guardian.co.uk,
Sarah Boseley, health editor, in Washington, Wednesday 25 July 2012
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Jim Yong Kim, president of the World Bank, speaks at the opening session of the International Aids Conference in Washington on 22 July. Photograph: Jacquelyn Martin/AP |
The new president of the World Bank is determined to eradicate global poverty through
goals, targets and measuring success in the same way that he masterminded an
Aids drugs campaign for poor people nearly a decade ago.
Jim Yong Kim, in an exclusive interview with the Guardian, said he was passionately
committed to ending absolute poverty, which threatens survival and makes
progress impossible for the 1.3 billion people living on less than $1.25 a day.
"I
want to eradicate poverty," he said. "I think that there's a
tremendous passion for that inside the World Bank"
Kim, who
took over at the World Bank three weeks ago and is not only the first doctor
and scientist (he is also an anthropologist) to be president but the first with
development experience, will set "a clear, simple goal" in the
eradication of absolute poverty. Getting there, however, needs progress on
multiple, but integrated, fronts.
"The
evidence suggests that you've got to do a lot of good, good things in unison,
to be able to make that happen," said Kim. "The private sector has to
grow, you have to have social protection mechanisms, you have to have a
functioning health and education system. The scientific evidence strongly
suggests that it has to be green – you have to do it in a way that is
sustainable both for the environment and financially. All the great themes that
we've been dealing with here have to come together to eradicate poverty from
the face of the Earth."
Kim, who
was previously head of the Ivy League Dartmouth College, is probably best known
for his stint at the World Health Organisation (WHO), where he challenged the
system to move faster in making Aids drugs available to people with HIV in the
developing world who were dying in large numbers. In 2003, he set a target of 3
million people being on treatment by 2005 – thereafter known as "3 by 5".
The target was not met on time, but it did focus minds and rapidly speed up the
pace of the rollout, which included setting up clinics and training healthcare
staff.
Now, he
says, he thinks he can do the same for poverty. "What 3 by 5 did that we
just didn't expect was to set a tempo to the response; it created a sense of
urgency. There was pace and rhythm in the way we did things. We think we can do
something similar for poverty," he said.
Asked if he
would set a date this time, he said he was sorely tempted, but would not yet.
"We don't know what they will be yet, but [there will be] goals, and
counting. We need to keep up and say where we are making successes and why, and
when are we going to be held to account next for the level of poverty. If we
can build that kind of pace and rhythm into the movement, we think we can make
a lot more progress," he said in his office at the Bank in Washington.
Kim was
seen by many as a surprise choice for president. During the election, critics
argued there should be an economist at the helm. Some said that, as a doctor,
he would focus too much on health.
But Kim,
who co-founded Partners In Health, which pioneered sustainable, high-quality
healthcare for poor people, first in Haiti and later in Africa, said his three
years at the WHO have been the only ones of his career that were solely devoted
to health.
"It's
always been about poverty, so for me, making the switch to being here at the
Bank is really not that much of a stretch. I've been doing this all my life and
we're in a bit of the spotlight because of the stuff we did in healthcare but
it was really always about poverty," he said.
Partners in
Health offered HIV and tuberculosis treatment to poor people in Haiti for the
first time. "We were trying to make a point. And the point we were trying
to make was that just because people are poor shouldn't mean that they
shouldn't have access to high quality healthcare. It was always based in social
justice, it was always based in the notion that people had a right to live a
dignified life. The good news is that this place – the Bank – is just full of
people like that."
Kim, who
has spent his first weeks talking to Bank staff with expertise in a huge range
of areas, strongly believes in the integration of all aspects of development,
and says the staff do too. He cites a new hospital Partners built in Rwanda,
which led to the building of a road to get there and then the expansion of mobile
phone networks in the area. "In a very real sense, we've always believed
that investing in health means investing in the wellbeing and development of
that entire community," he said.
Speaking to
the International Aids Conference in Washington this week – the first World
Bank president to do so – Kim told activists and scientists that the end of
Aids no longer looked as far-fetched as the 3 by 5 plan had appeared in 2003.
Science has delivered tools, such as drugs that not only treat but prevent
infection.
But the
cost of drugs for life for 15 million or more people is not sustainable, he
says. Donors are unlikely to foot the bill. Hard-hit developing countries have
to be helped to grow so they can pay for the drugs and healthcare systems they
need.
Kim would
like the highly active HIV community to broaden its focus. "We've had Aids
exceptionalism for a long time and Aids exceptionalism has been incredibly
important. It has been so productive for all of us," he said. "But I
think that as we go beyond the emergency response and think about the long-term sustainable response, conversations such as how do we spur growth in the
private sector have to be part of the discussion."
Every
country wants economic growth, he says, and people want jobs. "If I care
about poverty, I have to care a lot about investments in the private sector.
The private sector creates the vast majority of jobs in the world and social protection only goes so far," he said.
Nevertheless,
he is a big proponent of social protection policies. "I've always been
engaged in social protection programmes. But now it is really a signature of
the World Bank. We're very good at helping people look at their public
expenditures and we say to them things like, fuel subsidies really aren't very
helpful to the poor – what you really need is to remove fuel subsidies and
focus on things like conditional cash transfer plans. The Bank is great at
that."
New to him
are climate change and sustainability, he says. "We are watching things
happen with one degree changes in ocean temperature that we thought wouldn't
happen until there were two or three degree changes in ocean temperature. These
are facts. These are things that have actually happened … I think we now have
plenty of evidence that should push us into thinking that this is disturbing
data and should spur us to think ever more seriously about clean energy and how
can we move our focus more towards clean energy."
But poor
countries are saying they need more energy and we must respect that, he says.
"It's hard to say to them we still do it but you can't … I think our role
is to say the science suggests strongly to us that we should help you looking
for clean energy solutions."
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