What's right for Afghanistan - Should be defined by Afghanistan

July 16th, 2009
Kabul, Afghanistan

Answering the question of why international social marketing so often looks like s--t - as my former assistant so delicately put it, would require a universally understood definition of the term. In the United States the term 'social marketing' is often used to refer to any campaign that promotes a positive social message. For example, Ogilvy Public Relations uses the term 'social marketing' to describe the RED DRESS campaign which promotes heart health awareness. This campaign has inspired and educated millions of people - and generated millions of dollars for research. Another "Truth" campaign that disseminates the facts of smoking is also called social marketing.

Here in Afghanistan the term 'social marketing' has a very, very narrow definition - driven in large part by the specific service offerings of an American contractor who has the largest social marketing project in the country. They define social marketing as a commercial market strategy for aggressively selling condoms, contraceptive products & oral re-hydration salts - and for strengthening the private sector. By this measure it is hard to determine actual behavior change. The focus is almost entirely on sales - which infers use. But again, the focus is on selling products not on changing behavior per se.

We are tasked with reviewing the entire USAID health portfolio and designing a new five year strategy. So we're trying very hard to be objective and to think outside the box. But we have our biases. We are a good team of specialists in health financing, pharmaceutical management, governance, systems and social marketing - defined broadly and narrowly. I think we need to focus on getting out dynamic messages about healthy behavior. My colleague thinks we need to focus on selling products, pumping up a private sector - and not worry about training. But that's just the banter between a group of ex-pats trapped on a project compound.

By stark contrast, the Afghans at the Ministry of Public Health who have been the recipients of over $34 billion dollars in AID over the last seven year have a much broader world view and are more interested in tailoring a holistic behavior change communications and social marketing strategy that works for Afghanistan. They receive funding and assistance from over thirty donor agencies and have many creative ideas for how to influence behavior in their own country. But USAID is the biggest donor and the firm with the social marketing contract is determined to force private-sector strategies into the Ministry of Public health - allegedly to create competition in the market and to diversify funding sources for health communications. In many ways this is smart because the international community is not going to be able to sustain the current level of aid to Afghanistan indefinitely.

But the Afghanistan constitution states that all health services are free - including contraceptive services. So forcing a private sector model into Ministry of Public Health is creating problems. These problems are not just with the Afghans at the Ministry of Public Health - who are burdened with managing many international donor programs. But the 'market' (if you can call it that) is confused about why some products are free and others cost money.

As big USAID government contracting firms jockey for new USAID contracts the debate about best strategies for sustainability becomes even more ferocious. I personally hope the Afghans win. But this means they need to step forward and tell us specifically what they want and how they will manage it.

Hopefully there will be some new, fresh talent at the table for the next round of behavior change and social marketing contracts. I worry that too much of this important work in re-building Afghanistan is driven by the cut-throat strategies of competing government contracting firms. It isn't easy to roll out a project in Afghanistan, but it isn't impossible either. The cronyism amongst USAID contractors is disturbing to me. Afghanistan has a new generation of determined, courageous young people who are re-building their country. America is a great partner. America also has, arguably, the most talented pool of advertising, public relations, communications and marketing professionals in the world. In spite of the negative side effects of consumerism, Americans can sell anything. So why keep this industry out of the picture in Afghanistan? - where the need for smart, creative, professionals is crucial.