Lars Buur: Thanks for this opening to the Nordic talk: Just give all the money to the poor? – where we have a very interesting panel. Maybe I should present myself first. I’m a professor in political economy of development here at Roskilde University and I’ve been leading the research program called Cash-In that’s focused on social cash transfers by private managed organizations in Africa, predominantly Tanzania and Uganda. So, I’m a little bit acquainted with the theme of today, but the main experts here, no doubt, will be Miriam Laker and Jacob Ulrich. And I want you to present yourself and maybe come with a brief opening statement. Should we start with you, Jacob Ulrich.

Jacob Ulrich: My name is Jacob Ulrich, and I am currently a postdoc at Roskilde University. And I have done and finished last year a PhD about scaling of social cash transfers, looking at Uganda and Tanzania and globally. And before that, I have worked for many years as a practitioner, you could say, dealing with all sorts of development aid and working 15 years based in Africa, six, seven years based in Eastern Europe and working elsewhere as well. So that’s me in a nutshell. Do you want to move on to Miriam first, Lars, before I start talking about the issues or how do we do this? No, I think that’s perfect because you’re probably the one that knows most about the hands-on of cash transfers so, please Miriam.

Miriam Laker: Thank you, Lars, happy to be here. Jacob, I am happy to see you again after a while. I’m Dr Miriam Laker, I am the Senior Research Advisor at Give Directly, which is an international organization that gives cash unconditionally to people living in poverty. My background is in medicine, medical doctor who was practicing for several years and doing research in the clinical and public health field before I pivoted to the cash field, where I have been for five years now doing work on cash transfers and within GiveDirectly, my role has involved developing randomized control trials, evaluating programs, but also doing implementation science where we translate the evidence that is generated by us and other organizations into the way we practice cash in our organization but also in the way we talk about it in policy and other advocacy spaces so it’s lovely to be here.

Lars Buur: Yes, thank you Miriam and thank you Jacob. Just as an opening statement from my own side kind of setting the scene is that we we’ve seen dramatic changes in the global aid landscape here over the last year. Not only has USAID pulled out from many contracts, but the same has happened with DFID and many of the Western donors. There is a general pressure on aid, and that basically makes the whole question about social cash transfer even more pertinent, as the question is, what should we do with the rest of the money? Should we let global aid or other funding to be spent on social cash transfers instead of the many modalities we use now? And that, of course, raised some bigger questions. And I would just say that there are at least four themes, as we have discussed it, that we will take up today. The first one is related to the socioeconomic impact of scaled social cash transfers. What do we know? Can one actually scale in a sensible and pragmatic way? The second bigger thing is the issue of practicalities and the technology of scaled social cash transfers. How do we actually do it if it’s possible? The third one is where Jakob’s main expertise is probably, about the politics of scaling of social cash transfers. And then the last point that maybe is worth discussing is: How do we move forward if this is an agenda that we should pursue more globally. But first, I want to hear your comments on the first bigger theme about social economic impact of scaled social cash transfers. What do we know about the types of impacts that social cash transfers can do? What is the experience from the field and what do academia say? Should we start out with you, Miriam, because you have some very practical knowledge about what seems to work and not work, seen from your experience with Give Directly. And then we can revert to Jakob as a second point. But Miriam first.

Miriam Laker: Thank you Lars and you’re right, I’ve been exposed to cash transfers in multiple settings, give directly works in has worked in 15 countries around the world, most of them in Africa but also in Asia and in the in the global north which is the United States. I think what has been pretty striking from what we have learned from randomized control trials of cash transfers is that the impact of cash transfers remains the same irrespective of where you are. And essentially, it’s because people living in poverty tend to face the same challenges around the world. The findings have been consistent that when people are given cash transfers, a very high priority on their list is meeting their basic needs. It might be housing, it might be health, it might be food, it might be clothing. And this is not surprising because at the end of the day, when we all work for money, that is essentially what we are seeking to make sure that we have met our basic needs. So, we’ve seen this across the countries that we’ve worked in. But in addition to that, when cash transfers have been in large amounts, people then begin to think about the sustainability of the effects of the cash transfers they had. And so, across the globe, we’ve seen people investing in business. People are starting businesses or people are moving to better paying jobs or people are spending time to better themselves in the angle of education. It might be skills training; it might be getting a better degree or a better diploma. In other words, they are working hard to make sure that they continue to sustainably meet their own basic needs. And once again, what is true about this is that it is the same whether you’re talking about Europe, Africa, Asia, or the United States. The other thing that we have seen is that the duration of the impacts tends to very much be associated with how much people receive. We’ve generally noticed that when you give small amounts of cash transfers, the priority, again, because these are people living in extreme poverty, the priority is meeting basic needs. And then if you don’t have excess, then the small transfers will just be consumption smoothing transfers but once you have larger cash transfer amounts then you have longer term effects and i guess it’s simply because like i said earlier people are investing in things that can bring back an income return and sustain them out of poverty so those are some of the key things that we have been seeing in practice across the globe.

Lars Buur: Okay and Jacob, seen from an academic point and a person who has studied this?

Jacob Ulrich: Yes, I certainly recognize everything that Miriam talked about as well, but maybe I can highlight some of the key points that came out of the PhD analysis that I’ve done together with colleagues from, among others, Makere University in Uganda and also from Ministry of Finance in Uganda and with Michael Noble, former social policy professor from Oxford University. So, we tried to model what would happen if in Uganda, if we were, we, I mean mankind, were to spend a much larger share of the development aid that is available for Uganda on social cash transfers. And we went through a number of scenarios and put the data into different types of economic models, a static tax benefit model called UGAMOD, and also general equilibrium modeling just to double check the data and what we found out is that if we for example allocated around 75 or 80 percent which is an extreme scenario of the aid that at that point in time was available to Uganda, so this is one or two years back data. Uganda was receiving about 2.4 billion USD per year. So, if we allocate about 75-80% of that for social cash transfers in the form of child support, so around $18 per child at the age of 0 to 5 years old per month, so $18 per month per child, then what would happen to poverty figures? They would drop quite dramatically from around 22, which is, or at least at that point in time was the formal the official poverty figure for Uganda to around eight so you can reduce the poverty in Uganda by about two-thirds by allocating a little bit more than two-thirds of development aid for social cash transfers which is an astounding result, it’s quite amazing that how far you could get with just the money that is available. We also did a scenario which was a little bit less ambitious just to say what if we allocate only a third of development aid for social cash transfers. It’s the same scenario, child support $18 a month but only for the children between zero and two years of age as opposed to zero to five which was the former scenario. So, if you do that then you spend about a third of development aid for available to Uganda on social cash transfers and poverty would drop from about 22% to about 14%. So by allocating about a third of development aid for social cash transfers, you could then reduce poverty by about a third, at least for as long as you do the social cash transfers, because then there is the dimension that Miriam is also talking about. Is it a lot of money or is it not a lot of money? What happens when the cash transfers phase out and so forth. But at least for as long as you do this, then there would be that impact. And then we know from other studies from around the world that have looked at a much longer period of time that there can actually and there will most likely be intergenerational impacts for families that are receiving social cash transfers for their children. If they do that in a sustained manner over time, then 10-15 years down the road, when these children become adults, young adults, they will do much better in terms of income and in terms of educational attainment and in terms of general life performance. We know that from studies from, for example, Mexico and Brazil. So, all sorts of positive things would come out of allocating a lot more money for social cash transfers in at least Uganda was the result that we arrived at. And we can then benchmark that with other types of assessments that have been done at a global level. And it matches it. There’s not a conflict between our findings and then the findings of other researchers that have tried to look at how much money would you need globally to eradicate global poverty, maybe around $100 billion per year, which is comparable to the amount of global development aid, which until recently was about 180 billion dollars a year. So, to summarize and to conclude, it would be possible with the development aid that was until recently available at least, to make very big gains in the reduction of poverty, extreme poverty, by allocating it to social cash transfers, mainly in the format of child support. So that was sort of the opening salvo from my side. And then there are, of course, all sorts of ifs and buts and so forth. And we can discuss some of those.

Lars Buur: Thank you to both you, Mirjam, and to Jacob. This of course raises one of the big questions and big discussions that we have seen in the whole social cash transfer discussion and that is should it be given conditional or unconditional and part of this is related to where do you get the best results; what works the best; is it basically to set up certain conditions for how people should use the money. What is your experience from GiveDirectly? And I know that’s not universally for the whole sector, but that you have some very clear and practical results to refer to from many, many different countries. Miriam –

Miriam Laker: Yes, happy to take that question. So, Give Directly’s first value is recipients first. And what we mean by that is that people living in poverty have the same dignity as people that are living in extreme wealth. And so, recognizing that they should be given agency because they know what matters for themselves the most. And because of that, our model of cash transfers as an organization is unconditional cash. But then last, we haven’t stopped at that level of naivety. We’ve gone ahead and done rigorous evaluations. As we speak today, GiveDirectly has run over 20 randomized controlled studies independently evaluated. And these are looking at the impacts of cash transfers among the recipients. And we’ve seen the impacts that I talked about earlier on, we’ve seen that across the board, even when recipients are not told what to do with their money. So that has been a really important finding. And the other thing about unconditional cash transfers, therefore, is that it helps, even ask the practitioners, the donors as well recognize what is important for recipients. I’ll give you an example. In GiveDirectly’s very first programs, when cash transfers were given out in Kenya, a household received $1,000. What was shocking to the founders of Give of give directly and the people working there at the time was many of the recipients improved their houses either they built a new house or improved the roofing of the house and initially that was shocking and the question was is this a bad use of money and so in talking to the recipients we got some very interesting insights. Recipients said first of all if you replace a grass-thatched roof with an iron roof, it is going to be cheaper in the long run because you’re not going to have to replace your roof every one or two years. It’s a one-off and you’re going to have this for a very long time. Other recipients said the advantage of improving their roof from grass to iron to metallic roof is that they were able to harvest water. So, they’re not walking long distances to look for water and they’re getting cleaner water and harvest it directly from their roof. Another recipient said, for them, the peace of mind knowing that on a rainy night, your children are not going to get rained on in the house was a big thing for them. And recently, we published a paper with Johns Hopkins University where they were looking at the incidence of febrile illnesses, malaria, in essence, in places that received cash transfers. And there actually was, according to that, a qualitative reduction in the number of people that had malaria because the roofs were no longer a breeding place for mosquitoes once they were changed. So, by not telling people what to do, we are seeing all these different impacts. Recently we had results that were released from a study in Kenya where Give Directly gave cash for poverty alleviation. And looking back 10 years, we found that there was about a 50% reduction in infant mortality in communities that have received cash. No one told these communities about going to hospital to have their babies, but we saw an over 50% surge in hospital delivery, a reduction in infant mortality of 48%, 45% reduction in child mortality. So in other words, giving recipients the freedom to use their money as they see important drives many indicators of poverty rather than one. And finally, it is cheaper to do unconditional cash transfers because for the conditional cash transfers you need someone to actively check if it affects the condition. If it’s going to school, you need to make sure someone is making sure the recipients go to school and the question is why don’t you just use that money to give it to a recipient and also it is more scalable because as we think about scaling programs nationwide Jacob has been talking about giving 70 or 80 percent of funding to social protection if you’re going to scale something this big the cost of having people check the conditionality doesn’t make sense and then finally also we found that conditional cash transfer programs tend to alienate the most vulnerable because it’s usually the poorest in the communities that cannot meet the conditions that are being set up by the program and those are the premises around which Give Directly and I mean and I believe many other organizations that do unconditional cash transfers used to continue doing cash the way they do.

Lars Buur: We also raised the question about biases. Maybe you have a word on that Jacob because at least many of the rumors around cash transfers are related to temptation goods. Men use it for alcohol there are all kinds of rumors about what people use the money for and they’re not going to be spent correctly or rightly. What does the literature say about this this theme?

Jacob Ulrich: Yes, a good point and it actually relates also to the issue that Miriam was talking about with conditionality or not. So I think the literature is quite clear that poor people, when you give them money, tend to spend it wisely and responsibly. And they do not tend to spend them on what we sometimes call temptation goods, which would be alcohol or gambling or going out dancing or whatever it might be. Of course, you can always find anecdotal evidence, and you can always find cases where poor people spend money, if you will, irresponsibly, as you can with rich people who get money. We might also, from the more developed parts of the world, spend money in a way which we later regret. But overall, the findings from serious studies are pretty clear that poor people do not spend money irresponsibly. They do tend to spend them, as Miriam is suggesting, on immediate needs and immediate needs that are important for their family and for their children. Now, at the same time, the general understanding, and I think that goes for both Africa, as far as we can see from studies, but also from Europe, we are sitting in Europe now, you and me, Lars, is that there is a reluctance in the general population to believe that people, when given money, will spend them wisely. So, there’s a bit of sort of some people call it the belief in productivism. And you can’t just give money to poor people because they will waste them. It’s not going to lead to anything. So, the whole issue of conditionalities that Miriam was also talking about, I agree 100 percent with her observations that you don’t need conditionalities to make people do the right thing with the money. But conditionalities, for example, demanding that the recipients of cash, that they send their children to school or they let their children be vaccinated, these conditionalities can sometimes be useful for the political legitimacy of the cash transfers. So, to convince all the rest of the people that the money is not wasted, these conditionalities can then play a role, but they don’t play much of a role in terms of socioeconomic or the social impact. The evidence is quite clear. People will do the right thing with the money, and especially if they are families, they will do what they can to protect and promote the welfare of their children. So that’s sort of, in a nutshell, what I can say about these biases, if you will.

Lars Buur: It just reminds me about an interview I did with a member from Red Cross who had been working in the Bangladeshi camps and the shock they had from Red Cross when they realized that women used the money on getting big, nice cats. And they thought it was some kind of welfare syndrome until they realized in further research that that was actually the best way to protect their food against rats. So if a family didn’t have a cat, then they would basically be without food. So suddenly what they first saw as a major bias and a need to stop a whole program actually turned out to be something far more important that was actually about food security. But it does raise other questions related to what type of cash transfers are best. There are many things here that have been talked about, unconditional. But what about child support? Or is it focusing on the youth? Old age pensions, short, long-term, sequenced. I know, Give Directly use quite huge amount of money compared to other organizations that have it more small amounts every month or every two or three months. What are the evidence on the different types and modes of cash transfers in this regard? So we start with you, Miriam, you’re trying different things out, but you’re seen from Give Directly, it’s mainly bigger pots of money once in a time.

Miriam Laker: Exactly, yes. So yes, you’re very right. We’ve tried a number of different things, still trying a number of different things, but we predominantly do the large lump sum cash transfer because at the end of the day our ultimate objective is to meet needs that are urgent but also help people get out of poverty and be able to sustain themselves. Our overall goal is actually poverty alleviation. However, we’ve also tried different programs and really depending on the outcome that we’re interested in. For instance, in Malawi right now we have a program that is running alongside Save the Children where the primary outcome is really childhood nutrition and for these, we are giving small amounts of cash transfers and we’re giving it over a period of time, also evaluating using a randomized control trial. But the outcome that we are interested in, in this case, is just to make sure children at the phase of life when they need this extra nutrition are receiving it. We also just launched a program also right now in Kenya that is focused on infant, maternal, and child outcomes. And in this program, we are targeting cash transfers to women who are pregnant. And in this case, we are testing out different modalities this one where we’re giving a lump sum around the time the baby is born or shortly before and another one where we’re giving smaller cash transfer amounts during pregnancy then around the time of child birth a larger amount and then continuing for a few months after the child is born so i think just to answer your question what is important is what objectives someone is interested in. If the interest is consumption smoothing or just making sure that you maintain people at a certain level meeting their basic needs, then maybe the way to go is the smaller cash transfer amount. But if you’re thinking of getting people out of poverty, then probably the larger amounts. One of the things you brought up was old age pension. So, while we haven’t done this explicitly, I believe Jacob may have better insights on this. I think it gets to a point where it is unreasonable to think an elderly person is going to launch a business or is going to spend money on doing some kind of skills upgrade training. So, I believe for older people who are no longer able to do these kinds of things, a pension may be a better way to meet their needs so that for the rest of their lives they are assured of an income that is coming in that can help them meet their basic needs and have something extra. Sometimes a glass of wine there’s nothing wrong with having a glass of wine when you’re feeling good about life so that’s what I think.

Lars Buur: Any comments on this, Jakob.

Jacob Ulrich: Yes, I can follow it, I think that the modality of gift directly of giving sort of large lump sums when we say large it’s large in a sort of a poor african village context, it might be $1,000 or $2,000. We’re not talking about $100,000, which is something Piketty in his book is talking about, that there should be these large lump sum payments for the young generation of Europe of $100,000. That’s not where we are. We’re talking about $1,000 or $2,000. And that can, I agree with Miriam, in many cases be used as a productive investment that can have some permanent or semi-permanent impact in terms of a family building a business for itself or investing in a cow or several cows or doing something that is productive over the long term. I think, however, that there will also be many cases where that does not succeed, where people will make the investment, but it will not lift them out of poverty in the medium to long term. And I think the evidence would suggest that while that approach of Give Directly is useful in many cases, you can also find good arguments why it would be advisable to have sustained cash transfers over time, for example, child support, so that you go in and you give such as we have modeled for Uganda or such as it has been done in reality in places such as Mexico and Brazil and South Africa, where you give child support on a monthly basis for a long time until the children are at the age of whatever it might be, 12, 15, 18 years old. And then you will see a sustained impact in terms of intergenerational impacts that these children will actually do better than they would otherwise have done. So, I like the combination of something biggish and lump sum upfront, and that will help some families move out of poverty. And then also having this kind of a safety net, which is more permanent in the form of durable child support over a period of say 10 years or whatever it might be. So that combination might in many settings be quite helpful.

Lars Buur: Yeah, I think it’s an important agenda in that sense also to get beyond the issue of poverty alleviation, because one of the critiques that has been there from a more productive camp and from people who want to see transformation of the economies in manyof the developing countries is that it does not do anything to the productive basis of the society. People are basically maintained in a form of poverty. So, you just make it more doable to be there. So, this question about how one make it productive in a greater sense and actually transformative, is an important agenda. And that basically allows me to move to the second bigger point, I think, of today’s agenda and that’s related to the practicalities and technologies of scaling social cash transfers. How to do it? There are many new technologies at stake, many modalities that are tried out, but the first big question in this regard is, you know, what does technology mean for social cash transfers? Many of the first cash transfers was basically done in kind, then became cash and now it has become e-money in different forms. So with mobile banking, mobile phones, mobile networks, there are all kinds of different modalities at stake. So, what is the experience from Give Directly on this issue of the and this transformation of in the way you provide cash? Can you first speak to this Miriam?

Miriam Laker: Yes, I’m happy to speak to this. So sometimes when I sit back, I think about Give Directly and technology and they are so intertwined that I almost think without technology, Give Directly would not exist the way we know it. So, for Give Directly, technology has been a huge enabler because even while you say, and we all know that technology is advancing really fast, this is happening in many parts of the world. In most rural parts, we are still basic. And so Give Directly, in most of the places where we work, has taken advantage of the most basic mobile phone technology available most of them are not banks they do not have bank accounts in the traditional banking mechanism we now have at least a basic cell phone basic cell phone coverage and then we also have a mobile money banking which is really banking in an individual’s mobile phone using the mobile phone and telecom providers. So, Give Directly has taken advantage of that and all the cash transfers that we do are through mobile phones, mobile money platforms. We go out to a community, talk about mobile phones, train people in the community how to use phones and for many of them it is the first time they are actually seeing and having their own phone and we’re training them on how to use that. We are getting them registered into mobile money, in other words opening up a bank account for them in the mobile money platform showing them how to use it how to make sure that it is safe