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True Value

The International Rescue Committee helps tens of millions of refugees around the world, but how much good is it really doing? Its CEO wants to find out.

By  Marc Gunther
April 2, 2019
Aid groups are dealing with political, environmental, and economic crises all over the world, says IRC chief executive David Miliband, shown here in Yemen. “We’re a growth industry, for all the wrong reasons.”
Kellie Ryan/IRC
Aid groups are dealing with political, environmental, and economic crises all over the world, says IRC chief executive David Miliband, shown here in Yemen. “We’re a growth industry, for all the wrong reasons.”

Few charities do as many things in as many places as the International Rescue Committee, which helps tens of millions of refugees from Afghanistan to Zimbabwe.

The IRC, as it’s known, spent $744 million last year. It delivers food and water in Yemen, the site of the world’s worst humanitarian crisis. It operates medical clinics in war-torn Syria. It runs schools for Rohingya children who have fled to Bangladesh. It delivers cash, no strings attached, to refugees from Venezuela who have migrated to Colombia. It provides counseling and legal aid to survivors of sexual assault in the Democratic Republic of the Congo, which has been devastated by conflict, economic collapse, and Ebola. And, for refugees who have been fortunate enough to find their way to the United States, the IRC provides resettlement services including temporary housing, English classes, job training, and small-business loans.

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Aid groups are dealing with political, environmental, and economic crises all over the world, says IRC chief executive David Miliband, shown here in Yemen. “We’re a growth industry, for all the wrong reasons.”
Kellie Ryan/IRC
Aid groups are dealing with political, environmental, and economic crises all over the world, says IRC chief executive David Miliband, shown here in Yemen. “We’re a growth industry, for all the wrong reasons.”

Few charities do as many things in as many places as the International Rescue Committee, which helps tens of millions of refugees from Afghanistan to Zimbabwe.

The IRC, as it’s known, spent $744 million last year. It delivers food and water in Yemen, the site of the world’s worst humanitarian crisis. It operates medical clinics in war-torn Syria. It runs schools for Rohingya children who have fled to Bangladesh. It delivers cash, no strings attached, to refugees from Venezuela who have migrated to Colombia. It provides counseling and legal aid to survivors of sexual assault in the Democratic Republic of the Congo, which has been devastated by conflict, economic collapse, and Ebola. And, for refugees who have been fortunate enough to find their way to the United States, the IRC provides resettlement services including temporary housing, English classes, job training, and small-business loans.

Praiseworthy as all this may be, it raises a thorny question: How can a charity that is spread so far and wide and provides such a varied smorgasbord of services, often under emergency conditions, slow down long enough to figure out whether it’s making as much of a difference as it could? With an estimated 68 million people uprooted by crisis around the world, there’s a pressing need for all humanitarian charities to become more effective and efficient. Yet the world of humanitarian groups is fragmented and rarely shaped by evidence about what works.

David Miliband, chief executive of the IRC, says: “Refugees and displaced people ... need an effective system of support, and at the moment it does not exist. ... We need to reform the humanitarian aid system to make it more impactful and more cost-effective.”

Miliband, who is 53, has sounded the call for better aid since taking leadership of the IRC in 2013. It’s been a challenging time, to say the least: Tumult in the Islamic world, weak states in Africa, economic unrest, and climate change, among other things, have created what can fairly be called a refugee crisis.

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“We are witnessing the largest flow of people fleeing for their lives since the Second World War,” Miliband often says. “We’re a growth industry, for all the wrong reasons.”

Western governments have failed to step up. To the contrary, European nations, facing populist uprisings, have gone to extraordinary lengths to deter refugees and migrants, even arresting aid workers or volunteers who help illegal migrants. The Trump administration, for its part, says it will admit no more than 30,000 refugees to the United States this year, by far the fewest since the modern U.S. resettlement program was established in 1980. The average number of refugees admitted per year has been about 90,000.

In an interview with the Chronicle in his midtown Manhattan office, Miliband laments: “There are almost no countries on the planet where governments want to expand their legal obligations to refugees.”

Community health workers in Myanmar and elsewhere can now diagnose and treat children near where they live, thanks to a protocol developed by the IRC and other groups.
Kaung Htet/IRC
Community health workers in Myanmar and elsewhere can now diagnose and treat children near where they live, thanks to a protocol developed by the IRC and other groups.

Mission Is Personal

The backlash against refugees in rich countries is striking because the vast majority of displaced people wind up in poor and middle-income countries. Ethiopia, Iran, Jordan, Lebanon, Pakistan, Turkey, and Uganda all host more refugees than any country in Europe or North America.

For Miliband, the issue is deeply personal. His parents fled the Nazis during World War II and found their way to London, where his father, Ralph Miliband, became a prominent Marxist sociologist. Educated at Oxford and MIT, David Miliband grew up to become a young star of the Labour Party as a top aide to Prime Minister Tony Blair, as environment minister, and as foreign secretary before losing a bruising battle to become Labour Party leader in 2010 to his younger brother Ed. The IRC job came along several years later, providing David Miliband with a fresh start and putting an ocean between him and what he has described as the “soap opera” and “psychodrama” of internal Labour Party politics.

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Since then, he has emerged as an effective advocate for the IRC, a New York-based nonprofit founded in 1933 by a group of intellectuals led by Albert Einstein. (Its first task was helping Jews escape Nazi Germany.) The IRC employs about 13,000 people. Its revenues have grown from $456 million in fiscal 2013, the year Miliband took command, to $744 million in 2018. Government contracts fund most of the organization’s work, but the share of income from companies, foundations, and individual donors is growing so much that it was No. 67 on the Chronicle’s ranking of the 100 charities that raised the most from private sources last year.

The Power of a Cash Gift

It’s a familiar image: A convoy of trucks appearing in a refugee camp and unloading bags of stuff: food, water, blankets, clothing or tents. There’s a better way, numerous studies have found: Give refugees money.

Done right, cash aid reaches refugees more quickly and efficiently than commodities. It has the added benefit of supporting local economies, and thus making it more appealing for countries to host refugees.

Better yet, money, usually in the form of debit cards or vouchers, puts power into the hands of displaced people. “Rather than donors or aid agencies deciding what people need and want, they can decide for themselves,” Miliband says.

The IRC conducted the first study to compare refugees who receive cash with those who do not in Lebanon in 2014, and the results were striking: For those who got cash, child labor declined, school attendance went up, and the dollars given to refugees stimulated the local economy.

The IRC pledged to deliver 25 percent of its humanitarian assistance through cash by 2020, up from 6 percent in fiscal year 2015. It has already reached that goal. Other nonprofits are moving in the same direction: World Vision and Mercy Corps have also made pledges to deliver more assistance in cash, and global charities together have called on donors to scale up cash transfers. They’ve had some success: The U.N. World Food Program provided $1.3 billion in cash transfers in 2017, and about 30 percent of its food-assistance portfolio is now provided in cash.

“Our ability to grow has been remarkable,” Miliband says.

In 2017, the IRC and Sesame Workshop won a high-profile global competition called 100&Change run by the MacArthur Foundation, which gave the two nonprofits a $100 million, five-year grant to educate refugee children in the Middle East. Their joint effort recently attracted an additional $25 million in funding from the Lego Foundation.

“David’s been very effective inside and outside the organization,” says Alex Aleinikoff, a New School professor who was the U.N. deputy high commissioner for refugees from 2010 to 2015. “He has been a leading voice around the world for refugees, and he’s talked in serious and important ways about reforming the refugee system.”

The IRC has “a well-deserved reputation as one of the top-tier NGOs in the world,” says Jeremy Konyndyk, a former USAID executive who is now a fellow at the Center for Global Development in Washington. But humanitarian groups today reach “too few people, allocate resources inefficiently, and largely fail to listen to vulnerable populations,” Konyndyk says. Miliband hopes to fix that, too.

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Few Rigorous Evaluations

Visit the website of any humanitarian charity, click on “impact” or “results,” and you’ll find either stories of people who have received aid or numbers that say less than they seem to (“We directly reached over 33 million children through our global health program”). Rarely do nonprofits report on whether their work made a real difference. Kids were treated, but are they healthier? Schools were built, but are children learning? And what, importantly, did it cost to run any of those programs?

Often no one knows.

Relatively few humanitarian-aid programs have been rigorously evaluated, especially when compared with the thousands of evaluations of global health and poverty programs in stable countries. Says Miliband: “In the absence of a strong evidence base, the humanitarian world is relying on assumptions, experience, and intuition rather than research founded on fact or evidence.”

To begin to remedy that, humanitarian groups must move away from counting outputs to tracking agreed-upon outcomes. Sarah Charles, senior director for humanitarian-aid policy at the IRC, says: “How do we move from how many latrines were provided or how many textbooks were distributed to what are the improvements in livelihoods or learning?” Then, because programs can vary widely in cost-effectiveness, donors and aid providers must try to determine the most efficient ways to achieve these outcomes.

Shared Data

To that end, as part of a five-year strategy at the IRC, Miliband has promised that by 2020 all of the IRC’s programs will be either supported by evidence or used to gather evidence about what works. This is a straightforward goal, and the IRC says it is well on the way to achieving it.

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Miliband also promised to do better at measuring costs, which is obviously important but has proved to be more difficult. The organization developed a tool for calculating the cost of its programs per client, which is currently used by programs in 12 of the countries where it operates. It then said it would require any proposal that cost more than $100 per client to explain why it was so expensive. (The current median cost per client is $46, and 30 percent of current projects surpass the $100-per-client threshold.) Now, though, the IRC says it is developing a more meaningful cost-per-outcome metric.

To its credit, the IRC says its cost-effectiveness data will be shared with donors and the public — a commitment to transparency that’s unusual for a global charity.

Last year, the IRC published a 40-page report summarizing the findings of about 100 research projects focused on promoting economic well-being, education, health, and safety. Not all research can be translated into action; an elementary-school education program in Pakistan that improved reading scores might not work in the Democratic Republic of the Congo. “Most results are not straightforward,” says Jeannie Annan, the IRC’s senior director of research and evaluation. But as evidence accumulates, programs adjust.

One example: protecting women and children from violence at home. Community-based programs that rely on child-protection committees or public outreach are widespread, but they don’t appear to work as well as family-centered programs, the IRC’s research has found. The family-centered programs are more expensive, however, so the nonprofit is seeking ways to bring costs down so it can reach more people. Ongoing studies will seek to understand if engaging deeply with men or providing mentors to young women reduces family-based violence. It’s a never-ending process of learning and iteration.

Once Miliband and his colleagues find an approach that works, they must persuade partners and donors to go along. Bureaucratic obstacles often get in the way. For example, the World Food Program and Unicef share responsibility for feeding hungry children, but they offer “two different procurement systems to deliver two different treatments for essentially the same illness,” Miliband said in a speech last year.

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Some undernourished children have to travel miles to health clinics to get the supplements they need. The IRC and other charities, including Action Against Hunger, developed and tested an approach that uses community health workers to diagnose and treat children with a simple protocol near their homes. U.N. officials like the idea, but getting agencies to combine forces will be a challenge, as Miliband admits. “There’s some momentum being built, but it’s a hard road,” he says.

The IRC and Sesame Workshop won $100 million from the MacArthur Foundation to educate refugee children in Lebanon and elsewhere.
Tara Todras-Whitehill for the International Rescue Committee and Sesame Street
The IRC and Sesame Workshop won $100 million from the MacArthur Foundation to educate refugee children in Lebanon and elsewhere.

More Support

Will the IRC’s investments in research pay off? That’s hard to know. Grants and contracts from the U.S. government ($245 million), European agencies ($197 million), and the U.N. ($87 million) funded more than 70 percent of the IRC’s work last year. Government aid has not generally been driven by proof of impact. One insider says: “Donors talk a good game of wanting evidence-based evaluation, but they rarely demand it with any vigor or rigor.”

Businesses and foundations have stepped up support. The share of revenue coming from private sources has grown from 15 percent in 2014 to 30 percent as the number of staff members assigned to raise money from companies and foundations has more than doubled, to 32, according to Lauren Gray, senior director of institutional philanthropy and partnerships. Miliband “immediately saw value in working with the private sector,” she says.

Google, Cisco, Microsoft, and TripAdvisor all helped the IRC and Mercy Corps build apps, websites, and Facebook pages to help refugees in El Salvador, Greece, Italy, and Jordan. The Intel Foundation supports IRC efforts to train refugees in Germany in information technology, while Mexican-based brewer Modelo backs programs in the United States to train refugees in financial and career-building skills.

The story behind the MacArthur 100&Change grant illustrates the value of evidence to the IRC. Early in 2016, Sesame Workshop wanted to help refugee children and needed a partner; its staff talked to global nonprofits, including Mercy Corps and Save the Children, before choosing the IRC. “We honed in on the IRC because they are focused exclusively on refugees and because they cared deeply about research, which is a part of Sesame’s DNA,” says Sherrie Westin, Sesame Workshop’s president of global impact and philanthropy.

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The IRC had carried out the world’s first randomized, controlled trials of parenting and social-emotional learning programs in post conflict and refugee settings. With funding from the Bernard van Leer Foundation and Open Society Foundations, among others, Sesame Workshop and the IRC launched a pilot program in 2016 to help refugee children in the Middle East; preliminary results from that effort helped their proposal emerge from more than 1,000 submitted to MacArthur for its $100 million grant. “They had a strong body of evidence to back up their work,” says Cecilia Conrad, a MacArthur managing director.

Of course, emotion came into play as well. When MacArthur invited the four finalists in the 100&Change competition to pitch their ideas in a live video webcast, Miliband tugged at the heartstrings, describing how war and displacement had damaged an orphaned 2-year-old boy he had met in Jordan. “He was silent, still, withdrawn. He wasn’t like any 2-year-old I’ve ever known,” Miliband said, noting that there are millions more like him, suffering from stress so prolonged and extreme that it impairs brain development.

“We want to persuade you to bring laughter and learning to the most vulnerable children in the world,” said Miliband.

Whether the data or drama sealed the deal is irrelevant. Sesame Workshop and the IRC are now developing the largest early-childhood program in the history of humanitarian response. It is desperately needed: Education gets less than 2 percent of all humanitarian aid, and only a sliver of that goes to preschool children. Their three-pronged efforts will include TV and digital programming in Arabic, featuring a refugee Muppet developed by Sesame Workshop; home visits by an estimated 12,000 caregivers managed by the IRC who will work with parents and kids; and learning centers run by the IRC.

Miliband savors such victories but worries they are insufficient. The refugee crisis, he says, “is getting bigger, it’s getting more dangerous, it’s getting more long-term.” How those of us in the West respond is “a test case for whether the idea of an international community, joined by common humanity, is real or meaningless.”

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“This is about the rescue of us and our values, as well as the rescue of refugees and their lives.”

A version of this article appeared in the April 2, 2019, issue.
We welcome your thoughts and questions about this article. Please email the editors or submit a letter for publication.
Executive Leadership
Marc Gunther
Marc Gunther is a veteran journalist, speaker, and writer who reported on business and sustainability for many years. Since 2015, he has been writing about foundations, nonprofits and global development on his blog, Nonprofit Chronicles.

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