Volume 3 - Issue 2, September 2004

Printed Version [adobe pdf]

In this issue:  The World Bank’s new Country Strategy  Bank Shift to Development Policy Lending  Bank calls for stronger leadership to fight AIDS  Dialogues in Development  Events  Project News  Forthcoming Events

The new Strategy provides an update on India’s economic and political situation since the last full CAS (which was discussed and endorsed by the Board in 2000), assesses India’s development priorities in the context of India’s own poverty reduction strategy as reflected in its Tenth Five-Year Plan, and proposes a strategy for the Bank’s work in India in the coming years. 

“This Country Strategy sets out how the World Bank Group proposes to build a growing partnership with the Government of India during fiscal years 2005-08 – a critical period if the MDGs are to be met,” said Mr Michael Carter, the Bank Country Director for India. Assisting India, home to over one-quarter of the world’s poor (some 260-290 million people), with best practice knowledge and financing for development are central to the Bank Group’s mission to help reduce global poverty, he added.

After extensive discussions with government officials as well members of civil society, the Bank has zeroed in on three Strategic Principles to achieve this enhanced impact: 

 Focus on Outcomes: to ensure that all of the work of the Bank Group is explicitly geared towards supporting India’s achievement of its development goals;

 Selectivity: to target limited resources to activities where assistance is welcomed and where contributions can also be the most effective;

 Knowledge: to generate and provide knowledge that can be realistically applied.

In applying these Strategic Principles, the Bank is seeking a substantial increase in its volume of lending to India. Given the enormous needs, the strategy has identified three program priorities:

 Support efforts to improve government effectiveness

 To invest in people and empower communities

 To promote private-sector led growth

In line with these priorities, the Bank’s program expansion will primarily be in the following sectors: infrastructure (roads, transport, power, water supply and sanitation, irrigation and urban development – to underpin both accelerated growth and improved service delivery); human development (education, health, social protection – priorities to support specific MDGs); and in  rural livelihoods (with an emphasis on community-driven approaches).

Scaling up will require a strengthened program at the national level, including more lending compared to recent years. An important shift is the greater recourse to co-financing with other development partners under common arrangements for national programs in the areas most critical to meeting the MDGs, including using the new ‘sector-wide approach’ (SWAp) concept. Using such means, the Bank will seek to step up its national level engagement and work more closely with development partners.

This strategy also proposes some important shifts in the approach to India’s states. Since 1997, the Country Strategy has included a focus on states undertaking comprehensive reforms. With the widening gulf between reforming and non-reforming states, some shifts in this approach are warranted. These include:

 First, in consultation with the Government of India and other partners, the Bank will seek to ensure that all of the largest and poorest states of India that so wish are engaged in a dialogue on cross-cutting reforms.

 Secondly, the Bank will work proactively to try to build a productive development relationship with four states where poverty is increasingly concentrated in India – Bihar, Jharkhand, Orissa and Uttar Pradesh. 

 Thirdly, state-level adjustment lending operations aimed at supporting achievement of the MDGs, are also expected to remain an important part of the Bank program. 

 Fourthly, instead of concentrating on ‘focus states’, investment lending will be channeled more broadly to states that are able to comply with new ‘guidelines for engagement’ for the relevant sector. These guidelines attempt to clearly set out the sector-specific conditions that experience has shown to be necessary for project success.

For the Bank, global knowledge support – policy dialogue, analysis, technical assistance and advisory services – will be re-focused to better support the Program Priorities. The strategy envisions enhanced analytical work on emerging issues of national interest, as well as strengthening demand-driven responses by the Bank.  

The Country Strategy also proposes a new way of looking at IBRD lending. Rather than establishing low or base case scenarios for Bank lending, and structuring triggers to shift from one case to another, the Bank program will fall within a range limited by an upper bound for IBRD lending (US$2.15 billion per year on average). Getting to this upper bound will require strong reform performance as well as a strengthened pace of project preparation. 

IFC, meanwhile, will continue to provide equity and loan financing and guarantees. This will include pioneering investments in infrastructure where innovative structures and long tenors are required; and investments in projects which are constrained by limited risk appetite of other investors, including medium-sized manufacturing companies, agribusiness companies and companies entering new markets domestically and internationally.

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Bank Shift to Development Policy Lending

Over recent years, one of the most common instruments with which the World Bank supports developing countries has been the ‘structural adjustment lending’ program. The term structural adjustment usually referred to broad economic reforms -- supported by Bank financing -- designed to strengthen the structure of a country's economy. This kind of lending was particularly prominent during the financial crises of the mid- and late 1990s, when large loans were provided to countries struggling to avert financial calamities -- they were designed both the stave off further crisis, and also to address the fundamental problems at heart of the financial or economic emergency.

The Bank’s recent experience has shaped the evolution of structural adjustment lending, and it has tried further to refine the approach by consulting widely with governments, community representatives, academics and civil society groups. The result is a move to what the Bank now calls ‘development policy lending’.

At the heart of this approach is the recognition that there is no single blueprint for reform that will work for all countries. The key to any approach, however, is that the strategy is designed and undertaken by the country itself, with the support of those groups the government is seeking to help. Additionally, development policy lending differs from structural adjustment lending by disbursing funds only after reforms are in place, rather than on the promise of reform alone.

To get more information on this evolution and change in lending approach, go to the World Bank home page at http://www.worldbank.org.

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Bank calls for stronger leadership to fight AIDS

The World Bank, at the 15th International AIDS Conference in Bangkok in mid-July, made a call for stronger leadership in countries like India to overcome the HIV/AIDS epidemic.

The Bank, which is the largest financier of HIV/AIDS programs in South Asia, joined the rest of the international AIDS community at the Conference in drawing attention to the fact that India could face a full-blown AIDS epidemic if concerted action isn’t taken. India is estimated to have 5.1 million people infected with HIV/AIDS, making it the second highest infected country in the world, after South Africa.

"Even if the rate of prevalence (in India) seems low, the absolute number of people is high. If left unaddressed, the proportion can rise very rapidly," said Mr Praful Patel, the World Bank's vice-president for South Asia.

He went on to stress the need for political leaders “to take a stand -- to declare and act upon a commitment to steer their countries clear of the trap of inaction and denial.”

The Bank’s message was echoed in the Leadership Program of the Bangkok Conference, which brought together leaders committed to fighting the global AIDS epidemic, including, Mr Nelson Mandela from South Africa and Mrs Sonia Gandhi from India.

 “I have seen people who have lost jobs and who have been ostracized, and orphans not adopted because of the stigma, and I have seen people fading away in front of their helpless families,” said Mrs Gandhi.  She asked “those who have the power to act”,  to think of those affected not as HIV/AIDS patients, but as men, women, children, brothers and sisters.

Mr Mandela made a plea to world leaders to treat the issue as a top priority.  “There has never been a greater threat in the history of mankind,” he said, stressing that the kind of leadership needed to overcome the epidemic requires personal commitment, clear vision and  imaginative action. He urged countries to give more financial assistance, in particular to the Global Fund to Fight Aids, Tuberculosis and Malaria.

The Bangkok Conference was attended by nearly 17,000 delegates from over 100 countries, representing the spectrum of the global HIV/AIDS community, including people living with HIV/AIDS, world leaders and medical experts, as well as field development workers. 

The Conference brought forth some chilling facts about AIDS in India: Over five million people in South Asia are infected with HIV/AIDS; 90 percent of them live in India. The World Bank has long been on the frontline of the fight against AIDS in India. It helped set up the India National AIDS Control Organization (NACO), a semi-autonomous organization under the Ministry of Health and Family Welfare responsible for the National AIDS Control Program. The Bank has, since 1991, made US$275 million available for NACO’s programs.

The Second National HIV/AIDS Control Project, funded primarily by a $191 million credit from the World Bank, is now helping decentralize the program to the state level. This Project envisages a partnership between NACO, the NGO community and various state AIDS control societies that will ensure that AIDS programs can be designed and implemented at local community levels.

At the Delhi State AIDS Control Society, Project Director Mr Arun Baroka says HIV/AIDS is not just a health issue. “If we are to tackle the epidemic effectively, all government programs – from infrastructure to education projects – must integrate a HIV/AIDS component,” he adds..

With heterosexual transmission representing around 85 percent of HIV infections in India, and the epidemic spreading from high-risk groups to the general population, more resources are being invested in information, education, and communication. As part of this effort, the World bank and the Association of Indian Universities launched a campaign in 2003 aimed at fighting HIV/AIDS among youth.

For more information about the World Bank’s work on AIDS in India, please visit www.worldbank.org/saraids

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Dialogues in Development

Presentation/Ten Steps to a Results-Based Monitoring and Evaluation System: Handbook for Development Practitioners, by Jody Zall Kusek and Ray Rist

“Monitoring and Evaluation is all about asking the question – ‘What are we doing with OPM’?”. The handful of development practitioners in the room looked nonplussed at this poser thrown by Dr Ray C Rist, a World Bank Senior Evaluation Officer and co-author of the Bank’s bestselling book, Ten Steps to a Results-Based Monitoring and Evaluation System: Handbook for Development Practitioners. “OPM,” repeated Dr Rist dramatically, “Other People’s Money.”

The light-hearted take on the weighty issues of transparency and accountability set the tone for the presentation on the book organized by the Bank’s just-refurbished Public Information Center. More than 80 members of the development community, including representatives from government, academia, NGOs and the international donor agencies gathered at the New Delhi office on June 30 to have Dr Rist walk them through the basics of setting up an M&E system.

Stressing the importance of M&E as a strategic tool for organizations, Dr Rist said it was as vital an organizational tool as budgets and staff appraisals. “We in the development community don’t talk too much about the consequences of our actions,” he said. “An effective M&E system can help assess the impact of our development assistance and make course corrections if needed.”

International experience has shown that the setting up an effective results-based M&E system hinges on two key elements -- the political will within an organization to change and its technical capacity to do so. “A good M&E system is a profoundly political act because it is intended to surface your organization’s chronic problems so that you can fix them,” said Dr Rist.

Thus, the key elements needed for initiating a new results-based M&E system are a clear organizational mandate for change and the leadership’s will to carry the change through. This, in turn, involves the availability of reliable information and links to budget and resource allocation. In order to gain the widest participation and ownership for setting up the new paradigms, the rational and incentive for change must be totally clear. . The involvement of civil society, a participatory process and the use of pilots help broaden the support base.

Dr Rist, who spent 15 years working in the US government before coming to the Bank, spoke of the spreading phenomenon of M&E systems in developmental governance. Results-based monitoring systems are written into the Constitutions of Austria and Sweden; the United States has its Government Performance Regulatory Act; and even non-OECD countries like Sri Lanka, South Africa and the Kyrghyz republic are setting up their own M&E systems.

The audience’s level of engagement with the subject was evident in the latter half of the session when questions flew thick and fast. Answering a development consultant’s question about the difficulty of monitoring and evaluating long-term development projects where outcomes only become visible several years down the line, Dr Rist said, “M&E is all about measuring well and measuring continuously.” The monitoring and evaluation continues through the lifecycle of a project, though the indices might change –  if it is processes being checked at one point, it is the systems being evaluated at another and outcomes at yet another, he said. Other questions touched on the relative merits of independent evaluation versus internal evaluation and the difficulties of evaluating qualitative outcomes.

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Events

Abilities Mela
July 22-25

The Abilities Mela, 2004 centred on the theme ‘Promoting Inclusive Opportunities’, was organized by the Business and Community Foundation from July 22-25 at the Blind Relief Association in New Delhi. Apart from a display of products – ranging from handicrafts to textiles -- designed and made by differently-abled people, the Mela included several seminars and workshops on product design, marketing information, employment opportunities for the disabled.

The Mela, organized with financial support from the World Bank under its Small Grants Program, was inaugurated by Mr. Sunil Dutt, Union Minister of Sports and Youth Affairs. Mr Michael Carter, the Bank’s Country Director in India was the Special Guest. The Business & Community Foundation is a not-for-profit organization established in New Delhi by Indian and International companies in association with the Prince of Wales Business Leaders Forum, UK. Several organizations such as the National Handicapped Finance and Development Corporation, Muskaan, Mesh, Bhartiya Yuva Shakti Trust, ASRA Foundation, Aradhana and Samarthya were among the nearly 60 participants in this fair. 

Workshops held along with the Mela included one by the International Labour Organisation on employment areas for differently-abled people and by the National Institute of Design and the National Institute of Fashion Technology on product design, development and diversification, as well as on packaging and marketing.

Speaking on the shift in perception of disability both globally and within the World Bank, Mr Carter said, “Disability and Development is gaining ground as a new area of focus. The traditional view of medical and rehabilitation models -- prevention, cure and intervention -- is giving way to a social model that looks at disability as a socio-economic construct.” Delineating the Bank’s work on the subject, he said that the organization supports a range of national programs with direct bearing on prevention of disability, including Leprosy Eradication, Blindness Control, and Universal Immunization. The Bank’s other development projects also contain significant disability components.
 
Press Conference – Global Forum on Business Incubation
August 11

A Press Conference to launch the Global Forum on Business Incubation was held at Federation of 

Indian Chambers of Commerce and Industry (FICCI) on August 11. The Minister of State for Science and Technology, Mr. Kapil Sibal, the FICCI President, Mr. Y.K. Modi, and the Bank’s Operations Adviser in India, Mr Rachid Benmessaoud, addressed the media.  The Secretary, Department of Science and Technology, Prof. V.S. Ramamurthy, and Secretary, University Grants Commission, Prof. Ved Prakash were also present.

The Department of Science and Technology, together with the InfoDev Program of the World Bank Group & FICCI, is organizing the Global Forum on Business Incubation on October 14-19. The seminar, based on the theme ‘Creating Conditions for Innovation’ is intended to share best management practices of incubator management.

Report/ HIV/AIDS Treatment and Prevention in India:  Costs and Consequences of Policy Options,
August 13
>>>read the report

 As the Government of India takes stock of its first four months of distributing free antiretroviral medications for HIV/AIDS, the World Bank has released a study of various public funding options for the months and years ahead, designed to help the government maximize the positive impact of the drugs on the growing epidemic. 

The study, HIV/AIDS Treatment and Prevention in India:  Costs and Consequences of Policy Options,  focuses on ways the government can provide sustainable antiretroviral therapy (ART) to the greatest number of people while avoiding dangerous pitfalls such as the development of drug-resistant strains of HIV and a surge in risky behavior by people who mistakenly assume the drugs are a cure for HIV/AIDS. “India must accept the challenge of treatment, take advantage of its national wealth of pharmaceutical and public health expertise and of the proffered assistance of international agencies,” wrote J V R Prasada Rao, Secretary, Health, Ministry of Health and Family Welfare, India, in the foreword to the publication.  “…using these resources, it must extend a therapeutic hand to its AIDS patients,” he said.  However he advises against the improper use of the medications which could have negative effects.

According to the study, the country needs to collect better statistics on the current state of the epidemic to improve the accuracy of planning exercises, such as the public provision of ART.  It also advises that improperly administered ART could have negative “spillover” effects such as resistance to drugs or lack of effectiveness due to failure to take the medication properly. 

It suggests that efforts should be made to improve the quality of ART currently being provided by the private sector and to evaluate the costs and effects of alternative ART programs to identify which modes of treatment maximize patient adherence to a drug regimen in India.

The report stresses the importance of continuing to scale up measures to discourage high-risk behavior, such as sexual relations with multiple partners, failing to use condoms, and injecting drugs with shared needles, which in some other countries have been shown to increase once ART became available and fear about contracting HIV/AIDS subsided.

“If energy and resources for prevention start to decline, the results would be a reversal in progress made in fighting the epidemic in India,” said Peter Heywood, World Bank Lead Health Specialist and one of the main authors of the study.

“ART is a medical breakthrough and it can improve quality of life for those infected, but it does not cure HIV/AIDS.  In many cases drug resistance develops or the drugs fail because patients do not have proper medical supervision to stay with the regimen.  HIV positive people are also more likely to develop opportunistic infections which attack their weakened immune systems even if they are taking ART,” explained Heywood.
 
The Government of India had requested the study as it considered how to begin providing the medications as part of public health services.  Consultations with others involved in fighting the HIV/AIDS epidemic have strengthened the study’s recommendations.

Visit/ Suas Education Development
July 29

A group of volunteers/young leaders from Suas Education Development, Ireland, an international NGO visited the Bank and were given a presentation on the Bank’s work in India to bring about sustainable poverty reduction. They also visited a Bank-financed health project in Delhi. 

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Recent Project Approvals

Integrated Disease Surveillance Project
July 8, 2004

A US$68 million credit to the Government of India was approved for the Integrated Disease Surveillance Project.  This project will help to improve the information available to the government health services and private health practitioners  on a set of high priority diseases, such as Malaria, Tuberculosis and HIV/AIDS,  as well as other common risk factors for these diseases.  This credit aims to expedite action and the response to threats arising from these diseases.
>>>learn more

Hydrology II Project
August 24, 2004

The World Bank approved a US$105 million loan for the phase II of the Hydrology Project. This which will extend and promote the sustained use of the Hydrology Information System by all potential users -- both public and private -- concerned with water resources planning and management. This System is expected to improve the productivity and cost-effectiveness of water-related investments in 13 states and central agencies of India.

This credit will enable the Hydrology Project to be cover four more states -- Goa, Himachal Pradesh, Pondicherry and Punjab -- and two central agencies, the Central Pollution Control Board and the Bhakra-Beas Management Board.
>>>learn more

New Project Signings

The Uttaranchal Decentralized Watershed Development Project was signed at the Ministry of Finance on July 30.  Dr. Ranjit Bannerji, Joint Secretary in the Department of Economic Affairs, Ministry of Finance, signed on behalf of the Government of India. The Country Director in India, Mr. Michael F. Carter, signed on behalf of the World Bank.  Mr. B P Pandey, Secretary, Forest and Watershed Development, Government of Uttaranchal, signed on behalf of the Government of Uttaranchal.

Forthcoming Events
Workshop on “Reaching out to the Child : An integrated approach to Child Development”  (22 September 2004)

A workshop is planned to be organized to disseminate the findings of a report on "Reaching out to the Child - An Integrated Approach to Child Development" sometime in September.    The report is about Indian children and their development. It focuses on their physical, social, emotional, intellectual and educational development, and probes into the status of Indian children given an ideal framework for their development.    In the context of the status of the Indian child, policies for them and the spending on them, the report identifies certain salient issues emerging on the way of child development and proposes the way forward to ensure optimal development of children.

Workshop on Procurement procedures for World Bank aided Projects
(27 September- 8 October)

The Administrative Staff College of India (ASCI), Hyderabad  is organizing a program on procurement procedures for The World Bank-aided projects from September 27 to October 8. The program is supported by the Bank’s New Delhi Office by provision of faculty and training materials. Contact person: Dr. B S Chetty, Program Director. Fax: 91-40-2332 4365 and 91-40-2331 0952; E-mail: bschetty@asci.org.in and poffice@asci.org.in.