Adjustment with a Human Face – UNICEF in Eastern and Southern Africa
The Bretton Woods response to the debt-distressed countries of Eastern and Southern Africa in the late 1980s involved the imposition of “Structural Adjustment Programmes” as conditionalities for new low-interest loans. These “SAPs” – which were subsequently shown to be detrimental to long term economic growth - entailed major reductions in government spending on already-meagre basic services for children. They also entailed the freeing (and soaring) of market prices for food and other basic goods. The World Bank, which worked in formal agreement on SAPs with the International Monetary Fund, also made the introduction of user fees for routine health services a mandatory part of the package. This was put forward on implausible grounds of providing an efficient revenue-raising mechanism for the health system and imagined that there was “excess demand” among women and children for these services.
UNICEF staff in ESAR countries such as Mozambique and Zambia were horrified by these conditionalities which had immediate, negative impacts on families in poverty, including their ability to buy food and afford clinic visits. We began to lobby for “safety nets” to mitigate the effects on family budgets, including in Southern Africa, where, as documented in the “Children on the Frontline” series, child death rates had already soared as a result of the destabilizing actions of apartheid South Africa. These efforts were guided by and became part of the HQ-led “Adjustment with a Human Face” initiative (see article by Richard Jolly).
The first Regional Economic Advisor in ESAR was recruited in February 1992. The post was later handed over to the wonderful Ethiopian economist, Eshetu Chole. Together with other colleagues in the Regional Office, we developed a network of UNICEF staff and a few economists in African universities which produced analysis and advocated for the restoration and expansion of government spending on basic services for children, including social safety nets (later called “social protection”). This was linked in turn to improved monitoring of child wellbeing indicators and the introduction of multiple indicator cluster surveys (MICS), which enabled us to highlight and where necessary dramatize the situation of children. The ESAR network collaborated during the 1990s with a similar multi-office grouping led by WCARO.
Our work on the consequences for children of economic choices was spurred initially by the recognition by the World Bank, at global level at least, of the legitimacy and importance of safety nets for those impacted by Structural Adjustment. Unfortunately, the position of the 1990 World Development Report on the multi-facetted nature of “Poverty” was not widely reflected in Bank operations at the country level in Africa.
However, doors were opened more widely by the 1990 World Summit for Children’s commitment to the development of national plans of action (NPAs) for Children. UNICEF successfully lobbied for the ratification by African Governments of the Convention on the Rights of the Child. As governments ratified, we followed up with extensive support to the formulation of NPAs which would give weight to these new obligations through expanded investments in children and move towards the World Summit targets. Crucially – although we could have done more on this - the Plans of Action were linked to increases in budgets for the social sectors through basic costings. This in turn spurred a routine practice for UNICEF CO’s of “keeping an eye” on trends and changes in social sector budgets, and including some analysis in their Annual Reports. In a few cases, we produced detailed budget analysis or participated in Public Expenditure Reviews led by the IMF.
By 1992, ESARO and NYHQ had also worked successfully with the Organization of African Unity to hold a high-profile conference on “Assistance to Africa’s Children”, backed by a 2-volume advocacy report with sector costings for continental spending: “Africa’s Children, Africa’s Future”. This created further momentum for policy advocacy at country level for investing in children.
The 1990s were also the first decade in which HIV and AIDS led to devastation in Africa. UNICEF’s responses included an economic element, promoting the expansion of cash and in-kind transfers to orphans and other children made more vulnerable by the Pandemic. This drew on African experience with income and livelihood support in response to drought, famine and conflict in ESAR, and brought these transfers closer to the policy ‘mainstream’. ESARO produced a series of reports on safety nets in the Region, noting how higher-income countries such as Botswana, Mauritius and newly-democratic South Africa had entrenched these in their policies and budgets, and providing ‘back of envelope’ costings to encourage lower-income countries to make more substantial efforts to provide income support to highly vulnerable children and families. We also worked in a few cases, including Madagascar, to secure debt swaps that would result in better funding of social sector programmes.
A final effort during this period to increase the effectiveness of UNICEF advocacy for adequate and sustained public spending on children involved a partnership with UNDP (and eventually others), inspired by NYHQ – the “20/20 Initiative”. This proposed that at least a fifth of the national budget (including at sub-national level) and at least a fifth of international aid to developing countries, should be spent on basic services to benefit children. UNICEF worked with UNDP on a detailed definition of these services and, in ESAR, we introduced this benchmark into our advocacy with governments and donors on their spending plans.These were some of the initial steps, from one Region, that formed part of a global effort. Born in part from a “defensive” response to the Structural Adjustment and fiscal stabilization efforts of Bretton Woods agencies in the late 1980s, it grew into an increasingly confident and well-evidenced promotion of “investing in children … to the maximum extent of available resources” as a central part of promoting equitable, human development and the rights of all children. It thus combined an empirical and an ethical approach, in response to Julius Nyerere’s question, “Should we let our children starve to pay our debts?”. It attracted increasing rhetorical support from Governments at the UN and helped established new norms for budget decision-making. It also enabled UNICEF to claim legitimacy with Governments and international actors as an advocate and provider of analysis for child-focused, rights-informed economic policies, in what is now known as our global “Social Policy” networks, role and capacities.
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