The G8 Muskoka Summit on June 25th, like previous summits, culminated in pledges that will alleviate specific symptoms of poverty but lack the size, direction, and credibility to generate systemic reform. The leaders of the world’s eight largest economies discussed issues ranging from African development to the global economic recovery and Iran’s nuclear program. The summit marked both the failure to meet foreign aid commitments from the 2005 Gleneagles Summit and the creation of the Muskoka Initiative for Mother, Newborn, and Child Health (MNCH). These developments have reignited criticism of the G8’s commitment to, and policies for, African development.
At the Gleneagles Summit in 2005, the G8 made an ambitious pledge to increase annual Official Development Assistance (ODA) to Africa by $22.6 billion by 2010 through gradual increases in yearly aid. As the G8 accounts for 70% of all ODA spending, this increase—which would have more than doubled G8 aid to Africa—could have constituted a major push towards achieving the Millennium Development Goals. Specific goals of the 2005 commitments included investment in education, water, and sanitation systems; improved efforts to combat HIV/AIDS, malaria, and tuberculosis; increased support for African peacekeeping forces; and improved trade relations with African countries, with a vague proposal to eventually end protectionist trade policies. The G8’s record in living up to these promises sheds light on the possibilities and pitfalls of G8 aid, as well as the credibility of the group as a collective body.  
The G8 is on track to deliver only 61% of the Gleneagles commitments by 2010, an increase of approximately $13.7 billion per year. The actual amount of new funds going to Africa, however, is even less, because a large amount of these funds have been spent on debt cancellation. Debt cancellation can be a critical step towards helping impoverished countries stabilize their budgets and free up resources for economic development, but the savings do not constitute immediate new funds for anti-poverty programs. The $18 billion cancellation of Nigeria’s debt, for example, counted as an increase in foreign aid in 2005 and 2006. However, those savings will be spread thinly over the course of the next 20 years. Counting debt cancellation as foreign aid, therefore, significantly inflates the amount of money that is actually going towards new poverty-relief programs. Taking this factor into account, the G8’s performance over the last five years has fallen drastically short of the Gleneagles promises. 
The bulk of the shortfall falls on three countries: France, Germany, and Italy. Based on ONE’s projections, by the end of 2010 Japan, the U.S., and Canada will have exceeded their commitments, with increases that amount to 148%, 159%, and 170% of their pledges, respectively. The UK is expected to almost fulfill its promises, coming 7% short of reaching its pledge. On the other hand, France and Germany are on track to deliver only 25% of their commitments, and Italy has actually decreased foreign aid to Africa by 6%. The economic recession has been blamed for the G8’s failure to live up to its Gleneagles pledges, although a number of donors increased aid to African countries to help them manage the crisis. 
While G8 ODA fell far short of its promises, it is important to note where progress has been made. Approximately 3 million people are now receiving antiretroviral drugs for HIV/AIDS, a massive increase from only 100,000 in 2003. Comprehensive interventions have decreased the malaria infection rate by 50% in Ethiopia, Eritrea, Rwanda, Zanzibar, and Zambia. Furthermore, the school enrollment rate has increased to almost 75%, up from 58% in 1999. In other areas, however, G8 initiatives were less successful. Efforts to improve sanitation and access to clean water have been disappointing, and pledges to “make trade work for Africa” have amounted to little concrete success. While school enrollment has improved, many African schools remain severely underfunded and understaffed. Hundreds of millions still live in extreme poverty, demonstrating the necessity of improved G8 ODA policy and leadership. 
Muskoka Initiative for Mother Newborn and Child Health
The G8 revealed a new initiative at the Muskoka Summit on June 25th centering upon maternal, newborn, and child health (MNCH) to “i) prevent 1.3 million deaths of children under five years of age; ii) prevent 64,000 maternal deaths; and iii) enable access to modern methods of family planning by an additional 12 million couples,” according to World Bank and World Health Organization estimates. To fund the Muskoka Initiative, the G8 has promised additional funds of $5 billion over the next 5 years, noting that the G8 already contributes over $4.1 billion annually to MNCH efforts. Other donors, including Switzerland, Spain, New Zealand, South Korea, Norway, and the Bill and Melinda Gates Foundation pledged an additional $2.3 billion. The G8 believes that “support from the G8 is catalytic”  and will result in a total of more than $10 billion for the Muskoka Initiative.
MNCH progress has been disappointing since the adoption of the MDGs in 2000. MDG 4 calls for the reduction of the under-five mortality rate by two thirds between 1990 and 2015, and MDG 5 aims for universal access to reproductive health care and a 75% reduction of the maternal mortality rate. The G8 official communiqué maintains that progress towards both of these goals has been too slow. UN statistics corroborate their claim, stating that “nearly 1,500 pregnant women die each day and 24,000 children under five years die every 24 hours.” The failures in adequately addressing MNCH have garnered international attention. The Africa Progress Report published by a group chaired by Kofi Annan highlighted the importance of Women’s Empowerment, and Uganda has decided to make MNCH the theme of the 15th Ordinary Session of the of the Assembly of African Heads of State and Government of the African Union. The G8 has not focused specifically on MNCH in the past, only referencing the MDGs in general.
Quantity of money is not the only factor in determining the success of ODA. The Muskoka Initiative outlines various efforts necessary for achieving its goals, while emphasizing that each country has the right to fund the initiatives of its choice. The long list from the communiqué describing the initiative includes childcare, voluntary family planning, and prevention of mother-to-child HIV transmission along with calls for innovation, coordination, and research, such as expanded use of cell phones and civic mobilization to improve statistics. Many NGOs expressed concern about the lack of specifics, such as precise numbers of people to be trained for each initiative. The general approach by the G8 appears to be broad and inclusive, naming a myriad of useful elements without discussing how to balance them in a system where each country donates individually.
Beverly Oda, Minister of International Cooperation in Canada, noted in a press release that “each of our leaders informed us that the most effective approach to improve the health of mothers and children under five years is to focus on strengthening health care systems in developing countries.” The communiqué even emphasizes that many of the health problems “could be prevented with better access to strengthened health system,” and the G8 pledges to support health systems. However, the plans for strengthening numerous health systems appear only once in the communiqué: “improved health information systems, inter alia vital statistics registration, regular household surveys and applied research to monitor and evaluate implementation.”  While stronger information systems have the potential to improve health care in cities and developed areas, technological advancements will rarely impact rural communities without electricity and other infrastructure, areas which often need the most assistance. Statistics, household surveys, and applied research can improve the capacity of policy makers to make informed decisions about systematic reform as well as providing an accountability measure by potentially tracking improvements. However, these measures alone will not achieve the amount of systematic restructuring necessary for African health systems to function properly. Overall, none of the elements of the G8 plan to reform health systems intrinsically result in strengthening systems. G8 countries certainly can, and most likely will, expand upon the methods mentioned above for health infrastructure reform. Unfortunately, the lack of detail in the prescription for health system change might result in poor coordination regarding reform measures.
NGOs have largely regarded the Muskoka Initiative as a drop in the bucket for adequately addressing MNCH. World Vision referred to the initiative as “a down payment” rather than “an adequate investment,” arguing that “annual global health funding of $42.5 billion by 2015, including a doubling to $16 billion a year for maternal and child health, is required to fill funding gaps.”  The organization also disapproved of the lack of delineations of the financial expectations for each county, although Canada and the US have made specific promises. ONE also criticized the lack of funding, stating that $5 billion “falls far short of the $30 billion in additional funding that experts estimate is needed to meet the Millennium Development Goals on maternal and child health by 2015,” a number which the Partnership for Maternal, Newborn and Child Health acknowledged would be necessary. World Vision, ONE, and Oxfam all expressed concerns about whether or not the money given under this initiative would be new money or simply resources already promised and redirected through creative accounting.   
Maximizing the G8’s Impact
Improved accountability measures are necessary to hold the G8 to their commitments. The G8 has already commissioned the 2009 Muskoka Accountability Report to evaluate its ODA programs, an encouraging first step. Further support for the independence and legitimacy of internal accountability mechanisms will enhance the G8’s ability to implement substantive reforms. Non-profit organizations can expand upon accountability efforts by raising awareness about G8 commitments, thereby encouraging the public to monitor their government’s fulfillment of aid promises. An increased focus on multilateral commitments should result in greater adherence to aid pledges, as nations scrutinize each other’s fulfillment of commitments. 
To improve aid efficacy, the G8 must focus on defining their programs and commitments. Specificity allows groups to monitor G8 commitments against objective standards, increasing accountability and transparency. Enhanced clarity and credibility will also facilitate effective planning by providing more accurate information about donor activity. As the G8 agrees on broad outlines but allows donors to allocate funds individually, improved precision is necessary to foster collaboration and optimal resource distribution. Similarly, more accurate information will allow recipient governments and NGOs to direct their efforts as productively as possible. 
Simply giving money to Africa has not been and will never be the solution to Africa’s problems. A generation of aid initiatives has failed to raise significantly the quality of life in African nations, many of which contain vast natural resources. IIJD firmly believes that positive change requires institutional reform. The G8 must use their resources, both financial and political, to promote democratic systems and the rule of the law. Aid needs to be contingent upon higher standards of governance, and it must, by promoting transparency, accountability, and effective delivery mechanisms, foster civic institutions which can thrive without foreign assistance. Ultimately, strengthening institutions remains a prerequisite for sustainable economic development. As Bronwen Maddox wrote in The Times, “in the present anguished state of development theory, the only principle that looks solid is that without good government, aid is wasted.”