[MUSIC] I am now going to discuss some of the future opportunities to improve humanitarian response and perhaps to make it more effective. Cash and vouchers, often called cash transfers, are not new in humanitarian emergencies, they've been used for decades. However, they are being used differently now, particularly due to increased technology and due to the changing natures of these humanitarian emergencies. It is important to clearly recognize that cash transfers are a modality and they can be used to address basic needs. Or, they can be used to protect, establish, or re-establish community assets and livelihoods. These are two different objectives. In this particular area of humanitarian emergencies, I'm going to be concentrating on the use of cash transfers to address basic needs. And what we mean here is that as opposed to in-kind or simply giving goods, food, services. We are providing cash or vouchers to the affected populations, and they themselves are able to choose what they wish to buy or which services they wish to use. Cash transfers can come in different ways. One is unconditional cash transfers, sometimes called multipurpose cash. Cash is given without the need to work or to attend a specific activity. And cash is given to targeted households either through a set of criteria or through simply a blanket distribution. Conditional cash transfers are different because cash is given with the condition to participate in a specific activity or to undertake certain work. Cash vouchers are also different, because it is not cash directly given. But they are actually vouchers, which are interventions that aim to facilitate access to a specified range of commodities or services. For example, in the past we have given vouchers to refugees in the Dadaab refugee camp, and they were able to exchange these vouchers for fresh food. In other settings, the World Food Program has given vouchers to Jordanian refugees who are then able to go and use this voucher in a supermarket for a specified type of goods with the specified amount. Private sector, and particularly the banking and the IT sectors, as well as cellular phone companies, are becoming more involved in cash transfers, and this is welcome. So why give cash transfers? What is the benefit of cash transfers versus more classical in-kind transfers that we have traditionally given in humanitarian emergencies? Well there are many positive benefits, for example, the empowerment, dignity, and choice to recipients. I've been in many situations where people affected by humanitarian emergencies are not given a choice. They're given a bucket, they're given grains, they're given oil, no sugar, no salt, and no choice. The ability for anyone to spend money, to have a choice, provides dignity and actually may be more efficient. Because we have seen, and it is very common for people that receive specific food, or receive a blanket, or receive a mosquito net, in some situations they may be selling this. Not because they don't wish to have this specific material or this specific food. But in fact, they prioritize something else that they may wish to have. And then what happens, is they often sell this commodity at a lower price. Get cash and then buy something else, which they perceive to be of higher benefit to them. Therefore, cash transfers may actually be a more efficient modality in many situations. Finally, there's a multiplier effect that supports the local economy. In the past, we would often have food that would come from another country and be delivered inside the country affected by the disaster. When cash or vouchers are provided, they are buying from the local economy and therefore the local economy may be stimulated. And therefore, not only may the affected populations benefit, but as important, the nationals who are supporting, who are hosting these people may benefit as well. Hopefully, that will be a win-win situation. The evidence for cash transfers in humanitarian emergencies is primarily related to food and dietary diversity. There is little evidence of how cash transfers affect the health of communities. Cash transfers may be more complex in these settings because one has to take into account the supply and the demand. One can provide a lot of cash in a situation, but if there are no health centers, if there are health centers but there are no doctors or nurses, then the money will not be useful. Therefore, there needs to be more research into how cash transfers can be used in humanitarian emergency settings for healthcare, in terms of both access and quality. Humanitarian funding has increased over time, as have the needs for such funding. For example, humanitarian funding proposals grew over ten times, from US 2 billion in 2002 to US 24.5 billion in 2014. However, in 2014, only 62% of the funding needs were met. This was the largest shortfall ever previously recorded. In 2017, the appeal for humanitarian emergency funding was 22.2 billion to meet the needs of approximately 93 million people in 33 countries. What is important to understand, is that although the funding has significantly increased, due to the complexity, the magnitude, and the number of humanitarian emergencies, the needs have outstripped the funding available. Clearly, more funding needs to be available for humanitarian emergencies. However, most of the funding comes from Western governments, and it is not possible for them to continue to increase their funding year after year. Therefore, we need to look at different and innovative mechanisms to fund humanitarian emergencies. One area that we have discussed is to provide more funding to governments and local NGOs. This will change the power dynamics and responsibilities as we have discussed. We are also noting a change in the provision of humanitarian financing. Although Western governments are still giving the large majority, in the Syrian crisis we have seen an increase of funding from the Gulf states, and other Islamic countries. This is a positive dynamic that I hope will continue. Finally, we are noting that the private sector is becoming more involved. This should also be seen positively for a variety of reasons. As we mentioned with cash transfers, banks, cellular companies, IT companies, are becoming increasingly involved. And this may, in some circumstances, improve efficiency and effectiveness of the response. Again, there will be more diversity in the sources of funding, and that is clearly needed as the requirements for funding are outstripping the actual amount of money being given. The last component to humanitarian financing is innovative humanitarian financing mechanisms that need to be explored. This is already occurring but I believe will increase significantly over the next few decades. One example is health insurance which is quite exciting. Years ago, we never would have expected that health insurance could be provided to refugees, for example. However, currently there are over ten situations where refugees, or those helping refugees, have the opportunity to receive health insurance. Either private, or what we would prefer inclusion into national systems. One example is the Islamic Republic of Iran, that has allowed refugee access to their national health insurance programs. UNHCR pays for those that are most vulnerable and who cannot afford the premium, but because the Iranian government allows refugees to have livelihoods to actually work and make money. In many situations, the refugees themselves are able to pay for the health insurance. There have been many positive spin offs from the health insurance in Iran, including the possibility for increased protection of refugees. And increase interactions with these refugees from other agencies. Another interesting financing mechanism is bonds. For many years, there have been what are called catastrophe bonds, or bonds that are available when natural disasters occur, particularly drought or flooding. More recently, due to the Ebola pandemic, the World Bank and the World Health Organization, amongst others, are creating a Pandemic Emergency Financing Facility. This will allow a quicker response, but also funding coming from different organizations including the private sector in response to newly emerging pandemics. There are possibilities for many other bonds, ICRC, or the International Committee for Red Cross, has developed a humanitarian bond specifically to address prosthetics amongst war wounded. In the future, we look forward to working with a wide variety of actors. To see how the private sector, the banking sector, philanthropists, and others, can all work together to develop different financing mechanisms. To allow for a greater diversity of funding sources for humanitarian emergencies. The last area that I wish to discuss, is the humanitarian-development nexus. This is not particularly new, and in the past it's been called the humanitarian development divide or the humanitarian development gap. But in essence what it means is that we need to get humanitarian actors and development actors to work more closely. It should not be sequential, they should be working together in terms of preparedness as well as response. So the definition that we are using is the following. It's a connection between humanitarian and development organizations. Where each group works together in a concerted manner to address humanitarian requirements, while taking into account the current and future development needs. There's always been a need for this, of course, but the complexities and the magnitude of the Syrian crisis have really shown the importance of this. For example, in Lebanon, when you have one in four people in Lebanon right now being a refugee, clearly this is affecting the development of Lebanon itself. The World Bank became involved and started to examine the effects of refugees, both positive and negative, on the local economy as well as the development plans of Lebanon. And, the effect of existing services whether they be education, shelter, or health. The World Bank has begun to provide loans to middle income countries to whom they did not provide such loans in the past in cases where there are significant amount of refugees. And they are working with other UN organization to try to work on the development of refugee integration into hosting communities. As we had mentioned previously, it is preferable for refugees, or internally displaced persons, to be integrated within the communities and not to be in camps, if possible. But, ultimately, that is the decision by the government and there are many factors involved. However, in situations where refugees or internally displaced persons are settled into camps or settlement like situations, the master plan approach is preferred. This is a systematic, comprehensive, and holistic approach to settlement planning. We need to look at how refugee settlements can be a benefit to the host community, and how shared resources can be employed to benefit both communities. For example, parallel services should be avoided, and one should be looking at the development plans in those districts where the refugees or internally displaced persons are located. Can we develop schools or healthcare centers that will benefit not just the current nationals and displaced populations, but those in the future as the development plans and as the development occurs in those areas. I will end this subject of humanitarian-development nexus with an example in Kenya, called the Turkana Initiative. Currently, there are tens of thousands of refugees from both South Sudan and Somalia. That are located in the Turkana District, in a camp called Kakuma Refugee Camp. They've been there since 1992, and it has fluctuated over time. And what's happening in those camps is what we call a care and maintenance program. Which assumes that the refugee situation is temporary and that solutions for displacement will be found. And in those situations, parallel services exist, but they've been existing now for decades. Luckily in Turkana area, natural resources, both water as well as natural gas, have been found. So the Kenyan government, together with the World Bank, UNHCR, UNDP, and other organizations, are looking at how we can develop Turkana for the future taking into account what they believe will be a change due to these natural resources. The World Bank is offering concessional loans to the government. And UNHCR is working, because unfortunately there are more and more refugees still coming from South Sudan and Somalia. So together we're working on how we can develop a different sort of plan, perhaps more like a settlement or villages, where nationals and refugees will be able to benefit both in terms of livelihoods, in terms of resources. And in terms of future for Turkana to benefit ultimately both the displaced populations and the nationals. Here are the main messages for this module. There are multiple pressure points or areas of tension which can lead to new vulnerabilities and create risks for future disasters. These include, but are not limited to, demographic changes, food and economic factors, changing diseases patterns. Remember, we discussed non-communicable diseases and their increasing importance, fragile states, climate change. And these will create single, additive, and multiplicative vulnerabilities for future disasters. Understanding these risks, preventive actions can be taken to mitigate them. Humanitarian emergencies are becoming more prolonged and complex than they have in the past, making the case for bridging the divide between humanitarian and development actors. Coordination has become too complex with too many actors and a prominence of international players. As governments and national NGOs are increasing their capacity, the role of these international actors and their prominence will need to change. Cash transfers has become an important modality that provides more dignity and choice to recipients and could be transformative in humanitarian aid coordination and response. Humanitarian funding provided mainly by Western governments cannot continue at the same or increasing level due to increasing needs and political pressures. Other sources of funding from different governments and the private sector is increasing but needs to continue. And innovative health financing, such as bonds and health insurance, will likely also play a stronger and more important role in the future. Finally, the humanitarian-development nexus may also be implemented in a more concerted manner than in the past. As the World Bank and other institutions recognize that development of countries is impeded by the effects of increasingly prolonged humanitarian emergencies. [MUSIC]
