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After you've made the diagnosis, after you've mobilized

the development aid, after the key concepts of investing in

health and education, or in infrastructure, the real life of

implementation of development programs becomes the most important

issue. When the Millennium Development Goals

were first enunciated and I was asked and very honored by then UN Secretary

General, Kofi Annan to advise the UN system on how the MDGs could be achieved.

I called on colleagues and professionals from around the world, from many

different disciplines from agronomy, from public health, from the education

sector, from urban and rural engineering. To

suggest the most effective approach is the new technologies, the

best ways to make an advance. That was the UN Millennium Project.

And from 2002 to 2006 it prepared many, many studies.

And in 2005 presented a long

report and detailed information to the member states of the UN.

And in a special session of the General Assembly

in the fall of 2005, the UN member states adopted

a number of Ideas of how to proceed in a

practical way to achieve and implement the Millennium Development Goals.

One of the very lucky things for my colleagues and me was the

proposal that it would be a good idea to look in detail

at a few places, some very, very poor villages around Africa,

to see how these recommendations could work on the ground,

in practice. And to use that experience

to develop new tools for implementing the

fight on poverty. To implementing pathways

to saving lives through public health, to implementing new

cutting-edge technologies such as the use of mobile phones or

broadband for schools and for health systems, and

for business development.

This is how the Millennium Village project got started.

If you look on this map of Africa it shows you where the Millennium Villages

are located with each of the main village clusters shown on the map.

But it also shows you Africa in a bright colored depiction that

you haven't seen before most likely because these colors

on this map are not of the countries, or even of the

features of mountains and lakes and so forth as a standard.

But rather is a division of Africa into different

kinds of farm systems. So the yellow areas along the

east coast of Africa, the category shown in Kenya and in Tanzania

and Malawi, and other places down the east coast of Africa

is the maize production region of Sub-Saharan Africa.

Or if you look in the horn of Africa up

in northern Ethiopia where the village of Koraro is located,

you see a highland area.

In fact, in northern Ethiopia the main staple crop is something basically

not known in the rest of world, a grain called teff, which provides

a wonderful bread traditional in the Ethiopian diet.

But its a distinct ecological zone because it is a highland zone.

Or if you look

across the brown shaded areas where you see

cereal crops are mainly planted in, in very dry regions

or the area just above that known as the Sahel of

Africa, and a zone that from a farm system point of view

is called is, is called agro-silvopastoral.

So there's some bit of crops there's some tree crops grown and there's pastoralism

the goats and the sheep the camels that are herded in the very dry areas.

Well we wanted to see how the Millennium Development Goals

could be approached in each of these distinct agro-ecological zones.

Because each

one poses specific challenges. How to grow crops that are different.

How to manage livestock, particularly important in the pastoral regions.

The disease burdens are quite different as the climate varies.

In the highlands it may be Malaria isn't so much

of a problem, but in the tropical lowlands malaria can be

holoendemic, infecting just about everybody, unless it's brought

under control. And so the Millennium Village project

identified ten very poor places with the

help of the host governments. Each of these places

was at the beginning of this project in 2005 a

so called hunger hotspot.

That meant that there was a chronic undernourishment of, of at

least 20% of the population, and in many cases much more.

In other words, not only would the villages in poor countries,

but they were in the very poor parts of the poor countries.

The idea was to apply the Millennium Development Goals

as the guiding principle.

The core of the project was a holistic approach.

Remember that there are eight MDGs.

Now applying the MDGs therefore means to

design programs that aim to achieve all of those goals.

Not just a health project, or an education project.

But to achieve

all eight of the Millennium Development Goals.

There are two big reasons for that.

One is that each of the eight goals is meritorious in its own right.

Of course fighting hunger isn't the end

if there's big disease burden,or fighting disease and

hunger isn't the end if children are not yet going to school, and so forth.

Each of the eight goals is important

in and of its own right. But the goals are also synergistic.

Helping to provide safe water in a community

can not only rid the community of a big part of the

disease burden, but can help the children be healthy enough to go to school.

And so to help

meet the school objective.

Fighting malaria, similarly, is not not only protecting the lives of the

community but helping to protect the productivity of the community.

So that people are not sick when it's planting or harvest time,

or the children are not so sick that they don't get to school.

So not only do we want to achieve the eight Millennium Goals

because they're each important. But by targeting each

of them we actually help to achieve even

the others as well. So the Millennium Village Project took a

holistic and synergistic approach, aiming at a

rather low cost of donor funding. In the first five years, $60 per

villager per year to be matched roughly by the

host country government and the local community, so a total on the order

of about $120 per villager per year. To

face the whole range of challenges, higher productivity

agriculture making sure the children have classrooms,

teachers, school supplies for effective primary education.

Making sure that vaccines and bed nets

protect the children from malaria to reduce

the burden of childhood disease and to

reduce sharply the death rates among young children.

Ensuring emergency obstetrical care for mothers so that childbirth is safe,

and even when an emergency occurs the mother doesn't die of hemorrhaging or

a obstructed labor which kills so

many mothers if there's no emergency care available.

And using new clever ways to meet

environmental goals of proper sanitation, safe drinking water,

protection of the local environment.

It really is the idea of the differential diagnosis, but not

applied to one specific challenge, but rather applied

across the range of the goals so that all of the goals can be achieved, and

so that all of the synergies can be harnessed for success.

The project is now in its eighth year and what we have seen is that even in the

very poorest places it's possible to help mobilize a very active community.

Because across the world mothers and fathers want to ensure the health of

their children, they want to ensure of course the survival of mothers

in pregnancy and in childbirth. They want to reduce disease burdens.

So by harnessing the energies of communities with a little bit of help,

with best practices, with new kinds of

information systems, tremendous things can be achieved.

Have a look at some of the range

of activities taking place in the Millennium villages.

In Potou, Senegal a

huge expansion of onion production to serve the national market

has helped farm families to raise incomes and to raise

living standards, to invest in the quality of their

housing for the community to invest and improve health and education.

And to upgrade agriculture more generally by introducing

irrigation and introducing other parts of a high productivity agricultural system.

In Rwanda with the partnership of government a village area

that was bereft of just about everything and a place that had been a

gathering point after the Rwanda genocide where refugees from all over the

country came and gathered, but,meaning it wasn't a, a tight

knit community at the beginning. Was able to get power

in, into the community, electricity, a, a new road

connection new investments in health and in

education, and a tremendous take off of business activity.

In Sauri, Kenya, the very first of the Millennium villages you see the children

on their way to school and a big step up of school programs

including school meal programs throughout the whole community.

In Ambola in Tanzania you see a new

improved water source for safer water supplies for

the community. We've seen that that range of activities

is feasible. It was once thought that a poor

community might be able to do one or two kinds of things, this

is an old fashioned and poorly thought out idea.

Communities necessarily live holistic lives they earn

livelihoods, or they struggle to do so. They want their children

in school, they need healthcare, bo, both to prevent and to treat Illnesses.

Every community needs to have water but

if the water's safe the community stays healthy.

And so the idea that communities can improve

systems across the board has proven to be

a viable and a correct assumption

every day demonstrated within the Millennium villages.

And gender equality has manifested itself

by women's leadership throughout the villages.

And by new business development that women have

taken on and that have greatly empowered them,

given them their own source of income and a tremendous amount of pride.

And here you're, you're looking at the Rwanda women's cooperative in Mayange,

the Millennium village in Rwanda where the women are producing wonderful

artisinal goods of weaving and knitting.

These goods have been featured in American stores.

They're being marketed online and the women are as proud as can be and their

incomes and stability, ability to care for their children has absolutely soared.

One of the most exciting developments in

the Millennium Villages has been the development

of the community based healthcare, and within

that, the role of community health workers.

A community

health worker is a young person, very often a young woman from

the community, maybe with ten to 12 years of schooling in total.

Certainly no medical degree or no nursing degree.

But with a bit of training over a few months a local village

worker carrying a backpack with the right kinds of medical supplies can

absolutely transform, improve the health of the community, save

lives and help the community to get on its feet.

One of the things that a community health worker

carries is the combination of goods needed to fight malaria.

In the backpack of a community health worker typically will be three things.

First, a rapid diagnostic test which can diagnose malaria without the need for

a microscope and a laboratory at a clinic. Second is a

medicine carried in the backpack available right in the community.

again, the mother doesn't have to carry a very

sick and feverish child febrile child to a clinic.

But rather the community health worker can

treat the child at home and very effectively.

And third, in the backpack is a mobile phone, which changes everything.

If you have to call an ambulance, it's possible now, if you have to call the

clinic for advice from the nurse that's on

duty or the doctor that's on duty, it's possible.

And more and more these phones are also being programmed

with expert systems to plugin a patient's ID number or the results of

a test, and then receive the information

needed automatically by computer expert system that

says that given the test results and given the age and weight of

the child, here is the does of medicine that's needed to address the illness.

Absolutely wonderful, and

just the beginning of what will be

tremendous new IT-enabled public health applications that

I believe will provide a kind of

leapfrogging to improved heath in the communities.

I'm happy to say that the Millennium villages have been an inspiration for

many of the host governments to scale up large national programs in malaria

control, or AIDS treatment,or help for small holder

farmers, or electrification with off-grid solar based systems.

And many, many other innovations that have been

tested or demonstrated or pioneered in the Millennium Village.

These projects are now spreading.

What started as ten countries is now around

20, that in one way or another are drawing on the Millennium Village model.

And within those countries, what started as individual

clusters has now often expanded to national application.

It's exciting to see on the ground this kind of progress.

It's especially thrilling to see what is

now possible through improved technologies to make working

systems at very low costs for better

health, for better education, for access to infrastructure.

Because we know that if those systems can work effectively,

they can be the key to breaking the poverty trap and

enabling very, very poor communities to get on a

path of self-sustaining economic development.

Designing Practical Interventions: The Case of Millennium Villages

The Age of Sustainable Development

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