When James P Grant was appointed as its third Executive Director in 1980, UNICEF was already a highly respected organization that had won the Nobel Peace Prize and earned great reputation as the world’s premier humanitarian institution to help women and children in times of war and natural disasters. As a development agency, UNICEF was known for its practical actions and effective operations in community-based health care, education and certain social services. It was also beginning to play an advocacy role in supporting governments for better planning and policy development at the national level. However, the scope and coverage of UNICEF supported development programmes were rather limited, and it was not seen as a major development organization of the world.
Jim Grant came to UNICEF with the determination to turn an already good organization into one that could make massive national and global impact. He was convinced that in a world ravaged by political and ideological conflicts, the cause of children would be the most fitting to unite peoples and nations following different faiths and ideologies. He was inspired by his personal experience of how the Barefoot Doctors scheme in China had led to massive coverage of basic health care, and the Green Revolution in India had averted dire predictions of famines and led to food security and prosperity for many farmers. His experience in Sri Lanka, where he had served with USAID, had convinced him that even an economically poor country could achieve impressive results in basic health and education if it followed the right approach. He wanted to replicate such success globally in the areas of child health and human development.
Grant came to UNICEF like a tornado, with a bright rainbow on the horizon. He was bubbling with grand ideas, and bouncing with extraordinary energy and enthusiasm. He wanted to shake-up things and build a dream world that was fit for children. Upon becoming the head of UNICEF, he sounded as if all his life he was preparing to come to lead it. UNICEF seemed to provide him the perfect bully pulpit to espouse his grand ideas and bold vision.
Before coming to UNICEF, Grant had been champion of a school of thought that we now call human development. Development, he argued, had to be measured not by the gross national product of a nation but by the physical quality of human life. He argued that infant mortality rate, life expectancy, literacy rates and other social indicators were far more important measurements of a nation’s development than its economic wealth or military might.
Grant articulated a bold vision of unleashing a Child Survival Revolution. It was unconscionable, he argued, that 40,000 children a day, or 15 million annually, were dying at that time, when there were many low-cost, readily available interventions to prevent such deaths. He came up with an initial package of interventions comprising growth monitoring to promote child nutrition; oral rehydration therapy against diarrhoeal diseases; breast-feeding; and immunization – which together could greatly cut down child deaths and promote child health and nutrition. These interventions would be even more powerful if they were combined with family planning and female education. The whole package became collectively known as GOBI-FF.
Specific, time-bound goals and targets were set for each of these interventions – e.g. to increase childhood immunization rates in developing countries from less than 20 percent to 80 percent by 1990. Grant was convinced that the required financial resources and political will could be mobilized if one could show demonstrable progress on a large scale at relatively low-cost.
Within a decade of the Grant-led child survival campaign, the results achieved were impressive. Compared to early 1980s, some 10,000 fewer children died every day a decade later, thanks to the spectacular increase in childhood immunization, and similar rise in oral rehydration therapy and other child survival interventions.
Cumulatively, it was estimated that the child survival and development revolution that UNICEF spearheaded saved the lives of an estimated 25 million children and protected the health of millions more. In the words of the leading New York Times columnist Nicholas Kristof, “…the late James P. Grant, a little-known American aid worker who headed UNICEF from 1980 to 1995 and launched the child survival revolution with vaccinations and diarrhea treatments, probably saved more lives than were destroyed by Hitler, Mao and Stalin combined”.
Besides saving lives, the success of the UNICEF-led child survival campaign led to improved health and nutrition, and enhanced learning and earning capacity of millions of children, and real empowerment of women and local communities. Most importantly, it led to elevating the well-being of children high on the world’s development and political agenda as a subject of regular discussion in Summit meetings of world leaders, and a topic of increased media coverage.
Was Grant too simplistic?
Some of Jim Grant’s critics accused him of over-simplifying the world’s development challenges by boiling them down to just a few technical interventions aimed at reducing child mortality. After all, development is much more than reducing the quantity of deaths. How about the quality of life, social justice, gender equality, economic development, human rights, protection of the environment, and building of systems and infrastructure to sustain development gains?
For those who knew Jim Grant, this was a false and superficial critique. Far from being simplistic and narrowly focused, Grant had a broad and holistic vision of development. He was very aware of the multi-faceted nature and complexities of development. He spoke forcefully on issues ranging from the need to end the “apartheid of gender”, to reducing military expenditures, providing debt relief and fair terms of trade for developing countries. He even challenged the prevailing orthodoxy of powerful international financial institutions and called for “adjustment with a human face”.
With the help his Deputy, Richard Jolly, and other colleagues, UNICEF documented how the structural adjustment policies of the Bretton Woods institutions – IMF and the World Bank – that forced many governments to balance their budget by cutting expenditures on health, education and social services, were having a damaging impact on women, children and vulnerable groups in terms increased rates of malnutrition, inability of governments to replenish essential drugs or even pay the salaries of health workers and teachers. Grant used this evidence to challenge the orthodoxy of these institutions with a clarion call for “Adjustment with a Human Face.”
UNICEF’s well-reasoned and passionate case for protecting the poor and vulnerable in designing structural adjustment programmes gathered strong support from development activists, and eventually forced the World Bank and IMF to change their policies.
Grant advocated for the child survival revolution with a small number of highly “doable” interventions, not as a simplistic formula for just reducing mortality, but as a “Trojan Horse” for combating poverty, promoting democracy, slowing down population growth and accelerating economic development.
Putting Children on the Political Agenda
Jim Grant personally persuaded hundreds of leaders – democrats and dictators alike – as to why it was in their political interest to promote child survival interventions. But he did not want them to focus on small scale, symbolic pilot projects and marginal, incremental progress. He wanted to see action that was commensurate with the scale of the problems. Many leaders were persuaded that provision of such life-saving services would give them great political dividends at minimal financial cost.
Grant’s meetings with local, national and world leaders were never simply formal courtesy calls, as those of many other heads of agencies. When Grant met leaders, he always had a handy list of four or five specific things he wanted them to do. He presented them in a compelling manner explaining why undertaking those actions would be not only good for their country’s children, but how these would be politically beneficial for the leader concerned.
Heads of State and Government routinely meet many visiting dignitaries from international organizations. But most would not even remember their names and messages even shortly afterwards. Not so with Jim Grant. Leaders remembered Grant not only as a visiting Executive Director of UNICEF, but many referred to him fondly as “my friend Jim”. One could be pretty sure that long after their meeting with Grant, many leaders would still remember and recount the four or five things that they were asked and agreed to do.
Beyond political leaders, Grant approached religious leaders, the mass media, film stars and sports personalities, and non-governmental organizations to promote immunization, ORT and other child survival actions. In an era before the advent of mobile phones, the internet and today’s social media, such outreach and social mobilization greatly reinforced and energized the usually weak and lethargic health ministries.
Grant was masterful in generating a healthy competition among countries, provinces and municipalities to outperform their neighbours. If an economically poor country like Sri Lanka could reduce infant mortality to a low level why was not a much richer country like Turkey or Colombia or Indonesia doing better? Grant skillfully used such comparisons not to humiliate countries but to motivate them.
Grant’s crowning achievement was the convening of the World Summit for Children in 1990. It was the first ever world Summit, attended by the largest gathering of world leaders in history until that time. I personally had the great privilege to work closely with Jim Grant, including serving as his point man to draft its outcome document the “World Declaration and Plan of Action for the Survival, Development and Protection of Children”. The Summit laid down many time-bound and measurable goals for children to be achieved by 2000. The origins of the Millennium Development Goals adopted by the United Nations at the turn of the century and today’s newly minted Sustainable Development Goals can truly be traced back to the intellectual legacy of the goals of the 1990 Child Summit.
Jim Grant’s Ten Commandments for sustainable development
How can one summarize key lessons of Jim Grant’s approach to development, and might these be relevant in implementing today’s Sustainable Development Goals?
In a book entitled ‘Jim Grant: UNICEF Visionary’, I contributed an article on the ‘Ten Commandments of Jim Grant’s Leadership for Development’. The headlines of the commandments comprise: 1) Articulate your vision of development in terms of inspiring goals, 2) Breakdown goals into time-bound, doable propositions, 3) Demysify techniques and technologies needed for large-scale development, 4) Generate and sustain political commitment, 5) Mobilize a grand alliance of all social forces, 6) Go to scale, 7) Select your priorities and stick to them, 8 ) Institute public monitoring and accountability, 9) Ensure relevance to broader development agenda, and 10) Unleash the full potential of the United Nations system.
As the world community strives to implement a new set of ambitious Sustainable Development Goals, I believe these commandments can be as relevant today as they were three decades ago.
For those of us lucky enough to have known and worked closely with Jim Grant, his memory and legacy are a source of constant inspiration. For me personally, the greatest privilege of my life was the chance to work with and observe him at close quarters.
I know this is a sentiment shared by many who had such opportunity. One such person is former US President Jimmy Carter who personally worked closely with Grant, and is proud to acknowledge that nominating him to be the head of UNICEF was one of the best decisions he had taken as US President.
By Kul Chandra Gautam