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I recently had the opportunity to review a paper on mutual accountability for a special edition of a well-known global health journal. It was a difficult paper to review and I’ve been reflecting on why I found it difficult. Part of the problem (all of the problem some might say!) is my own ignorance: I’ve never really stopped to think about what ‘accountability’ means, what ‘mutual’ means, or what it means to juxtapose ‘mutual’ and ‘accountability’ to form such a heart warming new phrase. Well, why would you? For those of you who don’t have their Bluffers Guide to Mutual Accountability to hand, I summarise a few of the key points and flag a worrying trend emerging from new results on the extent of partner buy-in to this core tenet of aid effectiveness.

Mutual Accountability (MA) is a potentially liberating idea that just might help developing countries hold their international financiers to account. Historically, accountability has been a one-way street: donors have, understandably, been anxious that their aid money doesn’t end up being spent on the wrong things – like bags of ‘dirty looking stones’, for example. So they have tended to engage in unilateral relations with recipients of their aid and, essentially, ‘bought’ compliance – if you don’t do what you said you’d do, you won’t get any more aid.

As one of the five pillars of aid effectiveness enshrined in the Paris Declaration, MA attempts to shift the dynamic from unilateral to bilateral relations: recipients of aid remain accountable to donors, but donors have commitments too, and for the first time developing countries can – in principle – hold donors to those commitments.

One of the most commonly cited examples in recent years of a MA mechanism devised and utilised by donors and recipients of donor aid is the International Health Partnership (IHP+) ‘Compact’. Stripped down to its basics, the Compact is a list of transparent commitments: donors agree to do x; recipients agree to do y. The Compact is in the public domain, and all partners to it can hold each to account for their actions (or, as is becoming increasingly apparent, inaction).

At the national level, individual countries and donors have established their own mutual accountability mechanisms. We learn from a 2009 study by the Overseas Development Institute that Vietnam has a tool for monitoring progress towards development outcomes as part of its Poverty Reduction Support Credit – “a local version of the Paris Declaration”; that Rwanda’s Economic Development and Poverty Reduction Strategy – a strategy that evolved from Rwanda’s first Poverty Reduction Strategy – functions as an accountability mechanism; and in Mozambique, a donor assessment tool is being used that complements the country’s Performance assessment Framework. This is good news, but it is not the whole story, as we will see.

At the international level, there are few tools in the MA box that we can use to measure partner buy-in: peer review of “existing international accountability mechanisms” introduced at Accra but ill-defined, and the IHP+ review-come-monitoring exercise currently underway are two that come to mind. A 2008 study by researchers at Oxford Policy Management makes the fundamental point that MA is dependent on the willingness of partners to be held accountable. Unfortunately, there are signs that some donors are either less willing or less able than others to engage with the MA process.

In May, representatives from many International Health Partnership (IHP+) signatories attended an IHP+ partners technical meeting during the World Health Assembly to review progress on improving mutual accountability. An update on the IHP+ external evaluation-come-monitoring exercise was presented and it reported its initial findings on mutual accountability (see my earlier post IHP+: think creek, think paddle). According to the IHP+ Results Update, May 2010:

“Since 2007 no agency had publicly reported on their performance in implementing their IHP+ commitments at either the country or global level” revealing that agencies were not set up “to easily provide information on their performance when requested, or even to record what specific, accountable actions they have been taking to implement their IHP+ commitments”.

Then the update gets into specifics and lists those partners that have and those that haven’t reported.

Those that have reported:

AusAID (Australia), DFID (UK), GAVI, GFATM, UNICEF, UNFPA, UNAIDS, WHO, WB

Those that haven’t reported:

Governments of Burundi, Cambodia, Ethiopia,  Kenya, Mali, Mozambique, Nepal, Nigeria  and Zambia. Agencies: African Development Bank, AFD (France), European Commission, CIDA (Canada), Finland, BMZ (Germany), IPAD (Portugal), UNDP, Italy, Netherlands, NORAD (Norway), SIDA (Sweden), Bill and Melinda Gates Foundation.

These early indications of engagement in the MA process are not encouraging. The bottom line for MA is aid effectiveness: MA helps to mitigate the power imbalance that inevitably arises when one party is financially dependent on another party for money. In the past, this imbalance has been detrimental to the aid process, and it is hoped that MA will level the playing field, restore trust, engender ownership, and thus make aid more effective. This is not going to happen if partners – both international and national – do not, or cannot, report progress. Hopefully, this is a capacity issue; if not, and we are seeing the first signs of retraction, then a great opportunity for introducing equity into aid is about to be lost.

Andrew Harmer

Tags: aid, IHP+