IRIN Interview with UNICEF Executive Director Carol Bellamy

Carol Bellamy recently visited the Democratic Republic of the Congo (DRC) for a six-day tour to support and oversee the countrywide anti-polio campaign. Bellamy, who assumed office as the fourth executive director of the UN Children’s Fund (UNICEF) on 1 May 1995, has made polio vaccination a centerpiece of UNICEF and its partners’ development platform, following a global initiative launched in 1988 to eradicate poliomyelitis by the end of the year 2000. In the 13 years since the polio eradication initiative was launched, the number of cases has fallen by 99 percent, from an estimated 350,000 cases in ‘88 to 3,500 in 2000. At the end of last year, the number of polio-infected countries was no more than 20, having fallen from 125. The new target date for certification of the world as polio-free is 2005. In her interview with IRIN, Bellamy explained UNICEF’s massive mobilisation of resources towards the eradication of polio, convinced that it will become the next disease to be globally eradicated, and praised the broad-based mobilisation for the immunisation effort in the DRC. She also spoke of her recent meeting with DRC President Joseph Kabila, the upcoming UN Special Session on Children, the fundamental need to include girls and women in all development efforts and her introduction to humanitarian work early in her career. QUESTION: Are you encouraged by what you have seen in the polio eradication programme? ANSWER: First of all, I think the polio eradication campaign is going quite well globally. It’s had a major infusion of activity over the last couple of years, a dramatic leap in coverage - so that, in fact, 10 years ago there were 154 countries with polio, by 1999 there were 33 countries, by the year 2000 there were 20 countries, and, we hope, by the end of 2001, fewer than 15. That being said, the remaining countries are confronting particularly serious obstacles. Money is always a problem but, additionally, now we have the problem of war, and war makes even the simplest of activities a logistical nightmare. But on balance, I must say, certainly in the DRC, I’ve seen dramatic improvement over the last couple of years. I think Angola needs to put a little more energy in to their efforts, but I think that there’s certainly been an improvement this year over last year. Q: You have said you are very encouraged by what you have seen in the DRC, and that the DRC is more active than other countries in its efforts to eradicate polio. What do you see being done here that’s not being done elsewhere? A: Well, there are some other countries where there’s enormous activity. India is a country where 153 million kids were immunised in the course of national immunisation. I was thinking - for instance, having come from Angola - that there are parts of the country that are still incredibly inaccessible. The great majority of the population in Angola is accessible, and so we first need to have really energetic mobilisation to reach those ... But there are some places that are totally inaccessible. Here in the DRC, although we haven’t gotten to everyone, there’s been at least an attempt to get to them. Nigeria is a country where there’s a great deal of activity now, where for many years there was very little, so Nigeria has a huge amount of catching up to do, and it’s so big population-wise, the biggest country in sub-Saharan Africa. And then there are a couple of other countries where it’s almost gone, but it’s just that last step... But I think that in terms of broad-based mobilisation, the DRC - along with India - is among the best I’ve seen. Q: Why have you attached such importance to the issue of polio eradication, to the extent of making repeated trips to some very difficult areas?? A: Well, actually, Dr Gro Harlem Brundtland from WHO [the UN World Health Organisation] and I agreed at a meeting about a year and a half ago that we would lend our own personal energy to this final push - particularly in those countries that were proving to be hardest. Again, I mention India, Bangladesh; they are very big countries but they’re getting there. Bangladesh had only one case last year. In DRC, Angola, Somalia - countries where there’s war - not only do you need the vaccine, not only do you need the campaign, but you’ve got to try to get the parties to agree to stop fighting, at least for that period of time. So, it is a high priority for UNICEF, but it’s also a matter of lending some personal support to try to bring about these “Days of Tranquility” [for and around National Immunisation Days]. Q: How would you respond to critics who say that perhaps there are more pressing and widespread health concerns that could be addressed than polio? For instance, a doctor in Uganda recently asked IRIN why such a campaign wasn’t being mounted against tetanus? A: ... Or malaria or others. Well, I think there’s no question that this polio campaign is a very vertical campaign, and on balance it is UNICEF’s policy not to support major vertical types of campaigns but to support the development of health systems - but we are so close, globally, to winning this extraordinary war and wiping out a major disease that it would be, I think, unconscionable to lose all the effort that’s gone on for all these years. So I do consider polio to be something of an exception. I believe our efforts have to be very focused on health care generally and I try, wherever possible, to ask about what is happening with the cold chain, because the cold chain for polio will sustain the cold chain for measles, it will sustain the cold chain for hepatitis or for tetanus. Community advocates who are trained will be useful in other campaigns. Now, some of the other campaigns are more difficult. You can train many people to administer the two drops of oral polio vaccine; measles actually requires an injection, so that requires more sophisticated training. So, I think we should never only do polio without trying to leave in its place a strengthened vaccine delivery system. I do acknowledge the vertical nature of the polio campaign, but it would be just a catastrophe to lose these years that have brought us to the brink of success. Q: UNICEF and WHO have warned that there is an estimated funding shortfall of some US $400 million for polio eradication between now and 2005. Do you think there exists the political will and commitment on the part of donor countries, as well as those countries still suffering from polio, to see the campaign through? A: There are three major problems remaining: money, vaccine and reaching all kids, and the money issue is the really critical one. I hope there is the political will to do this. One of the problems that we’ve confronted is the fact that because polio does not exist, to speak of, in the north, it’s not seen as a critical matter. But polio, if you don’t contain it, ultimately it’s going to come back and affect others. There was a recent outbreak in Bulgaria, just one kid - but they were able to trace it back and contain it immediately, but otherwise you could have had some outbreak of polio in Europe. So I hope the money is there. What has also become clear is that it’s also very expensive to eradicate polio in these remaining countries. DRC is an example. You’ve got to virtually fly all of your materials everywhere, you can’t go by road. There really isn’t electricity in many places, so your cold chain has to be maintained in a more expensive way. It requires major mobilisation. You have to negotiate with the parties, and you have to bring in your supplies from different parts - you can’t bring your supplies for the [rebel-controlled] east from [the DRC capital, and seat of government] Kinshasa. So it becomes quite an operational challenge, which costs much more money. But, again, we at UNICEF have allocated US $10 million additional funding this year, and we hope donors will come in with more as well. [For more information on the global polio initiative, go to: http://www.polioeradication.org] Q: Though relatively small in number - vaccinators in Kinshasa estimated perhaps one case in every 100 - some parents are reluctant to have their children vaccinated because of fear that their children will contract polio, or because of mistrust of modern or western medicine. How would you respond to such concerns? A: Well, I think it’s mostly misunderstanding, not so much that the children are going to get ill. The polio vaccine has been around since the 1960s: this is not something new, it has been studied. We only use vaccines from WHO-approved companies, and every batch is tested. Some of the problems we run into, quite frankly, is that we’ve had to postpone some of the immunisation days a month because a batch didn’t come out right, and we won’t use a batch that doesn’t meet absolutely every standard. That’s all intellectual and medical but the fact is that there’s probably nothing that’s 1000 percent safe ... yet there’s probably very little more safe than oral polio vaccine in terms of how many people it has saved from being crippled, and it’s used all over the world. But I do think we have to not dismiss people’s fears, whether cultural or otherwise, and I think we have to work with our community advocates and mobilisers to keep getting the message out. Radio is a great way to get the message out, and neighbours; that’s why we use vaccinators who are from the community. I think there has to be a trust in who is doing it, as well as the fact that we can scientifically stand behind the medical facts. Q: You met with DRC President Joseph Kabila the other day. What did you discuss? A: Well, it was a brief meeting because he was leaving [the airport] and I was coming, but I was pleased to have had the opportunity to meet with him. I congratulated him on the recent position that he had taken publicly, and in front of the armed forces, in terms of discontinuing the use of children as combatants, and on the demobilisation of children. We are certainly prepared to work with any faction to any conflict in terms of demobilisation and reintegration. The programme isn’t entirely in place with the Kabila government, but he has also approved giving the humanitarian community access to visit the different camps, so our view is that this is an indication that he is serious about what he says: that it’s not just a proclamation. If the authority to visit the different centres and camps is there, that certainly is a strong confirmation of an interest in moving in this direction. Secondly, we talked about children in DRC, the polio campaign and other challenges. We discussed education, particularly the education of girls ... [We also discussed] the fact that the great majority of the education system in DRC is paid for by parents, that the government is assuming very little responsibility in the area of education, and that there’s a new budget being developed - which I realise will not be large - but that education needs to be an important part of it. Finally, we discussed the upcoming Special Session of the UN General Assembly on Children [scheduled for 19-21 September] and I encouraged him to attend, representing the DRC. I thought that he had a strong message [to give] in terms of moving towards peace and how important that was for children, and he indicated that he was giving serious consideration to coming to the Special Session. Q: Regarding the Special Session on Children, you’ve set out a very broad and ambitious agenda: what has been accomplished in the past 11 years, and what hasn’t; new areas to be addressed; the formulation of policies; and the concrete actions to be taken. How optimistic are you that real, tangible results will come of this conference? A: Well, 11 years ago, in 1990, the World Summit for Children was held, and there was a specific, concrete plan of action that was largely focused on health issues, with some focus on education and then a fuzzy one on protection. Most of it was quite measurable, like reducing infant mortality rates, increasing access to water. And UNICEF and others - but UNICEF, in particular - have really monitored, country by country, what has happened, with the participation of the countries themselves. UN Secretary-General Kofi Annan’s report, capturing generally what has or hasn’t happened since that time, is quite an interesting document. It is based on over 140 country reports that the countries themselves have done, reporting on whether or not there has been improvement. So, to the extent to which people think that UN meetings are just meetings where people come and talk and nobody does anything, I think the follow-up and monitoring from the World Conference for Children has been good. We know, for example, that of the 20 countries in the world with the worst record on under-five child mortality, 19 are in sub-Saharan Africa. We know, generally, what the enrolment rate is in different countries; with the best figures that we can get, they’re still not perfect. So, our hope is that the 1990 World Summit for Children model (not saying everything has to be the same as 1990, but that model of having a relatively concrete plan of action) will not be quite as specific as 11 years ago but will allow enough local or regional focus, with monitoring and with resources. We are hopeful that, over the next five to 10 years, even more can be accomplished than over the last 10 years. Now, what I think is the disappointing element over the last 10 years is leadership: that money alone, plans alone, are not enough and there needs to be leadership. Even in the poorest countries who have a right to complain about debt burden, many of those are involved in war, so part of the challenge of this Special Session and beyond is to try and create more pressure on those who have to act on behalf of children so that more of the promises will be kept. That’s also why we, working with others, are trying to help generate a Global Movement for Children so that government knows that it has a responsibility - and that parents also know, and kids know, and the private sector knows, and civil society knows, and everybody is going to be trying to hold each other to their promises. There is no magic wand but we’re looking for ways to try to bring more focus and pressure on keeping the promises we make. If you’re prepared to make them, then you need to keep them. Q: Do you have a sense that, being a woman leading a major UN organisation, your visits have an impact on women and girls in countries where opportunities for them are sometimes very limited? A: I hope so, actually. I try to make sure that I take a little time with the women; it may only be a brief time but, for whatever it’s worth, I try to encourage and empower them. And because I feel so passionately - as we do at UNICEF - about girls’ education, I raise the issue of girls education virtually everywhere that it seems to be appropriate to raise. I truly believe that you will not see real development, real grassroots development, take hold unless women are more empowered to make some choices about their lives. That doesn’t mean that they’re out marching in the streets - well, maybe a few may - but that’s not what I’m talking about when I refer to empowerment; I’m talking about women just having the basic tools - that boys go to school but girls get to go to school as well. We know that there’s a direct correlation between the fact that a girl who has even a basic education is, as a woman and therefore mother, less likely to have her children die under the age of five than a girl who has not had a basic education. She is more likely to take care of herself, so she is more likely to be healthy. By being more likely to be healthy, she is more likely to be economically somewhat more secure. All of this ultimately contributes not only to that woman and to her family, but to the community. So it is in the community’s interest that women not just be subjects of violence, not just be assumed to not need school because they’re “just trying to get married” ... Fine, you can get married, I’m all for that, but that there really does need to be a participation of women in society and that’s going to have to start with girls. My three predecessors at UNICEF have been men, and they have done great things, so it’s not that only a woman can do that. But, occasionally maybe, just the fact that the women will see a woman there - and even for the men there - maybe they’ll think “maybe we have to take women into account.” Q: How was it that you developed an initial interest in humanitarian affairs, and children in particular? A: Well, it wasn’t really in my plans [as a youth], and then I got locked in the library one night at my college, and I was stuck there all night and I didn’t know what to do (It turned out the door wasn’t locked, as I found out later) but I found a Peace Corps pamphlet. It seemed really wonderful, and I joined it for all the same reasons that I think kids - because we were mostly kids - joined in those days. I joined it because I wanted to save the world, but it also sounded sexy. So, it was a little bit of “make the world better” ... I grew up in the ‘60s. I believe that everybody makes a contribution to make the world better. It was the best, best, best thing I ever did. I think that’s how everything started for me, to tell the truth. I came back from Peace Corps, went to law school and then went to Wall Street and worked for a big law firm doing business law, but it still was the ‘60s so, at night, a bunch of us started a group called the New York Law Associates, and we used to do ‘pro bono’ [for the public good] work for tenants and poor people, and stuff like that... In fact, it’s still the biggest ‘pro bono’ legal group in New York City at this point. So, it just got under my skin. Then I was in politics for many years but, again, I did a lot of stuff on foster care and adoption, and teen pregnancy and kids... But women always get into the women. I said, ‘I want to do insurance and finance because those are the areas that I’m interested in and which I like’ but, in those days, as a woman, you also understood that you have this additional kind of challenge, because if you didn’t get involved in those [social sector/developmental] things, other people wouldn’t get involved either. So, Peace Corps for me is the underpinning of everything I’ve ever done, good and bad! Q: So what brought you back to humanitarian affairs? A: I liked having had private and public sector experience. What brought me back is that Bill Clinton got elected President [of the United States] and the Peace Corps offered me the job of director. Initially I turned them down so they said, ‘Come down and see the Peace Corps.’ And I said, ‘No, no, I love the Peace Corps, but I’ve already been a Peace Corps volunteer.’ But I went down to Washington one day and just fell in love with the Peace Corps again; I called them back and said, “That was my evil twin who had said no, and yes I’d love to be director of the Peace Corps.’ I was Peace Corps director when my predecessor at UNICEF, Jim Grant, died. I didn’t know about all the politics in the UN and I didn’t realise it was a big fight between the Americans and the Europeans trying to pressure the UN Secretary-General to appoint somebody [of their own]. I think the Americans said, ‘We’re looking for a woman, somebody who has business experience and somebody who has development experience’, and I, just luckily, was sitting in the right place at the right time ... I have the best job in the world, and I work with great people. It’s a wonderful mandate.