Good afternoon everybody, and welcome to this final session where we have brought together a distinguished panel to help conclude this conference between wider Brookings and the African Development Bank. One of the key objectives of these conferences is that we have a very sincere wish to bring people together to serve as a platform where views, research insights, new trends, old insights can meet and can help further thoughts and research ideas about the future. As a very young researcher working in a number of southern African countries, I had a deep wish of sort of speaking with these people who have deep insights, and this is really one of the things that we are pursuing with these conferences, bringing people together across age groups, across perspectives to serve as a real platform. I'm therefore pleased to say that we have this afternoon a great panel who will engage in a conversation with all of us, share their insights and try to make sort of points about what we have learned, what we don't know, and also maybe some hints as to what might be the core elements of the future research agenda. So let me just very quickly introduce the panel, and then we will take off Professor Ernest Arijiti, Vice Chancellor of the University of Ghana, Chair of the Wider Board, Dr. Furt Kassim, an old competent from South Africa, advisor to the Minister of Finance from South Africa, Professor Karen Newman, one of the rising stars, collaborator with John Rand and myself in quite a number of works in Vietnam and Mozambique, Dr. John Page, former senior staff member of the World Bank, senior research staff for Brookings, an external project director wider, and one of my rare dance partners at the ARC Dance Floors, Professor Daniel Rodrik, international leading academic, I think I don't need to say more, witness the just appointed research director of the most successful economic network in Africa, the African Economic Research Consortium, John Sutton, leading international academic and what you said this morning in your keynote is still swearing around my head and I'm thinking about broken wheels. And Samuel Wang, an old Tanzania colleague, one of the African Lions I guess, thank you for joining us this afternoon, and if I may ask maybe Ernest to start out by just saying a very few words about some of your observations and then if any of the remaining panel we will take it in the alphabetical order, maybe just one comment, two comments, tell us what you want to say, but you are allowed to be extremely brief, because what we really want to do is that we want to have a conversation going here. My administrative boss, he told me later on that I'm supposed to act like a moderator, we earlier on this year had a moderator called Hillary, she was much more pretty than I am, but I am going to try to see whether I can help motivate the discussion, feel free to get your questions ready and it is perfectly fine in this audience to be very frank, this is about learning, this is about sharing knowledge, let's get going on that and let's conclude our conference in a really nice way. So Ernest. Thank you very much Fin for inviting me to be on this panel, indeed having missed yesterday's discussions, I probably am not well qualified to be talking about what we've learned here for the past two days, but I'm very happy to see that the learning to compete project has come this far, three years ago John Paye and I were so working on how to structure it and what countries to look at and which issues to focus on, so I'm very happy to see how fights come, I'm very happy to see that there are projects going on in several countries and these projects seem to show us that learning does okay under some circumstances and we are probing further to find those circumstances. I listened to the discussions on Vietnam and the discussions on Ethiopia, this morning I listened to John Sutton and as Fin said, pose the issue of whether we needed to have an approach that would fit every country or each country had to explore for itself what works best for it. He did talk about men in a broken wheel or men in broken wheels, that really sits to be the right place in a sense that yes we need to focus on industrialization by way of mending broken wheels, but what happens if there's no wheel to be fixed? What happens if we have a country that for as a result of its structure has never really had any cart with wheels so the wheels are broken? How do you start in that kind of situation? We need to begin a conversation on how to industrialize Africa. There's no doubt in my mind that industrialization is a way to go and many people have given reasons for that. I run a university, luckily we don't do much engineering, but in our sister universities they have focused on engineering for both of 40 years and yet I see today in Ghana and also in many African countries, mechanical engineers, electrical engineers, unemployed. Who would have thought 10 years ago that those would be happy in Africa? Chemical engineers, unemployed. And now people blame the universities for producing people who are unemployable. How do you create a system in the first great African economy where you put public money into universities to produce chemical engineers? I can't find just for them. You can't find just for them because there's no money factory taking place. Your civil engineers, your architects are unemployed because there's no construction taking place. These are the things that make it necessary for every African economy to begin to focus on why should there be a link between the human capital we're generating and the way the economy functions in your every African economy. That discussion takes places in separate corridors. And that's what for nothing at all I've learned. As long as you don't plan properly how to develop manufacturing, how to link manufacturing to other sectors of the economy, including education, it's a waste of time. African countries spend so much money on education at different levels and yet can't make good use of these, the human capital generated in the right places. So when I hear about the oil industry, new oil industry in Ghana or in Tanzania lacking petroleum engineers, what is that kind of producing petroleum engineers for many, many years? And they know how to do it. So how come they haven't produced the right type of petroleum engineers? I do hope that discussions we will be able to find answers to some of these questions. Thank you very much. Thank you very much Ernest. What? Thank you and thank you for inviting me and congratulations to wider for getting this conference going. I want to start with a comment on John Professor John Sutton's paper, which I think was extremely elegant paper and well presented. I think the notion of an enterprise map is quite an interesting way of dealing with the problem and I agree with you Ernest that the broken wheels approach does certainly make sense because it's a very pragmatic approach and a non kind of ideological approach. But I want to nudge Professor John Sutton to go a step further and embark on a state map because that will also enable us to understand how the state works because that is often misunderstood in a lot of the literature. Now the role of government failure is often my second and this brings me to my second point. The role of government failure is often overplayed because the success of it depends on state capability. The better the state capability is the more likely is industrial policy to achieve its intended objectives and a realistic assessment of industrial policy and how ambitious you want it to be needs to address the question of state capability, which I think features very much in the East Asian context. So what is state capability? It's the capability of bureaucrats, the functioning of institutions and how effectively these institutions work. My third point is that and which I'm pleased this conference did not miss out on is the whole question of what does political economy mean because if you look at industrial policy it is so all encompassing that the biggest political economy constraint is the lack of departmental coordination in government and this is what I mean when I say understanding how the state works because industrial policy has to do with alignment with various other government departments. Now in other words it's hard to achieve success in one without the other. So policy makers need to be aware that industrial policy can work and industrial policy can fail to and you know one has to adopt a pragmatic approach to this. The other important thing that I think I want to comment on is that we have to change the way economists, international institutions and governments think about industrial policy because sometimes we tend to think of it simply as a technocratic part of government policy and to do so we have to understand politics which I think this conference did address particularly in one of the parallel sessions today that we have to understand politics or more appropriately the political economy of industrial policy and that means the role of institutions in that way I think this may generate a more informed policy outcome. The final comment is that if one is looking at industrial policy I think we have to be aware that industrial policy can work but equally it can also not work and the difference really lies in the objectives and the functioning of institutions. Implementing the policies, the institutions implementing the policies and those are determined very much by the political system. So we can't divorce industrial policy from the politics over a country the specific institutional context. I think I'll leave it at there. Thank you Fuat. Thank you. Carol. Thank you. Thank you Finn. So my observations and the points I would like to make are based on the work that I've been doing with the Learning to Compete project and with the various country teams and also based on my observations of the work that's been carried out over the last two days. So we've seen a variety of papers a variety of micro studies that provide us with an evidence base now for thinking about enterprise policy for thinking about industrial policy and for thinking about you know how the opportunities that Africa have in the coming years and how these can be exploited. I want to identify two opportunities and both of which have been touched upon and mentioned in the keynote speech yesterday. The first relates to the decline in the traditional sectors in Asia and the potential for Africa to exploit these opportunities and I think that this can be done through there will be competition for this investment and that's the first point is that there will be competition for this investment and how this investment is realized in Africa will depend on private sector development linking in with what John Sutton was talking about this morning and the development of a mid-sized manufacturing sector is very important here but also in attracting foreign direct investment and one thing that we've learned from the Learning to Compete project is that foreign direct investment in many African nations is not in anywhere linked in with the domestic economy provides employment but does not link in with private enterprise. So finding ways in which to create a dynamic private sector that can link in with that supply chain will be crucial in that. The second key opportunity and another core theme of the Learning to Compete project has been in relation to exporting and understanding learning by exporting and what lots of the studies that we have seen presented over the last two days have shown is that it's the productive firms who export. We've also seen the born global phenomenon with firms being created just to serve the export market. One point that was made very briefly in yesterday's keynote was about intra-Africa trade and in fact intra-Africa trade accounts for a very small proportion of trade in Africa. This is the fastest growing population in the world, growing incomes, this is a huge market that can be exploited. So I think that one potential opportunity here is to help private domestic firms to link in with local African markets and to trade and to start to trade there. Learning takes time and that learning process will evolve over time. And here it's about understanding the capabilities as John mentioned this morning. It's about perhaps working with export promotion agencies. It's about thinking about clusters and agglomeration and all of these factors that we are looking at in the Learning to Compete project. And if I may, my very last point is that I don't think we can forget about fundamentals. One shocking thing we've learned from all of the scoping papers that have been presented over the last two days is that one of the main constraints to business in Africa is infrastructure and in particular power. And again, this is something that was mentioned in the keynote yesterday. And it's a fix that could be made and needs to be made. Investment in power, power outages are one of the biggest constraints to business in Africa. So there's the three points that I would like to make. Thank you, Carol. John Page. Let me use Governor Endulu's afro-optimism to make a point which emerges both from the work that we've been doing but also from the discussions we've had over the past two days. I truly believe, as he does, that we will see in the 21st century a group of African leopards. I do not believe that the African leopards will look like the Asian tigers. I think for a number of reasons, the abundance of natural resources, the emerging new discoveries and here to for non-resource rich economies, the nature of the global economy, and perhaps the smaller window of opportunity to enter international markets in trade and tasks, what we'll see is a successful African economy with a robust manufacturing sector, but perhaps not a dominant mass manufacturing sector, some natural resources. And very importantly, I think, some industries without smokestacks. Agro-processing, even if you like industrialized agriculture tourism, which is enormously important and in which the continent has a major natural resource-based competitive advantage, I always think of it in terms of Dorothy lions and tigers and bears, oh my, you don't have that very often. And so I think in thinking about where do we go from here, one of the things I would urge both African governments and aid agencies to begin thinking about is some of the challenges of managing such a diversified economy because we tend to put things in boxes. All right, over here we have natural resource rich economies and we worry about public expenditure and we worry about transparency and the management of the resource. Over here we have a coastal economy and we worry about industrial policy and somewhere in the landlocked space in the center of the continent, we worry about an economy that may have no natural advantage in doing either of them. I think what we need to do is get away from that a bit and think about where the kinds of characteristics capabilities, if you will, are similar across these sorts of activities. And then urging, someone asked Danny today, do we know anything about whether tradeable services have the same characteristics as manufacturing in terms of his findings on the more rapid productivity and constrained productivity convergence? The answer is probably not because we simply don't have the data. So there's a big area I think of research there, both in terms of learning and in terms of what the characteristics of these activities are. And the second area is then in thinking about how you manage such an economic transition in a more diversified type of world, getting away from the one economy types of policies and getting back to the recognition that, yes, you need basic, you need the basics right, the fundamentals have to be there. But beyond the fundamentals, I think you then need to get into a conversation with the principles. And that brings us to the topic that we covered on business government relations where I think we still have a long way to go in understanding what works and what doesn't in the African context in terms of business government relations coordination and understanding what the true constraints are to development in such a diversified production space. Okay. Thank you, John. Professor Rodrik. John and I didn't coordinate beforehand, but he's actually talked much better than I could have about the first two things that I was going to say. So I just want to sort of repeat those and not, I mean, not repeat, just say that I very much second the two things. One is I don't think African countries are going to replicate anything like the industrialization experience that Asian countries had, or for that matter, the European countries had in an earlier period. I think we're moving into a world where you'd be lucky if you can get 12, 13 percent of your employment into manufacturing that alone 30, 40 percent as some countries have achieved in the past. So that's going to be a very different kind of world. And I think in many ways actually manufacturing is taking on the the characteristics of natural resources. When you think about how capital intensive and skill intensive, some of the export oriented manufacturing that if you want to get, you know, plugged into global supply chains in terms of its its their ability to absorb domestic employment. Actually, you know, these kinds of activities often do not necessarily look all that different from from some resource enclaves. So the implication of that is that that the kind of very rapid growth that we saw in Asia may very well have turned out to have been a historical aberration, something that we're never going to see again. And I think, you know, when we talk about African leopards, I mean, maybe we want to significantly lower what our reasonable expectations are about how much growth can can be experienced without the kind of industrialization that that Asia went through. Again, the point about state business relations, I think the thing to to note is that that even if in some sense an implication of what I just said is that you don't need the same kind of state business framework for industrial policy nearly as much because in some sense industrialization isn't going to get you nearly as far as as it did in in East Asia. You still need that state business relations and for a whole wide set of issues that across cut across everything in economic policy where it's where it's labor policy, it's education policy, fiscal policy, so getting into that frame of mind in terms of establishing these those collaborative state business institutions seem to be very important. Finally, I would just emphasize something that I think may have been talked about in some sessions, but I was in other sessions. So the micro macro link, particularly in terms of the relationship between industrial policy and the exchange rate. I think it's important to understand, at least I think, is the case that industrial policy and exchange rate policy are basically substitutes at some level. That you know the less you can use the exchange rate to gain give your modern industries your trade trade tradeable industries a competitiveness edge the more you have to rely on industrial policy. So the more your exchange rate is is is hostage to natural resource prices or foreign aid inflows the greater than it becomes the premium on industrial policy which is in fact you know for all reasons we discussed so hard to do. On the other hand the more you can target the exchange rate on on competitiveness the less you need industrial policy. Thank you. Witness? Okay thank you very much. So for me I think you have sort of the starting point for me is that yes I think based on what we have had in this conference industrial policy does have a role to play in Africa, but perhaps we have to conceptualize a differently from the way the orthodox way of looking at it which is what Professor Rodriks just talking about now. Obviously the appeal of industrial manufacturing or industrialization in Africa is that the possibility of having mass mass job creation because of mass production but again I don't quite I fully agree with the previous speakers and that I don't quite see that happening any time soon in Africa because I think this is a very contested space. South Asia I think they're probably better proximity to major industrial powers or so clearly for me it's probably we have to take a slightly different form. So one thing that I also sort of think is interesting or important to note is that recent research or studies have shown that actually if you look at value-added because one of the appeals of industrialization is that it was this high value-added production so then that allows for raising of incomes of the workers but actually if you look at recent studies for example there's an inverted use where there's a U-shape where the lowest value-added is on production the actual physical production but actually the pre-production stage and the post-production stage does have higher value-added so essentially those who are partaking the pre-production stage which is R&D logistics pre-production logistics they accumulate most of the value-added and those who do the post-production logistics and marketing and things like that they also get the most value-added those who actually undertake the physical production they get the least share of the pie and I think a good example is of course what has been happening with Apple for example most of the value-added goes to to Apple which is in the U.S. but actually probably the list of amount goes to China which is doing the assembly so I think that's something that is interesting so in terms of where we go from here I think for me I think yes there's a need obviously I think it has been talked about that it's a strong need for partnerships between industry and government but obviously it's sort of risky in terms of capture there's always a possibility for capture there but one thing that I also sort of struck me in terms of the sessions I attended especially the scoping papers was that in Africa if you look at the trends towards industrialization for the last five decades there's a clear sort of trend appearing that there's no the kind of policies that are being pushed there they lack sort of if you want a social appeal so essentially each government that comes to power they will actually completely change the policies and they have a completely different mix of policies which I think probably partly explains the sort of the failure of takeoff in Africa that there's never been sort of any desire to care on what has been working and what and drop what has not been working but actually it's more like also changes whenever a new government comes in they have a different ideology and they try to pick it up from there so I think that's something that probably going forward from a policy point of view I think having a more socially acceptable sort of economic policies or economic plans I think is quite important for continuity purposes then the other thing that also I think is important is that probably there's need for further work to looking at kind of competitive or competitive advantage areas and the precedent conditions that are required to realize those and of course one of the things that we have to be one of is that do we really want to be bound by a competitive advantage or can we actually buy a competitive advantage and at what cost I think those are some of the issues that one might want to look at and finally for me I think given what we've just talked about earlier in terms of the unlikeliness of Africa being the mass producer so I think there's probably room for industrial policy in terms of helping producers target niche areas so I think that's an area that probably needs to be explored a bit further Thanks a lot John, in 1978 I came to Switzerland as a young associate expert I had a boss, a supervisor his name was John Menz he sort of used to talk about missing links and then occasionally he would sort of look up in the air and say what does one do when the chain is missing could you relate that to your sort of broken wheels? No, I'm not going to rise to that base I'm going to do what I usually do I'll just tell you a story I was in Azerbaijan nearly 10 years ago discussing all these things and being asked all these questions and you tell the guys in Azerbaijan well they do it this way in Germany and their faces go blank they say they do this in America and their faces go blank and then you say they do this in Turkey and their faces light up they speak Turkish almost this is a relevant point of comparison anything the Turks can do we can do that what really struck me with the international media is how they all latch on to intellectual fashions did you ever read a good story about Africa three years ago then about two years ago they suddenly realized that there had been all these countries growing so fast and within six months all the Africa stories were positive now when I sit and over here conversations about this subject what strikes me is the divergence of views half the guys are talking Sub-Saharan Africa up and the other half are saying oh no it'll stumble this won't work well let me give you my eternal optimist scenario I think it has to do with emulation and relevant comparisons I think we underestimate the power of gossip in the international business community the MNCs go where their fellow CEOs tell them we've had a good experience here I've seen it happen all over the place from hungry onwards well happens with countries too and I think my optimistic scenario runs like this that we've had half a dozen countries that have performed in a way over the past 10 years that has surprised people and they haven't quite caught up with her haven't quite figured out whether they think this is real or whether it'll continue I think over the next five years we'll probably see two or three those countries forging ahead even further and if we do that then it'll light a fire because people will look over their borders and say look if those guys can do it we can do it and they won't copy them I'm echoing John and I'm echoing Danny development in sub-Saharan Africa won't look like Asia and it won't look like Europe it'll be its own thing and development in different sub-Saharan countries will look different but there will be relevant lessons you can look over the border and say well if those guys could fix the wheel then we could fix that one too is it worth fixing in our context? they'll pick the wheels to fix they'll do their own thing but there'll be relevant points of comparison and that is what sub-Saharan Africa has lacked for decades and now those exemplars are beginning to appear and that's good news thank you John Sam thank you thank you to me the two days have really emphasized the point about learning to compete is essentially about accumulation of capabilities in a continuous manner just as you don't interrupt your location stop, go home come back after two years stop, go home accumulation of capabilities on a continuous manner now the experience of Africa the most important element I picked up here is the way we interrupted accumulation of capabilities we started with a much state involvement then it messed up and we were told stop, state out so it was really cut off from development leave it to the market and the private sector after several years at Niki Noso we discovered the market and private sector do not operate alone they must operate in the private public sector so interruption of those capabilities a situation we saw in Asia where countries learned over time through capability accumulation from import substitution to competition to export to orientation in a way where capabilities were being accumulated continuously so this interruption of capability building is a lesson which in Africa we should really learn how to avoid it and create continuity in capability accumulation of a time and related to this is state capabilities whereby right now having broken the rule of the state for quite a decade and now we are coming back to learn how the state operates in a market economy how to make markets function how the state can make markets develop how the state can facilitate private sector development to develop now that delicate balance is what we need to learn not many African countries know how to handle that delicate balance because of the big interruption which you had of a period of time so if it's one point I would emphasize is a accumulation of capabilities by the state by the industrialists by those operating enterprises on a continuous basis are not interrupted rather built on what has already been accumulated thank you okay so development is a cumulative process of capital, physical, human, institutions I guess I buy that one so now is your chance for asking questions I would request that you try to be very concise because while we do have actually 45 minutes for this discussion try to be precise state your questions and if it's directed at one specific member of the panel please do say that or otherwise state that it's for the panel in general to comment on so I will I started over there last time now I'll start over here and then I will move that way so we'll start here on the left side I guess that's and then let me see so anybody who wants to take off okay professor here yeah I'm Sajer Lahiri from Southern Illinois University now we talked about the political economy and the sustainability of the process of growth now we have seen that in some countries the reforms have stalled like India my the country I originally come from and thus because people say that the growth has not been inclusive the inequality has raised inequality and so I think for African country we talk about industrialization and growth and all that but to sustain that one you need to have the political support and of course Danny Roderick's in the picture the diagram he drew at the top of it was the society so if the society accepts it or not and that's kind of a going one step beyond the politicians and the business community and that's something I have not heard much in this conference so far okay behind yeah Peter thank you very much I think I've enjoyed the conference so far I have two questions and I think to all the panel the economic partnership agreement that African countries have signed how do you think it will help address the challenges of African industries because there's been the skepticism that it might hurt African industries or as others say it would rather promote African sports to what extent do you think it is a way forward in terms of addressing African industrialization then the second one which we all know is the ban of African industries the influx of cheap products from China many African industries have collapsed as a result of trade liberalization and the influx of cheap products from China as a way forward how do you suggest we deal with this challenge thank you okay thank you anybody else here yeah okay thank you I've also enjoyed the conference I think I have one comment and two questions so far in this conference the issue of gender has not come out very well and I want to congratulate Professor Carol Newman for having an opportunity to be on the panel and I think that is a problem in Africa also because whereas we have about 50 percent of the population being women we find out that almost 70 percent also of all micro small enterprises are run by women and yet we don't have clear policies to help them so if you see I was looking at the enterprise map for Ghana and the kind of work that Professor Staten shows you hardly find any women running those medium-sized large enterprises and we need a kind of industrialization that will focus on the comparative advantage where we have many many jobs are being created in the micro small enterprise and I think I need a bit of discussion on that the other question is are we very sure that the African governments are fully committed to industrialization I'm not quite sure then the other issue is how do we finance industrialization in Africa given the low domestic resource mobilization in those countries thank you okay yes please one just just a thought there yeah my name is Chukumago and I have three issues that I'm worried about from the comments from the panel number one on the is on the matter of institutions and industrialization and what we had was that institutions and industrial policies are very closely linked and I'm worried say in most African countries institutions are not the best in their best of shapes so what comment will you have about our best to proceed on ensuring that institutions particularly public institutions are well positioned to be able to help industrial policy my second challenge is on the changing global environment which we have seen a whole lot and it's related to the question by Peter on EPA there is a whole lot of you can't do this anymore you can't do that anymore you can't do this anymore and some of us who face government find them spending a lot of resources just trying to understand and implement most of these international protocols what do you how can you help government agencies to overcome some of these you can do my final is on education which professor already also raised there is this Africa seems to have invested so much in education but not reaping from it and I was trying to listen to see if you have a suggestion about what an average policymaker could do about it okay and we take one last question up here in the front um Tony Tony Addison from wider the question for the panel to reflect on is what information both qualitative and quantitative do we really need as researchers to better understand the policy questions that Africa faces and what information qualitative and quantitative do governments need to enact the policies that we want to see or do we in fact have enough information and data okay thank you Tony wider has never really been involved in primary data collection as such so that is something that actually interests me quite a bit but can I ask the panel to react you don't have to react each one of you but I'd start with Ernest you have any reaction couple of things that came up we I thought I should address and leave some of the others for the others to take care of there was a question from Charles about how do you finance industrialization which I thought is one that we haven't paid enough attention to in all the discussions everywhere about industrialization in Africa I believe you are fully aware of the situation where most financing in Africa is of a short-term nature when African governments began their first attempts at industrializing in the 60s they accompanied these efforts with development banks and we are fully aware of how measurably they failed in the 70s and 80s and make us go away from the whole idea of development banking today the kind of institution that we established to provide 10 finance for industries have not performed as expected there are very few financial markets or capital markets that work effectively to finance the long-term activity and even when you move to the small enterprises it becomes even more difficult for me the issue is can we bring back development banking in a way well structured to take care of the financing needs of small and medium enterprises as well as firms that are seeking to grow much larger how do you structure a development bank in such a manner that it has not become the tool for the state to siphon capital from the markets how do you structure a development bank such a manner that it has all the information that is required to make effective lending decisions you know it's something that can be done but we haven't paid enough attention to that in the literature we simply assume that with the death of these banks in the 80s there was no way you could deal with that issue we thought the capital markets working well should be able to deal with the issue but we know from 20 years of experience that's not going to happen so is there space a scope for doing development banking in Africa in a manner that supports effectively that's I believe there is and I'm working on that question was about whether there's room for education yes indeed we need to realign the kind of education we're doing at different levels in Africa to provide the right human capital for stricter transformation universities have to modernize the ways have to change their curricula to suit the new needs of a growing first growing economies but governments have to be fully aware of what their commitments should be changing try to transformation requires research more and more research there's throughout Africa hardly any country where you can look at a university and say it is a research university not even in South Africa so how are African governments positioning themselves to focus on research provide the kind of capital needed to do good research that will support stricter transformation that's the kind of thing that and I believe there are examples all over the world that we can look at to push this a particular agenda thank you okay Danny you wanted to react you took notes well you're you're you're forcing me yes I am I have a chance now you know it's it's it's partly related to the question about you know development banking and I'm and sometimes I think that that we we over obsess about finance as a constraint and I think clearly finance is a constraint to small enterprises to the among the small and medium enterprises certainly at the very at the small end so for them clearly finance is a constraint I wonder how much of a constraint finance really is for for medium enterprises and the larger enterprises and and this takes us to to a bigger question as to whether if you're interested in industrial restructuring and industrialization to what extent can you actually hope that your small enterprises will actually grow up to be your your medium industry ultimately your large industry whereas as opposed to whether those small enterprises will always remain your small enterprises and I think there's a sometimes a risk that by focusing too much at the small end of the enterprise distribution you know the policies you pursue end up being more or less more like social policy rather than industrial policy in the sense that that you really you know you are aiding and you are assisting a lot of small scale producers but it's not quite clear how much you're really helping lay the basis for industrial diversification and growing if I understood what what John Sutton was saying this morning and I think it's a very important point that it's really the base for what will be your spearheading firms they're going to be sort of the medium sized firms 50 employees or more and then the question you want to ask is why are they staying small and or and A and B why aren't there more of them okay so small is not always beautiful yeah John yeah I'd like to elaborate on that because this is certainly not something that's just discussed in an African context I find that wherever I open my mouth and say something about firms or policies anywhere in the world I run into this great big misconception which flies in the face of the facts everyone seems to think that they're only small firms and the small firms are really important because they grow into the big firms and all your big firms come out of those small firms and you really need to remember two big facts which emerged from Birch's study 30 years ago in the United States where he traced all the new firms created these tens of thousands of firms and the fraction of them that ever became big firms was minuscule you know like a small fraction of one percent and was there anything that those firms had in common? Yeah everyone thought they'd be Silicon Valley high-tech firms you know this was starting in the 70s but they weren't those Silicon Valley guys were there but they were a minority health and leisure centers number one why? because that was a new sub-market you ever see an American jogging in the 1960s? Do you ever see an American not jogging in the 1980s? health and leisure centers in other words the small firms that become great big firms are doing so because they're not typical small firms they're in a niche a particular sub-market they're doing some stuff which is new the market's going to grow the sub-market that business is going to grow and they'll be carried forward on the wave because they were one of the five people that got in first and maybe the other four failed and maybe they weren't the first one but it's the market that carries them up so you have to look very carefully at your group of small firms most of them are three-man jobs and they're going to always stay that because that's what they're designed to be lots of the firms that are mid-sized firms are born as mid-sized firms they may not have 50 workers in year one but by year two they will because they're just recruiting that first year they're designed to be that kind of enterprise and those kinds of enterprises are often the ones that grow and become larger now who runs into the financial constraints it is the mid-sized firm I hear a sad story in Ethiopia and I did the book launch there we did a special book launch just for guys from industry and this guy stood up and he said look I'll tell you what it's like trying to get finance he was running a building supplies company to make building materials very successful mid-sized business and they wanted to move into a new product line making gypsum-based products now Ethiopia as you may know has huge deposits of gypsum this is comparative advantage squared and this guy had a well-functioning company and this was an obvious business opportunity and he went around and the banks turned him down they said how do we know Ethiopians to be able to make this you know we import this stuff and that's a sad story it doesn't always happen but those mid-sized firms can run into constraints and we do need to be imaginative about asking these problems are more serious in Ethiopia than many other sub-Saharan African countries because of the approach they take to liberalization capital markets and so on but there can be constraints and those constraints need to be addressed but it's those mid-sized companies that we have to worry about John in Copenhagen in October last year we had an aid and jobs conference and you made that point about we need to think about who are actually the companies that are creating the most jobs and when you sort of made it there were a number of donor representatives who were sort of sitting there jumping in their seats are they wrong you know I'm a misunderstood person I spend my life having people quote back to me things I'm alleged to have said 10 years ago in some lecture I'm not against small companies small companies are really important they employ an awful lot of people in these countries that we're talking about you've got to look after the small company sector they're a huge part of your population is employed in these I'm not saying anything that cuts against that but I'm saying don't forget that it's a minority of people that are going to be your mid-sized companies you're short of good well-functioning mid-sized companies that you've got to grow please look after the particular things that stop them in growing from being a 30-person company to a 60-person company but I'm entitled to worry about those guys without people thinking I'm putting down everyone else but what do we do if the resources available are constrained I mean okay that's a very fair question but it comes back to questions implicit in this discussion of development banks is your the question is is your banking sector biased in some direction realistically these guys you should only lend the money if they have a really good commercial prospect like my friend making gypsum products a system that's not giving finance to him that's a really malfunctioning system I'm not saying they should take bread out of the mouths of babes in order to give it to him I'm just saying that you would expect in a well-functioning financial system that a good business prospect from mid-sized companies should be financeable that's all but there I leave it sure John you wanted to say something yeah I couldn't pass up Peter's tempting question about the EPAs because as most people in this room know I thoroughly hate doing business there's only one other international initiative I like less than doing business that's the EPAs the EPAs point to a very important problem in the global aid architecture or development architecture if you will which is that in a world of WTO rules about the protection of imports and in a world in which most African countries are now obliged under the EPA for their memberships to maintain an open trading system on the import side one of the few measures of a bit of a leg up we can give to economies trying to get started trying to break into the international market is preferences but then preferences really have to be combined with an aid strategy that supports the ability of these economies to respond to the preferences and they actually can't be bait and switch mechanisms and the EPAs because they are inherently a product of the trade directorate in Brussels have been set up with the objectives of trade negotiators in mind and the trouble with trade negotiators is that the incentive structure for a trade negotiator is to get as much as you can for your side while giving as little as you can to the other side so the EPAs as they are currently structured have highly restricted rules of origin which do not encourage accumulation of value even across borders within the region they're complex they are far more beneficial to European investors and in particular in the areas of such things as intellectual property rights and so forth than they are to African manufacturers and so the question really is what has the development directorate been doing in Brussels and the answer is it's been sitting on its hands or it's been smacked down one of the two things now to share the blame broadly a goa isn't much better but the point is if the US, if Europe, if Japan wants to get proactive in terms of thinking about African industrialization one thing they could come up with is a consistent, reasonable, time bound and fairly liberal system of preferences that's not rocket science that's something that could be done but it simply hasn't gotten on the agenda on the other hand to show my neoclassical origins Peter's second question about the cheap goods from China I think represents one of these dilemmas as economists that we face if we were certain that the cheap goods from China were dumping then we could easily be against it but if cheap goods from China are simply cheap goods from China because China is better able to produce the products than competitors in the domestic economies in Africa we are then taxing consumers for the benefit of industry and there the real question is how much you believe people like Danny and people like me and others that there may be some externalities involved or some productivity benefits involved in industrializing and what degree of inefficiency you want to impose on your consumers in order to do that again that's a cost-benefit calculation but one of the purposes of a conference like this and the research that people have done is to try to get some bounds on that to try to get some reasonable parameters on how much you should be prepared to sacrifice in order to get a head start if you will or a leg up so I'm much more agnostic on the cheap goods from China issue simply because I don't believe we have the evidence base coming back to Tony's point today to really be definitive on that Thanks Don Carol, you have a point on the data what have we learned over the last five years? What have we learned over the last five years and data? So on the data point I think that there's a two-pronged approach needed in fact what you can see from the studies that we've presented over the last two days is that there's some very good quality firm level microdata available in Africa that allows us to understand how firms evolve how they grow, how they're impacted by foreign investment whether they export and why they export and these kinds of data are incredibly valuable so I would say that extending that finding collecting these data making sure we've got good panel data is a really important part of understanding the process but there's huge value in the type of data that John has been collecting as well through his country studies and in particular if we're thinking about Africa developing in a different way to Asia and other countries we've got to think about new ways of collecting data about understanding where the emerging sectors are case studies of, for example, green technology sector green energy, how do we grow these sectors we need to have specific examples but there's simply not enough quantitative data out there available or not enough firms available doing this kind of work to be able to gather it so I would say we have some the countries that we know most about in terms of learning to compete are the ones where we have the best quality microdata and firms but we need more data we need more data on service sector firms we need more data on traded services and we also need more data on these emerging sectors one other point very quickly on the gender dimension because I can't resist I did notice that there is a very notable gap in any discussion on gender over the last two days and I think that the question of why micro enterprises and female and micro enterprises don't pretend to graduate to be small and medium sized enterprises is something that needs further discussion I think this starts at a very high level in terms of political representation of women and also addressing social norms and cultures that prevent women from having equal economic opportunities is something that has got to be built into any future policy agenda Thanks, get your further questions ready but witness and Sam have also indicated that they have a comment let me say on the end of a gender point that we are actually implementing a project on aid and gender and gender is written into the 2014-18 work plan so I just sort of wanted to highlight that and assuming that our advisory board will approve that we will be having a strong focus on that in the coming years so I just sort of wanted to make that point get your questions ready witness you had a comment and Sam you also had a briefie for it okay Okay, thank you Che so for me I think it's just a quick comment just to agree with John on the impact of China I think as long as there is no other evidence to the effect that it's unfair competition I think it's very difficult to argue against or to argue for any measures that would curtail if as long as it's not what one needs is to get the information that all the evidence that is actually unfair competition then of course in that case you can say you're actually disenfranchising a local or African producer so it's unfair then you can have what you want to do and it's a big duties or anything like that then the other question that the gentleman over there raised was the issue of the fact that the trading environment has become very constraining which I think it's a valid point that there are so many constraints one of them being the EPA and the others being for example W2O rules which restricts measures that governments or policymakers can implement in their jurisdictions to try to support their firms and I think it's sort of consistent with what the panel has been talking to here in terms of maybe the kind of industrial policy that we have to see going forward is not the same as what we've seen before so one has to be very strategic about it and maybe you have to target for example this niche sort of product and then you can support those in a way that obviously has to be in conformity with the agreed international rules so yes it's true that the environment is quite constraining but I don't think it does mean that there's nothing that can be done I think one of the things that obviously could be done for example if you look at regional integration and of course aligning the national and regional economic industrial policies I think that can also help to alleviate some of these problems thanks okay Sam thank you witness Sam yeah two quick comments one on data our experience with the data is three challenges one data is very much outdated industrial data eight years old ten years old six years old this is an indication that the government may not be very keen to understand what's on the ground in order to act but two the content of that data you find a very critical element missing which if they had included them in the questionnaire you'd have had the analysis much better I think it's the challenge of us the researchers to feedback to the national Bureau of Statistics on how to improve the content but third is the analysis itself we analysts there's so much data which is not analyzed and sometimes we rush the field to collect new data when there's data in the national Bureau of Statistics which is not analyzed so the three points I observe but one quick point on small firms much as I agree that very few of them actually grow into medium and large scale firms but I think there are three other sources of dynamism with very small firms which in the survey made in Tanzania 97% of enterprises were very very small we have seen the productivity improvement in them compared to the people who came from agriculture to enter small enterprises they have improved their productivity but to the productivity in the small firms is operating under very difficult conditions in terms of the policy environment so enabling them to operate in a more friendly environment without giving social support but simply making premises available for them and they'll pay making credits available and they'll pay can increase their productivity and if the base is so large the productivity gains can be large but third they can easily these will be the firms which can specialize through competition they begin to specialize much as small they are but they begin to specialize and some of them a third point they with their experience they move from owners of enterprises to employees in larger technical firms so I think there are many channels of dynamism of small enterprises not only growing to large but they can be dynamic in our economies okay yeah so many channels of influence what to the question on inclusive growth and India unfortunately I can't comment too much on India my family left India three generations ago but what I want to say is I think that's a problem which is well captured if one looks at the comparison of Nordic countries and let's say in countries that don't have the requisite institutional development then you get a kind of extractive development part and the danger is that that doesn't lead to a broad-based development so India may partly have that kind of problem but in many African countries I think the problem is that you have kind of extractive capitalism because of its natural resource base so I mean I think there the case is for deeper and broader institutional development and part of that challenge can be addressed through developing educational institutions that put the society and that's a very important institutional development that needs to pay attention to okay thanks for what I'm going to take two questions here two here and one over there in that row Roger you first and then just behind you thank you very much Roger Williamson Institute of Development Studies for dad like to push you a bit further on that because on inclusive growth and job creation are you worried about the brazil example because even in a country like Brazil which has made real strides on industrialization and real efforts on social justice you have an educated, underemployed, urbanized, discontented people and so what do governments do and I think you know in South Africa you have some similarities because the government has made real efforts on social justice and other members of the panel is this a factor which concerns you because if you educate people but don't give them jobs or don't provide jobs which actually fulfill them and give them a real wage and real prospects of things getting better you're educating people for discontentment yeah let's get a quick answer to that one okay just a quick response yeah you're raising something that is a real source of concern because with that comes a very high level of inequality as well so that's a potential threat in any society and I think yes in as much as at very many stages we look towards Brazil as a model for developing inclusive growth or growth with reducing inequality which in South Africa does deliver to a large extent because we have one of the largest social grants welfare programs in the world you know so the question is that if you're not going to create employment growth where Brazil has managed far better that remains our key problem at the moment and we're not going to generate that kind of growth with the manufacturing constraints that we face at present so we have to look at the future with alternative areas and alternative sources of growth wider is very shortly publishing a study on inequality in Latin America the conference in September will to a very large extent focus on inequality issues so just to sort of draw attention there was one question here and then one here and then John and then I'm going to take one more and then here that was four we take those four okay good afternoon my name is Nadia I'm a PhD intern here at wider I wanted to link to the comment that John Page made before about tourism I have been thinking a lot about tourism as an alternative to industrialization actually and I was wondering how you think that the protection of natural capital which is so big and so important for Africa should be a part of industrial policy actually considering that there might be in the future an important comparative advantage deriving from the protection of natural capital which is also important for livelihoods for many people in Africa okay here hello my name is Francis Mulango from the African Center for Economic Transformation a lot of my work has been on this question of agro processing and based on my observation I've looked at I've noticed that when it when it comes to job creations there's not much because there for them to be competitive they have to be highly automated when you look at the cocoa industry for example which I'm very familiar with the one in Ghana in the 1990s two companies 400 workers per company now 11 companies about 100 then you have this EPZ where they don't pay taxes and they stay there for a long time and if my question is this what is it to gain with industrialization okay strong question what is that to gain really John yeah I have a question regarding the how disconnected Africa is in the product space if we relate to the houseman Hidalgo we haven't talked a lot about this John Sutton he touched upon it the importance of entrepreneurs being able to switch sectors when they fail in one sector but where if Africa is very disconnected in that product space it's not that easy to move between different products what should we do thank you okay thank you John yeah then this one thank you my name is Sapa Chan from Cambodia my question is a bit broad I'm not sure how to put it but I think a lot of rich countries now are rich because of industrialization I've heard a few statements throughout the two days that no country can be rich without industrialization so now it seems that we recommend different countries to become industrialized so my question whether is whether it is possible to always have a positive stop on industrialization I'm not sure if we can have a positive balance of payment or trade balance for every country so my view is that it could be very challenging for every country to industrialize it could depend on who would be who would do it first and at the expense of others so I'm not too sure about that are we talking about global rebalancing in industrialization if so are we willing to aid the third world with technology I wonder if ODA or foreign aid has a role in providing hardware technology to the third world to catch up not just ODA in terms of you know research and ideas but really to start up capital and technology because that is badly needed thank you okay thank you one question here okay over to the panel who wants to take the lead Ernest yeah thank you very much let me let me answer the question about what is that to gain from industrialization and I think the examples you chose about the cocoa processing in Ghana probably mask the the nature of the effort that needs to be made so if you take an industrialized the cocoa sector yes you need those large firms that would process for exports and go on to manufacture chocolate they produce they provide employment for 400 people which will go down different type of technology they're using but it's a whole big industry that has room for small scale operators also who would have 20 employees 30 employees 40 employees etc so it's a matter of how do you process enough of your cocoa beans to provide jobs for several thousands of organic and it's possible so it's not about if you look at those two firms you are likely to say oh after all the effort that all the capital that's all you have 400 jobs but think about the several women in Ghana who do make handmade chocolate with five employees and are exporting these nicely packaged if that industry were to grow and serve the Japanese market for example and there's a very high demand for beating Ghana chocolate in Japan that's how these things happen and I link you to the last question about everybody wants to industrialize so how do you create large enough space for all of them through aid yes there are 54 countries in Africa all seeking to industrialize some will industrialize before others and those that come ahead of the pack will probably industrialize in a manner different from what the later countries will do that is here I sort of have a different view in terms of the issue of how Africa's industrialization will be that it's not going to be like the Asian one not going to be like the American or going to be like European but the end of the day industrialization means modernization industrialization means modernizing an economy using technology to produce things on a scale larger scale than before and so in that respect I don't believe that industrialization in Africa will be any different from what it's a matter of simply producing things on a scale cheaper than others and that's it's not African it's not Asian it's not European it is the way the modern economy operates there will be a specific country context there will be an African context by way of the workers attitudes there will be an African context by way of what goods are considered important but it will not be an African industrializing it will be industrialization thank you Ernest Danny you are to leave in just five minutes you have anything to say connected then let me thank you for coming and then when you sneak out you're allowed to do that with John you had a comment yeah I wanted to come back to this question of natural capital and industrial policy we can get a bit too far afield I think I was just a meeting for a couple of days in Yokohama along with Jose Hosono with Joe Stiglitz who these days is using the term industrial policy to cover such a wide range of things that one sometimes wonders where you draw the boundaries but the point is absolutely germane and that is that one our consciousness that there needs to be some sort of environmental accounting that begins to go into our thinking about economic development may actually create some opportunities for Africa but two in a field like tourism this comes back to the role of the state there's an obvious need for tourism strategies to reflect them on the sustainability of the resource and what kind of tourists you want how many tourists you want what kind of use of the resource you want so that does become part of your sectoral policy if you will it should be coherent with your overall national environmental strategy but I would argue that if your national environmental strategy is kind of caught and things are not moving I'd rather see a much more aggressive move to bring that kind of thinking into the tourism strategy and one of the things I think that has been difficult in Africa is that we haven't really had very systematic thinking on the part of national governments about how they want to see their tourism sector develop and it's enormously important if you look at Tunisia for example the Tunisians have fundamentally wasted their most precious resource which is narrow relatively constrained beach front land by not having any strategy about how it should be used or even worse by having a strategy which is if you're a friend of Ben Ali's you get a plot for a hotel now they're trying to undo that undoing that is a much more difficult thing than fixing it in the first place so I think you're absolutely right and I think because tourism for many countries in Africa will be very important sector it's something where we really need to bring the environmental agenda and the industrial development agenda industry largely written together let me just reflect on Fuad's point I too worry and I am optimistic like Ben oh I am optimistic like John I'm on record as having said there will be African leopards but I do worry about an African spring the fastest growing economies in Africa today are the economies that are generating the least employment per percentage of GDP growth so we have masked that largely because people move into the informal sector but these are not good jobs and increasingly we're going to find and if Ernest succeeds in improving the quality of education we will increasingly find frustrated young people constrained from entering into the kinds of positions that they aspire to and feel qualified for and forced into other kinds of economic activity and that can lead to a fairly difficult social situation as we've seen north of the Sahara and the fundamental reality is that this is likely to get worse rather than better because as we see more natural resources discoveries we come up against the fundamental reality that gas fields oil wells and gold mines don't generate very many jobs directly so thinking that through and linking it to the development agenda I think it's got to be part of what is the next generation of concerns for policy makers okay sam you had a comment that will then be the last one yes one comment on industrialization I think there are two contradictory lessons which I see in the history of industrialization one every country which came later adopted a different strategy because other countries had already come before it so a late come always adopted a different strategy of industrialization because the predecessor was already in place but two all countries share one common thing they industrialized by building capabilities by taking the opportunities which were available to them at that time given the global economy given the country conditions so I would not be pessimistic thinking room is not there for industrialization room is there given the conditions at that time and opportunities available at that time but one thing is in common accumulate capabilities on the lines which are available at that particular point in time okay witness you indicated you wanted just a quick problem abusing the opportunity of keeping me chair so I think in in the previous round of questions I didn't sort of come in but I think the issue of finance is something that is quite interesting and quite relevant and topical in Africa so so obviously something that that is a LSE also I think we are quite quite keen on and so actually I just wanted to point out that in our descent upcoming December by annual actually the theme there is financial inclusion and innovation so it's also trying to address that issue of how to improve access to finance then of course that I think that was also quite interesting and topical also in terms of the work that we do is which I think is relevant to what has been discussed here is the issue of inequality growth and poverty reduction so I think there is that issue that growth hasn't translated into to poverty reduction and obviously that's a source of concern and it's something that that I think all policymakers would be worried about quite quite a lot yeah thank you very much witness colleagues ladies and gentlemen these were 10 questions and 10 thorough sets of answers comments but there's of course still a lot of work to do but it is now time to call this conference to a close we have reached the conclusion I very much hope you found it useful fun thought provoking and that you have met both old and new colleagues thank you very much to the excellent panel members this was great thank you very much to presenters to chairs and to all of you those of you who asked excellent questions got debates going make sure that they keep going development is also about exchanging it's about sharing get the information the knowledge out there let's address all of these difficult questions and let's try and figure out whether we cannot come up with some helpful advice to polish policymakers who have to take decisions often in split seconds thank you very much to Anna thank you very much to the wider support staff you have been there in the background we have seen you and we have noted that without you this kind of conferences could not be done thank you also to the recording staff you will be able to revisit our deliberations on the web you will be able to download the slides and have a look and also do check our angle our newsletter because there will be continuously stories messages news about what the wider global network is experiencing there will be information about the next conference and if you yourself can't come well maybe you have a colleague who can come look for that in september we will have the wider annual lectured given by president Ardasary on inequality and social conflict and then I have a question or I have a request or a plea or whatever in about a week's time you're going to receive an email with an evaluation form can I please beg you to please fill it in when I'm sitting with the ones who pay for this and who are kindly paying they really get upset when I cannot report back that we held a conference and that you felt this and that and the other about the conference can I please make that plea I know I get these forms as well and sometimes yeah can I request that please we look forward to seeing you again and I wish you a safe travel back home and for many of you back home where the real development challenges are facing us 24 hours a day seven days a week 12 months a year safe travel and see you next time


at the right time. You know, I should be doing this better or should be doing this differently. That's the ego's way of solving a grievance is do something different. And Jesus' way is a miracle. Think something different. If you think something different, then it doesn't so much matter what's going on. The behavior will flow automatically and you know there's no big deal. It makes perfect sense too when you really think about it and just it works. It's the good news. I mean we are really getting a good blast of the good news, the gospel that was given you know two thousand years ago. We're getting a real clear explanation of it through the Course. Now, that thought occurred to me earlier. I thought the first time or when Jesus was here and the real gospel was written, the Bible was written about New Testament anyway. Did he teach the same thing and it wasn't heard or it certainly wasn't passed down through the ages? It's identical, but he described it in the Course as that basically the apostles still had their egos so to speak in a metaphorical sense and so they still had upside down perception. Well did he try to teach them like this? Oh yes, I mean he came at it through every different angle and he could.


Greetings to you all in the room and to the members of the media joining us from all over the world through our live stream. A very warm welcome to this exciting press briefing on health equity and the zero health gaps pledge. My name is Trevor Tuiwu. I'm the lead for media relations and public affairs at the World Economic Forum. And today I'm joined by an esteemed panel. Firstly, we have Michelle Williams, dean of faculty at Harvard Chan School of Public Health. We've got Binta Diop, the founder and chair of the board, Firm Afrique Solidarité and special envoy of the chairpersons of Africa Union Commission on Women, Peace and Security. Thirdly, we are joined by Joe Okuzoglu, global chief executive officer of Deloitte. We've got Nancy Brown, chief executive officer of the African of the American Heart Association. And lastly, we have Christof Weber, president and chief executive officer of Takeda. Now, we all know that there is a significant disparity in health care access and health care outcomes across the world. And the Forum's global health equity network and its partners really envision a future without unfair differences in health and well-being outcomes between and within countries. In support of this vision, I am delighted to announce that 39 organizations have signed the pledge to support this vision of zero health gaps. Now, I would like to start with you, Michelle. Can you briefly tell us about the state of health equity from a public health perspective? Sure. Thank you, Trevor. And good morning, everyone, and I'm delighted and honored to be on this esteemed panel, a member of this panel. Let me start by defining health equity because it's important for us to be grounded in why this pledge is so important. Health equity means, for me, fair and just opportunities provided for everyone to thrive and meet their human potential. And we know historically that there have been systematic, pervasive systematic reasons that drive inequality in access to health care and access to the drivers for health and wellness that are way upstream, excuse me, of the medical health care system. So why now? Why think about health equity now? Because we've had a number of shocks to society that clearly highlight the impact inequalities in health have on all of us. We have seen, for example, in the COVID crisis, that the members of the most vulnerable communities across the world have higher risks and worse outcomes than others with resources and access to housing, food security, medical care, and so on. So for me, health equity is important and it is an issue for all of us. Explain some of the metrics that we use to evaluate health equity and how this drives why now. It's important for us to realize that metrics like life expectancy, we can see a 30-year gap in life expectancy across countries. You mentioned this, Trevor, and that life expectancy of 30-year gap can be seen between Japan and Lusoto and other African countries. We also see gaps in life expectancy across, within countries. So in the United States, for example, African-American versus white Americans have a five-year gap and the gap is even wider for Native Americans. That's a 10-year gap. These types of gaps within countries are seen in other countries such as the UK. Beyond the health and personal risks of health inequity, there are economic and societal impacts. We have seen in the European Union, for example, a 1.4% loss in GDP annually because of health inequity. On the African continent, there is a $2.4 trillion loss in GDP because of health inequities and put it in human life terms, 704 healthy person years of life lost on the continent because of health inequalities. So there are moral and economic imperatives that drive this. Finally, I will say health inequities result from societal, systemic, historical issues. We are all vulnerable as we have seen in the face of shocks like climate change and COVID-19. We believe our network that now is an important time where the crisis has sharpened our focus and we are realizing increasingly that health inequity results from societal factors and it will take all of society to engage. So having public, private and civil society involved in addressing this solution and making a commitment like we are asking for in the pledge is critically important. Thank you. Thanks, Michel. I want to turn it over to you, Binta. If you could just give us an overview around the health equity landscape in the policy and partnership space. Thank you so much and let me just say how delighted to be part of this high-level panel. But let me just say that today in Davos, this is going to be a historic moment because of this pledge is made by public, private, civil society, private sector and why it's important that we have public support because it's a primary responsibility of healthcare delivery in terms of engagement and policy and making the environment being friendly for others to come in is a government and I think they have to buy in to support this initiative driven by investors but also the private joined by civil society. So let me just say why it is so important for our government and the leaders of our government to join such an initiative. You know, we have experienced COVID but also we know that there will be other pandemic and we saw the impact on our population. We have also seen that there will be future pandemic and we need to be prepared for that. Let me also say that by joining this partnership, it's the right thing to be done. That's the right thing but it's a smart thing to do. It's smart thing because we see that it's going to save lives. It's going to impact on the communities. It's going to impact on the entire ecosystem as we said, you know, in our own country. So let me just point out few in terms of the continent where I come from, Africa, when it comes to why we need to be part of this pledge. I think number one is about a few examples. It's about numbers. It's about the people. Only 48% of people in Africa receive the healthcare services that they need. So there is a gap. What do we do with the 650 million people that want healthcare and which need to be, you know, serviced? The second issue is the quality of the healthcare service. I think in many African countries, you know, we see that they are very low in the performance of the universal healthcare. So we need to make sure that the quality is there and I think that this pledge is about delivering quality service. The number three for me is the disparity. The coverage with essential health services in Africa is, we know that it's inequitable. So we need to do address that issue. For example, let me just give one example. The demand for family planning satisfy among the rich is higher than, you know, for the poor. So we need to see that disparity and see how do we address that. And the last one for me, and just to have a few, is the gender gap. And for this, for me, is the women and the girls. I can say between 2015 and 2019, less than half of African women have the demand for family planning satisfy by the method, the modern methods. Just a few examples, that's it. Why we need to join this platform, public, private platform, because this is time for revolution. You know, and what I see in the pledge that the time that's together we are, the revenue will be raised together, will be pulled together, allocated and used efficiently and equitably. So the reform must go beyond spending only. And I think that the government have to invest. And this is a bill, this is a demand, but we need also to make sure that we measure the impact together. And the web is here also to offer the platform to collect the data, to measure, and in the platform to share the best practices to be scared up. And I'm sure that we will all work together to make this happen in the few years to come. It's for humanity, it's for the good. And I think this is what all of us are disabled, but beyond those who are listening to be part of this pledge. Thank you. Thank you so much, Pinta, for those insights from a government perspective, really, really compelling argument. Joe, I'm going to hand it over to you just to give us some thoughts on a business case. What do you think corporates need to be thinking about when making corporate investments into health equity? Well, first, thank you for the kind invitation to be a part of this discussion. And all of us at Deloitte are very appreciative of the opportunity to co-lead the Global Health Equity Network. These issues around health inequities are longstanding. They were thrust front and center into public view during the brunt of the COVID-19 pandemic. And if anybody thought that sort of as the pandemic subsided that these issues would go away, that's been laid to rest. We now see a number of new stressors that are exacerbating inequities, war, supply chain issues leading to increased food insecurity, climate events. And so the imperative is significant. And this is fundamentally an issue that the business community has to be engaged in. There is the broad macroeconomic cost that, as you shared, can be measured in the trillions of dollars to the global economy. There is an issue relative to companies' own workforces where we know that healthier individuals are more engaged and more productive. And then there's the societal imperative that we're sitting here facing questions about whether the free enterprise economic system can deliver for society broadly. This is a core element of stakeholder capitalism, the business community demonstrating that we're part of the solution and that we're taking action relative to the commitment to make good on the United Nations' sustainable development goals. Now, the words are the easy part. So then the question is, well, what specifically can businesses do? We are pleased with the momentum and the number of organizations that have already signed up. It's not enough. And so we're going to be focused on expanding that ecosystem that we're creating. We need to develop measurement mechanisms so that we can actually quantify individual companies' health equity footprints. And with measurement, that allows for setting goals. It allows for accountability. And we're going to do this as a collective. No one has all the answers, but we're putting together the ecosystem to really be able to drive change at scale.  Thank you so much, Joe. Now coming to Nancy, we all know that you're a very strong and big advocate for health equity. And I think this gives me an opportunity for me to allow you to just tell us about what this Zero Health Gaps pledge is all about. What does it mean for the organizations that have joined, but also those that would be called upon to join? Thank you so much. And it is an honor to join this prestigious panel to talk about the Zero Health Gaps pledge. We're very honored at the World Economic Forum to be launching this pledge today. And we are calling on all of the members of the forum to join us in taking this bold action. The pledge itself is a series of 10 commitments designed to counter all of these issues that my colleagues have talked about today. As Joe just mentioned, corporate action is necessary to galvanize the global community to address the inequities that exist in the world itself. At the American Heart Association, we are proud also to co-lead the Global Health Equity Network and also to be one of the inaugural signers of this pledge. The 10 commitments in the pledge itself really are a call to action for our companies. We know, as Joe just stated, that there is a clear business case for why companies should be at the forefront of leading this health equity charge. We know that health inequity, it leads not only to financial loss for individuals but for organizations and for communities at large as well. And to reach health equity by 2050, which is our goal, public, private, and philanthropic institutions must join together to take a leadership role. Some of the things that we are asking companies and those who signed the pledge to consider are to, first of all, take a deep look with inside of our own organizations. Some actions like access to employee health insurance and living wages should be prioritized across all industries. However, businesses can really take the lead in showcasing what that looks like. We know that in order to help those who have signed the pledge or who are considering signing the pledge, that tools and resources, including guides to measurement will be really important. And that's why we're very proud today to not only be launching this pledge and these 10 commitments, but also a toolkit for those who signed to be able to deeply integrate this program within their organizations. As it was said earlier by my colleagues, signing a pledge is not the end, it's the beginning. Signing the pledge means that those will stand together and stand tall to help lead this global movement, to help our organizations make sure that every individual has a fair and just opportunity for health and well-being, which is our vision and which is a human right that has been designated by the United Nations. Thank you very much. Thanks so much, Nancy. Christoph, very excited that you have joined the pledge. And I think this gives us the opportunity to get your thoughts around how, you know, having committed to this has worked for your business. How are you integrating it into your organizational strategy and the implementation thereof? Yeah, thank you. I'm really delighted that we are all here together today because we know that we have been knowing that health equity has been an issue. Takeda has been created 240 years ago. We are present in 100 countries. We are in healthcare. So we see every day the health disparity, both within countries, Michelle mentioned it, as well as globally. And so this is something very dear to us. Our mission is to deliver, develop, deliver life-transforming medicine and vaccines to the world. And so it's very impactful when we launch a new concert treatment or new vaccines. And so for us, it's morally necessary to think about equity. But it's also a good business. And I think I should be clear on that because companies don't get the credibility if people see that there is an autonomy between the intent and the business. But I would like to stress out that for companies to really aim for health equity is actually morally right, but it's also a good business. And for our employees, I can tell you that they are expecting from a company like us to really thrive for health equity. So what have we done? When we develop a new product, a new treatment, a new vaccines, we think globally about whether the way we develop it is right to get this product approved in many countries. So it's not a development for one country only. It's really a global thinking. We have been looking at our clinical trial diversity, for example. And we know it's not where we should be in terms of recruitment of patients. And so this is something we are now very actively looking at how we can increase our clinical trial diversity because it starts there. If you don't have the data for a certain group of patients, then they won't trust potentially the vaccines or the treatment, so it's very important to have enough clinical trial diversity. We'll never match the diversity of the world, but we can improve a lot our clinical trial diversity. And then the other strategy and things we are doing is about access. So starting with price. So in the company, we have a very clear tier pricing mechanism where we have four, we group countries in four groups, and we have very significant price differences between the group because at country level, we need to recognize that the wealth of the countries and investment in healthcare is very different. So we try to really match where the country is when we price our medicine and vaccines. And I think this pledge would also hopefully help countries to invest more in healthcare because one of the issues that we are seeing is that healthcare is under a huge financial pressure in many countries. And this pledge I think will help countries to look at their investment in healthcare. And then beside the tier pricing and the access, within the country, we have some patient assistance programs to help people within the country to have better access to our medicines and vaccines. So it's a country approach in terms of access as well as within the country because there are significant disparities within the countries. So I'm very delighted that we are here launching this pledge and I'm sure many companies, many organizations will join in the future. Thank you very much. Thank you so much, Christophe, for sharing that proof point about how organizations can actually really take commitment on this pledge. It is at this point where I would turn it over to the floor to ask questions. Please do raise your hand and the mic will be brought to you. Are there any questions? None at all? May I just add a point because all of our panelists and members of the panel really emphasize something that I don't want to be lost and that is in addition to the pledge, I want everyone to understand that the Global Health Equity Network more than developing this pledge are also developing a toolkit because one of the reasons for an action, I mean to be honest, is that the solving health inequities is going to require all of society to be involved and it's going to require a range of different actions and activities to really meet the commitment that we are asking the pledge signers to commit to. So the network is also developing toolkits to help implement, to help promote action when there is a will. And as we've spoken together before, we're also very eager to go beyond the rhetoric and to have measures so that we can test and learn, measure, and scale. And so for me, this is really exciting because we know making the commitment needs to be followed by having quality performance that yields impact. And I want people to really understand that this network beyond the pledge is committed to the long-term effort that it will take and the collective and collaborative effort it will take. Thanks so much, Michelle. Now, I just think that adding on that is, you know, when we look at the whole landscape of recovering and when we look at not just the healthcare, the education, you name them, the whole SDGs, if we don't address healthcare, I think that we will not address the other SDGs gold. So it should be one of the driving element of recovery. And I think that's why it's very important for government to come in and buy in. So now it's up to those who have signed, the 39 who have signed, you know, to look into those actions and the solution that we are putting in place to make sure that we have the interactive dialogue because this about discussion is about bringing everybody together and making sure that we deliver together. So I think that it will help to identify the concrete as you mentioned at country level, at local level, and who will be the actors that will be involved and make that those solutions are live rock and we can share those in the platform, we can share those best practices. I'm sure that the public, even at local level, you know, we'll engage with such initiatives because it will fill the gaps of health, but also the gap, the other issues, foods insecurity, the issue of education for all, the gender gap as we say, because it's going to address the health, not just of individual only, but the family, the community, the whole ecosystem will be addressed. So I just wanted to add that as well. Thanks, Binta. Joe, just one thing you would like corporates to take away as we work towards achieving health equity for all across the world. Those of us in the corporate world know that when an organization commits and sets their mind to something, generally they get results, but it comes through measurement. There's an old saying that what you measure gets managed and so we have to find ways to actually turn these broad, very laudable words into measures of health equity footprint. We're making a lot of progress on that and that in turn allows for specific goals and making people accountable, building this into strategy, tracking it over time to demonstrate results. Thank you so much. Nancy, it's time to mobilize organizations to join this pledge and the health equity network. What are your last thoughts for them? I would just say we have a vision to have at least 100 organizations join us and as my colleagues have said, the pledge is the beginning. We look forward to learning from each other, those of us who signed the pledge through a learning lab that the World Economic Forum is creating so that tools, resources, and actual experiences can be shared. The concept of measurement that has been mentioned so many times today is critically important and I would just like to mention the importance of big measures and small measures. As Joe just said, what gets measured gets done. So if each of the companies and organizations and governments who signed this pledge would understand through the toolkit the very specific actions that need to be taken and set measurements within an organization around each action as we continue to work together to define the ultimate measure of the success not only of the global health equity network but of the movement for health equity for all. I think it will be a wonderful beginning for our work together. Thank you so much. Christophe, one thing you think your peers could learn from you? Oh, I'm not too humble for that. I would just say that this is possible to be achieved and that's why it's the right time to do it because there is enough first societal awareness and there is enough scientific innovation and technological innovation to make it happen. I wouldn't have said that even 15 years ago. So I think this is really the right moment to do it and it's possible to be done. Thank you so much. We really hope that organizations can be inspired by the 39 that have joined the pledge and that they will also make a commitment in really driving this pledge in achieving health equity. Thank you so much, members of the media joining us in the room and to those who are online. Thank you.


Hi everyone, Joe for jaspyscasewrakes.com coming at you with a 2017 Panini Daunras football hangar box break number six one spot gets you two and You have a shot at getting some teams in luminance football So here's what we're gonna do one spot gets you two teams, right? So let's double you up right here All the NFL teams are in will do the break itself first at the end of the break We're just going to use the original 16 names and top four out of 16. We'll get spots in the In the luminance break. We just come up right after this All right, so let's roll it. Let's randomize it. This is for the break first three times one and two three two and three after three times Mark down to Rick And after three times the teams Teams would help So once again three times for the teams After three times we got the Houston Texans down to the Los Angeles Rams I'm not gonna read off the whole list here, but we're looking really looking for the chiefs because this is a 2017 box There you go Jpf KC Let's print and Rip Right, right, right, right, right Steven punk. We cannot forget Mitchell Trabisky In this 2017 set in fact There he is right on the box. All right, so again, no trading windows and stuff like this, but there's that right there There's a luminance case right back there. I think the second half of lumens does not have Any filler or number block attached to it It does not in fact, there's only two teams left We can definitely run this back Steelers and Niners are left in the second half of this case right here Press proof any Dalton Colby Colby cleaner no adoption rated rookie press proof Odell Beckham Jr. Dominator See that we've got Mack Hollins the rookies we've got Kenny Galladay Rookie Kenny G. That's how he signs it Hatcher Mahomes rated rookie card nice no parallel just a base but Pretty nice Probably cover a few spots in this break grades out nicely more actually how much does this go for? Now I'm curious Bucky Hodges James Connery to rookie and Aaron Jones in the back right there. Let's go 2017 Anini or no, let's call it Donner's football rated rookie Patrick Mahomes Well PSA nine is 200 bucks PSA 10 400 bucks raw 150 bucks Most recent auction today actually today's 28th right just sold at around six o'clock LA time Nine o'clock East Coast time auction just ended one of these Open auction 17 bids one 157 45. That's not bad. Not bad at all. All right So there you go a winner already John Paul There it is right here. All right now. Let's go back here. What do we say the top four? There's There you go. So we'll re-randomize the original 16 names right here The fourth name down will get the Titans the third name down will get the Vikings the second name We'll get the Colton the name on top. We'll get the Dolphins after Three and a three six times hard six one two three four five and Six after six Eric J. Congrats to you mark mark and the Nicholas. There you go. You are the top four right here After six times You are in luminance number Six I think luminance six luminance seven luminance seven there you go So you've got those teams luminance seven we'll put a little rooftop next to your name So you know you won that in these randomizers here. Thanks for watching. Thanks for breaking with us I'm Joe. I'll see you next time for the next one. Bye. Bye