MICHAEL GREEN: May I say how wonderfully beautiful and radiant you're all looking today.
It must be the blessings of Archbishop Tutu having their effect.
Delightful, to see so many of you here today.
I'm Michael Green, I'm moderating the session --
-- so, my job is to not get in the way of these brilliant people having a conversation with you.
Let me quickly run through the housekeeping rules.
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Open up Twitter, or whichever social media channel you like.
The hashtag is - #skollwf
But I didn't need to tell you that. You've been tweeting away already, haven't you.
And then look, there's another hashtag [web address] here, to continue the discussion on this session in particular --
-- right here in the bottom left. I won't read it out.
What we're going to do, is have a couple of presentations and some discussion amongst the panel, then open it up to you.
We very much want to bring you in to be a part of this discussion.
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This session is being live-streamed.
So, hello world, welcome, glad you're with us, you're looking radiant and beautiful as well.
Good.
Now, this session is all about a paradigm shift.
The paradigm shift is, the world has changed in an extraordinary way in the last 10 years --
-- the way we think about the world.
We've had the financial crisis of 2008, --
-- we've had the Arab Spring, --
-- we've had the growing recognition and acceptance that the world is running up against environmental constraints.
We wouldn't be here if we thought the world was on the right path.
We know we need to think differently about the world, --
-- to redefine our goals, redefine where we're trying to get to.
And so, I'm delighted that we have someone here today who's going to reframe that debate, and describe that paradigm shift.
Karl Marx said, "Philosophers have so far only described the world in various ways - our job is to change it."
Professor Michael Porter is a living [representation] of Karls Mark... Karl Marx --
[AUDIENCE LAUGHTER]
-- because he is a philosopher, a scholar, of outstanding distinction --
-- but has also changed the world in fundamental ways.
He's changed the world of business, with his work on strategy.
He's changed the way countries think about economic development, with his work on competitiveness.
Today he's going to tell you about how he's changing the world in a third way --
-- talking about the Social Progress Index.
Professor Porter, welcome.
[AUDIENCE APPLAUSE]
PROF. MICHAEL PORTER:  My gosh, Michael.
Well, thank you for that kind welcome, I'm so thrilled, again, to be at the Skoll Forum --
-- and to just get the energy of everybody here, --
-- and the energy for change, --
-- and the energy for tackling challenges that are frankly incredibly challenging, incredibly difficult.
As Michael said, I think I am a, kind of, reformed economist.
You know, I spent much of my career working on economic development, --
-- and I co-chaired the Global Competitiveness Report, --
-- which is now the standard way that countries compare themselves in terms of economic development.
I think we've actually learned quite a bit about economic development, --
-- and we've taken our thinking about economic development to, really, a whole new level in the world, --
-- and I'm proud of that, and I think that's good.
But, I think what we have come to understand is that, you know, --
the traditional model of development focused on economic development alone.
It's incomplete, and, frankly, has created many problems in the world.
The challenge we have now is to, kind of, open up our model of development, --
-- and think about it in a more fundamental way.
In order to do that, we're going to have to go beyond just economics, --
-- and we're going to have to avoid the short cut of thinking that --
-- if we can just get the economics right, everything else takes care of itself.
That is the work that I have been doing with a wonderful group of colleagues, on this notion of the Social Progress Index.
So, let me give you the very high level view of what we're trying to do, --
-- and what it might mean for you, the folks here at this meeting, --
-- and invite you all here to work with us, and push us, and challenge us, --
-- and we'll work together, hopefully, to make this truly the paradigm shift that Michael just so boldly spoke about.
The traditional thinking about development has really been riveted on, as you see here, economic development, --
-- and the assumption has been, that if we achieve improved economic development and higher GDP per capita, --
-- that will lead to a better society.
And, as we'll see, there's a good reason for that thinking, and actually, --
-- the effect is there.
Economic progress does make a positive difference, in general, to social progress.
But we've also learned that sometimes, --
-- and we're seeing this more and more, --
-- economic development is NOT leading to the kind of societal progress that we all care about and hope for.
The Arab Spring is just one manifestation of that.
Tunisia was a country that was really successful, economically, --
-- it was a star, in terms of economic development.
But, ultimately, this country fell apart.
Why?
Because the economic progress wasn't leading to the kind of societal progress that we all hope for.
We're also learning something that I think all of you intuitively knew, but it took us economists a long time to catch up, --
-- and that is, that unless you have a certain societal fabric, and societal assets, --
-- and societal improvement, --
-- ultimately, you run into a wall on economic development, --
you can't do that successfully.
So, what we're starting to see is there's really a two-way connection here, --
-- economic development really is important for moving society forward, --
-- but, not always.
Moving society forward is critical to actually succeeding over the long run in economic development.
But, ultimately, this is going to require us to, kind of, open up our work, and our thinking, --
-- and our measurement on the social side, just as we, historically, have focused primarily on the economic side.
If we're going to actually open up this paradigm, --
-- and expand it, ---
-- we're going to have to learn how to measure social progress itself, --
-- rather than the shortcut of GDP.
That's what the Social Progress Index project is really all about.
This is a project that's been underway now for about 4 years; --
-- last week we released the 2015 version of the Social Progress Index, --
-- I hope you saw it, and if you haven't, I hope you'll look at it.
It's based on a number of premises, that we have to bring the same rigor of measurement to social progress, --
-- as we long have to economic progress, --
-- if we're going to achieve these dual goals of development.
To achieve both.
The social progress framework, then, is based on a number of core premises.
One is that when we measure social progress, we should do that exclusively, --
-- we shouldn't mix in economic variables.
A lot of the previous efforts here have co-mingled economic and social, --
-- and that actually obscures what's going on, rather than clarifies it.
We don't know what's causing what.
We don't know what's enabling what.
The Social Progress Index, as you'll see, is fundamentally ONLY about societal improvement.
It's focused on outcomes, not how hard we tried, not on how much money we spent.
We're trying to measure just the outcomes of society, --
-- and I think this is something that the field of social development needs to really embrace much more aggressively.
We have to focus on outcomes; --
-- good intentions are not enough, working hard is not enough, it's the outcomes that matter, --
-- and this effort tries to capture those absolutely directly.
We try to create a holistic framework that applies to every country, --
-- every country can improve.
There's a wide set of social attributes and characteristics of society that matter; --
-- we need to try capture as many of those as possible, --
-- rather than the siloed view of social progress that we often see, where everybody works on THEIR issue, --
-- rather than see holistically how the entire society is progressing, and how the pieces fit together.
Finally, we need to be specific enough, and concrete enough, that it's actionable.
That we're actually measuring things that we can imagine actually changing, because we're measuring at a concrete level; --
-- we're not measuring broad concepts, we're measuring specific dimensions of a good society.
The Social Progress Index framework then, it looks like this.
As we see social progress broadly, we see it in three fundamental categories.
One - are we meeting people's basic needs, --
-- in the country, in the society, in the region, as you'll see later.
We can look at this at the national level, but we can also look at it actually at the regional level, the municipal level, at any level we want.
Are we creating foundations of wellbeing, and better life?
Things like access to basic knowledge, things like access to information and communication, and so forth, you see.
And finally, and very very importantly, it turns out from the work we've done, --
-- is there opportunity for any citizen in the society to reach their full potential, --
-- whatever potential they want to pursue.
Is that opportunity present?
These three broad dimensions then add up to what we define as social progress.
Of course, we've got a very granular, data driven way of trying to measure those concretely, --
-- with the help of many of you.
There's vast literature and knowledge about social development, and about all these dimensions, --
-- what we've found is the best possible measures that cover a large number of countries, --
-- and we've pulled those together in what I believe is a very very rigorous measurement framework.
Now, this kind of gives you a picture of the world, if we want to look at the world as a whole.
Where are we making the most progress?
The way that social progress is measured is, is it's put on a scale of 0 to 100.
0 is the worst we've ever seen in any country, ever.
100 is the best performance we've ever seen in any country ever, on a particular dimension.
So, you can think of this as, kind of, an absolute score -  the closer to 100, the closer we've solved this problem.
The closer to 0, the closer we are to being nowhere.
If you look at the major dimensions of social progress, you can see that in terms of basic human needs, --
-- in terms of access to basic knowledge, we've made a lot of progress in the world.
On average, we're performing at a quite high level, --
-- but, you can see that on many other dimensions of social progress, the picture is very very different.
We're much farther behind.
It's interesting that one of the major challenges in the world is this issue of opportunity, --
-- how we can create societies where there really is opportunity for everybody, --
-- rather than limits on their rights, or intolerance, or discrimination, or other forms of those limits.
We use this framework to actually now look at 133 countries in the world, accounting for virtually all the world's population.
99% of it.
For each of those countries, we can now have a very rigorous picture of how society is progressing and doing in that place, --
-- and this is just a part of the ranking of those 133 countries.
If you look down this list, you can take any country there, and now pull it apart, --
-- really expose the society, and how it's progressing.
To do that, we also made use of the linkage between the social improvement, and the economic improvement.
So, what this chart does is it, sort of, plots the social progress of the country, Vs the economic development of the country, --
-- and what you see is, yes, there is a relationship, --
-- economic prosperity is associated with better social progress, --
-- but, boy, it's a messy and incomplete relationship.
We can see countries on the lower part, below the line, that are really underperforming from a social progress point of view.
You can see that China, and Russia, and India, as much economic progress as they've made, society is lagging behind.
You can see other countries, like New Zealand, or Costa Rica, or Norway, where the opposite is true, --
-- where the society is over-performing; what you would expect given the level of GDP, --
-- and that says that social policy matters, that social policy can be driven and effective, --
-- it's not all a fatalistic result of your economic success.
People like you ARE making a gigantic difference, on the ground, country by country, --
-- and this data is just revealing that, very very clearly.
Now, once we have this measurement framework, once we can apply the same rigorous measurement, --
-- to social progress as we have long applied to economic progress, --
-- what does that allow us to do?
Well, first of all, we can benchmark our performance, we can say how are we doing, how is this country performing, relative to its peers; --
-- relative to countries of similar economic development, --
-- you know, is the US doing well, or is the US doing poorly?
Where are we better, where are we worse?
What are our strengths, what are our weaknesses? What are the priorities?
If we look rigorously and compare ourselves to other countries that are in a comparable situation.
We've never been able to do this before.
When we think about social development, we think in silos, we think about discrete issues.
We, kind of, have a very inward looking, we have to start comparing and measuring ourselves, --
-- if we're going to actually take this incredibly important feel for the future of the world, --
-- and move it more rapidly than we have even in the past.
Now, let me just show you some of the data. Here is my country - the United States.
This is, kind of, the dashboard of how the US is doing on social progress, compared to other countries of similar economic prosperity, --
-- and the answer is - lousy.
[Audience laughter]
You know, America, we think of ourselves as number 1.
We're nowhere near number 1.
In many of these areas of social progress, the US was actually a leader, a pioneer; --
-- universal primary education, access to universities, --
-- area after area, if you look at the proud history of the US, we led, --
-- not just in economics, but in social development.
But, now, for a variety of reasons, we've slipped, we're far behind, --
-- our dashboard is covered with red.
We're failing because we haven't looked at these things in this way.
We haven't had the visibility to actually compare ourselves to what we should be achieving, relative to other advanced countries.
Now, let's take Costa Rica.
Here's a much lower income country, but its dashboard is full of green.
It's been able, through remarkable commitment, and remarkable policy, and the work of many people like you, --
-- to really move way ahead on some dimensions of social progress, for a country at its level of development.
But, even Costa Rica has some issues, --
-- and this analysis allows us to see exactly where those red spots are, --
-- and hopefully, do something about them, and set better priorities.
What we're hoping, and this is starting to happen, is that nations are starting to use this dashboard, alongside of their economic dashboard.
Finally we have the opportunity to accelerate the change in many of these dimensions.
We're going to hear, a little bit later, about Brazil.
I thought you'd be interested in the Brazil dashboard.
You know, Brazil's got great strengths, Brazil is actually doing pretty well on social progress overall, --
-- but there's some conspicuous problem areas.
You'll hear about some of those.
Then finally, Paul Farmer probably will talk a little bit about Rwanda; --
-- Rwanda's a country that started in a disastrous situation, 20 years ago, --
-- and because of an enormous focus on social progress, in a variety of critical areas, you see a lot of green.
I personally believe, having worked in Rwanda, that the economic success of Rwanda today, --
-- that has been sustained now for well over a decade, --
-- is due to the fact that the country also made aggressive investments in lighting up this dashboard with green, --
-- in a variety of key areas, --
-- including health, that Paul will talk about.
The opportunity we have here is to really change our paradigm for development.
I think what we have to understand is economic development is two things, --
-- it's economic progress, it's increasing economic prosperity, but at the same time, it's improving society, --
-- and we can't leave the improving society part to chance.
We've got to give that visibility, we've got do that as equally important, --
-- and also, I think what we'll find 10 or 20 years from now, --
-- is actually that the improving society part will probably be the key to economic development.
That's the opportunity, and that's our obligation as we do this work, and work with all of you in the process.
So, we'd love to hear all of your thoughts about this, we'd love to hear how we can make it better, --
-- we'd love to work with you at the grass roots level, wherever you're working.
I think we have an opportunity to change the game in development over the next 5 or 10 years.
Thank you.
[AUDIENCE APPLAUSE]
MICHAEL GREEN: Thank you, Mike.
Policy makers, politicians, beware!
There's a new paradigm in town.
So, I'm delighted that our next speaker is someone who's really practically working on how to develop and improve the lives of her city, Rio de Janeiro.
Eduarda La Rocque, I asked her, how would you like me to describe you? You've got a PhD in Economics, --
-- you run a research institute, you've been involved in government, --
--you're a very distinguished person, --
-- and she said, "say, Eduarda is someone who loves Rio de Janeiro."
Eduarda.
[AUDIENCE APPLAUSE]
EDUARDA LA ROCQUE: It's a pleasure to be here, --
-- because it's important.
I'm a social entrepreneur who has been working for the government for 6 years, --
-- because, well, your indicators show that security is the biggest problem of our country, --
-- especially in Rio, --
-- and more than 6 years ago, I was shot in my car, --
-- and since then, I decided to work for a safer, and more equitable city.
So, I began by accepting the invitation of Mayor Eduardo Paes, to be his secretary of finance in 2009, --
-- and we [did] a good job; --
-- we got 3 upgrades from the rating agencies, and now, Rio has even higher grades than the federal government, --
-- and since August 2012, I became the president of IPP, --
-- that is the research department of the city hall.
The mayor invited me [to] that, because I had been asking him [for] an opportunity to be more close to social causes, --
-- and so, we are in charge of this program, that is called 'Rio + Social', --
-- that was awarded last year, from UN Habitat, for promoting urban, economic, and social development of our slums in Rio de Janeiro.
22% of our population lives in slums.
But then, well, I love Rio + Social, but then, I have found out that [the] IPP research department, and information database, is a diamond.
It's the jewel. It's... how should I say it?
[Portuguese]
AUDIENCE MEMBER: Crown jewel?
EDUARDA LA ROCQUE: Yes! That's it.
Information is the key issue, [xx], Professor Porter.
Then, we are one of the anchors of this Sustainable Development Solutions Network, that is co-ordinated by Jeffery Sachs, on behalf of [the World Bank], --
-- and we at IPP are one of the 4 anchors, together with [xx], an NGO company, --
-- and the aim of SDSN is to make Rio an example, as a city, [how] to achieve sustainable development.
In this context, we have launched Rio's Pact, for a more integrated city.
I will show a video, that shows a little bit of our reality, --
-- the video please, --
-- of our slums, and also what the Pact is for.
Please, the video.
[MUSIC]
♫ Ah, Rio de Janeiro
♫ Know that I am two
♫ Made of the most imprecise blend
♫ Mixing yellow with lime green
♫ Red clay with beige sand
♫ Know that I was born
♫ From the womb of the native people, the black people, mixed
♫ I wasn't discovered, I was born
♫ Know that I know what it is to fall
♫ I know even better how to rise up
♫ I learned on the hills, I lived, I resisted
♫ A split city can no longer be
♫ So let's make a pact, you and I
♫ There is a newborn Rio
♫ So let's make a pact, you and I
♫ There is a newborn Rio
NARRATOR: The Rio Pact joins information, projects, and actions in a large network of partners for a more egalitarian, more humane, more integrated city.
It is a pact made with everyone: the government, NGOs, companies, and you. Be a Rio Pact partner, because this Rio is here inside you, asking to happen.
♫ So let's make a pact, you and I
♫ There is a newborn Rio
♫ So let's make a pact, you and I
♫ There is a newborn Rio
♫ So let's make a pact, you and I
♫ There is a Rio here inside, here inside, here inside... newly born
[MUSIC]
[AUDIENCE APPLAUSE]
EDUARDA LA ROCQUE: And the best part of it, do you have any idea how much this video cost to the public sector?
Zero, --
-- because, it's one of the Pact partners that provided  the video, the translation, everything.
So, we share the belief that qualified, and shared information, has a huge power for transformation.
The idea of Rio's Pact, [is] that we can strengthen, a lot, individual actions, --
-- by connecting and integrating them, in order to promote inclusion.
So, we are taking the opportunity, and the advantage, of this world wide spread love for Rio, --
-- and all this energy, --
-- to make Rio an integrated city.
So, we launched Rio's Pact last December, --
-- and we define it as a set of commitments between the public, [the] private [sector], NGO's, academia, civil societies, and international organisations, --
-- [to] monitor... sorry... --
-- and [promote] sustainable urban developments in Rio de Janeiro.
So, it's what I call a PPP 6.
A public private partnership, with 6 segments.
The public sector, the private sector, NGOs, academia, in order to provide indicators and monitor everything, --
-- and most importantly, the population that usually don't feel represented by any of the 4 sectors, --
-- and then we have this opportunity of having also international partners, --
-- and we aim to implement and to adopt the Social Progress Index, as the main indicator to orient the projects that we're going to finance under the umbrella of Rio's Pact.
And now, what we have is a centralised model,--
-- all the agreements are made with IPP, --
-- but we are going to be successful only if we can distribute this model, and it becomes a product of everyone, --
-- not just the government.
This is the main issue.
So, what we aim to do, is to leave after 2016, a de-centralised model, --
-- self financed, self regulated, --
-- in order to keep this inclusive, urban motor alive.
That's Rio's Pact.
So, we have [lots of] information that I can provide, I have some folders, something like this, --
-- all the information that we can provide here.
We have maps of all the slums that weren't in the official maps previously, --
-- and this is the main thing here; we have already mapped all the conditions [of] the micro-areas of the slums [in] Rio de Janeiro.
We already have the basic needs sphere of SPI, so we're going to also implement opportunities, --
-- major opportunities, --
-- and also the foundations of wellbeing, in order to complete this.
That's it.
[AUDIENCE APPLAUSE]
MICHAEL GREEN: I'd like to welcome Mike and the other panelists to come and join us, --
-- ready to start a discussion.
Thank you, Eduarda, it's great, you know, that video about the pact, about the different people coming together in unison.
We're going to move now [to] a bit of a discussion of some of these issues.
We've had the perspective of the reframing from Mike Porter, and then Eduarda's talked about the way Rio and this Pact for Rio, --
-- and for those of you who're tweeting out there, I think that was an announcement, --
-- Rio is going to be using the Social Progress Index as part of the Pact for Rio, which is fantastic news, --
-- tweet that out.
[AUDIENCE LAUGHTER]
Our next speaker, I've got a one word description of him, --
Paul Farmer - legend.
No introduction required, but Paul, you've worked a lot in Rwanda, you're worked with Mike Porter on many of these issues, --
-- you've been such a driver in global health.
Tell us about the paradigm shift.
You want to come and join us over here?
Paul Farmer.
[AUDIENCE APPLAUSE]
PAUL FARMER: Thank you, thank you.
Thank you, it's good to be back, and I'm going to talk a little bit about a case study, --
-- 5 minutes, no video... --
-- you told me no video. That's not fair, I mean --
[AUDIENCE LAUGHTER]
First of all, how can you compete with Eduarda.
[PANEL CHATTERS IN AGREEMENT]
Alright, now, I'm going to skip ahead [to] one of the points that Michael made, --
-- the other Michael, Mike, --
-- about claims of causality, although I think, there are reasons to be sceptical, as he is, about claims of causality; --
-- they have dominated the late 20th century models of development.
I know we're stuck with a nation state, and Mike Porter didn't mention the Treaty of Westphalia, but I knew that he was thinking about it.
You know, as Eduarda said, there are important internal, and trans-regional, and trans-national problems, that I think are well worth discussing, --
-- but, having just come from Liberia, --
-- well, not in the last 21 days, --
[AUDIENCE LAUGHTER]
--I can just say, you know, that an instrument like the SPI, and, preferably in my view, --
-- the SPI would tell us a lot about why public health catastrophes are spread more in those three countries, --
-- than in others surrounding them.
And that's an important thing to know, because since the wars ended in two of those countries, --
-- Sierra Leone and Liberia, --
-- this approach was not taken. Right?
Investments in health and wellbeing were not at the forefront - it was the growth of GDP, --
-- and by those measurements, actually, Sierra Leone and Liberia are way up near the top, in rate of GDP growth, --
-- but right down near the bottom, if you compare them, as I will, to Rwanda.
Now, I was lucky enough to get to know Mike, first, not at our university, --
-- a small community based college in Cambridge, Massachusetts, --
-- but in Rwanda.
I knew he was giving a seminar on competition, and I was out at a rural hospital, --
-- and I said, "I can't wait to see Mike Porter, 'cus I'm going to tell him, you know, you should see the great collaboration, --
-- between TB, tuberculosis, HIV, and even parasites like malaria, --
-- so, I'm going to spool up my video on the way that those bugs collaborated against us, --
-- while we were competing with each other in development and health care.
[AUDIENCE LAUGHTER]
I'm kidding, I don't have that video, --
[MORE LAUGHTER]
-- but I think it would be a great video, because the inside social progressives, instead of collaboration, --
-- there was competition where it wasn't warranted. Right?
Public health is full of it.
Prevention versus care. Eric Goosby, I hope, will talk about this later on.
I could go right down the list - cancer versus safe motherhood, --
-- these are insane kinds of discussions, that are the result of those silos that you talked about.
Now, in Rwanda, --
-- after the genocide, which, as you know, was in 1994, --
-- think about it - I wish I did have some way of showing this progress visually and compellingly, --
-- in 1995, it is likely that Rwanda was the poorest country on the face of the Earth.
By any index that we would use, any metric in my field, meaning, medicine and public health fields, --
-- maternal mortality, infant mortality, [juvenile] mortality, camp epidemics, --
-- not just of TB and HIV, but cholera, typhoid, --
-- Rwanda was at the bottom of the heap.
Now, that's 20 years ago, that's not a long time, --
-- and what happened after that is going to be disputed, --
-- again, claims of causality SHOULD be disputed, --
-- but I'll give you the short version that I believe, --
-- and that is that progressive social policies led to a fairly substantial, and by local standards, --
-- meaning, the GDP of the country, --
-- massive investments in the development of a health care delivery platform, and also important investments in education.
Now, how was this done.
I'm sure you all read our piece in the British Medical Journal last year...
[AUDIENCE LAUGHTER]
... I mean, no one would ever miss that...
[MORE LAUGHTER]
... or the Lancet; that one was on the anniversary of the genocide - no one missed that, right?
[MORE LAUGHTER]
We even have downwardly mobile medical journal names in medicine.
The Lancet. It's old and it's British, what can I say.
[MORE LAUGHTER]
So, basically, the programs were to have an equity focus from the beginning. Right?
What does that mean.
That means girls, women, rural areas, and the poorest quintile - as we've been taught to say by economists, [are] preferentially served.
This is what the liberation theologians call the preferential option for the poor.
Now, that wasn't the language of the Rwandan policy makers, but was fine with us; --
-- I say us because Ophelia Dahl is here, and some of you heard her last night, --
-- so, what we got to see, in the last eleven years working in rural Rwanda, was a transformation.
In fact, these are probably the steepest drops in mortality ever recorded anywhere, any place, in human history.
Now, how could that happen in Rwanda?
[AUDIENCE APPLAUSE]
Now, to close, I mean, I feel like applauding every time I look at the data, --
-- and trust me, it's pretty boringly presented the way I do it - Eduarda, can you do a little seminar with me afterwards?
[AUDIENCE LAUGHTER]
But, these are indisputable developments.
The claims of causality will be made by many, and I've said than an investment --
-- look at the fraction of the public budget of Rwanda that went into health care, and compare that with India, --
-- compare that with Sierra Leone, Liberia, Guinea, any place you want.
This is the largest investment in health care - delivery, not the fights between prevention and care, that hobbled our world for so long - and it was intentional, it was a policy.
Now, understanding how to study the feedback loops that would allow us to improve policies, and economic policies, I think, is a critical challenge for everyone in this room.
I mean, some of the claims of causality that are made are absurd, right?
Some of them are historically uninformed, most of them, in fact, --
-- and some of them just don't understand what's happening to our world; some of these claims reflect ignorance.
For example - everyone should know about the massive, worldwide declines in infant and child mortality, --
-- because now we're going to get stuck.
If maternal mortality drops from the levels that Rwanda saw 20 years ago, and gets stuck somewhere, then you want to know why, --
-- and the answer is, this requires more investment in health care for safe mother[hood] at the level [for] those who would have complications.
If infant mortality gets stuck at 30 per 1000 live births - why?
Again, it requires more investment, more difficult... --
-- being born at home isn't safe for neither mother nor child, etc, etc. --
-- and I won't go into all the examples.
I will say that [in] Liberia and Sierra Leone, as I said - and I'm looking forward to learning more about Guinea - that's not what happened, after 2002.
Investments were not made in these sectors in the same way - in the health sector in particular, but also in education.
So, the SPI is a welcome development because it [gives us], again, a benchmark, --
-- and I'd like to mention here, in closing - announce, in fact - that this lack of higher education, --
-- you know, in my line of work, each of us has gone through multiple, years and years, --
-- I have an MD AND a PhD, right?
[AUDIENCE LAUGHTER]
I know, my mother laughed when I said that too.
[MORE LAUGHTER]
And here we are, doing the equivalent of prevention versus care in education.
We're saying, oh, for Africa, primary education only.
No wonder there is umbrage taken, I mean, we've all gone through that process, --
-- and then to dismiss the talent [of] the human resources that there are in places like Rwanda, --
-- or Sierra Leone, or Liberia, or across the world.
People want higher education.
So, I'm announcing, thanks to some private donors, and partners in the Rwandan ministry of health particularly, --
-- but also education, --
-- the establishment of the Rwandan University for Global Health Equity, as of today, --
-- and thank you, [to] those of you who've supported that, supported this effort and others.
We will not pay attention when people say you don't need universities in rural Rwanda, --
-- that you don't need advanced degrees, that you don't need people like Mike Porter from Rwanda; --
-- that's false, and I hope to see a lot more of genuinely egalitarian development, using this tool.
Thank you very much.
[AUDIENCE APPLAUSE]
MICHAEL GREEN: Do tweet as you get that, [the] announcement, get tweeting that announcement out.
Thank  you, Paul, so much.
I don't know, as I've listened to you, I've felt there was, sort of, this inspiration of what we can do, and the frustration about so many places where we're not doing it, --
-- and the fact that if we really push, bring together the innovations, have that political commitment and will, and commit the resources, --
-- how much we can achieve.
It's just so exciting, so, thank you so much.
Sometimes when you talk to someone, within 5 minutes, you just know that they're the smartest person you've ever met, --
-- when I talked to Diana Good, it was within 2 minutes.
[AUDIENCE LAUGHTER]
Diana has a distinguished career as a city lawyer, and now has this really important job on the independent commission on aid impact, --
-- which oversees Britain's overseas aid budget.
I think this fits in so well to the discussion we've had about collaboration, how do we actually make things really really work on the ground.
So, Diana, we're really keen to hear your reflections on how we make this system work.
Thank you.
[AUDIENCE APPLAUSE]
DIANA GOOD: Well, nobody's ever said that of me before, I have to say [LAUGHS], thank you.
I'm the oddity on this panel, so I will just quickly explain where I come from.
As Michael says, I was a lawyer in a major international law firm for 30 years, and I was also a judge in the criminal courts, here in the UK for 11 years, --
-- so, when I shifted, 7 years ago, out of that, by choice, into the world of international development, --
-- and also doing access to justice and access to education, for the poorest people here in the UK, as well, where there's still a lot of need, --
-- the job that I took up 4 and a half years ago, was as a commissioner with this newly created international aid watchdog, --
-- called the Independent Commission for Aid Impact, --
-- which was effectively, the UK government's quid pro quo for committing to the 0.7% of GDP.
We're an entirely independent body, so I don't speak for government, I review and critique government.
We report direct to parliament here in the UK, we publish all of our reports, --
-- and in 4 years, we're about to have published 43 reports, --
-- and we cover every aspect of what UK government aid expenditure is spent on.
So, our job is to find out whether UK aid expenditure is actually having the impact it's meant to be having, --
-- is it getting through to the people it's meant to be getting through to.
We make recommendations, and the UK government, the department for international development, --
-- which is the major department spending that money, --
-- and that is almost 11 billion pounds a year, so it's quite a lot of money.
They are required to respond to our recommendations, and then we follow up after a year, --
-- we follow up after two years, --
-- to see whether they've actually put in place the improvements that we recommend they should put in place, to do the job even better.
So, I've found all of these presentations very powerful and provocative, and, so many of them chime in with... --
-- my starting work in international development was working with Camfed, who, as you undoubtedly know do girls' education in sub-Saharan Africa, --
-- and we did a report for them called Accounting to the Girl, which was all about Camfed's governance model, --
-- which we presented at the opening plenary, at the Skoll World forum 5 years ago, so it's a great pleasure to participate here.
I thought it might be helpful to draw out a few of the very common themes, that we're finding in these 43 reports, --
-- in relation to UK aid expenditure, which chime in for me with a number of the themes that have been made so far, --
-- because these are things we're finding over and over again, --
-- and they are all about good development, and how best to achieve impact; --
-- how to maximise it, how to make it sustainable.
First and foremost, the focus [is] on beneficiaries.
I come from a world where we call these people our clients, to whom we have a duty of care.
I like to think of them in this world as intended beneficiaries, which is, --
-- the development work is intended to assist them, but is it ACTUALLY reaching the poorest people, is it ACTUALLY for their benefit, --
-- are they ACTUALLY being included in this, --
-- not just as a tokenistic consultation, but as Eduarda was saying, actually bringing the population in as part of the process.
Who better to supervise implementation, to see whether there's corruption, to work out whether it's actually helping them, to make it sustainable?
I find it very interesting that in the 4 years we've been doing this, Mark Lowcock, --
-- he's the head of the department for international development, --
-- has, twice now, publically said that one of the things that our commission has done is made DFID refocus on the beneficiary.
He said this to parliament, at the end of our first year, --
-- he said it was one of the most significant things we'd achieved in terms of impact on the UK government, --
-- and he repeated it before OECD/DAC, only a few weeks ago.
Now, you might say it was rather obvious that you should have a focus on the beneficiary, and the poor, who you exist to serve, --
-- but it is something which, the bigger an organisation, the more remote it is from the actual people who it exists to serve, --
-- the more the line of sight through to those people can be lost, --
-- and I think that what I'm hearing about this Social Progress Index is that it brings the people, --
-- and their needs, --
-- into the fore, which I think is an incredibly important thing.
Secondly, again, it sounds obvious, hanging in there for the long term, as Paul said, --
-- I've done a lot of work in education, particularly education for girls, in this area, --
-- and the notion that one only concentrates on primary education...
When I was in Ethiopia, in December, the recurring theme from the incredibly poor people that I was meeting, --
-- was their disappointment that the standard of teaching, and the schools, was not sufficient to enable their children to get through to secondary education.
A good part of the problem is because the teachers themselves dropped out of education when they were only at level 10, --
-- because THEY didn't get on to secondary education.
The investment has to be long term.
We've ALL been to school. We know it takes a very long time.
There isn't a quick way through it, and certainly primary education isn't enough.
So, hanging in there for the long term.
One of the issues we've come across, time and time again with DFID, is that the pendulum needs to shift; --
-- there's been a strong focus on achieving results.
That's good, that's important, --
-- but if it's at the sacrifice of longer term, sustainable development, --
-- because there's a desire to come up with positive big numbers, quickly, --
-- you're going to be losing sight of the real problems that affect people.
A third common issue is - get away from silos, again.
Multiple, multi-pronged approaches; absolutely vital.
Collaboration, across all these different sectors.
Again, when I was talking to women in Ethiopia, there, they've been helped with food security, and public, basic goods, --
-- and the profound effect on them was that this meant not only were they able to feed their children three times a day, --
-- which they certainly couldn't do 10 years ago, --
-- but also, now they could send their children to school, --
-- NOW they were members of committees, who actually have some vision of what spending money meant, --
-- what deciding whether we're going to work on that irrigation ditch, or are we going to build this school, --
-- what are our priorities.
It made them feel, as they said to me, they'd undergone a mental revolution, realising that they could actually say THIS is what needs to be done.
This was empowerment in action, --
-- and in turn, it meant their girls, and they themselves, weren't going to tolerate violence and abuse at home any longer.
They just were transformed people.
Now, the silo effect of programming, means that what the donors are doing is measuring the success of that particular silo of expenditure, --
-- thereby missing, in this instance, the fantastic multiple, holistic beneficial effects of that program.
Unless you see things from the point of view of the intended beneficiary, and look at problem solving THEIR problems, --
-- you're going to be making assumptions about what these people need, --
-- and you're going to run the risk of either misfiring, or actually not doing as much as you could.
Fourthly, learning.
This sounds so obvious it's hardly true, that obviously people ought to learn from what they're doing, --
-- but, there is not nearly enough really active learning going on, --
-- by which I mean, not doing quantities of evaluations, however good they may be, and putting those on the shelf, or an IT system that then becomes inaccessible.
It's a question of ensuring that that learning, and the real experience of people on the ground, is turned into action.
Always actionable work.
If it's only going to sit on a shelf, quite frankly you have to ask yourself, was it worth doing in the first place.
If it's not making a difference, not just to that program, but across programs, across the sector, across countries, --
-- learn the lessons of what's working best, and turn it into action elsewhere, --
-- and that's something DFID has responded to our challenge on that really very well, --
-- they're making enormous changes there.
Then, I think, finally, I just wanted to say that the business of context analysis and focus is absolutely vital, --
-- and within that - and I'll be interested in the ongoing discussion - I mean, really vital in all of this, --
-- is what kind of political settlement is actually responsible in a country.
Rwanda, I mean, I was in Rwanda in December, and it is, as Paul says, incredibly impressive.
The way that whole country has come in 20 years is quite, quite astonishing.
The government has a distinctly pro-poor agenda.
I've met people in the Rwandan government, at very senior levels; they are really dynamic.
They say, they do division of labour, between the major donors and agencies, --
-- they say, we're not having you people doing health, we want THESE people to do health, --
-- and the reason for that is we're not going to comply with umpteen different donors' requirements, and program measurement requirements, --
-- that's wasting our time and our effort, --
-- but also, we like looking at are you any good at doing this education thing in your OWN country? --
-- and if you're not very good at it in your own country, why would you come and tell us about it?
[AUDIENCE LAUGHTER]
Now, that is an impressive approach, and it really galvanises the donors, --
-- and it makes them focus, and it makes them concentrate on doing this pro-poor agenda, --
-- but if you're dealing with other governments and other political settlements, it's a different thing.
So, I do see the enormous strength of this index, but it does seem to me that the big question is HOW will governments use it, --
-- how will political settlements use it, and how can one make a difference, --
-- because certainly our work is always about the how; --
-- IS it going as far as it should, IS it penetrating as far as it should.
So, thank you.
[AUDIENCE APPLAUSE]
MICHAEL GREEN:  Thank you, Diana.
Citizens of the world, don't accept cheap alternatives, like, money spent, or other such metrics, --
-- only accept real progress, real outcomes.
Demand that of your leaders and politicians.
I want to bring the wider group in, in a moment, --
-- let me just say, Social Progress Index methodology is, there's a complete report, all data is on the website, there's comprehensive FAQs, --
-- so if you want to ask about details on the Index, don't bother.
It's all there, and I think we want to focus a lot more on the action orientation at this stage.
But, let me just - I think Diana's challenge at the end was a very good one.
Mike, how do you make change happen, how do you get governments, leaders using it, I mean, Eduarda's a great example of how it's happening in Rio, --
-- Paul's talked a bit about Rwanda, --
-- but you've got so much experience about making things happen in the world; --
-- how do you get leaders to use a tool like this?
MICHAEL PORTER:  I think, you know, in the Global Competitiveness Report, in the economic measurement, what happened, it's kind of, --
-- and I hate to use the word, but --
-- kind of shame.
It's getting the data out, it's talking about the results, it's doing the ranking, it's showing the peer comparisons, --
-- it's actually making people feel accountable for results.
I think, in the social sector, we've had a pass.
Governments, you know, they haven't actually been comprehensively and carefully measured, --
--maybe on specific areas, once in a while, but there's really been no sense of where do we stand, --
-- and I've seen with my own eyes how this kind of measurement activity has made [a] huge impact on cleaning up, --
-- and improving the economic development agendas of country after country.
I'm confident that if we can just get these messages out, and have lots of others doing that as well, --
-- and this starts to become a way of talking about this agenda, the societal agenda in country after country, --
-- and we start to talk about it with this data, --
I think we're going to see a lot of change, at least, that's been my experience in other fields.
MICHAEL GREEN: Eduarda, you're nodding.
EDUARDA LA ROCQUE: Of course, I think that the citizens, the population has a huge role to play [in] that.
So, we have to present summarised indicators [that are] very comprehensible, --
-- and then the population, the citizens, must be complaining - that's what I aim to do in Rio.
MICHAEL GREEN: Is that what you're seeing, Paul? Citizens engaging?
PAUL FOSTER: Well, you know, one of the tragedies that is only possible to see [through] an historical lens, is that, you know, --
-- social policies in many of the countries we're talking about, certainly in Africa, were not determined so much by local politicians, --
-- but by ideological agendas around structural adjustment, you know, it's important to remember that, --
-- not because I'm a grumpy social scientist --
-- - I'm definitely not grumpy, and I'm probably not a very good social scientist either --
[AUDIENCE LAUGHTER]
-- but, I did finish that PhD, --
-- but, because it matters to people - it's not just shame, it's pride, right?
I think you'll agree, Mike, that, you know, if you can say look where you were.
I mean, nobody in Rwanda forgets the transnational architecture of how they got to have a genocide.
We all forgot, but they've remembered.
Nobody in Liberia or Sierra Leone forgets the diamond trade, or, you know, --
-- we forget, but they remember.
I think putting that in there, which actually is already in the SPI, the rate of improvement, and an acknowledgement of a lot of misery and suffering  that was not of their own [doing], --
-- I'm not just talking about the people we would serve as doctors, but even as civil servants, you know, not of their creation, --
-- and some of the colluded or participated... again, I'm not talking about Rwanda, --
-- I'm talking about in general, --
-- I mean, Rio is bigger than all of Rwanda, probably, right? Rwanda would fit --
EDUARDA LA ROCQUE: 6 million people.
PAUL FOSTER: -- well, getting there, because we're talking about 11 million, maybe?
MICHAEL PORTER: Close, yeah.
PAUL FOSTER: There are cities in China that are bigger than Rwanda, but this memory part is really important, --
-- and, I think, that's why we can add that, you know, out of humility, on the assessors side.
At least acknowledge people's histories.
MICHAEL GREEN: Eduarda, you wanted to..?
EDUARDA LA ROCQUE: We also have to establish performance targets, the way of checking who is responsible for what, --
-- and if the improvements are coming or not.
Monitoring every[thing], and having targets to achieve, then I think we can go there.
MICHAEL GREEN: Everyone needs a Diana to oversee their enterprise.
EDUARDA LA ROCQUE: Yeah, yeah! More Dianas [working with] institutions around the world, yes.
PAUL FOSTER: You know, there's our new index, the MDI - the More Dianas Institution.
[AUDIENCE LAUGHTER]
MICHAEL GREEN: That's not an announcement.
[MORE LAUGHTER]
Let me come to the audience - who wants to jump in?
Please.
AUDIENCE MEMBER BILL ACKMAN: [inaudible]
MICHAEL GREEN: Can we get a microphone to the front, please, sorry.
Do tell us who you are as well, it's always nice to know.
PAUL FOSTER: Say the inspired part again.
[AUDIENCE LAUGHTER]
BILL ACKMAN: Bill Ackman, Pershing Square Foundation.
Is this working?
MICHAEL GREEN: Yeah, there we go.
BILL ACKMAN: There we go.
So, inspired by the comments [of] the panelists, one thing that strikes me in terms of making progress on social progress is, you know, --
-- in the room, at this Skoll Forum, [there are a] large number of very talented, motivated entrepreneurs, focused on different areas, --
-- but unlike in a capitalist for-profit model, where you'd see mergers and integration, and scale, and synergies, you know, --
-- if you think about the nature of many of these organisations, is that they spend a lot of time fundraising, --
-- many of them working in the same countries on the same problems, --
-- but there's very little co-ordination, there's competition for resources, --
-- that to me just seems like a very wasteful long term model, so, I guess maybe it's a question for Michael Porter, --
-- but, without economic drivers, shareholder value type performance metrics, for these, sort of, entrepreneurial ventures, --
-- how can we create better collaboration, and frankly, mergers where, you know, --
-- you don't need so many CEOs, you know, how do we make this happen, and deliver more progress, --
-- instead of competing for funds, and not working as efficiently together?
MICHAEL GREEN: Great question. Let's take a few, I've got a-
AUDIENCE MEMBER PAUL DICKINSON: I have a mic, is this working.
MICHAEL GREEN: Yes, we can hear you.
PAUL DICKINSON: Yep.
MICHAEL GREEN: Your question?
PAUL DICKINSON: My name is Paul Dickinson, from CDP, and I'm very interested, I mean, the global business system is running everything now, --
-- and that's why I'm so inspired to be here, because this feels like a, kind of, political meeting of the new politics, --
-- but, I'm just aware that, you know, for example, with climate change - a lot of the problems in the developing world, --
-- are caused by us here, --
-- and where do we see social entrepreneurship in the advanced economies, and indeed, in the preciously weak international system?
MICHAEL GREEN: Great. One more? Have we got a microphone with someone?
Has someone got one?
There's one down the front here.
There we go, I can see this chap.
AUDIENCE MEMBER: Hi, thank you very much, [xx] from [xx], and thank you for presenting the SPI, --
-- it seems like a very important set of numerators, --
-- and I'm wondering, given the contrast of more community based, and more country based perspectives, --
-- if having the notion of states as denominators, is also a short cut with implications in the SPI model.
I wonder what the panel thinks about that?
MICHAEL GREEN: Well, cool. Mike, do you want to kick off [with] Bill's question about the capital market; --
-- can the capital market [efficiently] drive social innovation to scale.
MICHAEL PORTER: Well, I'd say I haven't been on the ground, like Paul, in this area, but I think we've all seen the fragmentation of activity on many of the items on the social progress agenda, --
-- which, you know, because, in a sense, there hasn't been a good accountability model, if you will, --
-- that model hasn't changed because it really hasn't been carefully measured and benchmarked, --
-- and there's relatively few governments like Rwanda, that just say wait a minute, we're about results, and therefore, this fragmentation isn't working.
So, I think part of it is holding these entities accountable, but, I think this is a very deep issue in the social sector, --
-- because we don't have the traditional mechanisms for driving efficiency and scale, --
-- and, in fact, it's incredibly complicated - having been involved in many non-profits, talking about merging, --
-- it's almost impossible, and nobody wants to do it.
It's your project, it's your project, it's your priorities, it's your priorities.
So, I think it's a deep issue, and I can only turn it back to this group.
If we really cared about the outcomes in our field, wherever we worked, how would we re-organise ourselves as institutions, --
-- to actually drive those outcomes forward in the fastest way.
Now, in Rwanda's case, the Rwandan government just says okay, if you want to operate in Rwanda, do it our way.
The government has done the co-ordination, but that's very rare so far, --
-- the question is - can that bubble up in the field.
Paul, you might want to comment.
PAUL FOSTER: Yeah, I would.
I would, since you've covered, in response to Bill, the Rwanda example of having adequate capacity, --
-- not for implementation, they would have been the first to say, that's why we don't have it.
So, there was an anti-NGO sentiment, although the NGOs complained, very vocally, that that was the case, --
-- and that had echoes in the state department.
It happened to be wrong, empirically, but what the Rwandans were saying [was] --
-- we might not have the implementation capacity, but we have the co-ordination capacity, and obligation.
Now, in Haiti, when we tried to push this forward as an NGO that had been there a long time, --
-- right after the hurricane, and right before the earthquake, --
-- the ministry of planning, you know, sounds like something out of a Graham Greene novel...
[AUDIENCE LAUGHTER]
... we don't have those in my country, Diana. As you can see by our SPI score.
[MORE LAUGHTER]
In Haiti, we worked with two people who were signed just to that task, of co-ordinating NGOs, and they were both killed in the earthquake.
The whole ministry collapsed on them.
I'm just using that as an empirical part of it.
How do we capture the QPE, the quest for personal efficacy, that is, like, at high tide in this room.
This is my tenth time here. I think.
I might be exaggerating. So I'm lying.
But I've been here a lot, you know, and there's a lot of QPE.
I have it. We've all got it. We want to be successful in the social sector.
How do we capture that, and still say, as the Rev. Tutu, the younger, said - we have a goal, and here's where it is.
It is inclusive growth, and it's global health equity, in the words of others.
This last point - our work in implementation would be so much easier if the ground rules from the larger donors forbade the kind of problems that cause fragmentation.
That is, are you helping the public sector to recover after an emergency?
Are you creating jobs locally?
Can we measure, you know, some of these kinds of successes?
It would just be so much easier for us if people with resources were setting the rules of the road differently.
MICHAEL GREEN: Now, I'm being waved at that we have to finish, but, Eduarda, I'd love for you to take on this issue about the nation state as the unit of discussion.
Because you're talking about a city.
Surely a city can be different from a country.
Also, what about the interdependence? How does the development of Rio fit with the wider thing.
Any final thoughts? Then Diane, I'll come to you for a final thought, then we'd better wrap up.
EDUARDA LA ROCQUE: Yes, first, answering him - I'm a very optimistic person.
I do believe that the capital markets will play a major role in promoting sustainable development, and better urban life conditions.
PAUL FOSTER: What about capital markets again?
[AUDIENCE LAUGHTER]
EDUARDA LA ROCQUE: But, I believe that what capital markets provided for economic sectors in the last century, it will provide, --
-- because, we economists, want to complete markets, and there's a huge inefficiency in the whole process.
So, I believe that we are going to have funds, and we are going to have performance evaluations of funds for this, and for that, and for that, --
-- and then my dream is to create a social exchange, a stock exchange, something like that.
This is my future job, probably.
[AUDIENCE LAUGHTER]
MICHAEL GREEN: The stock exchange, is that another announcement?
[MORE LAUGHTER]
EDUARDA LA ROCQUE: The role of cities in this liveability thing is HUGE. I think that the power will be concentrated on the cities, --
-- and on the citizens, especially.
MICHAEL GREEN: Diana.
DIANA GOOD: I think I just want to say is that, this is a very major issue, and one of the things we're constantly saying to the UK government, --
-- is that they have to focus on what they're seeking to achieve.
Big ambitions are important, but, unless it can be turned into action, --
-- and that involves recognising what - and this would apply [to] any player, I would suggest - what your real strengths are, --
-- and what you can really bring to make a difference.
Part of that has to be knowing when to step back and allow others to step in, --
-- and that's why the division of labour in Rwanda is such a powerful thing.
A final thought - when I kicked off in this whole world that you all operate in, I met a very ancient Zimbabwean farmer, --
-- who walked very slowly across the village to single me out, --
-- and he said to me, do you people realise - I mean, he didn't know who I actually was, but he assumed I was there as an NGO or a donor - he said, --
-- do you people realise that you only have jobs because we're still poor?
[AUDIENCE REACTS]
And I thought that was an incredibly powerful thing to say, and it's really been ringing in my ears every time I do anything in this space, --
-- which is unless what we're all doing is REALLY going to make a difference to THAT Zimbabwean farmer, or his equivalents, --
-- you really have to ask, why do this, --
-- and that does involve holding back, and genuinely collaborating, and genuinely focussing on how to achieve the best.
[AUDIENCE APPLAUSE]
MICHAEL GREEN: Diana, thank you.
The paradigm shift leads the reality shift of living in a world without poverty.
Fantastic ending.
Thank you panel, thank you all, it's been a pleasure.
[AUDIENCE APPLAUSE]
