“I thought, how do we let these things happen?” he said during a talk at Dalberg’s Washington DC office last Wednesday. “We need to create a world where human dignity is realized, and we don’t live with the illusion that we are solving the problem, when we are just pretending.”

His presentation, titled “Paradigm-busting Advocacy Strategies,” focused on his experiences over the past twenty years developing, promoting, and implementing programs for HIV/AIDS, child survival, reproductive health, and health systems development around the world. As Founder and former CEO of the Global AIDS Alliance, where he worked between 2000 and 2011, he played a critical role using advocacy to affect change. During this time, he saw The Global Fund to Fight AIDS, Tuberculosis and Malaria established, as well as the implementation of key policy changes in the US, including the creation of PEPFAR and an increased commitment from the Obama administration to treat six million people suffering from AIDS by 2013.

His strategy? Figure out what is needed and ask for it.

“We in the development business need to take a lesson from the Pentagon and say, ‘what do we need to get the job done?’” Dr. Zeitz said. “The AIDS movement is one of the only ones I know of that actually asks and demands what they need to solve the problem, and in this case, make AIDS history.”

However, despite many successes, with just one-third of the demand for lifesaving AIDS treatment fulfilled, challenges remain in the fight against the disease. In his current role as the Vice President of Policy for Act V: The End of AIDS, Dr. Zeitz is working to strengthen the AIDS movement, focusing on mobilizing the resources necessary to achieve universal access to AIDS medication.

This requires a shift in strategy: public and political perceptions around HIV/AIDS have changed dramatically over the past thirty years, and the movement’s opposition now argues that it is too costly to sustain funding for long-term treatment and prevention programs. Changing this perception requires relying on evidence-based policy making, which calls for balancing the tension between science and ideology.

With the rising popularity of celebrity spokespeople and social media outlets like Twitter and Facebook, advocacy efforts need to reconcile traditional tactics with these 21st century approaches. Additionally, advocacy needs to adapt to the changing global power dynamics and institutions.

“We’re moving from a G8 to a G20 world,” he said. “We’re still in an early phase of the transition, learning how to fully engage the 20, and many of these countries still need to master their own architecture before they can look at global development issues.”

Dr. Zeitz’s talk ended with a few words of encouragement.

“There are always challenges that can block you from achieving paradigm-busting advocacy goals,” he said. “For example, this year President Obama is proposing that PEPFAR’s budget be cut by 12%, despite the fact that it’s helping millions of people, and is considered the most successful global health program the world has ever seen.”

Dr. Zeitz said that although paradigm-busting advocacy can be successful, some gains may be short-lived and will always be challenged. Advocates must be bold, strategic, and relentless in the pursuit of ambitious goals that others don’t think are possible, and gear up to overcome each and every challenge.

Dr. Paul Zeitz visited Dalberg’s DC office as part of D. Talks, an ongoing leadership series that seeks to bring together the development communities in each city where Dalberg is located.

The following is an excerpt from “Fund This, Not That: Ideas for Improving Investments in Global Development,” a Dalberg Global Development Advisors compendium released this week, available here.

In global development, good intentions are no longer enough. The idea that aid for poor people in foreign countries is simply altruism or charity has all but vanished. Today we understand that every program, every initiative, every partnership is an investment in a shared future. And we expect results.

"Fund This, Not That" was released earlier this week.

The question is, how do you do it? How do you change processes and mechanisms that have evolved over decades, in order to make organizations more accountable and maximize the impact of every dollar? In some cases, it only takes a willingness to adapt to new thinking or methods – a better way of doing things. In others, it involves difficult tradeoffs in the deployment of time and resources.

There is plenty of room for innovation here, and Dalberg is convinced of the value of trying new approaches. In this spirit, we asked some of our staff to offer their insights about the future of development: what to think about before taking on a new challenge, how to target and structure a new investment, and how to foster accountability for measurable results. Contributors from seven of our practice areas answered these questions in a variety of contexts, emphasizing the choices that need to be made at each stage. Together, they’ve offered a basket of ideas for a new kind of global development. We hope you’ll join us as we try to turn them into reality.

In a new report called The New Global Health Agenda: Universal Health Coverage, Dalberg and the Council on Foreign Relations discuss the rising of support for universal health coverage (UHC) in developing countries, citing the implementation of various schemes in China, India, Rwanda, and Mexico. The report speaks to the shift in global health priorities from combating specific diseases to the overall strengthening of health systems, of which health coverage is an important component.

Dalberg Project Manager Oren Ahoobim

“By increasing and diversifying the risk pool, UHC programs can reduce the financial burden of ill health and increase the use of formal health care,” said Oren Ahoobim, a Dalberg project manager who contributed to the report.

Oren said that UHC is particularly critical for low-income households around the world who may be “one illness away from bankruptcy.” UHC programs can lower costs for users, which will increase utilization and, it is hoped, improve the health status of the population.

“When implemented well, UHC schemes can ultimately make the overall health care system more sustainable,” he said.

According to the report, UHC schemes need to be tailored to the countries where they operate to be effective. Often this means that countries working with limited resources prioritize different things, such as what services to cover and how much cost to absorb.

The impact a UHC scheme will have on a household varies depending on these choices. For example, if a country chooses to fund its program in part through deductibles, households will still need to pay fees to receive healthcare, which in some cases may still discourage people from obtaining services.

However, the report says that costs such as these are small when compared to the benefits of implementing an effective UHC system, both at the household and country level.

“There are significant societal benefits that extend well beyond the narrow benefits of healthier individuals,” Oren said. “It’s not easy to pull it off, but when you do, ultimately you bring about stronger and more resilient households. Health is an engine for much broader social and economic development.”

In 2011, the world produced more data than in all previous years combined. Collected through digital platforms such as social media, mobile phones, and other technologies, “big data” – or the massive amount of digital information that is created in real-time as a by-product of people’s activities and transactions globally – presents a unique opportunity for companies to understand what people want and how they think.

Robert Kirkpatrick, Executive Director of the UN Global Pulse, presents at D. Talks in New York

The Global Pulse team has discovered numerous examples in which this “new data” relatively accurately predicts trends in development issues, including the food prices, unemployment rates, and rise in conflict levels. For example, one of Global Pulse’s first data-mining research projects illustrated that changes in sentiment expressed by people in social media (particularly, blogs, online news, and discussion forums) can be a several-month leading indicator of unemployment spikes in the US and Ireland. However, a strong understanding of local context is essential to accurately correlating behavior changes captured with “new data” with economic trends. Global Pulse is establishing Pulse Labs in several countries around the world, including Uganda and Indonesia, which will serve as hubs for testing new techniques for collecting and analyzing new data sources that could be useful for development. These labs sit within UN country teams and work with a range of local actors, including governments, civil society organizations, and NGOs.

Mr. Kirkpatrick said that real-time data analysis is beneficial for the monitoring and evaluation of policies, programs, and projects in global development. Traditional M&E programs involve piloting a program several years and then analyzing results or reviewing existing metrics monthly or annually. ”New data” sources can be used to identify successes or challenges in real-time, allowing for immediate course corrections and program reforms.

This approach to data offers an opportunity for the private sector that Kirkpatrick called “Data Philanthropy.” Large private sector companies who own much of the valuable data can partner with development players such as the UN Global Pulse to share their data and coordinate on what type of information is captured. Since the data is used to better understand markets and influence policies, collaboration can benefit both development agencies and the private sector.

Mr. Kirkpatrick was Dalberg’s first D. Talks speaker, a new initiative that works to bring together the development community in each city where Dalberg is located. D. Talks aims to drive dialogue and critical thinking on global development issues and provide networking opportunities within the community.

Lily Lyman (Consultant), Angela Rastegar (Senior Consultant) and Dan Zook (Project Leader) are all based in Dalberg’s New York office, and serve as the New York D. Talks coordinators. For more information on the D. Talks program, contact lucy.mele@dalberg.com.

“One of the things you notice coming to a place like Mumbai is that there is a plethora of individuals and organizations all doing their part to contribute,” he said. “But I noticed very early on that there was very little awareness about the rising players in the space, especially those who are a few levels below the leadership.”

In an effort to become more familiar with his colleagues in the development space, Vinay, along with friends from UnLtd India and Dasra, decided to host an informal networking event, bringing together 20-30 individuals from the social impact sector for drinks and casual discussion about development last August.

Vinay Taylor is a consultant in Dalberg's Mumbai office

“There are annual forums that allow individuals to focus in on different issues, like energy access or clean water, but there isn’t anything happening at a higher frequency that allows individuals to engage in broader conversation,” Vinay said. “Think Social addresses this gap by inviting people to engage more often in a way that facilitates the free flow of ideas and enhances collaboration.”

Vinay said that by offering a venue for Mumbai’s development community to meet, people can stay up-to-date on activity in the space and find new ways to work together. Think Social is exploring the possibility of organized content, such as bi-monthly speakers and volunteer opportunities for members.

Currently, the organization has a member base of nearly 400 people in Mumbai, and Vinay hopes it will continue to expand and eventually reach other cities in India.

“The social impact sector is inherently collaborative,” Vinay said. “The more connections you can form, the more likely you are to see more collaboration happen at the micro and macro level, either here in Mumbai or elsewhere.”

For more information on Think Social and networking events in the Mumbai area, email thinksocialmumbai@gmail.com.

There are 783 million people around the world without access to safe drinking water, yet safe drinking water is a basic need for survival. Safe water also promotes good health, food security, energy security, and reduces incentives for conflict.

Over the past decade, access to water has gained traction as a development issue. In 2008, the UN General Assembly formally recognized safe and clean drinking water as a human right, and called upon states and international organizations to facilitate access for all. This put the ball squarely in the court of the public sector – but what role can the private sector play?

James Eustace is a consultant in Dalberg's Geneva office.

As part of a recent Dalberg engagement, we spoke with representatives from some of the world’s largest corporations to understand what they are doing to improve access to water in developing countries, and why they’re doing it. We learned that corporations approach this issue using 3 different models:

• Corporate Social Responsibility. Firms donate services or equipment to local communities to improve access.
• Business as usual. Firms focus on improving internal water efficiency, indirectly improving access to water for other users by using less of a scarce resource.
• Inclusive business. Firms provide water services to those at the bottom of the pyramid as part of a profitable, sustainable business venture.

Andrew Takawira, a Senior Programme Officer at the Global Water Partnership working throughout southern Africa, agrees that the private sector has an important role to play, but recognizes the barriers of working with those at the base of the pyramid.

“In developing countries, it is a challenge to expect full cost recovery from the poor,” he said. “Innovative mechanisms have to be developed that present a win-win situation. To date, innovative approaches in the private sector work best when companies assess water use in their value chains, and look to implement water catchment management to the mutual benefit of the business and local communities.”

Focusing on water sustainability along company supply chains can be hugely beneficial to local communities. However, achieving access for all requires a more inclusive approach to private sector water provision. Inclusive business means providing safe drinking water to low-income users at a price that is both affordable and commercially viable. This type of model offers the greatest potential to improve access in an economically sustainable way. However, success stories can be hard to find.

Companies face considerable challenges, particularly when asking consumers to pay for a free resource. Water provision services cost money, and often users are not willing or able to pay for them. Donors frequently subsidize service costs, but in order to move business models in the right direction, consumer perceptions must be changed.

Another barrier to economic sustainability is scale. From our work in impact investing, we know grant money can be effective at proving new business models as part of pilot projects. However, to expand operations, projects should be commercially viable. Water projects viable without grant funding have the greatest potential to scale up and improve access in the long run. To facilitate this transition and prove that water access business models can become commercial, some models are using a combination of subsidy and user payment.

Grundfos, a global water technology provider, is a good example of a company moving in this direction. The Grundfos Lifelink initiative manages several community water access programs in Kenya that blend public and private money to run a semi-commercial business model. Donor funding is used to invest in capital equipment, and revenue from user payments funds ongoing operations, maintenance, and community training. Additionally, the business model is adapted to meet local needs: in some markets, programs are run on a fully commercial basis, and in others, where ability to pay is lower, programs rely more heavily on donor investment.

The private sector can help increase access to water in several ways. Challenges to economic sustainability and scale up are considerable and water user perceptions are perhaps the biggest hurdle. However, a flexible approach like that of Grundfos can help move companies towards inclusive business and provide opportunities to improve access to water in an economically sustainable way.

Chris Denny-Brown is a consultant in Dalberg's New York office.

One of the most exciting global developments of the past twenty years has been the rapid progression of economic growth across the developing world. From India to Chile, living standards are on the rise. However, one need only glimpse at the smog hanging over cities in China or witness damage from deforestation in Nigeria to understand that this growth often comes with a price. Unchecked resource-consumptive growth models are reaching a breaking point worldwide. If we truly hope living standards will continue to rise for all, then we will need to develop new, less consumptive growth strategies.

This is precisely what Dr. Ashok Gadgil, Director of Environmental Energy Technologies at LBNL, had in mind when he came up with the idea for LIGTT. Dr. Gadgil is regarded as an innovative legend in his field, with a track record of successes including designing methods for extracting arsenic from drinking water in Bangladesh and developing fuel-efficient stoves in Darfur. Earlier this year, Dr. Gadgil was awarded the prestigious Zayed Future Energy Prize Lifetime Achievement Award, accompanied by a $500,000 cash prize to continue his work, providing some additional potential resources for the Institute.

Last summer, Dr. Gadgil and his team gave Dalberg the opportunity to assist in developing his idea. Our team conducted extensive interviews with funders, NGOs, policymakers and the private sector to fine-tune the value proposition, and helped hone a strategy that would enable the Institute to leverage the extensive resources and vast technical expertise of LBNL (+$650M annual budget; ~4,000 staff) to push its low-carbon innovations. Additionally, our team provided guidance on the optimal organizational structure, provided recommendations on necessary funding levels, identified high potential funders and high potential technologies, and provided a directional roadmap for the initial growth phases as the Institute gets off the ground.

Less than a year later, LIGTT has launched with substantial funding and a truly unique model to deliver transformative and sustainable impact to fuel the next generation of growth in the places that need it most. With its unique model, the institute is drumming up excitement in the development community and has already earned recognition from the White House for its innovative approach; I look forward to following the initiative, and anticipate many more innovations to come.

Project Leader Jane Kaggwa, Washington DC

She said pre-competitive collaboration, where private sector companies work together to overcome barriers along the value chain, is key to success in the region.

“The challenges in the agriculture value chain in Sub Saharan Africa are too big to be solved by any one entity, and as such, they can be a benefactor of pre-competitive collaboration,” she said. “This type of collaboration allows actors to distribute risk when operating in new environments while leveraging each other’s unique competencies. It has potential to change the agriculture sector in developing countries.”

The public sector is also emerging in the pre-competitive environment, seeking to build partnerships that will help address major challenges along the food supply chain, Jane said. One such challenge is physically transporting food products into urban areas and ensuring access to cold storage and warehousing facilities to maintain food quality.

Jane, who recently completed a project for an African government seeking to stimulate private sector investments in agriculture, said that more broadly, the coordination between public and private actors in agriculture optimizes investment returns for both public and private investors.

“Food security presents a strong value proposition, particularly in the context of Sub-Saharan Africa,” she said. “The fast growing population presents a huge basic need that has to be met. If a private sector company figures out a business model that allows it to deliver to these populations, it has the potential to be very profitable.”

When I walked through Kibera during lunchtime last year, smoke was everywhere as residents cooked with firewood and charcoal. Now, a new business launched by a pioneering Kenyan company is about to change the cooking scene in Nairobi’s low income neighborhoods.

Most Kenyans (and most Africans, too) either use kerosene or more traditional fuels such as charcoal and firewood for cooking – all of which have negative effects on health and the environment. Indoor smoke contributes to respiratory tract infections, which is the number two cause of death in Kenya and in many African countries, often second only to HIV/AIDS complications.

One substitute, liquefied petroleum gas (LPG), offers a solution to this problem. In addition to emitting much less smoke, LPG allows faster cooking, has no odor, and carries less risk of fire.

So why isn’t LPG a more popular source of energy? Is it too expensive? Not really. As part of a business development project with Premier Gas, a Dalberg team enlisted urban households to create energy diaries, tracking fuel use and spending to allow the team to compare prices between LPG and its substitutes. The data indicated that LPG was price competitive.

We found that consumers have not been using LPG because of the typical barriers the base of the pyramid market regularly faces. Without access to finance, few can afford the upfront investment in a large fuel cylinder or in the cooking appliances. Additionally, a high required purchase unit carries a minimum purchase price that can be prohibitive to consumers with fluctuating income streams. Consumer knowledge and opinion also varies; many don’t know about LPG, or believe that it’s either dangerous or expensive.

Premier Gas’ innovative model tackles all of these barriers. It runs a consumer education campaign to inform people about the product and raise awareness about the health impacts of the alternative fuel options being used. It retails LPG in middle- and low-income residential areas, and provides cylinders and appliances at affordable costs. Most importantly, it allows partial refilling from machines at the sales sites to significantly reduce the purchase price.

Reducing the purchase unit isn’t an easy change; it requires significant investment in expensive refilling machines, which is likely the reason that few companies have tried similar distribution models. The upside for those who work for greater social impact is that there is strong incentive for Premier Gas to scale up its business and reach as many households as possible to make their business commercially viable. Although many cook stove initiatives with similar health and environmental goals face challenges in project expansion, the strong motivation and commitment from an established for-profit company gives us hope that LPG will reach a mass of consumers soon.

Naoko is a Project Manager in Dalberg’s Nairobi office.

And…the applications are in! The application period for the G20 Challenge on Inclusive Business Innovation has now closed, and we’re sharing a sneak peek into what the overall applicant pool looks like, as well as the early lessons we are learning about the growing movement of business leaders who are committed to ending poverty through their business models. (If you aren’t yet familiar with the G20 Challenge, the Challenge website or the earlier D.blog post can catch you up.)

To recap, inclusive businesses work with people living at the base of the pyramid (BOP). These businesses work with low-income people at different points along the value chain: as suppliers, distributors, retailers, or customers. For example, a company that adapts its core product to be both appealing and affordable to low-income buyers is an inclusive business. So is one that sources its agricultural products from a number of low-income smallholder farmers. Inclusive business models vary widely, ranging from the seemingly obvious to the truly innovative.

Challenge applicants came from a wide range of sectors, including agriculture, health and education, and retail. (Photo Credit: IFC)

But if a company doesn’t realize that it’s an inclusive business, how does it know to apply to a contest on “Inclusive Business Innovation?”

We began reaching out to more than 300 organizations to publicize the Challenge and encourage nominations, ranging from purely business networks such as Africa’s Frontier 100 or local Chambers of Commerce, to development networks such as the Aspen Network of Development Entrepreneurs (ANDE) and the World Resources Institute (WRI). The outreach also included critical networks that align the two, such as the World Business Council for Sustainable Development (WBCSD) and Business Fights Poverty.

We found that interest in the Challenge was widespread, particularly in regions such as Latin America, South Asia, and Sub-Saharan Africa where the concept of inclusive business has gotten more exposure. To support these regions’ growing interest in inclusive business, Dalberg held marketing events in Mumbai, Delhi, Johannesburg, and Nairobi to answer questions and inspire dialogue within nascent regional inclusive business communities.

After four months of diligent outreach, the Challenge ultimately attracted 291 pre-applications, which converted to nearly 170 full applications. (Companies that pre-applied but didn’t meet all of the eligibility criteria were not invited to submit a full application, and not all that were eligible were able to complete the rigorous application.) Some interesting observations:

• Applications came from 75 countries
• Larger companies (> $1M USD in annual revenue) and smaller ones are represented equally
• Applicants operate in a wide range in sectors, from housing to telecom, with particularly high representation from the agriculture, health and education, and retail industries

The diversity of the applicant pool shows that inclusive business is a flexible strategy: it can be employed at nearly any scale and any sector, whether it’s from a sparsely populated island or a burgeoning mega-city. When up to 15 winners of the challenge are announced at the G20 Leaders Summit in June, their examples will highlight the ways that businesses across the globe can pursue commercially viable models that raise the living standards of people living at the BOP. And with such a strong applicant pool, the Challenge’s panel of distinguished judges certainly has their work cut out for them!