THE STANDING SENATE COMMITTEE ON FOREIGN AFFAIRS AND INTERNATIONAL TRADE
EVIDENCE
OTTAWA, Wednesday, December 4, 2024
The Standing Senate Committee on Foreign Affairs and International Trade met with videoconference this day at 4:15 p.m. [ET] to examine and report on Canada’s interests and engagement in Africa.
Senator Peter M. Boehm (Chair) in the chair.
[Translation]
The Chair: Good afternoon, honourable senators. My name is Peter Boehm. I’m a senator from Ontario and the chair of the Standing Senate Committee on Foreign Affairs and International Trade.
Before we begin, I want to invite the committee members in attendance today to introduce themselves, starting on my left.
Senator Gerba: Amina Gerba, Quebec.
[English]
Senator Greene: Stephen Greene, Nova Scotia.
Senator Ravalia: Mohamed Ravalia, Newfoundland and Labrador.
Senator MacDonald: Michael MacDonald, Cape Breton, Nova Scotia.
Senator Adler: Charles Adler, Winnipeg, Manitoba.
Senator Boniface: Gwen Boniface, Ontario.
Senator Coyle: Mary Coyle, Antigonish, Nova Scotia.
Senator M. Deacon: Welcome. Marty Deacon, Ontario.
Senator Al Zaibak: Mohammad Al Zaibak, Ontario.
The Chair: Thank you very much, senators. I wish to add that Senator Adler is visiting us again. We welcome him to the committee.
I want to welcome all who may be watching us across the country today on ParlVU. Today we are going to continue our study on Canada’s interests and engagement in Africa.
We have the pleasure to welcome today, as witnesses, Dr. Jason Nickerson, Humanitarian Representative to Canada, Doctors Without Borders; Wendy Harris, President and Chief Executive Officer, Catalyste+; and Steve Gilbert, Chief Operating Officer, Nutrition International. By video conference from Montreal, we have Anne Delorme, Executive Director, Humanity & Inclusion Canada. Welcome to the committee, and thank you for taking the time to be with us today. Before we hear your remarks and proceed to questions and answers, I would ask everyone present to please mute notifications on their devices.
We are now ready to hear opening remarks of five minutes each from our witnesses, which will be followed by questions from senators.
[Translation]
Ms. Delorme, you have the floor.
Anne Delorme, Executive Director, Humanity & Inclusion Canada: Good afternoon, and thank you very much. I’m sorry to be participating remotely, but VIA Rail is having issues with its trains these days.
[English]
Humanity & Inclusion Canada, also known as Handicap International, is co-laureate of the Nobel Peace Prize for its international campaign to ban land mines. We provide humanitarian assistance, inclusive development and reduced armed violence programming in 60 countries around the world, including 16 countries in Africa. For 40 years, we have worked in partnerships with people with disabilities in health, education and economic development programming.
On the question of disabilities, between 10 and 20% of the African population is affected by disabilities. Among refugees from conflict settings, this number increases to 25%.
Canada has made a number of commitments to disability inclusion in the Feminist International Aid Policy, multiple ministerial mandate letters, as a signatory to the Convention on the Rights of Persons with Disabilities and at Global Disability Summits. Further, the Official Development Assistance Accountability Act, or ODA, focuses on poverty alleviation, and none are more poor or more marginalized than women and children with disabilities. Yet there are serious gaps in funding for disability inclusion in Africa. A more targeted approach is recommended to ensure the achievement of the Sustainable Development Goals, or SDGs, and to fulfill the promise that no one is left behind.
As my time is limited — and I would love to provide a bit more detail on conflict, rights of women with disabilities, inclusive health or even economic development in Africa — I will focus on inclusive education, but I welcome any questions on these other topics.
[Translation]
Of all the regions in the world, sub-Saharan Africa has the highest rate of children with disabilities — 34 million — excluded from education. Less than 5% of children with disabilities are enrolled in primary school.
Children with disabilities face many behavioural, physical and institutional obstacles to accessing quality education. Stigma and discrimination by the community and education professionals are key obstacles to their inclusion. A recent Humanity & Inclusion report on West and Central Africa documents how customs and beliefs hinder educational opportunities for children with disabilities, who are often invisible in their communities because their parents hide them or keep them at home to protect them.
[English]
When it comes to children with disabilities, we often speak of the fifth hidden child. In Kakuma Refugee Camp in Kenya, I met a boy named Brian, who, at age 8, was kept from school. His mother explained how she chained him in the house to prevent him from wandering when she left for errands or for work. She was afraid of the community discovering about her child. Today Brian is thriving in school, thanks to the support from Humanity & Inclusion, and his mother is part of a mothers’ circle seeking to change social norms in her community so that other children with disabilities, whether physical or developmental, can access education and thrive.
Furthermore, girls with disabilities are one of the most discriminated groups regarding access to education. UNICEF reported that only 42% of girls with disabilities completed primary school. They are twice more at risk of violence, harassment and trafficking, particularly on the way to and from school.
Humanity & Inclusion, or HI, has supported inclusive education in countries across Africa, currently in 16 countries. HI’s experience has demonstrated that multi-level approaches increase access and success rates in children with disabilities. When we talk about multi-level, we are talking about the individual level. It means support for children, including access to aides and health services; at the school level, providing teacher training, pedagogical materials, curriculum support, learning tools, infrastructure updates, each tailored to children’s needs; at the community level, transforming those social norms in families, communities and schools to ensure children have a supportive environment, free of discrimination; and at the national level, to change government policy, teacher training curriculums and budgets.
In conclusion, I wish to highlight two important recommendations — the need to allocate funds to targeted disability-inclusive programs in Africa to allow Canada to fulfill its international commitments responsibly and measurably, and this is particularly true for education; and to ensure measurable impacts, which means robust monitoring measurement, including disaggregated data collection on types of disabilities and the use of the Washington Group question set. Thank you very much.
The Chair: Thank you. We will go next to Ms. Harris, please.
Wendy Harris, President and Chief Executive Officer, Catalyste+: Thank you, and good afternoon. My name is Wendy Harris, and I am the president and CEO of Catalyste+. You may know us from our former name CESO-SACO. Catalyste+ focuses on economic-based development in Africa, Asia, Latin America and the Caribbean, and in partnership with Indigenous peoples in Canada. Our track record includes supporting over 120 countries to strengthen government institutions and grow their private sector for more than 55 years. We believe that good governance and institutional strengthening is the foundation of sustainable development and that a resilient and thriving private sector is the engine of economic growth.
The African continent faces significant challenges in achieving sustainable development, yet with its abundance of natural resources and a young population, it also offers a wealth of opportunities, with economic growth projected to outpace the average global growth rate. Many African countries are still struggling to meet the Sustainable Development Goals, with these difficulties exacerbated by the impacts of climate change and the COVID-19 pandemic. The region is also expected to experience a large demographic shift with the working-age population projected to nearly double by 2050.
This dramatic increase in the working-age population will require substantial investments in education, skills development and job creation to harness this growing human capital effectively. If not managed properly, the influx of young people could strain existing resources, worsen unemployment and contribute to social and political unrest.
On the other hand, this shift represents a potential opportunity for the region, offering a large pool of human capital for economic growth and progress. One of the key elements for navigating these demographic changes to achieve sustainable development will be the establishment of strong, accountable public institutions.
The African Union’s Africa Governance Report 2023 emphasizes the need for African countries to prioritize key governance elements, including economic governance, public sector accountability, constitutional order, rule of law and human rights, all to ensure political, economic and social stability.
Addressing these areas are crucial in tackling poverty, addressing inequality and human development, as well as creating a stable, predictable environment for businesses and communities to thrive and to attract trade and investment.
The 2030 Agenda for Sustainable Development defines “international trade” as “an engine for inclusive economic growth and poverty reduction . . . .”
Another key element is support for micro-, small- and medium-sized enterprises, the engine of any economy. Entrepreneurship and innovation are key drivers of economic growth, serving to grow a vibrant middle class, addressing inequality and the wealth gap that often leads to social exclusion and political instability.
Through decades of engagement across Africa, Catalyste+ has actively promoted good governance and institutional strengthening among various stakeholders, including national ministries, regions, municipalities and major sectorial institutions.
Our experience has shown us that good governance provides the necessary framework and stable foundation for managing resources, delivering services efficiently and implementing policies that benefit and engage all citizens to safeguard the environment.
Strong democratic public institutions are the foundation of good governance, vital for formulating, implementing and managing citizen-centred sustainable development policies and ensuring that initiatives are effective, equitable and sustainable. By empowering these entities in strategic decision making and strengthening their institutional capacity, Canada supports their journey towards more sustainable and inclusive development.
Transparent and accountable institutions are conducive to private sector development by attracting trade, investment and innovation, improving tax and fiscal management, fostering participatory development and establishing a transparent and predictable legal framework. By strengthening policies, processes and systems in these institutions, Catalyste+ helps them be better equipped to innovate and adapt to changing circumstances. This is particularly important in the context of sustainable development, where new challenges such as climate change and global economic shifts require adaptive strategies and resilience.
The needs highlighted above are largely consistent across the African continent. While there are a growing number of actors with renewed interest in Africa, Canada still has an important role to play in reinforcing governance and strong institutions.
By supporting the readiness and resilience of African leadership to effectively navigate these challenges, Canada can contribute significantly to mitigating the risks of external interventions and support more sustainable development outcomes. Strengthening institutions and enhancing governance frameworks create a more stable and transparent environment that ensures that development strategies are implemented effectively and resources are managed efficiently.
Canada’s involvement in these areas can provide crucial support and resources, addressing complex and interconnected development challenges, and contributing to a more sustainable and equitable future for the continent. Thank you.
The Chair: Thank you, Ms. Harris. We will move to Dr. Jason Nickerson, please.
Jason Nickerson, Humanitarian Representative to Canada, Doctors Without Borders: Thank you very much. Doctors Without Borders, or Médecins Sans Frontières, is an international medical humanitarian organization that provides medical care to people affected by armed conflict, natural disasters, forced displacements and, increasingly, climate change, and 35 of the 74 countries that Médecins Sans Frontières, or MSF, works in today are in Africa, representing more than half of MSF’s activities by expenditure and totalling roughly C$1.15 billion.
As well, 8 of our 10 largest country programs are in Africa. Each of these countries and our work in them is complex and diverse, so I want to focus on two countries in particular today: Sudan and Democratic Republic of the Congo. We have been sounding the alarm on the deteriorating humanitarian situation after more than a year of violent conflict in Sudan and a response that is both obstructed by warring parties and completely inadequate. Millions of people are facing immense suffering, including malnutrition, trauma and lack of basic health care.
Last month MSF was forced to stop outpatient treatment for 5,000 children with acute malnutrition in Zamzam displacement camp, which today hosts at least 450,000 people in North Darfur, because warring parties blocked deliveries of food, medicines and other essential supplies.
Earlier this week, the camp was attacked by the rapid support forces, and on Monday a shell hit near our field hospital, forcing staff and patients to flee. All of this occurs within an extremely violent conflict where our teams are treating thousands of war-wounded patients, including children, as we call for an urgent scale-up in the humanitarian response, for warring parties to ensure the protection of civilians, humanitarians and health care infrastructure, and for countries like Canada to leverage their full diplomatic influence to ensure it.
Meanwhile, in the North Kivu province of Democratic Republic of the Congo, we are responding to a massive humanitarian crisis following renewed fighting since 2022, in a largely neglected conflict that has displaced at least 2 million people, and where violence against civilians is widespread.
As an example, in 2023 alone, MSF-supported clinics provided care for 22,905 survivors of sexual violence across North Kivu. This is an alarming situation that has deteriorated even further this year, as our teams treated nearly 70% of the total number of survivors of sexual violence in 2023, just between January and May 2024.
Yet the broader humanitarian response to this crisis has been grossly inadequate, which is why MSF has been calling repeatedly for a scaled-up humanitarian response, including a specific call for Canada to increase its humanitarian assistance funding and to leverage its full suite of diplomatic tools to find solutions to this crisis.
As a medical humanitarian organization, we remain extremely concerned about our teams’ and our patients’ access to essential medicines, which during the COVID-19 pandemic became a flashpoint at the intersection of public health, human rights and international trade, and which saw many African countries deprived of timely access to vaccines and therapeutics. Unfortunately, this is not unusual for the way the medicines market works, but there are some lessons to be learned for Canada’s approach to medical research and development. Canada has been a leader in the development of vaccines and therapeutics for some high-impact infectious diseases that are relevant in some African countries, including discovering vaccines candidates for viral hemorrhagic fevers like Ebola, Marburg and Lassa, but has failed to provide the necessary supports to get these Canadian innovations to all who need them at an affordable price, which leaves a significant gap in the public health tool box for responding to public health crises on the continent.
Canada has options here, including putting the currently dormant Biologics Manufacturing Centre in Montreal to work to help close global gaps in access, but also needs to reshape its positions on global instruments, such as the pandemic accord that is currently being negotiated and issues related to intellectual property rights to better address access concerns raised by African countries.
I will conclude by noting that Canada is a respected humanitarian donor that operates in a principled manner that keeps life-saving humanitarian assistance and politics separate. This separation is important, and it needs to continue as a matter of Canadian foreign policy. But I want to empathize that resolving conflicts is not the work of humanitarians; it is the responsibility of states. Humanitarian crises are created by political crises that require political solutions and diplomatic action. These are political problems and they require political solutions from you and your colleagues, who yield control over the diplomatic, financial and other tools at the heart of resolving these crises. Here, we would like to see a clearer proposal for Canadian diplomacy and engagement in fragile and conflict-affected states, including in African countries. Thank you.
The Chair: Thank you, Dr. Nickerson.
Steve Gilbert, Chief Operating Officer, Nutrition International: Good afternoon and thank you for inviting Nutrition International to appear before this committee. Nutrition International is Canada’s global nutrition organization, founded by Canada over 30 years ago as an expression of Canada’s bold commitment to end preventable child deaths.
Nutrition is the foundation of human and economic development. Without it, brains cannot develop fully, bodies cannot grow properly and immune systems weaken, leaving everyone more vulnerable to disease. This forces health systems to spend on treatment rather than prevention, drains resources and undermines long-term health. For girls, proper nutrition means staying in school, securing better jobs and lifting their families and communities. By prioritizing nutrition, we build stronger societies, drive economic growth and promote gender equality, creating a future where everyone can thrive.
Nutrition International’s approach to working in Africa is to support national and sub-national governments as an expert ally to support their efforts to scale evidence-based nutrition interventions that directly address their critical public health burdens, such as child mortality, stunting, anemia and neural tube defects like spina bifida, among others. To ensure that these efforts are sustained over time, Nutrition International helps governments to strengthen their health systems that deliver critical services. We also help governments, regional institutions and development banks to allocate investments more effectively to interventions that have scientifically proven impacts.
Over these past 30 years, Canada, through Nutrition International, has averted over 7 million child deaths, 34 million cases of anemia, and has contributed to over 45 million IQ points gained among children. These results have laid the foundation for good health, educational achievement and economic productivity in many countries.
Despite progress, under-nutrition continues to cost Africa over $150 billion annually. Anemia alone affects 60 million girls in Africa and costs the continent over $9 billion annually. Anemia undermines girls’ ability to perform in school and stay in school. It lowers their productivity and perpetuates gender inequality, trapping girls and women in a cycle of poverty. While scalable programs to address anemia in women and girls exist, this is one global nutrition challenge where we have seen stagnation and even reversal of progress in some countries. This is a great example of an area where Canadian leadership can have a measurable impact on millions, responding to an area of priority for many African countries.
Three weeks ago Canada, Canada convened a high-level dialogue with the African Union in Toronto to discuss Canada’s renewed partnership with Africa. Through these conversations, one thing was very clear: With the current challenges that Africa is facing, including climate change, conflict and rising debt, greater engagement from Canada is desired to partner on these challenges.
Africa is also now home to the largest demographic of youth that the world has ever seen. As a member of Nutrition International’s board of directors, former Tanzanian president His Excellency Dr. Jakaya Kikwete pointed out during the dialogue that in order to prepare these young people to steward Africa’s future we need to invest in the foundational services that will allow them to thrive and lead, including nutrition. This will not only benefit their health, but broader trade, economic prosperity, and peace and security efforts in the region.
Given this, the challenge before Canada is how to position itself as an ally in Africa’s economic and social transformation. We are indeed at a tipping point where Canada can play a critical role in supporting this transformation. To offer recommendations for Canada’s future engagement with Africa in the development sector, Canada should step in and not step back, which means increased engagement with the African Union, regional economic communities and national governments to support their bold goals.
Focus on the best things first. We live in an era of big data with better scientific evidence than ever for what has the greatest impact at the lowest cost. Canada should strive to allocate resources on that basis. Align behind African priorities: Africa’s Agenda 2063 lays out some clear goals that Canada can support.
Last, recognize that Canada cannot do everything. We need to put energies and resources towards the intersection of African-identified priorities and Canada’s areas of traditional strength. Nutrition is one of the things where Canada has been a leader for decades.
As a final example of what Canada’s leadership has looked like and can look like going forward, in 1990, Canada led the creation of the World Summit for Children. From that, Canada committed a long-term investment in Nutritional International’s vitamin A program, which has prevented 7 million child deaths. I think that this is something that all Canadians should be really proud of. Canada has a lot of strengths that we can offer to our partners around the world, especially in Africa, and I think that Canada should do more of these ambitious programs. Thank you.
The Chair: Thank you very much.
I wish to inform senators that you will have a maximum of only four minutes for the first round for this panel. This will include the question and answer, so I would ask, as I always do, to keep your preambles short and your questions concise so we can extract as much as we can from our witnesses here today.
Senator MacDonald: Good afternoon, everyone. I will direct my first question to Dr. Nickerson, though everyone else can feel free to jump in afterwards.
In recent years, several long-standing UN peacekeeping missions have closed in Africa, including the UN stabilization mission in Mali, the UN assistance mission in Sudan, and now a third mission, the UN stabilization mission in the Democratic Republic of Congo, is going to withdraw its peacekeepers. How, if at all, has the closure of UN peacekeeping operations affected your organization’s work in Africa? Given the potential security vacuum left by these missions, how can Canada and its partners effectively support peace and stability in these regions?
Mr. Nickerson: Thank you. We work in all of these countries where there have been peace operations.
There continues to be a gap in protection. This is fundamentally the major problem and a big question. If a peace operation ends, then who assumes responsibility for ensuring the safety and protection of civilians in these places? Typically, there tends to be a gap that is created, and these are imperfect peace operations to begin with. I don’t think that we should presume the presence of a peace operation naturally and definitively creates peace and stability and so on.
As a humanitarian organization, it is a bit out of our scope to say exactly how countries in the international community should pursue peace and stability, but I think that Canada really needs to consider what its role is here in supporting and facilitating these kinds of initiatives, whether it is through the UN-mandated peace and security operation or through other mechanisms as well.
Senator MacDonald: Anyone else?
Ms. Harris: Our organization focuses on development. When countries are in crisis or regions of countries are in crisis, it prevents us from doing the work we do, which is being that bridge between a crisis situation and sustainable growth and progress. The effect on our work is when the local conditions deteriorate to that state — for example, for many years we worked in Burkina Faso. We can no longer work in Burkina Faso — it stops that development work and keeps the region or country in that crisis state.
What I think is the path out is strong local institutions and good governance. That is at the bureaucratic and the political level, right? The political level comes and goes. The strength that is institutionalized can help really improve the stability.
The Chair: Thank you. I’m going to interrupt. Ms. Delorme has her hand up.
Ms. Delorme: Thank you. What we are seeing in Africa but also around the world is a dismantling, a fragilization of the entire system of international humanitarian law, the rules of order that are supposed to manage these conflicts so that we have greater protection of civilians. This is also linked to treaties. Canada was a huge leader on the Ottawa Treaty to ban land mines. They signed the Oslo Treaty to ban cluster munitions, yet the use of land mines and cluster munitions are on the rise. We are starting to see that countries are making exceptions and saying, “Oh, but it’s different when it’s in practice, it’s different when we are defending our borders.” But the reality is that these treaties are only as valuable as when they are put into practice in situations of conflict.
International humanitarian law is most useful when it is protecting civilians and when it is protecting humanitarian workers. So our diplomatic efforts as Canadians need to strengthen that system of international humanitarian law.
The Chair: Thank you, Ms. Delorme. I’m sorry to interrupt you. We are running out of time. We’ll move on to the next question.
[Translation]
Senator Gerba: Welcome to our witnesses today. My first question is for Ms. Harris. Given your extensive experience on the African continent, what are the most in-demand skills in Africa today in terms of technology transfer, and how can Canada help make that technology transfer more fluid?
[English]
Ms. Harris: Thank you. It is a great question. The needs are for skills to get jobs. We talked about the youth. Jobs are jobs, but it is also entrepreneurship, so it is skills development, whether it is in entrepreneurship or trades or something like that.
Really, in terms of knowledge transfer, the best thing I can do is explain how we approach capacity building in this space. Catalyste+ has a roster of over 1,700 Canadians. They are not average Canadians. They are Canadians with at least 20 or 25 years of experience in the field in which they are going to be advisers. They are partnered with our local clients, and they work together to help build the local skills and experience necessary for our local partners to achieve their goals, stabilizing and scaling businesses, better operation of businesses, accessing finance, gender equality and women’s economic empowerment.
I think of it as the raw materials being there. Canada could have a huge role in helping to catalyze local African partners achieving their goals by this influx of Canadian knowledge and experience.
[Translation]
Senator Gerba: Thank you for talking about local aid. During this study, we’ve heard a lot of witnesses talk about shifting paradigms and moving from development aid to win-win partnerships. What are your thoughts on that? This question is for all the witnesses.
[English]
Ms. Harris: Maybe I’ll just add a couple of things. Good development starts with empowering and strengthening the capacity of local clients. I don’t think you can have sustainable development without that. It is an effective model for sustainable development. If there is a paradigm shift, I think it is because people are listening now. That has always been an effective approach. It has always been the one that gets results, and it is honestly the right way to get things done. Our local partners, local people, local staff are the experts in their community, in the opportunities they have, the barriers they have, the intercultural nuances that are important to them.
The Chair: Ms. Delorme, we’ll get to you at some point, but the time has run out on that segment. I do appreciate it when you put the hand up, because it reminds all of us that you have something to say. We’ll come back to you, and I’m sure Senator Gerba would like to ask a question in the next round as well.
Senator Ravalia: Thank you to all of you for being here and for the work that you do in often difficult circumstances.
My question is for Dr. Nickerson. As we reflect on World AIDS Day, marked on December 1, the fight against HIV/AIDS remains a critical global challenge. Your work on rolling out long-acting, injectable medications for pre-exposure prophylactics in Southern Africa is to be commended. What lessons from MSF’s implementation can help inform our strategies for global health care initiatives to serve at-risk and marginalized groups and the attendant stigmata?
Mr. Nickerson: Thank you very much for the question. The long-acting injectables, so cabotegravir, for example, are potentially transformative medical technologies. We are talking about long-acting prevention and treatment that can and really should be rolled out.
In many ways — and I’m happy to submit a longer brief to the committee that gets into this in detail — we face many of the challenges here that we have faced for decades, which is that the way that the market for pharmaceuticals operates accepts that there is a fatal imbalance that is inherent in access between patients in high-income countries that are willing to pay for these new drugs and patients in low-income countries that are simply priced out of the market. We don’t accept that as a reality. None of us should, but, frankly, it is the way the market operates.
There are a number of challenges here. One is that these are drugs that are owned by private companies, and they make a choice of where to introduce or not introduce them. There has been some success in pressuring for things like voluntary licensing agreements that allow for the scale-up of lower-cost generic medicines that can enter the market in low-income countries and improve access. In our view, particularly for technologies where the development is funded by taxpayers — like the Canadian Institutes of Health Research, which funds a substantial amount of drug development in health research — that funding should be conditional on reasonable access and affordability conditions being applied to that funding. If the public is paying to discover and develop a new medicine, there should be a return on that investment that makes it affordable and accessible.
That’s a more general answer to the global access to medicines problem, but we are certainly seeing problems with access and affordability of the long-acting antiretrovirals that, frankly, should have been addressed further upstream.
Senator Ravalia: I’ll switch gears and ask Ms. Delorme this question. Would you be able to elaborate on specific advancements in mine clearance technologies or practices, such as the use of drones, artificial intelligence for mapping or mechanical de-mining tools that have had the greatest impact in Africa, especially in countries like Angola and Mozambique?
Ms. Delorme: It would be my pleasure. There are also de-mining activities in Senegal, for example, in the Casamance region. De-mining is a bit of a painstaking process where, centimetre by centimetre, metre by metre, we are de-mining, but what we have been able to develop with heat maps, drones and even satellite imagery is to reduce the breadth of the land we need to analyze in order to do mine clearance. We are working more immediately in those smaller metre-by-metre squares, and we have a better sense of where the mines are. That technology, of course, is very important.
I also want to add the social aspects of de-mining. It is often viewed as this very technical field where men from different armed forces are doing the de-mining, but in actual fact we train women and other community members to do different levels of de-mining. There are different levels of certification and we certify. What is rather transformational is that these women who become de-miners become leaders in their community and are often able to influence conflict resolution processes to transform communities.
The Chair: Thank you very much.
Senator M. Deacon: Thank you to our guests for being here and on screen. I think we could spend a whole lot more time this afternoon to listen and learn.
I’m going to ask my first question of Ms. Harris, which is about the Accelerating Women’s Empowerment program, and specifically your work with small-hold farmers. We have heard in prior testimony that these farmers often fall through the cracks when it comes to the programs intended to assist with agriculture.
In your experience, do you think Canada is adequately reaching these farmers with the development programs in the best way possible? What can we change to make sure these small-scale farms that did not necessarily make a surplus but can still account for a huge portion of agriculture in Africa get the right supports?
Ms. Harris: Thank you very much. It is a very interesting question. Women make up the majority of the workforce in the agricultural and agri-business sector. From farm to market, it is mostly women. We have good examples of approaches that work and that we could scale. Everyone wants a pilot and to see the results of a pilot scale. We have those pilots, even rather than large pilots. Whether it is organizing individual small-hold farmers into cooperatives so they have for efficiency in the production line. We can help them have better standards. When the circumstances are right, we can get them to a level where they can trade either regionally or internationally, whether it is working with an individual woman who is producing or could produce an agricultural product from her home, like honey, and teaching the skills to be able to do that, providing the equipment and then connecting that individual to a supply chain of a bigger honey producer.
There is a ton of work in terms of the packaging, understanding the health requirements of agri-business, food processing and things like that, and then bringing in nutrition. There are all kinds of great examples of working with our local partners to create a high-nutrient content biscuit or something like that, or having a larger impact by changing recipes to use local grains to support local farmers instead of using imported grains or things like that.
That is a long answer to your question. Do I think we could do more? Yes. Do I think we know what’s effective? Yes, I do, and I think we could invest to do that.
Senator M. Deacon: In that way, you have responded to the second part of my question, which was how we update our approach to give this a boost. I think the examples you have given me will give this a boost. Thank you.
Senator Al Zaibak: My question is directed to Ms. Delorme and Dr. Nickerson. Both of your organizations mention bearing witness as a function in your work. Could you tell us more? Could you elaborate more on what “bearing witness” means, how important it is and how Canada can be of help to both of your organizations in the African context?
Ms. Delorme: Thank you. It is interesting because, as humanitarian organizations, HI is a bit of a nexus programmer. We do everything from humanitarian to development, including conflict-related programming.
We are meant to be impartial. It is a very important line that we walk, because that is how we protect ourselves under international humanitarian law, but at the same time, we bear witness. We are present, especially in the age today where at times, through the media, we are unsure of what to believe with so much disinformation. I believe that international and Canadian international development organizations are able to bear witness and provide real data on what is happening on the ground.
I think Sudan is a really important example of that. The use of, for example, explosive weapons in heavily populated areas in Sudan is causing horrific damage — the destruction of infrastructure, the injuries are causing permanent disability. As was explained by MSF, the ability to treat those injuries is very much limited by these conflicting parties, so those injuries will become permanent disabilities over time, which is why we see such high rates of disability among post-conflict populations.
Mr. Nickerson: Thank you for the question. We are a principled humanitarian organization. We are impartial, neutral and independent, and we assert and action that everywhere that we work. We have also given ourselves a mandate to bear witness to the suffering that we see.
For us, the humanitarian medical act is deeply personal. Our organization prioritizes proximity to patients. We are in communities, we are working in hospitals, we are providing care to people who need it. When we speak out and bear witness to the suffering that we witness, we are speaking from a place of providing patient care. It is the numbers of patients that we see, it is the stories that our patients tell us, and it is the patterns of injuries that we witness. This is how we speak out, how we bear witness.
That is a mandate we have given ourselves but it’s one that we take very seriously and that we integrate into all of our operations because it is the way that we can push for change. It is the way we can push actors — like the Canadian government, other governments and parties — to the conflict to modify their behaviour, to change the way that conflicts are being conducted and to end the neglect of populations who are so often left behind and forgotten in the places where we work.
Our words are about speaking truth. It is about bearing witness to what we see in our programs. We speak out with the intention of improving the condition of people who are severely neglected and often the victims of horrendously violent conflicts in many of the places in which we work.
The Chair: I wanted to say that was a perfect question because it allowed two panellists two minutes each, so it worked out very well.
Senator Coyle: Thank you to all of our witnesses here today.
Senator Gerba raised a point that I think is probably shared by many Canadians. Frankly, I think it is Canadians who do not know that there is a paradigm shift away from development. I think there is a paradigm shift within development and within humanitarian assistance, and in some ways the public has not caught up to the shift that has happened.
I have heard language here today which is encouraging: Africa has a wealth of opportunities; we are working towards strong African institutions; we are backing Africa’s priorities; we are looking at citizen-centred activity.
Starting with you, Ms. Harris, and perhaps going to Ms. Delorme, could you speak about that paradigm shift that has happened and continues to happen in Canada’s very innovative civil society sector that engages with Africa?
Ms. Harris: Absolutely. Let me start by saying that 14 years ago, I came to Catalyste+ from a finance background. I did not understand or know anything about international development. I mentioned to my colleagues here, I had a vertical learning curve. I am lucky that I have some mentors within the organization who taught me the strong development fundamentals.
From that very first lesson, it was that priorities need to be locally driven, and capacity-building needs to be of local people and local institutions.
As I ventured further out into the world and into the dialogue around international development, I was quite surprised that everyone didn’t hold that same perspective. It is a hugely positive shift that we are moving toward much more locally driven, designed development initiatives.
At the same time, we need to be careful that we do not come across as figuring out the new way to do development. I think that is artificial.
The other thing that I think is really important about this is we need to make sure that we accompany our clients. In this process of paradigm shift — I will give you the easiest example where funders might, instead of going through an intermediary like my organization, give funding for programming directly to the recipient. It is fantastic if the recipient has the capacity to manage the money, to deliver the programs, to do monitoring and evaluations and report back to the funding. If not, you are setting up that local partner for failure.
Good localization is a continuum. We need to recognize what supports our local partners need to move through that continuum.
Ms. Delorme: May I jump in? These aren’t old concepts.
[Translation]
In Quebec, people talked a lot about international solidarity.
[English]
My career has been in international development and different organizations have different approaches. We are moving. We are seeing the sector move, absolutely.
The importance of locally led initiatives cannot be understated. Working with our partners locally and letting our partners let us know what the needs are is at the core of good development practice.
I will give you an example. We have a fabulous project called Making It Work. It is with women-with-disability-led organizations across Africa. There’s a grouping in different francophone African countries and a grouping in English-speaking countries. We brought them together. Often, we convene and create space. We are strengthening their capacity to be able to run good programs. Yes, these organizations have average budgets of maybe $25,000 a year. Canada is not going to start dispersing cheques by cheque. We can provide that support system to strengthen the organizations, to fund their programs according to their priorities, but also to host the space so that they can share best practices amongst each another and maybe even, as they are starting to do, advocate nationally and regionally for the rights of women with disabilities. This is what is the most important —
The Chair: I’m sorry to interrupt. It’s all very interesting but we need to move on.
Senator Boniface: I have two questions. First, Mr. Gilbert, I will let you take it up. You said in your opening remarks that Canada needs to step up, not back. Can you elaborate on where we are and where we need to be?
Mr. Gilbert: There are many ways that Canada can step up. I mentioned that Canada had a dialogue recently. That was definitely the words that came out of the folks from the African Union; they want Canada to lean in on a lot of things. There are many areas. Canada has a G7 presidency coming up. There’s opportunity to promote some ideas and to do something bold. That is the way to step up. There are many things that need to be done in development. I said that Canada cannot do everything. One thing that we can do is maybe break some silos. There are a few things that we support. We can see the opportunities where we can connect some things. In the area I work in, I see things like education and nutrition going hand in hand.
Maybe Canada cannot fund everything or do everything, but Canada can convene and bring people together. We have done this before with the Muskoka Initiative. I mentioned the World Summit for Children. There is a lot of stuff that Canada can do. I think we are in a really good position to do that. I have seen a lot of receptivity from African leadership to Canada’s involvement.
Senator Boniface: Thank you. My second question is to Dr. Nickerson. I would like you to give us more detail on Sudan. I know it has been in the press a lot lately about being forgotten.
Mr. Nickerson: Yes. This is a horrific conflict. We are talking about millions of people who are internally displaced, millions of people who have fled into neighbouring Chad, the Central African Republic and South Sudan. We are seeing the corollary effects of that in those countries now where there are so many people who have been forcibly displaced and who are living in, frankly, unsanitary and inhumane, in some way, circumstances.
The access situation inside of Sudan itself is incredibly complex. We and many other organizations have been repeatedly denied access to populations who are in need. There are a number of hospitals that are no longer functioning because they simply do not have supplies or staff. We cannot reach them. Other organizations cannot reach them. There is a massive humanitarian crisis here that is — I do not want to say flying under the radar — certainly under-appreciated by the international community.
Really what I am talking about is the person impacts of this crisis on millions of people is immense. As I said in my statement, as a humanitarian organization our role is to do our very best to scale up and provide life-saving medical care to people inside of Sudan and in neighbouring countries.
Fundamentally, what is needed here is that the international community needs to exert effective diplomatic pressure to find a solution to this crisis. That is not what we can do as a humanitarian organization, but what countries like Canada and others need to be mobilizing is some form of effective diplomacy to find a solution here.
The Chair: Thank you. I have a question for Mr. Gilbert.
In my previous life, I was working in international development, and I recall a former president of the World Bank telling me that the biggest problem, from his perspective, was stunting in children.
Could you give us an indication of how that is progressing or regressing, and what is the international response, the donor community response?
Mr. Gilbert: There are about 150 million children stunted. In Africa alone, I think there are over 60 million children who are stunted. Stunting is a terrible start in life. It correlates to less education, to death, to all sorts of terrible outcomes. The truth is that a stunted child’s brain simply does not grow at the same rate as a child’s who is not stunted grows.
Stunting is improving globally. If I look back even to 1990, 12 million children a year died. Today, it is about 5 million. It is huge progress, but for heaven’s sake, we do not want 5 million children to die or 150 million children to be stunted.
There are clear solutions to these things. That is what I was emphasizing earlier as well. We have the science; it is known. We know what to do. It is not that difficult. We should follow things where there are proven interventions that are actually low cost that you can implement.
There are ways to address stunting. It is something we should lean in on. I would love to see a Canadian project. Let’s eliminate stunting. We did an incredible job reducing child death. Let’s eliminate stunting.
The Chair: Thank you.
[Translation]
Senator Gerba: Mr. Gilbert, you said that lack of coordination is the reason we don’t have a good handle on the situation and aren’t aware of what’s being done. People are working in silos. What would you recommend to improve coordination and reduce fragmentation? CIDA used to be the lead on development assistance. Should it be reinstated? It seems like everything is so scattered these days.
[English]
Mr. Gilbert: Perhaps I may have spoken too strongly on that. I do not want to give the impression that everything is terribly siloed. It is a principle of our organization to try to break silos. We do see that a lot. We talk about it as “no missed opportunities.”
For things like immunization, nutrition and immunization go hand-in-hand. It is important for those sectors to work together. We do work together, but it could be better.
If I were to ask what the Canadian government could do to make that situation better, the Canadian government funds immunization, and it also funds nutrition. It could put some conditions saying, “We need you to work together.”
There are tools the government could use. In many ways, they are doing a good job. I do not want to suggest that it is all terrible. It is one of those things where you see these opportunities where we could easily combine things. It would save money. It would make interventions better. We should try to foster that wherever we can.
There are some good examples. The vitamin A program that I mentioned earlier is co-delivered with polio. The polio vaccine and vitamin A are co-delivered. That is smart. Polio needs to reach everyone. We put the vitamin A capsules there, and it reaches all of the children. There needs to be more of that.
There are opportunities right now with expanded programs of immunization to integrate nutrition interventions. That is one example. Education and nutrition is another one. There are many. The Canadian government could begin to empathize that with their partners, and particularly some of the global organizations they work with. Does that make sense?
Senator Ravalia: Dr. Nickerson, if I could return to you, the recent rollout of the R21/Matrix-M malaria vaccination in Nigeria, a country that counts for almost one third of global malaria deaths, highlights its potential to significantly reduce mortality rates. Is your organization involved and engaged in that initiative, and, if not, what is the potential for actually moving that type of initiative to other areas?
Mr. Nickerson: That is a great question. We are not specifically involved in that rollout, to my knowledge. We are still assessing what our role in the malaria vaccination campaigns is going to be.
There are quite a few important limitations to the malaria vaccines, to the R21. We are still at the point of considering what the operational implications of that are, because it is quite intensive to mount a new vaccination campaign.
As an emergency humanitarian organization, we want to ensure that the rollout of that vaccine is not going to come at the expense of prioritizing emergency malaria treatment. We are already seeing, for example, in places like South Sudan, a significant increase in the number of patients being admitted to some of our pediatric wards for severe malaria, requiring extensive blood transfusions and everything.
That is because of a resource gap in the health system at a more community level. People are not getting treatment for uncomplicated malaria, so they are developing complicated malaria and require hospitalization.
We are still focused on responding to the most acute needs. We have several projects right now that are specifically looking at what our role could or could not be in using that vaccine. But an effective malaria vaccine would be transformative, potentially averting millions of deaths.
Senator Al Zaibak: My question is addressed to Dr. Nickerson. I am not sure about your funding model, whether Doctors Without Borders accepts funding from governments or relies on government funding or not.
Other than the way in which you suggested Canada can help through diplomacy, are there any other things that Canada can do to ensure access to your organizations, to the areas in trouble? Could you clarify that?
Mr. Nickerson: I will answer your first question first.
We are mostly a privately funded organization. In the two emergencies that I mentioned, Sudan and in eastern DRC, we are entirely privately funded. That is an operational choice we have made to preserve a real and perceived independence and impartiality and neutrality. We make operational choices that go down to our funding model that prioritize private funding, because, one, in our view it protects that principled humanitarian response. It also allows us to respond very quickly when emergencies occur. We are not waiting for funding cycles. This is a funding model we have built up over our 50 years.
The second thing I wish to say is that Canada is one of only three government donors that we apply for funding from, precisely because, in our view, in the places where we allocate funding, Canada is a good donor and respects our principled way of working.
What I do want to say is that is MSF. We have structured ourselves in this way so that as a more than €2 billion a year organization, we can be largely privately funded. That is not the reality for most other organizations.
There is not a full appreciation of just how significantly humanitarian needs have grown in the last five years. They’ve effectively doubled inside of five years. There are more than 300 million people in need of life-saving humanitarian assistance on the planet today. That is about double what it was in 2019. We have seen a massive growth in the number of people who are in need of life-saving humanitarian assistance because of major crises like in Sudan, like in DRC, like in South Sudan. The list goes on and on.
Funding has not kept pace with the growth of these needs. Canada did a good thing by increasing its humanitarian assistance budget last year. That was, I believe, a time-limited two-year increase. But funding globally has not kept pace, and it is going to be important for Canada to continue to increase its humanitarian assistance budget to make sure that there is adequate funding for organizations that need it, because the needs are immense.
Senator Al Zaibak: Thank you.
Senator Coyle: I was not aware, Dr. Nickerson, that both Sudan and the DRC were 100% privately funded.
I am interested in your work with people who have suffered gender-based violence. You mentioned the scourge of rape being used as a weapon of war. Could you tell us what you are seeing in terms of the best remedies or the best responses to that? Where are they? Are there things that Canada could learn from that, in terms of what it does in other places? I’m sure we are actually operating in those places in this area, just maybe not with you.
Mr. Nickerson: Right. Two things: We are partially funded in DRC, just not in the eastern Kivu provinces, and our other two funders are Japan and Switzerland.
For responding to sexual and gender-based violence, there are a number of components to this. There is the immediate, urgent care that needs to be provided, which is medical and psychological care. This is what we are good at. This is what we have integrated into basically every project we run everywhere. That includes things like Hepatitis B vaccinations, emergency contraception, post-exposure prophylaxis for infectious diseases and HIV and so on, but also providing psychological care to survivors of sexual and gender-based violence in that immediate window of time. We have many sexual and gender-based violence clinics that provide ongoing care for patients for days, weeks and months, because this is a horrendous thing that people have survived.
Where we consistently see gaps in programming is on both sides of what we do. First of all, there are protection gaps, which I mentioned before. When I say “protection gaps,” I mean that people are exposed to a circumstance that puts them in a vulnerable position where they become a victim of a horrendous act. That is the front-end preventative protection piece that is lacking in every conflict on the planet today.
On the other side, outside of the medical and psychosocial care that we are capable of providing, people need safe housing to return to. Depending upon whom the perpetrator may be, it is not safe to return to your community or to your own home. There is a real lack of shelter space and that transition out of the medical and psychological care model that we are capable of providing, but also accountability and access to legal tools if people want to pursue that.
There are huge gaps everywhere on the planet, all around. We can provide emergency medical and psychological care, but it is not just about that; it is about prevention and it is also about thinking through the long-term implications and supports that people are going to need.
Senator M. Deacon: Dr. Nickerson, I would like to dig in and ask you, before we finish, about how your programs communicate and work with their target demographic. I think about examples like the BRIGHT program in Tanzania, targeted for 10-year-old to 19-year-old girls, trying to address misconceptions around the use of contraceptives, societal norms, diet and food, the whole bit.
I am trying to determine the best practices that you use, because these are knowledge-based programs so that these young girls take home and apply the programs as they are intended to be applied. How do you believe you are best doing that? What is in the way? What are some of the obstacles that probably stop you from being able to do that?
Mr. Gilbert: Maybe I can start with the obstacle. Some countries don’t necessarily share all the same values we might have as Canadians. Sometimes it makes it a bit tricky to operate. You have to build trust to make it possible to be able to introduce the types of programs that may not even be legal in some countries.
To answer your first question about how we work with youth, it is very important for youth to be involved even at the design stage of the program. In the case of BRIGHT and other such projects, we involve young women even at the formative research stage when we are trying to figure out the issues and barriers to progress. They will actually be involved in conducting the interviews, and they will act as youth peers. If they are involved in the design, first of all, we get better designs for the projects, and we also literally make champions of the project. Programs like BRIGHT are operating through schools as well and they can act on that basis within the schools they operate in.
We strongly believe — particularly with youth, but it is actually with other groups we are working with as well — and we want to ensure they are involved from the earliest stages. We mostly work with government, so we are trying to make health systems more accountable to youth. If a young girl is pregnant, she often cannot go through the antenatal care system. It is socially not acceptable, so she does not go and does not get the right help. Working with the girls and with the health system, we are trying to make some of the changes required so the girls can truly benefit over the long term, and the next group of girls is benefiting from an improved system.
The Chair: Thank you.
Senator Adler: Forgive me for introducing politics to a question about humanitarian development, but I need to ask whether or not democracy — more democracy — would be of assistance to your efforts. Do you think that the international community, including Canada, of course, should be doing a better job of perhaps being bolder in supporting democratic movements in Africa?
The Chair: I will intervene for a moment to say we would like to hear from all four of our witnesses today. If you agree, senator, we will start with Ms. Delorme and have everyone make a comment.
Ms. Delorme: Yes, I do think that working on what I would call conflict transformation, democracy building and community building is very important. These are some of the projects we do receive funding for from the Canadian government through the Peace and Stabilization Operations Program.
What I feel is most important at this time, at this juncture, is that we are in a system where we have double standards. We expect some countries to follow the rules and other countries are let off, and those countries are starting to pay attention.
I am returning on this point around international humanitarian law, these rules — things like democracy — that we believe in and that are a part of this rules-based order, only work if we apply the same rules everywhere. Right now, there are many countries in Africa looking to Canada to see if they will be consistent with their leadership and if they will be consistent in the way in which they judge, inform or call out different countries. That consistency is very important.
Ms. Harris: Thank you. Your question goes to the heart of what we believe as an organization, which is that strong institutions and good governance are the foundation of sustainable, equitable and inclusive development. Thinking of the long term, not the short term, it is investment in building these strong institutions that can function and weather changes in party or this or that or whatever. That plays a huge role. We find, practically, where we work that has stronger institutions, we have more impact in what we do. So there is a cause and effect.
I just want to reiterate what Anne said about the world is watching how Canada is reacting to behaviour on the world stage, and it is important that we are equitable.
Mr. Nickerson: As a humanitarian organization that works in conflicts in some of the most difficult places on the planet, with the model of governance, it’s not really our role to comment on what is good and what is bad. What we need is assurances of our safety and protections for our staff, and we do that through negotiations.
We don’t use armed escorts or force our way in, none of that. There needs to be a negotiation and an acceptance of our presence and that we are there to provide medical assistance. That can happen independent of whatever the model of governance is. We work in some extremely challenging environments with some extremely challenging governments or entities that control territory, and we need the protections and acceptance of our presence and adherence to things like international humanitarian law to do that work.
Mr. Gilbert: Maybe the only thing I’ll add is with respect to nutrition and global health, they don’t really know boundaries. They don’t care if a country is a democracy or not. I certainly would not advocate that we would make such assistance conditional upon it being a democracy, no matter what my personal opinions are about the subject, similar to what Dr. Nickerson was saying.
I think there are things that Canada can do, and one of them is — we have done it and other groups do, but not as much Nutrition International — building up civil society and supporting civil society. I think it works in a lot of domains, including in global health, and those things are important contributions that Canada has made and can continue to make.
The Chair: Thank you very much. We have gone over time in this hearing. It was only meant for an hour, and we have gone an hour and 15 minutes. With the advantage of not having a panel after you and still having the room, we have managed to do that. On behalf of the committee, I would like to thank our witnesses, Wendy Harris, Jason Nickerson, Steve Gilbert and Anne Delorme for being with us today, for taking the time and for your very candid and helpful responses to questions from senators. Thank you very much.
Colleagues, we will reconvene tomorrow morning at 11:30 in this room. Our first hour will be dedicated to an in camera discussion, and the second hour, starting at 12:30, will be a public panel again on our Africa study. With that, thank you, and we are adjourned.
(The committee adjourned.)