U.S. Midterm Election Results: A Bumpy Road Ahead for International Development Agenda?

Like every good Harvard Kennedy School student, I spent Tuesday night nervously jittering in my seat while watching the 2010 midterm election results, fixated on my computer screen and clicking "refresh" over and over until my index finger hurt. Although the 2010 election issues centered on domestic economic recovery and health care reform, I couldn't help but wonder what the Republican gains would mean abroad.

What do the US mid-term election results mean for the U.S. international development agenda?

In his lecture this afternoon and on his Foreign Policy blog, Harvard Kennedy School Professor Stephen Walt re-assuredly answered the question with, "probably not much." Although the Democrats have to forfeit US House of Representatives control to John Boehner, when it comes to USAID, Departments of Defense, State, Treasury, and the intelligence agencies, Barack and his appointees still call the shots.

OK, I can breathe a little bit easier now. But wait, what about all of the anti-trade campaign rhetoric we were barraged with for the last 6 months? China was the punching bag of choice for most politicians this time around, and the attacks seemed to successfully translate into votes in light of the sluggish economic recovery at home. My favorite campaign ad was Congressman Zack Space's attack on free trade proponent Bob Gibbs, ending with the line, "as they say in China, sze sze (thank you), Mr. Gibbs." Even Harry Reid joined the protectionist bandwagon this election season to score some leverage with Nevada voters. (Really, Harry? I expected more from you.)

Whether we like it or not, the rhetoric of the mid-term elections was heavily anti-trade. For now, the state-run news agency of Xinhua has dismissed the rhetoric as "much ado about nothing" and desperate attempts to win votes. But when it comes time to make hard legislative decisions, campaign promises may raise the political pressure for Congress to urge punitive measures against China, responding to the U.S. perception that China is not playing fairly by swindling U.S. jobs.

Let me be clear - protectionist trade behavior against China will only dig the U.S. economic hole deeper. Dangerous protectionist policies could manifest itself in increased support for the controversial House bill aimed at punishing China for supposedly keeping its currency undervalued, which could be the first shot fired in an all-out U.S.-China trade war. In addition, Congress may prove less likely to endorse any free-trade agreement, such as the one pending with South Korea, which has the potential to really stimulate some U.S. export industries.

Next week as Obama enters G20 talks in Seoul, he will be faced with tough issues that directly affect the international development agenda, including issues of trade and currency wars. Let's only hope that Obama does not stifle economic development opportunities abroad by further succumbing to the anti-free trade rhetoric back home.

Beyond campaign rhetoric, the changes in U.S. House of Representatives committee leadership may also prove detrimental to providing necessary funding for international development initiatives. Replacing Rep. Howard Berman (D-CA) as Committee Chair of the House of Representatives Committee on Foreign Relations, Rep. Ileana Ross-Lehtinen (R-FL) will likely re-possess the gavel.

A Cuban-American, our new committee chair is likely to oppose Obama's efforts to move towards repealing sanctions on Fidel Castro, not to mention thwart Berman's foreign aid reform bill and seek cuts in foreign aid budget in her authorization bill. The Washington Post also reports that Ross-Lehtinen has a penchant for withholding contributions from the United Nations to force organizational reforms. Similarly, as the likely new head of the Appropriations panel that oversees foreign aid spending, Rep. Kay Granger (R-TX) has been known to be tight with the purse strings when it comes to development aid.

Buckle your seatbelts for what may prove to be a rocky ride for the U.S. international trade and development agenda. Today, more than ever, Obama needs our support to help him hold onto the reigns.

Are We Running Before We're Walking?

Researchers recently announced that they have discovered a medication that is highly efficacious in the treatment of the Ebola virus.  This is good news if you are one of the hundreds of people who are likely to get this virus in the next decade.  However, if you’re one of the 4,500 children in the developing world who will die of diarrheal disease in the next 24 hours, you may not view this as much of a triumph.

Ebola is sexy.  It passes the “bleeding out of your eyes test” so crucial for media coverage (that is, any disease that causes ocular hemorrhage tends to attract a good deal of mainstream coverage).  However, in terms of global health scourges, it doesn’t crack the top 10.

They probably won't get Ebola.

I don’t mean to be glib.  Anyone who has read the Hot Zone understands the graveness of an Ebola infection.  And Ebola’s penchant for devastation makes it a possible candidate for use in bioterrorism.  However, the drivers of death rarely make for compelling narratives, nor do they receive the funding they deserve.  The list of leading causes of death throughout the world includes many diseases that shouldn’t be fatal or shouldn’t occur in the first place.  Pneumonia (#3 worldwide, #1 in low income countries) is usually treated without hospital admission in America.  Ditto for diarrhea (#5 worldwide, #3 in low income countries).  Measles (#16)?  We average 56 cases a year in the U.S.

These diseases have at least one thing in common: there are vaccines that reduce (but do not eliminate) their incidence.  These vaccines are cheap, effective, and widely available in the developed world.  But vaccination requires more than vaccines;  an effective inoculation campaign relies on primary care infrastructure- both physical and human.  Want to give vaccines?  You probably need a clinic where patients can go.  That clinic needs doctors and nurses to administer the shots.  And electricity to keep the vaccines cold and unspoiled.  A medical records system would be helpful to keep track of who is due for their vaccines.  And, should someone get sick in spite of all of this, the clinic can serve as an early point of intervention where antibiotics or oral rehydration solution could be dispensed.

Ensuring that the health needs of the industrializing world are met requires a concerted effort to build capacity, not a scattershot approach targeted at the rarest and most shocking diseases.  Vaccines, health care workers, clinic construction, antenatal care, water and sanitation.  This is an argument I will return to time and again (and one made quite convincingly by Laurie Garrett) and you may even begin to agree with me.  But will you agree when I argue in my next post that overfunded HIV interventions are jeopardizing the very infrastructure I'm calling for?

Welcome to MethodLogical

I want to start by making one thing clear: This wasn’t my idea. The credit there belongs to Andrew, a fellow MethodLogical contributor. But one thing I’ve learned through my experiences in my most-nascent career as a global health researcher, is that ideas are merely the beginning. Necessary, no doubt, but hardly sufficient. It is only through the systematic execution of ideas that knowledge can be found and progress made. Andrew had a great idea, but now it’s up to all of us—the MethodLogical team—to execute and produce a great blog.

I offer this example because it is core to the mission of this blog. We are a group of young individuals who share a vision of global health equity and sustainable development. While we could hardly be called “dispassionate,” we strive to be objective evaluators of evidence. There may not be one correct way to reduce diarrheal disease, to build roads, or to increase access to credit, but there are correct ways to evaluate these ideas. We will go beyond the conclusions reported in article abstracts and on cable news channels, in an effort to understand and illustrate the implications of research, global events, and daily occurrences.

In our posts, you will see analyses of the current research in the fields of global health and development and a vigorous debate of ideas. We will tackle current events and attempt to appraise the impact of elections, new laws, and even weather. We also will share some of our experiences working abroad and comment on the various projects we are undertaking. We will not always agree with each other and, perhaps, that will be where we have the most fun.

Some of us are researchers, some of us are policymakers, and some of us are practitioners. Many of us are students. What we share is a fierce sense of social justice and bit of a sense of adventure. We strive to be creative and innovative in finding solutions to those challenges facing the developing world. And we demand rigor in evaluating those ideas.

In the coming months, we will post on the blog (hopefully daily), with rotating contributors offering their unique perspectives. We hope you join us and read this blog. And we hope you join the debate. Otherwise, this was nothing more than a good idea.

Meet Your MethodLogical Contributors

Danika Barry has a BA from the University of North Carolina at Chapel Hill, and is currently a first-year MPH student at Emory University. She has worked with the Jamkhed Comprehensive Rural Health Project in India and the Kyetume Community Based Health Care Programme in Uganda. She is interested in community-based primary health care, implementation science and continuous quality improvement. Her passion is how to engage with community-empowering approaches which can effectuate "just and lasting change" at scale.

Ben Elberger currently works at Kiva.org, a microfinance lending platform, as the Regional Director for Anglophone Africa and South Asia. While linguistically impaired and working on his Swahili, he's lucky to be surrounded by a team of three field staff who work with him to conduct due diligence on microfinance institutions and evaluate partners' social performance. Ben was previously a Microfinance Partnerships Manager and Microfinance Partnerships Coordinator with Kiva joining the team in early 2006. Prior to Kiva, Ben was a research assistant at the Center for Global Development where he worked with research fellows investigating the impact of International Monetary Fund programs on developing country health spending and on the political dynamics of the global health agenda. Ben graduated from Stanford University with a B.A. in Public Policy, lives in San Francisco, and is originally from New York. He was once a Mets fan but his heart can no longer take it.

Andrew Goldstein is currently pursuing an MPH at the Harvard School of Public Health with a concentration in Global Health as part of the Reynolds Fellowship program in social entrepreneurship and an MD at the Mount Sinai School of Medicine. His career is focused on the development of delivery systems for health and development services in developing countries. Andrew has worked with community-based health and development organizations like the Millennium Villages Project, the Comprehensive Rural Health Project in Jamkhed, India, and now with Tiyatien Health in Liberia. This work has focused on community health worker training, management capacity, information systems, and operations and with Sana Mobile. His work with Sana is focused on developing training materials for implementing partners that enable them to setup Sana, train their team, and use our technology to enhance their services. Andrew is also on the Student Advisory Committee for the Global Health Education Consortium and he has worked with Mount Sinai's Global Health Center on curriculum development. Andrew is looking to embark on a career focused on building comprehensive, quality, scaled-up health services in resource-constrained settings.

Jason Hopper graduated from Stanford University with a B.A. in Science, Technology, and Society with a focus in Development. He is pursuing a PhD in Anthropology from the University of Wisconsin-Madison. His research interests include development studies, political economy, political anthropology, South Asia and the Himalaya, and religion, particularly Buddhism. Currently he is teaching Sociology at Royal Thimphu College in Bhutan while doing pre-dissertation research. Last summer he did preliminary research investigating how the monarchy in Bhutan is transforming a traditional gift-giving practice into a modern, state welfare program and is currently beginning to look into youth and modernization in Bhutan.

Jason Kerwin is a second-year graduate student in the Department of Economics at the University of Michigan, where he is pursuing concentrations in development economics and labor economics. He is also a Student Associate at Michigan's Center for Global Health and an Economic Demography Trainee at the Population Studies Center. Jason completed his M.A. in International Policy Studies at Stanford University, where he also received a B.S. in Physics and a B.A. in International Relations. His research focuses on health care and behavioral economics in the developing world.

Adam Schwartz is a medical student at the Mount Sinai School of Medicine. Currently on scholarly leave, Adam is living in Gaborone, Botswana investigating health systems-related treatment delays in patients with HIV and tuberculosis. Adam is also working to determine the potential of using telemedicine to meet radiology needs in resource-constrained settings. A graduate of Stanford University, where he majored in social change policy, Adam also has worked in South Africa and rural India. Adam’s principal interest is the development of sustainable primary care infrastructure in industrializing nations. Originally from Philadelphia, Adam will stand by his Phillies whatever may come.

Seema Shah is a final year MD/MPH candidate at Emory University. She has spent several years in India now, doing research/work in women's health, traditional medicine, CVD/diabetes prevention, and youth ultimate frisbee coaching with NGOs (CHETNA, Matrika, Manav Sadhna, Manzil) and academia (Public Health Foundation of India, Delhi). Seema will be continuing her training/career in community-preventive medicine with a focus in mental health, making her way back to India whenever possible. She hopes to eventually settle there and spread the joy of ultimate frisbee as a means to good health and happiness.

Pam Sud is currently a Harvard Kennedy School / Harvard Business School joint MPP-MBA degree candidate. Prior to Harvard, she worked at the World Bank as a Junior Professional Associate in the Latin America & Caribbean region’s energy group. Her project work included preparing a nationwide energy efficiency program in Mexico, exploring renewable energy development potential in Central America, and analyzing low-carbon growth strategies for Brazil. Pamela has also designed and implemented a field research initiative in Punjab, India, evaluating alternative primary schooling options for child labor communities in northern India. Her fieldwork served as the basis for her Stanford honors thesis and first peer-reviewed publication, "Can Non-Formal Education Keep Working Children in School? A Case Study from Punjab, India". Pamela plans to shape her career in international economic development through integral partnerships between the public and private sectors.