Memorandum submitted by Médecins du Monde UK

 

Medecins du Monde

 

1. Médecins du Monde UK - (MDM UK) is part of Medecins du Monde (MDM), an international medical humanitarian organisation whose volunteers provide healthcare to vulnerable populations in both developed and developing countries. Our aim is to provide healthcare for people in situations of crisis or social exclusion around the world. In order to be effective in the long term, Médecins du Monde's work goes beyond providing healthcare. Based on the information and testimonies collected through our medical practice, we identify and highlight violations of human rights, particularly with regard to accessing healthcare.

 

2. Since its founding in 1980, MDM has been present in nearly all of the countries referred to in DFID's annual report. Based upon our experience we make the following submission.

 

The effectiveness of DFID's mechanisms for evaluating impact of its aid

 

3. We share DFID's view that an effective aid partnership is based on a shared commitment to the three stated objectives of reducing poverty and the MDGs, respecting human rights, and strengthening financial management. With the goal of maximizing impact DFID, has recently increased its contributions to pooled funding mechanisms and multi-laterals such as the World Bank. When it comes to evaluation, it is crucial that mechanisms be in place to ensure that those recipients are committed to the same objectives.

 

4. Such evaluation should also extend to cross cutting issues such as gender equality and operational transparency and accountability.

 

5. The mechanisms for such evaluation are not presented or referred to in the annual report. Given that 43% of DFID's aid is channelled to multi-lateral institutions, this is a considerable gap.

 

 

Mechanisms to provide immediate field input when DFID is undertaking assessments of rapid onset emergencies.

 

6. Especially where DFID does not have a strong in-country presence, persons working in DFID funded projects might be well positioned to provide timely information about the situation in the field during periods of rapid onset emergency. It might be useful to have a mechanism in place through which such information could be quickly transmitted to DFID.

 

The exchange of lessons learned through a shared monitoring and evaluation database

7. DFID encourages grantees to undertake rigorous monitoring and evaluation in order to track progress against their stated goals. These tools have great potential to provide lessons learnt, both positive and negative, for the grantee and indeed for those within the larger community. Perhaps DFID could create a central and widely accessible database to which grantees could contribute their reports. This would also help reinforce DFID's message that it values critical self assessment and the exchange of information and ideas, both overseas and here in the UK.

 

A greater role for DFID in the Call to Action

 

8. Reference is made to the fact that the Call to Action is about mobilising "not just governments but private sector, NGOs, civil society, faith groups and cities to do more to deliver the MDGs" as well as the fact that the government will "push forward the need for accelerated action at every possible opportunity in 2008 including through the G8 and EU" as well as at the high-level meeting on the MDGs in September, 2008.

 

9. The annual report makes no reference to DFID's efforts at doing so in partnership with or on the basis of the shared expertise of these actors. Given the UK government's leadership role in these meetings, it is perhaps uniquely positioned to help ensure that these voices are heard.

 

Encouraging projects which meet cross cutting and complementary DFID objectives

 

10. There are numerous opportunities for DFID to encourage projects which effectively meet a number of its objectives. Unfortunately DFID's funding streams do not always afford the requisite level of flexibility to do so. A project which, for example, combined service delivery and research might be seen as too research based to qualify for CHASE funding and too service focused to qualify for research funding. It may be worth considering a pilot program for the funding of such projects.

 

Assessing the extent to which civil society delivers in ways that may not be possible within a pooled fund or multi-lateral context

 

11. We agree with DFID that the rich diversity of civil society is reflected in the multiple roles they play, including "giving poor people the voice to demand better from their governments and others in power." When DFID participates in pooled funding, "One UN" funding, or indeed World Bank funding, there is an inherent risk that the recipients of such funding may not feel free to voice demands from governments supported by these actors. And in some cases, the recipients may consider that these actors are themselves "in power." DFID may want to assess this risk, in order to be certain it is being adequately addressed.