The CommonHealth Live! IRC President David Miliband: A New Crisis Landscape

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This transcript is from a CSIS event hosted on January 11, 2024. Watch the full video here.

J. Stephen Morrison: How and why are global humanitarian crises evolving? How do we address these challenges? We’re joined today by – we’re joined today with David Miliband, president and CEO of the International Rescue Committee on CommonHealth Live!


This is the CommonHealth, from the CSIS Bipartisan Alliance for Global Health Security, engaging senior leaders on questions of how to address our common health security challenges in this post-COVID moment.

I’m J. Stephen Morrison, senior vice president here at the Center for Strategic and International Studies in Washington, D.C. Thrilled today to be joined on CommonHealth Live! by David Miliband, president and CEO of the International Rescue Committee. Welcome, David.

David Miliband: Thank you, Stephen.

Dr. Morrison: Thank you so much for being with us. It’s wonderful to have you with us. You’ve come here today, a short while after the launch of the IRC Emergency Watchlist, which came out back in December 13th of last year. An impressive piece of work. Lots to unpack from that. So I think what would be a great way to get started here is to have you walk us through the most important elements of this.

Just by way of background, David Miliband has served in this position as president and CEO of IRC since 2013. Congratulations on that decade of achievement. Prior to that he served as the minister of foreign affairs in the U.K., 2007-2010, and was a member of Parliament, 2001 to 2013. Thank you so much, David. It’s great to have you with us.

Mr. Miliband: Yeah, thank you, Stephen. It’s good to be here. There’s a lot to unpack, as you say, and I won’t take up too much time. But let me give you an overview of this document, which is our signature publication. It originated as an internal management tool, preparing and positioning for the crises of the year ahead. But it’s become more and more important over the last decade, as the crises have multiplied, to try and get this out into the public domain because we’re running up an escalator that’s going down faster and faster. And that’s a massive problem.

There are 300 million people in humanitarian need at the moment. The headlines, understandably, are about Gaza. We have an emergency medical team in Gaza, in an incredibly challenging situation from a humanitarian perspective, desperate situation. But the watchlist looks broader. It looks at the 20 countries that we think are going to be at the forefront of humanitarian crisis in the year ahead. Your viewers and listeners may know that the U.N. says about 300 million people need humanitarian aid to survive. So that’s our constituency, if you like.

What does the watchlist bring out? Well, Gaza is actually number two – Gaza and West Bank are number two on our watchlist. Sudan, number one. South Sudan number three. Twenty-five million people displaced and in humanitarian need as a result of the fighting in Sudan. Now, here are three or four, I think, interesting facts coming out of the watchlist. The concentration of humanitarian need in the top 20 countries is growing. Eighty-six percent of the 300 million figure I just quoted are in the 20 countries here.

Secondly, I think the overlap between conflict and climate crisis is stronger and stronger. There are 16 countries in the watchlist that are in the top quartile, the top 25 percent, of climate-vulnerable countries, according to the Notre Dame Index. Now, 14 of them are here in the watchlist. I’m sorry. So not 16. Fourteen of the countries that are in the top quartile of the Notre Dame Index for Climate Vulnerability are on the watchlist. And what we argue is that climate crisis now overlaps with conflicts. They’re not just separate buckets. And for obvious reasons we can get into, the climate crisis increases resource stress. Resource stress is one of the conflict multipliers that comes out quite strongly.

Third striking thing is the duration of conflict, the prolongation of conflict. And seven of the watchlist countries have not seen a single year of peace in the last decade. And the sense that conflict – that the most likely outcome of a civil war is further fighting is, I’m afraid, the syndrome that we’re seeing, but more so the prolongation of conflict. That’s got big implications for humanitarian work. And then just the fourth thing to bring out at the beginning is the internationalization of civil conflict. More and more external meddling, support, sponsorship. And Sudan is an obvious example of that. So that’s what we’re seeing.

We took a slight detour in the report this year to say there are some things you think – you might think come out of this, but they’re myths. And we thought it was important to challenge the myths, because the myths get in the way of our work. I mean, for example, the myth – probably the most prevalent myth is that most refugees are in rich countries. Wrong. I mean, the refugee, quote/unquote, “crisis” that exists in Europe or in America is serious. But we show three-quarters of all the world’s refugees and asylum seekers are in poor and lower-middle income countries, not in rich countries.

There’s a myth that, oh, well, as long as you get the trucks across the border with some aid, you’ve done – you’ve satisfied humanitarian need. Wrong. As we’re seeing in Gaza, getting across the border is one thing. Getting to people in need so that they can safely access aid is another thing. Third myth, that you need – if you can’t get the government to work – so-called capacity building – you can’t get anything to work. Wrong. We are showing that partnership with nonstate actors, civil society, can be a very effective and efficient way of reaching people in need.

Myth that the climate crisis is so grave that we haven’t got time to worry about adaptation; we’ve got to focus everything on mitigation. We can’t afford that. When I was secretary of state for the environment 15 years ago, adaptation – if you talked about adaptation, it was almost like surrendering to climate. We’ve failed on mitigation. We’ve got massive catchup to do as a world on mitigation of climate change. But we don’t do adaptation at the same time because the climate crisis is here.

But because we’re a solutions-oriented NGO, it’s a detour to address the myths. We do get down to practicalities of what needs to be done. And just to run through the priorities that we highlight here, one, climate adaptation in fragile states, which are not just climate-vulnerable but have the least investment in climate resilience, climate adaptation is possible. We’re showing how even in the most fragile and conflict-affected situations, it’s possible to help, for example, rural farming communities adapt to climate change. But they need help in seed strengthening. They need help on farmer information systems. They need much more of the humanitarian sector to work to be anticipatory rather than reactive.

Priority number two for practical action is to change the way the World Bank works in fragile and conflict settings. There’s a lot of talk about the finance gap in fragile and conflict states, which the new leadership of the bank wants to address. They’re also flagging, and we’re flagging with them and for them – there’s a delivery gap, not just a finance gap. And that calls for different ways of working in fragile conflicts.

Just so you know, 50 percent of the world’s extreme poor now live in fragile and conflict states. It’s going to become 66 percent. So there’s a changing geography of poverty in the world. It’s not India and China anymore who have most of the world’s poor. There are more extreme poor in Nigeria than there are in India, even though the population’s a fifth of the size.

Gender equality – if women and girls in humanitarian settings around the world had investment in in proportion to the number of political speeches that have been given about the prioritization of their needs, they’d be far better off than they actually are today. It remains a massive gap. We say that unless you – that to be a successful humanitarian organization, you have to be a feminist organization that takes seriously structural inequalities that face women and girls in the conflict settings that we work in. We give some examples of that.

Just one more that I think is important and is topical. International laws and norms on the conduct of war are absolutely critical to delivery for civilian populations caught up in conflict. The proportion of victims of war who are now civilians is 80 or 90 percent. Soldiers get killed in war, but civilians get killed in much greater numbers. And the tide of impunity that we’re seeing in conflicts around the world, where laws and norms, hard fought after the Second World War – there was no golden age, but they set benchmarks for protection of civilians, both from the fighting and for access to humanitarian aid. Those laws and norms are not being adhered in more and more cases.

I mentioned before we started, I am the co-chair of the advisory panel for something called the Atlas of Impunity. This was published first last February at the Munich Security Conference. The second edition is coming out this February. But the need to turn words about adherence to international humanitarian law into actions to defend international humanitarian law is absolutely vital.

So I hope that your viewers and listeners will go to the IRC website,, to access this – No Myths, Just Facts – which feels in the spirit of the CSIS. And in the spirit of this podcast, the common health is about health, but it’s about more than health. And we talk a bit about that in here. And I’m very happy to get into that in the conversation that we’re about to have.

Mr. Morrison Thank you so much. And congratulations. I think this really is a very important instrument, this annual watchlist that you’ve put out.

A couple of questions.

One is on the big picture. This is a moment in which we’ve got multiple geopolitical crises that dominate the tension, and they’re in the ascent; I mean, what’s happening between Palestine and Israel most notable. It figures as your number-two priority, which is quite important. As you point out, no civilians are – of any kind are safe inside Gaza. It’s a crisis that’s now widening. We’ve got the continued crisis in Ukraine and they – and the threat of a rising confrontation in China and Taiwan and the like.

So we do face an exceptional environment geopolitically in trying to break through. You hooked this in some fashion to the COP in terms of the release at the time of the COP, which was great, and you’re putting so much emphasis in this report on climate.

But in terms of tactical – tactics in this particular moment in time how do you break through? I mean, the wealthy and most powerful countries in the world it’s more and more difficult, it seems to me, to get their attention focused upon the issues that you’re laying out here.

This is – your job has become much more difficult in these last few years. So what’s going to work, do you think?

Mr. Miliband:

Well, two things I think are important. It’s a very good question. Two things.

First of all, let’s get our analytical framing right. I think we do – we’ve got a good take on what’s going on. If you read the last U.S. National Security Strategy it says two things are happening. There’s geopolitical fragmentation so-called. I prefer the term multi-alignment to multi-polarity. I think the idea of a multi-aligned world is powerful.

Secondly, in terms of getting attention the bandwidth issue is a massive issue because, of course, it’s not just multiple international conflicts and crises. It’s not like the domestic scene in countries like the U.S. I’m not a(n) American citizen, but I’m a resident of New York, which still counts as part of America, and I watch. You’ve got a massive set of issues that you’re addressing.

The Council on Foreign Relations – I don’t know if we’re allowed to mention them here.

Dr. Morrison: Yes, of course.

Mr. Miliband: They’re some kind of think tank that’s maybe in New York. I think they have an office in Washington as well. I did an event with them, and their version of the watchlist says the biggest foreign policy risk this year –

Dr. Morrison: Right here.

Mr. Miliband: – is actually internal. So the bandwidth question is, I think, a massive issue.

Now, how do we think about that? We think about it in two or three ways. One, when governments are in retreat from big global problems NGOs and philanthropists and the corporate sector have to step up as the solution makers and that’s a big emphasis of ours, that governments – the best we can hope for at the moment from them is that they come behind – come in behind proven solutions because they give us scale. They’re not going to take the risks to find the solutions. So there’s an important angle.

Secondly, the rich world and the Western world are no longer the same thing. There are responsibilities to be distributed more globally. That’s a very long, hard road but I think it’s important – it’s important to say it.

Thirdly, the argument has to be made inside the United States, inside Europe, that if you don’t contribute to addressing the world’s problems the world’s problems will become your problems, and an underestimated part or an underinformed part of the southern border debate is about unresolved problems at the border which the primary responsibility is not America to solve those problems but it has a role.

Europe – when I think about the situations in sub-Saharan Africa there’s a big European interest – strategic interest, not just a moral interest. So I think that I feel it’s important to remake the argument that foreign policy so-called isn’t just about what goes on abroad. It has an impact on what goes on at home.

Dr. Morrison: But you agree that this is really an exceptionally difficult moment. It’s always difficult, it seems to me, for the humanitarian world to come forward with an argument that says the situation is terrible and it’s getting worse and you need to pay greater attention because we’ve heard those arguments a lot and so people turn off. They turn off, so you have to sort of break through that apathy. You have to break through that sort of calloused approach on some of the, you know, well, we’ve heard that before. Sudan we’ve been dealing with for years. The fact that it’s moved to the first and the third position is kind of an extraordinary thing and I want you to say a bit more about that.

But for the moment, if we could just focus on – let’s take the United States. You’re here in Washington. You’re going to be engaging with the administration and with others around trying to focus on the agenda that you’re advancing. We’re in the midst of a democratic crisis. We’re in the midst of an electoral process. We’re the most divided. We’re in the period of a nativist, isolationist, populist moment in our history. There’s a few precedents, but we’ve never lived through something quite like this. We’ve got a White House that’s prospects of winning are up in the air. And dealing with these multiple geopolitical crises, that themselves are a source of debate here.

So what is it that you can ask for now, as you come here in this moment? What do you want to see in terms of the administration? And how do you grade this administration in terms of its – of its humanitarian response? Because typically, the United States has been a pretty strong leader on these matters – budgetarily, ethically. And it’s certainly shown remarkable leadership in many of these conflicts that you’ve painted.

Mr. Miliband: Well, I think there’s a lot – there’s a lot in there. I mean, I think first of all, we’ve got to come to New York – to Washington not to say, look at all these problems, because they know what the problem – we’ve got to come and say: Here’s what you can do about these problems. And we’re saying malnutrition – 45 million kids are acutely malnourished at any one time at the moment. That means in the course of a year, 100 to 200 million kids are acutely malnourished. We’ve got – and 80 percent of them get no help at the moment. We’ve got a program that could actually tackle that. And we’re talking to congressional leaders and the administration about it.

And we see malnutrition as the apex of the pyramid. If you’ve got malnutrition, there’s loads of other things going wrong in health, education, poverty, underneath in the pyramid. So we’ve got to be the solution-makers around malnutrition, around education for populations that are on the move. On early childhood development we’ve got some interesting things. On immunization we got a fantastic program for zero-dose kids that are there. And I think we – our first job is to inspire policymakers with a sense that there are things they can do.

Secondly, we’ve got to build coalitions. There’s no point in doing this in a narrow way. U.S. Global Leadership Coalition is a big part of that. But we’ve got to build coalitions and we got to be scrupulously nonpartisan in the way that we do that. We’ve got to be the expert witnesses about what’s really going on and what can be done. Thirdly, we’ve got to be opportunistic. Now, we’re here on January the 11th. You know that the Ukraine-Israel funding bill got rebuffed, and stuck, and the rest of it. There’s an opportunity, though, in that moment, to make sure that when this bill does come through, the humanitarian international aid aspects are properly dealt with.

And the administration gets high grades for putting that –

Dr. Morrison: There is a heavy component in that bill.

Mr. Miliband: There’s a heavy component. And that’s – I mean, just to – so that your listeners don’t just breathe a sigh of relief, what that heavy commitment does is sustain American commitment for 2024 at the level it was in 2023. So it’s not like massive breakthrough. You spend about 0.17 percent of national income on international aid. It’s not 17 percent – 0.17 percent. And so we’ve got to – we’ve got to sustain and build on that.

Now, I think there’s one other part of this, which you suggested, that your system should make the alignment of aid questions with diplomatic questions stronger. Just one example, the director of national intelligence was in the Democratic Republic of Congo and in Rwanda last month talking to presidents and prime minister to negotiate a 72-hour ceasefire in the east of Democratic Republic of Congo, which is one of the countries on our list. The alignment of the money and the diplomacy is an important part of that. And that obviously is susceptible to bandwidth questions too. Many people concerned that Ukraine is going to suffer because of the attention that’s going to Gaza. But our contribution – we got to humanitarian agency, not a political agency.

Dr. Morrison: Are you hopeful that it’s possible to avoid the crowd-out effect of Ukraine and Gaza? And, you know, these are a massive tap on our budgets, the commitments that have been made on the humanities side. But we’ve –

Mr. Miliband: Yeah, although the humanitarian is cheap compared to the military.

Dr. Morrison: No, I understand all of that. And the U.S. – one of the – one of the interesting facets of the history of U.S. engagement on humanitarian response has been very strong bipartisan foundation of support for it, historically, and it’s been a bit of an oasis in terms of trying to avoid politicization. That’s come under a lot of stress, as well as the sort of just the fact that the demand side has become so high. How are you doing in terms of making sure that you have strong Republican support up on the Hill –

Mr. Miliband: Well, one interesting thing is that in the years of President Trump, in the four years after – 2017 to 2020, Congress sustained American international humanitarian engagement; the sort of Lindsey Graham-Chris Coons partnership was important leadership in holding the line on that. And I think our best contribution to their argument is to say, this is how your aid makes a difference, not just lives saved but the strategic play, because remember, as I inferred earlier, there’s plenty of other players in these places who are playing, and American absence, Western absence, if you like, if you want to use that expression, can be highly notable. I think it’s important to say, in the Ukraine context, Europeans have paid more. The majority of the financial support – if you add the military and the humanitarian and the development and the economic together – has come from Europe. There’s a reason for that: Ukraine’s on the edge of Europe. So there is burden sharing going on, but on the military side, the U.S. is absolutely critical –

Dr. Morrison: Sixty, 70 percent of the flow -

Mr. Miliband:

 – to holding the line. And that’s obviously under very significant strain. And so I think you asked am I hopeful about the ability to work on many fronts at the same time. I think the evidence is that it’s very, very hard to do so, and there are many reasons why it’s so important that the situation in Gaza is addressed, but one of them is that there’s a lot else going on.

Dr. Morrison: Yeah. You mentioned Gaza. Len Rubenstein from Johns Hopkins and I have been doing a lot of work recently looking at what’s happening in Gaza, and we’ve got our own separate video series looking at the human toll of Gaza, and we’ll be putting a piece out this week that’s examining sort of where are we, and the situation is astonishing in terms of the – a population that is trapped, no escape, no security, the level of destruction of infrastructure profound, particularly in the north, but it’s – we’re staring at an indefinite wasteland, and now the health situation’s deteriorating. It’s going to contribute to even higher mortality than the bombardment phase, and no one’s coming to the rescue. And the discussion has been largely focused on, well, what happens when the fighting ends and what might be the governing arrangements and the possibilities there? All very important issues. But in terms of looking at the immediate crisis, we’re drifting into a dangerous situation of a semi-permanent wasteland with no immediate strategy for how to – even before a cease-fire – to try and stabilize this population. What are your thoughts on that?

Mr. Miliband: Well, I would say that the situation is not just astonishing, it’s astonishingly bad, and we’re not just drifting into dangerous territory, we’re in – the Gazans are in very dangerous –

Dr. Morrison: Dystopic.

Mr. Miliband: – dystopic territory. The testimony that I can give is only what the staff of the International Rescue Committee is seeing. We have an emergency medical team working in a hospital in southern Gaza at the moment. We have aspirations to do more work in other parts of the – of Gaza, including in the north, that you mentioned. It takes a lot to shock humanitarians, but it’s a shocking situation. Yes, the scale of the physical devastation is evident from any drone footage or anything else you look at, but the human toll on bodies and minds of people there is just astonishingly deep. And the trauma, even if the conflict ended today, is massive. But you’re right, I think, to flag that the danger from bombardment is matched by the danger of the consequences of bombardment for public health, for water and sanitation. The communicable disease situation is terrifying to people there.

And that’s –

Dr. Morrison: Should we begin – should there be a new mobilization of folks like yourselves, along with Palestinian leaders, along with U.N. agencies and NGOs and others, to – and national governments – think the United States – to really press to stabilize this situation? Because we’re drifting into an ever-worsening scenario.

Mr. Miliband: Well, our conclusion is absolutely clear. From a humanitarian perspective, the only way to protect life is to halt the fighting; that we can do some work while the fighting is going on and the conduct of the conflict continues. I’m incredibly proud of what our teams have been able to do, but it’s absolutely clear that, both for humanitarian aid delivery reasons and for treatment of the injured – you know, I don’t want to go in too deep, but you know, 1-year-old kids with limbs blown off, terrible burns of those who survive. For that reason, too, and for the fact that there is continuing danger from bombardment including for our staff, there’s no other conclusion that we can come to from a humanitarian perspective. The only way to fully serve the humanitarian imperative is for the fighting to stop, for there to be a sustained ceasefire. And that’s – we need to continue making that case. Certainly, if this is what you’re hinting at, any notion that this current situation should be normalized and just become kind of background music/wallpaper would be an absolute – would be to pile disaster upon disaster.

Dr. Morrison: Well, you know, you’re putting out the Impunity Atlas again at the Munich Security Conference next month. Impunity’s a huge issue. Conditioning security assistance is a huge issue, as well as calling for a ceasefire. What more should we be doing on those fronts in terms of –

Mr. Miliband: Well, there’s a –

Dr. Morrison: – conditioning security assistance but also in terms of trying to guarantee some level of accountability?

Mr. Miliband: So the Atlas of Impunity measures impunity across five different dimensions: conflict, governments, human rights, economic exploitation, environmental degradation. The data is often annual in this. It’s very data-based. So some of – a lot of what’s happening in the – in Israel and in Gaza will not yet be picked up in the – in the figures that come out, but eventually it will certainly follow through.

Look, our strength, though – I hope I bring strength from my previous role, but I have to be quite disciplined in making sure that I do my current job, not a previous job. So questions of aid conditionality, et cetera, that’s – those are political questions for Americans and American policymakers to wrestle with. The humanitarian contribution, I think, is to document and explain what the situation is. And that’s what we think we have a responsibility to do as well as to do our humanitarian work, which we can only partially do because of the way the war is being conducted.

Dr. Morrison: Right. I mean, you’re like many other NGOs that are attempting to work there. You’re largely thwarted in your ability to put people in safely, Palestinian or international staff, and deploy them.

Mr. Miliband: Yeah.

Dr. Morrison: The humanitarian mission has basically disappeared.

Mr. Miliband: Well, no, it’s not true that it’s disappeared, but it is facing an incredible uphill struggle in all of the countries, actually, that we document in our – in our watchlist. But it’s extreme level of difficulty in Gaza at the moment. Wherever there is active conflict, it thwarts, to use your word, humanitarian action. A point you made earlier, the density of the Gaza situation, the comingling of civilians and fighters is a big part of the challenge.

But it’s not the case that we’re not making a difference. We’re not making enough of a difference, and we can’t make more of a difference because of the way the war is being fought.

Dr. Morrison: Yes.

Let’s move on to a couple of other issues. You put a lot of emphasis on the climate argument. You have some specific figures around resource allocations, towards adaptation, this whole tension between adaptation versus mitigation. That debate continues. You’ve taken a very strong position on this.

Tell me, do you think this climate argument is going to resonate with policymakers in terms of – you know, you’re bringing forward data saying that you look at Somalia, look at Sudan, look at Syria. OK, these are places where there’s dramatic evidence of the link. What difference do you think this is going to make, do you think?

Mr. Miliband: Well, I think the humanitarian community and the climate community have not done a great job at working together.

Dr. Morrison: Yeah.

Mr. Miliband: And I think that’s undermined both, to be honest. I think we’ve not done a great job at risk mapping. We’ve not done a great job at solution-making. We’ve not done a great job at joining up. I think we’re doing a better job. I mean, it’s incredible, by the way. This 28th COP that has happened is the first time there’s ever been a conflict and climate day or declaration.

Dr. Morrison: Yes.

Mr. Miliband: It’s an extraordinary situation, when you stop and think about it. So we’ve got to do a better job. What kind of resonance – I think we’re into – the new leadership of the World Bank is critical in this, and they’re very open, Ajay Banga and his team. We’re hopeful on that score.

I think that the argument that rich countries are recognizing the need to invest in climate resilience but poor countries need to be helped to do so is getting resonance. The whole Barbados Initiative by Mrs. Mottley, the work she’s been doing with the government of India and the government of France, I think, is important in that respect.

This is somewhere in the weeds of the international system but I think is important. And the basic argument that says, look, after Hurricane Sandy in New York did its resilience work in a serious way, that needs to be – you can’t afford that level of investment. But the idea that at the moment it’s satisfactory that one dollar per year per Somali is spent on climate resilience makes no sense at all.

Dr. Morrison: I mean, what we’re seeing in terms of climate and health – there was a climate and health day dedicated at the COP, an important event.

Mr. Miliband: It was the same day as the conflict day, so it was a shared day.

Dr. Morrison: Some money attached to that, some new initiatives. There’s been a shift of consciousness, certainly. We see institutions starting to internalize these priorities and begin to act. But it’s very fragmented. The financing levels are woeful. It’s very hard oftentimes to see what the real priorities are. And there’s lots of tensions among stovepiped budgets and programs. And the cultures and habits of the health community and the climate community are quite different.

Mr. Miliband: Yes, that’s a very good point.

Dr. Morrison: Quite different.

Mr. Miliband: That’s a very good point.

Dr. Morrison: And I think you could make the same case on the humanitarian community.

Mr. Miliband: I think that’s a very good point. And the sort of – the routines and the rhythm of the communities is different. But we’ve got to learn from each other and we’ve got to work together.

Dr. Morrison: How do you crack that code? Is it Ajay Banga and –

Mr. Miliband: No, I’ll tell you how we – my learning on this. Of course, I don’t – we’re all in new territory. But my answer to that is do stuff. Get out there and do it. Strategic planning and all, that’s important. We’re big advocates of new decision rules that force the pace. Fifty percent of climate finance should go on adaptation. Within adaptation, 25 percent should go to fragile and conflict states. Within fragile and conflict states, 20 percent should go to civil-society organizations. Within civil-society organizations, at least 5 percent is on anticipatory action. We need to force the pace. But we’ve got to get out there and do it in South Sudan, in Sudan, in Somalia, in Mali, in Afghanistan.

Dr. Morrison: Yes.

Mr. Miliband: Let’s put the money to work. And the argument – I understand why there’s been an argument, have we reached 93 billion (dollars) a year? Have we reached 95 billion (dollars) a year? Have we reached 100 (billion dollars)? Let’s go spend the money that’s there.

Dr. Morrison: What would be success for Ajay Banga at the World Bank? You know, he’s committed to global public goods – fragile states, conflicted settings, cutting across these disciplines. He’s committed around pandemic preparedness and response. He’s looking to change the mindset and the funding streams and the conditionalities. He’s calling for pretty major changes.

What would – from your standpoint –

Mr. Miliband: Well, there’s an easy answer to that. There’s a –

Dr. Morrison: What would success look like in three to five years?

Mr. Miliband: I think he’d think it’s good news, but it’s challenging news, but there’s an easy answer, which is that we know extreme poverty is going down in stable states, but it’s going up in fragile and conflict states. So the test of success is simple: Do the number of extreme poor in fragile and conflict states stop going up and start coming down? That’s the test.

Dr. Morrison: But what would – what would you – what do you – what would be success in terms of the changes within the bank?

Mr. Miliband: OK.

Dr. Morrison: Like, my point is what are you – what would be the optimal?

Mr. Miliband: Yeah, but I think it’s – first of all, it’s important to say we are very outcome driven, not just output driven.

Dr. Morrison: Yes.

Mr. Miliband: And but the outcome is singular and clear – are there fewer people living in extreme poverty.

Dr. Morrison: Yes. Yes.

Mr. Miliband: The goal – the new goal of the bank is to end extreme poverty on a livable planet and the simplest, toughest metric is is the number of extreme poor going down, not up.

Now, you then perfectly rightly say, well, OK, what are the contributory (success factors ?)? In our model the next click down is – well, there are two key elements to it. There’s a finance gap and there’s a delivery gap.

Dr. Morrison: Right.

Mr. Miliband: World Bank lending as a share of total lending in developing countries is going down, not up; problem. Climate adaptation going to richer countries, not poorer countries; problem. So you can see there’s a series of aspects that – IDA, International Development Association, too small. It needs to be tripled, according to the G-20 panel led by Larry Summers and others.

So there’s elements of fixing the finance gap but then if you fix the finance gap but don’t fix the delivery gap, in other words, how to reach the disadvantaged communities, the hard – so-called hard to reach communities. I always – whenever people say that the communities are hard to reach, no, the services are hard to reach. We’ve got to change our mindset.

The delivery gap requires a totally different modus operandi than one which says, well, we’ll fly to the capital. We’ll deal with the central government. We’ll have an action plan and then, oh, four years later nothing’s actually happened. And the commitment of the bank to a new partnership charter that’s not just partnership between the bank and central governments. It’s got to be a new way of working in fragile and conflict states that recognizes capacities of governments are challenged. We call it a people-centered approach. So I think that’s the next click down.

Dr. Morrison: OK. In the time that remains I want to talk about a couple of specific countries that you’ve highlighted here and then I want to close with a question around what are some of the positive developments that we can point to to prove the case that putting a much higher investment in these issues can deliver results.

But set that aside – that’ll be our closing segment – Sudan has raced back to the fore. What happened in this last year is also astonishing what’s happened within Sudan. Southern Sudan is about to – South Sudan is about to go through an electoral process. It’s very fragile and in a pretty poor state itself.

But what’s happening in Sudan proper has been gargantuan but has sort of moved off the screen.

Mr. Miliband: It never got on the screen, I’m afraid. I mean, last –

Dr. Morrison: And so say a bit about this because that’s your topline country. Not a lot of talk here in town about Sudan.

Mr. Miliband: Top of the list, yeah. So 2019 end of the rule of Bashir. Civilian government 2021. Coup 2023 – the military splits in two and starts fighting and the ripple effects are huge. I mean, this is extraordinary. Khartoum was a city of 8 million people. It’s been depopulated.

Dr. Morrison: Right. And Sudan through all its decades of internal war has never had anything like this, right?

Mr. Miliband: Well, hang on. Here’s the thing. The danger is it has in the following way. So Rapid Support Force – Sudan armed forces clashing supported by different internal actors, back to my point about internationalized civil conflict. But related but separate, what’s happening in Darfur. And this is where –

Dr. Morrison: Mmm hmm, the reignition

Mr. Miliband: – those who are experts tell me they see horrific echoes of 2002, ’03, ’04. I don’t want to get over my skis on that. But there should be real alarm. Twenty-five million people, as I say, in the country in humanitarian need, 1.5 million refugees. They’re not ending up in America. They’re in Chad. They’re in South Sudan. There are people fleeing from Sudan to South Sudan even though South Sudan is one of the poorest countries in the world. Quite a few of those are South Sudanese going home.

Dr. Morrison: Right.

Mr. Miliband: But there’s also Sudanese going to South Sudan, and a very weak and fragmented diplomatic process to try to stop – that’s the first priority, is to stop the fighting. There may be some incentives for each side to stop, but obviously their external sponsors need to – need to be part of that.

And that’s where there’s desperate need for weight to be applied. And it’s very bleak there. At the moment, we’ve got – we’ve had to move our HQ. We’re still operating in four provinces. We’re in South Sudan. We’re in Chad. I mean, Chad’s got – 900,000 refugees are in Chad in total, 450,000 new ones. So I don’t know if it needs to be on the front page, but it needs to be much closer to the front burner. I think –

Dr. Morrison: How do you reprioritize this among those – I mean, those who jumped in – including Washington, who jumped into the early negotiating efforts –

Mr. Miliband: Yeah, they were only allowed into the –

Dr. Morrison: – have largely cooled.

Mr. Miliband: They were only allowed into part of the negotiating efforts. There’s a –

Dr. Morrison: Right.

Mr. Miliband: There’s an – there’s a Jeddah process led by Saudi Arabia, but the Emiratis say that they’re not being allowed to be part of it. There’s an IGAD process, which is an African-led process. It needs some focus. We think an envoy would be helpful in providing a point person on this. We think –

Dr. Morrison: Through the secretary-general – U.N. secretary-general?

Mr. Miliband: Yeah, but also from within the U.S. I think would help in the U.S. system.

Dr. Morrison: Yeah. We had one – something like that – with Mike Feltman.

Mr. Miliband: Yes. So I think there’s room for some joining up there. I’m going to be in the region next month, so I’m hoping to come back with more information about it. In a way, we’re never – it would be wrong to think that the American public is ever going to become expert on the Sudan question, but –

Dr. Morrison: There have been periods in our history where Sudan dominated the debates in Washington.

Mr. Miliband: Just let me finish the point. It would be wrong to think the American public’s going to be expert on it. It’s wrong to believe that the American public can’t be mobilized about it. And just think back 20 years, when there was a massive mobilization around Darfur.

Dr. Morrison: Yeah, around Darfur.

Mr. Miliband: And we think that’s an important part of this process of explanation that we’re trying to do through our watchlist. And the fact that Sudan has vaulted from being a story that gave people hope to one that gives them a sense of dread, I think, should be a mobilizing factor.

Dr. Morrison: One question, you – Haiti’s on your list. Of course, we have now an effort; the Kenyan police are going to be coming in with a deployment. The report’s fairly pessimistic about the prospects for stabilizing the situation in Haiti. Can you say a little bit more about that?

Mr. Miliband: I mean, I’m not an expert on Haiti at all. So we’re working through partners there.

I think that anyone who looks at it and says they’ve got a silver bullet on this – you know too much, you know, to suggest that. There’s, obviously, a massive security question. There’s a massive set of political questions. But there’s also a massive humanitarian question, which we are, at least, able to address some of the symptoms of the problem. Getting to the roots of it and the security/politics dynamic is, obviously, fundamental to it.

I think the Kenyan interest is very interesting. I think the determination of Kenya to put itself at the forefront of a range of questions – economic, climate, as well as intergovernmental and security – I think is quite striking, and I don’t want to pour cold water on that at all.

Dr. Morrison: OK. All right.

And one last thing before we get to the closing question: Ecuador. It’s an interesting case, also, where it’s jumped onto your list. And it’s – the dominant – the lead theme is state trafficking in drugs and imported instability through – from Colombia and various gang-related stuff. But you put a finger here on state drug trafficking. That’s a bit of a standout, too. Say a bit more about that.

Mr. Miliband: Yeah, and I’m actually really – proud is not quite the right word, but struck, because we say at the front of our report that we use 60-plus qualitative and quantitative indicators, and we say it’s helped us predict 85 to 95 percent of the crises. We don’t have a perfect record. We didn’t get Ukraine right. Yes, we didn’t get Ukraine right in 2022 because we were doing the work in September/October of 2021. But we published in December, as you say, and the situation in Ecuador has developed in exactly the way that we feared, which is that you’ve got this historically peaceful country but with a massive drug issue. We’ve got also a climate element with El Nino. And you’ve got threats to political stability from the – from the violence. And as your viewers and listeners who have seen the latest news from Ecuador will say, well, actually, that’s right.

I mean, it was a case for some preventative diplomacy, I’m afraid. And, you know, we said here, state-led militarized responses to crime risk further fueling insecurity and displacement, undermining the ability of rural communities and Venezuelan refugees to access services and afford basic goods. Moreover, the crisis in Ecuador will continue to contribute to historic levels of regional displacement and migration. That’s actually been borne out by what’s happened even in the week since we published the report.

Dr. Morrison: Thank you.

I want to close on a positive note, talking about some of the developments that have occurred, that give you hope, that prove some of your points about the need to focus with purpose and with a clear strategy on some of these issues. I want to mention Ukraine because we haven’t talked about Ukraine. Ukraine’s still in crisis. The status of its own society is under just enormous stress and continued threat. It’s frayed; it’s – clear gaps on many levels within Ukraine. But then the story in terms of the respect and treatment and integration of refugees is an impressive story, and that gets lost, too, in some of the narrative. So I wanted to ask you, as you sit back – this report is meant to focus on ending apathy, put a focus on the prioritization, those that are innocent, dispel myths, and motivate and activate policymakers. I get that. But you also need to counter the “nothing’s going to work” argument, and you need to bring people back to understand that investments have paid off in very significant ways.

Mr. Miliband: Yeah, so that’s a great point. Look, the macro story is that 2023 was a bad year; there’s no two ways about it. And there’s an irony. Six months ago you would have said, well, name me a country where things are turning around. I might have said Yemen, because they got a peace agreement. But you wouldn’t say that now, given what’s happening in the Red Sea.

The contrast, though, to the macro level – and this is what creates frustration for us: The micro level – 2023 saw some developments that I think – three developments that I want to mention, which make me think we can make a dent on this. Number one, we get the results of a study of early childhood development and intervention in the Middle East, which we won the MacArthur Award with Sesame Workshop. It turns out in Lebanon we’ve shown you can make a year’s worth of pre-primary progress through 11 weeks of our Ahlan Simsim program, which was innovated through COVID and is about early – trauma amongst kids. We helped 27,000 kids recover from malnutrition in Mali. We showed you can get a 20 to 30 percent efficiency saving by catching kids early with moderate nutrition. And just this week, I’ve been catching up on a program funded by GAVI, the Global Alliance on Vaccines and Innovations, to immunize zero-dose kids in East Africa. We’ve reached 700,000 zero-dose kids who were considered beyond the reach of authorities in the first nine months of the program. So what fuels me is that actually it’s not just about money, it’s about –

Dr. Morrison: Programmatic effects.

Mr. Miliband: – mandates and focus, you said. The way I put it is, don’t let policymakers hide behind the excuse that they don’t know what to do. There’s a lot that they can do if they read the report.

Dr. Morrison: Thank you. David, congratulations. Thank you so much for making time to be with us today.

Mr. Miliband: Thank you, Stephen.

Dr. Morrison: Look forward to talking further at Munich Security Conference. Look forward to the Atlas of Impunity, the next iteration of that. And come back again.

Mr. Miliband: Thank you very much, Stephen. Good to be with you.