Middle Income Countries: Reclassified

On 24 March 2016, STOPAIDS held a symposium bringing together over 60 representatives from government, multilateral organizations, NGOs, academic institutions, private foundations and activists living in middle income countries from across the international development field to generate ideas and debate around how to engage with middle income countries.

The outcome document from the symposium in now available.

You can read about the symposium in the Guardian or check out the social media activity from the day.

Photos from the day are available here.

STOPAIDS will circulate the notes from sessions and an outcome document to participants and more widely in the coming weeks. A short summary of the day is below. Thanks to all our speakers and attendees for an insightful and motivating day.


Opening Plenary

The day began with a keynote address from Stefan Dercon, chief economist at DFID. Stefan gave an overview of DFID’s views on aid allocation and transitions, in the context of the new UK aid strategy. He was followed by Abhina Aher, Programme Manager at the HIV/AIDS Alliance in India, who outlined her work in India with men who have sex with men, transgender, and hijra community members. Abhina highlighted the impact of reduced Global Fund support to India, especially where political will to invest in marginalized populations is weak.  Mike Podmore, Director of STOPAIDS concluded the plenary session calling on the audience to challenge the assumption that supporting MICs comes at the expense of LICs, and arguing for a better understanding of the needs of particular countries and the marginalized groups within them.


Leaving No one Behind in Middle Income Countries

Hosted by BOND, this session featured presentations from Violeta Ross Quiroga (Bolivian Network of People Living with AIDS), Tim Wainwright (ADD International), Tanvi Bhatkal (Overseas Development Institute), and Katy Wright (Oxfam). Violeta and Tim gave examples of challenges faced by two particular marginalized groups, women and girls and people living with disabilities. Tim argued that to ensure people living with disabilities are not left behind, we must support civil society organisations in MICs to advocate to local and national governments and engage health and transport specialists to ensure their policies include people with disabilities. Tanvi then presented her research on identifying who is being left behind in different regional contexts- highlighting the importance of having reliable data on marginalized groups and the challenges of capturing qualitative aspects of marginalization with simple quantitative indicators. Lastly, Katy addressed the broader issues around economic inequality in MICs and the way wealth distribution influences who is left behind.


Beyond GDP: Indicators for Assessing Development

Hosted by MSF, this session included presentations from Stefan Dercon (DFID), Anna Thomas (Action Aid) and Mit Phillips (MSF). Stefan agreed that GNI is a poor measure of need and the health burden within a country but argued that it was a good measure of the domestic fiscal space. He acknowledged that transitions away from aid were political, and that it is necessary to ensure that fiscal space is translating into actual government spending. Anna outlined three schools of thought behind how to allocate aid and the implications of each for funding for MICs. Her overarching message was that aid can achieve many different outcomes, and the purpose and type of aid should be adapted to country context. Finally, Mit focused on the implications of using income based classifications for the health sector and the findings of the recently concluded Equitable Access Initiative, which recommended using indicators to measure health burden in addition to GNI when making funding decisions.


Funding for Civil Society in Middle Income Countries

Hosted by the Alliance, this session included presentations from Christoph Benn (Global Fund), Violeta Ross Quiroga (Bolivian Network of People Living with AIDS), Irene Keizer (AIDS Fonds & Robert Carr Network Fund). Christoph presented on ongoing Global Fund processes including the strategy, allocation methodology and eligibility policy and their focus on human rights and implications for MICs. He addressed the Global Fund’s role in using their leverage to encourage governments to work with civil society and the Fund’s role in funding civil society directly. 

Violeta spoke to the importance of investing in civil society to ensure the gains of development are sustained when a donor leaves and reminded the audience of the additional challenges civil society faces in undemocratic states. Irene outlined the Robert Carr Network Fund’s work funding civil society networks to do advocacy but stressed that a lack of resources mean high quality proposals go unfunded. Other issues discussed in the panel included: the importance of demonstrating impact of advocacy, mechanisms for funding civil society and sources of funding for civil society.


Ensuring Responsible and Sustainable Transitions

Hosted by the Eurasian Harm Reduction Network this session included presentations from Ken- Marti Vaher (Estonian Member of Parliament), Valentin Simionov (INPUD), Fanny Voitzwinkler (Global Health Advocates), Julia Greenburg (OSF) and Phil Johnston (DFID). Ken Marti reflected on the Estonian transition experience, identifying the key components that led to its success, including early planning and political will. Valentin, in contrast, reflected on the failed Romanian transition, picking out a lack of funding for civil society and lack of planning as key issues.

Fanny then addressed the impact of transitions on TB particularly in terms of the availability and pricing of drugs. Julia highlighted the responsibility donors have to spot the gaps that a transition might create in order to ensure the sustainability of their own investments. Phil reiterated the need for early planning for transitions and importance of predictable funding, suggesting the Global Fund needed to have a list of countries and their timelines for transition. He also suggested that there needed to be a mechanism for civil society to notify a donor when it looks unlikely the government will take over programs.


Closing Plenary

Baroness Barker chaired the closing plenary session of the symposium. Anton Basenko (Alliance for Public Health), Ken-Marti Vaher (Estonian Member of Parliament), and Anna Thomas (Action Aid) presented. Anton highlighted the role of international aid in his life personally and in Ukraine more widely, highlighting the lack of political support for harm reduction programmes and the need for civil society advocacy and service delivery to continue. Ken-Marti spoke to the importance of integrating development into national frameworks and the importance of transparency and monitoring in order for governments to be held accountable. Lastly Anna, reinforced the critical importance of ensuring the sustainability of donor investments and the role civil society can play in supporting this.

To stay up to date or join in on our work on MICs, please email alysa@stopaids.org.uk