Episode Overview

Title: What Do We Mean By Results-Based Development?
Podcast: The CGD Podcast
Date: February 17, 2016
Guests: Raj Shah (former USAID Administrator), Michael Gerson (Washington Post columnist, former speechwriter for President George W. Bush)
Host: Rajesh Merchandani, Center for Global Development

This episode explores the concept of results-based development assistance in foreign aid. The discussion centers on how rigor, measurement, bipartisan support, and evidence-based policies are transforming international development. The guests, hailing from different political backgrounds, examine landmark US-led foreign assistance programs such as PEPFAR, the President’s Malaria Initiative, and Feed the Future, sharing personal stories and making the case for robust evaluation to ensure aid works.

Key Discussion Points & Insights

1. Defining Results-Based Development

[01:02–01:45]

• Raj Shah: Results-based development is about using American assistance to "create human opportunity and to end extreme poverty around the world."
• Programs must have clear objectives, rigorous measurement, and adaptability for improvement.
• Michael Gerson highlights that while it sounds obvious, traditionally, aid has often been used for geopolitical aims rather than strictly measurable outcomes.

“Results are about… using American assistance to create human opportunity and to end extreme poverty around the world. You just have to know what you're trying to achieve, measure it with rigor and sophistication, and make adaptations.”
—Raj Shah [01:20]

2. Historical Context and Bipartisan Progress

[01:55–03:27]

• Aid was often used for political rather than humanitarian reasons, especially during the Cold War.
• Both guests agree aid is most effective when oriented toward tangible, large-scale effects.
• Notable bipartisan achievements in foreign assistance showcase that measurable results foster broad support across the aisle.

“Aid has a variety of geostrategic objectives. Now, I don't think that's always wrong, but I do think aid is most effective when it is achieving the greatest effects.”
—Michael Gerson [01:55]

3. PEPFAR: A Case Study in Results-Driven Aid

[04:02–07:35]

• Michael Gerson recounts visiting African communities ravaged by HIV/AIDS before PEPFAR: entire middle generations missing, orphanages full of dying children.
• Passage of PEPFAR in 2003 (from announcement to law in four months) demonstrated exceptional bipartisan commitment.
• After antiretroviral drugs arrived, survival rates soared—termed "the Lazarus effect."
• A moving moment: visiting Rwandan clinics years later, where HIV/AIDS and malaria cases had all but vanished due to program success.

“Every single child died... And then the day after the drugs arrived, everyone was surviving. Children... had their sight restored. This was... the Lazarus effect.”
—Michael Gerson [05:44]

“It was one of the most moving things I've ever seen in Africa were empty hospital beds. I mean, this is a return to normality.”
—Michael Gerson [07:26]

4. Proving That Aid Works & The Importance of Evaluation

[07:35–09:47]

• The Center for Global Development's Millions Saved catalog demonstrates that aid can and does work.
• Shah points to Feed the Future: used country-led plans, public-private partnerships, and rigorous surveys to reduce child hunger and stunting.
• Spending on evaluation is a small but crucial investment for ensuring impact and accountability.

“When the Feed the Future has moved 12 million children... into an opportunity where they're not suffering that way.”
—Raj Shah [08:26]

“You can't say with confidence… that this is the impact unless you spend on evaluation.”
—Raj Shah [08:41]

5. Challenges of Promoting Evaluation in Field Programs

[09:46–12:35]

• Shah acknowledges not enough is spent on evaluation but “those would be percentage points well spent.”
• Advances in mobile, satellite, and data analytics now provide real-time, granular evidence of impact.
• Overcoming reluctance in the field requires showing that evidence-based programs attract greater investment and political support.

“Today, we can have a much more granular understanding of who's hungry, who's vulnerable... and we can go after things in a much more efficient, much more targeted way using modern data and evidence.”
—Raj Shah [10:16]

6. Building Bipartisan Consensus & Political Will

[12:35–13:19]

• Well-designed, results-driven programs have become “models for the way government should work,” driving down policy change based on data, effective bureaucracies, and strong leadership.
• Both guests emphasize that bipartisan backing is strengthened by demonstrable outcomes.

“These outcome-based, rigorous programs… have had broad support in the Congress because they deliver results.”
—Michael Gerson [12:48]

7. Advice for Future U.S. Presidents on Development

[13:19–15:24]

• Raj Shah: The next President can position America as a leader in ending extreme poverty, but this means personal investment and appointing leaders focused on results.
• Michael Gerson: Previous unthinkable goals, such as malaria eradication, now seem realistic due to proven progress and bipartisan coalitions.

“For the first time in human history, we can envision achieving [ending extreme poverty, child hunger and death] in just 15 or 20 years. But to do it, you have to be personally invested in this outcome.”
—Raj Shah [13:32]

“When Bill Gates talks about malaria eradication... ten years ago, that would have been insane. And there are a number of other areas where we have these vivid possible goals... because results have been achieved, because political coalitions have been built.”
—Michael Gerson [14:30]

Notable Quotes & Memorable Moments

• On seeing the effects of aid:
  “It was one of the most moving things I've ever seen in Africa were empty hospital beds.” —Michael Gerson [07:26]

• On evidence and investment:
  “We can use new ways of collecting data... that would give us the ability to visualize what's happening.” —Raj Shah [09:47]

• On bipartisanship:
  “The heroes of the process were Nancy Pelosi and Henry Hyde... Joe Biden and John Kerry were real supporters. It was just totally different.” —Michael Gerson [05:09]

• On the "Lazarus effect":
  “The day after the drugs arrived, everyone was surviving.” —Michael Gerson [05:54]

• On the future of development:
  “Think boldly, because things that once seemed impossible are now possible.” —Michael Gerson [15:13]

Key Segment Timestamps

• [01:02–01:45]: Defining results-based development assistance.
• [04:02–07:35]: PEPFAR’s origins, stories of impact, and the “Lazarus effect.”
• [08:01–09:47]: Feed the Future and the role of evaluation in proving aid efficacy.
• [10:47–12:35]: Challenges and opportunities in promoting data collection and evidence-based programming.
• [13:19–15:24]: Advice for the next U.S. President on leveraging development for achievable, ambitious goals.

Summary

This episode of the CGD Podcast uses powerful stories and expert insights to advocate for results-based development. Raj Shah and Michael Gerson—drawing from Democratic and Republican administrations—demonstrate that foreign aid, when focused on clear goals and rigorous measurement, saves lives and creates opportunity, with the bipartisan support to prove it. The discussion underscores the need for ongoing investment in evaluation, highlights significant progress in global health, and challenges future leaders to think big, backed by robust evidence and political consensus.