilets you're also producing a resource in the end are there creative ways that profits that come from the sales of that resource can then be fed back into the system to actually subsidize the provision of sanitation services to people. So I really thank you for bringing that up and I appreciate the question. John roll of local governments and also how do you how do we commercialize how do we people have good ideas have good marketable solutions how how should those be how should those be brought forward. I think I'd have two basic thoughts on this one is again segmenting the different environment so I actually think the middle-income countries have a very different environment instead of challenges than the low-income countries so South Africa is a middle-income country or Brazil or even now India Ghana is now technically a middle-income country if we believe the books you know these are very different environments in terms of the capital that's in that environment and economy and generally speaking the technology because you're absolutely right though one of the deepest insights of the economic growth research is that gains in technology and productivity drive everything and so finding ways to boost that is central. I actually think that with the emerging economy so called the bricks and brick pluses and whatever accurate an acronym you want to use we're in the this country we're so used to describing them as the next great investment places I think we have to be understanding them as also the next great investment sources because they're really providing a bridge function in the global economy and as wages keep going up in China and a lot of the low-cost labor will move to other parts of the world for example that's going to be huge shift in investment in the next generation but I also think we need to I think there's a gap system-wide internationally around innovations so we don't really have a lot of these public finance dollars going into innovations because they're risky taxpayers don't like to see their dollars fail we do domestically in or this country domestically puts for example a lot of money into NIH National Institutes of Health National Science Foundation those are central to all the commercialized technology you see down the pipeline the basic science but we don't have those similar pipelines in the low-income countries although we're starting to see them in many of the middle-income countries and there's a lot of boosting happening for the low-income countries but I just want to share some basic arithmetic to illustrate some of this when we're talking about foreign aid and and so forth I never think we should be thinking of substitutes I think we should only be thinking of compliments so these are links in a chain and it's a little bit like I always say do I like my heart my lungs or my liver best I actually like them all and if I want to run a clinic do I or if I want someone to be able to run a clinic do I want there to be a nurse or running water or medicine we'll actually think they should have all of them and one of the basic challenges and those are analogies for a lot of these problems if you're looking at the lowest income countries the bottom billion so called they're typically an economy that are maybe four hundred dollar per capita income technically and a lot of that's imputed value of what the agriculture would be worth if they sold it rather than eating their own food if you were to do really well and squeeze 15% of GNP and tax revenues you might be getting you know 50 $60 maybe 70 of per capita income for tax for expenditures for everything for your health clinics your schools your roads your judiciary everything that's not much now what we've done a lot of work on this in the past over years we've estimated that the total cost if you want to use the millennium development goals as a frame the total cost of the agriculture support the education the infrastructure the health and so forth in a bare bones way is probably on the order of a hundred two hundred fifty dollars per person per year which is almost nothing unless you're at a four hundred or five hundred dollar per capita economy and your tax basis maybe sixty bucks per person that is so incalculably different in a spirit from being a five thousand dollar per capita we're getting 10% of GNP which is low as tax revenues means that you are five hundred dollars per capita if you're not doing as well on effort but you have so much more to play with in a sense and so I think it's really important to understand that it's not a foreign aid and official development assistance is in no way a substitute or shouldn't be for the private finance and the incentives nor is it letting off the hook a low income country to do their best it's got to be best from everyone but you know no one more than me and I spent a lot of time arguing the case for foreign aid I don't want to penny more than what's needed to solve the problems and I as a general rule speaking very roughly but just conceptually countries really graduate on the low income side from the need for foreign aid once they get above about a thousand dollar per capita GNP so in my view we should really be focusing the dollars on an aid basis in those countries and really supporting the private investment in the ones that are more advanced in the middle income and we need to just see that those aren't the same problem I'm just I'm time sensitive I'll make a deal with the audience if you ask very brief questions I'll take two more questions so name who you're with and a very brief question will take to the gentleman in that corner and anybody over here and I'll go over here so I'll be hit both sides. Ranjan Gupta from NIAID NIH but I'm speaking for myself not for NIH I just want to say this was an excellent panel because you all touched on some very key issues one was such a demand group create the demand to drive the process you talked about the people thirst for knowledge and the social entrepreneurship and I just want to make a quick point that I go to India for my scientific issues periodically and I'm always amazed that I go to the houses where people have even the rickshaw puller on the street has a cell phone people have every house nowadays has an LCD monitor flat screen TV and I walk out of their house as an open hydrant with mosquitoes flying everywhere which goes to show that people do not have the knowledge and the awareness to say well this is a basic necessity and the second thing is that the political will is not there oftentimes local and state governments are so caught up fighting their political issues they don't have incentive to do things that will be for the public good but here's what I have a message is that I found talking to average Indian on the street that people love American shows you know when they watch National Geographic when they watch Animal Planet they say you know I never knew that these things need to be protected though the education that they receive or something like it's a Sesame Street so basically a social entrepreneurship is a social engineering chain making a cultural chain from bottom up and I think U.S. can really do that by infiltrating into that mode you know have all people even don't understand what HIV AIDS is and we have tons of good TV shows this that because you know you can really make that change so much so that people can then demand that they want that and maybe then politicians will feel here's something I can do so that I can stay in power thank you change the politics that's great thank you I'm gonna ask that the gentleman over there to make a last comment of course you know many the Sesame Street programs around the world aside from the U.S. one are funded by AID we're helped that Alam Simpson and and others yeah in Russia as well thank you hi my name is Zach Sarno I'm with the public international law and policy group I was just wondering if you could speak to the use of innovations in legal service delivery as part of the holistic element of sort of aid in general nations and public service delivery and legal service legal service if you use them at all or if you're aware of them like paralegals as a form of legal aid like community health workers as opposed to doctors or I know of some innovative work that's been done especially in post-conflict settings and like Liberia and Sierra Leone and there's some great young lawyers who have been doing what I would call interface law between community legal systems and the kind of more classic if you will internationally defined formal systems and bridging that through community tribunals on things I'm not expert in that so I wouldn't want to overstate great I think we've had an excellent panel I want to thank our sponsors the University of Miami and our friends here at CSIS thank you