Earlier this year, Cecilia Vaca Jones stood down from a powerful and highly unusual position in the government of Ecuador. She was 'co-ordinating minister' for the social sector, bringing together the Ministries of Health, Education, Welfare, Sports and Housing, deciding on their work and controlling their budgets. The post represents an innovative solution every government is struggling with: that if you want to prevent social problems before they get out of hand, you have to get traditionally separate departments to work together.
For example, the way to reduce crime among young men with drug problems may not be to deploy more police; it may be to improve education or healthcare or housing or welfare. And in a system where each department has its own money and its own duties, that is incredibly difficult to do, because why would, say, the ministry of the interior give part of its budget to education, with no guarantee of results?
In Ecuador, a long period of ungovernability, with eight presidents in ten years, led to the writing of an entire new constitution in 2008, in which the state tried to wipe the slate clean and design a cutting-edge way of matching the nature of the problems it faced. One aspect of the reform was the creation of these 'co-ordinating ministries'. A similar attempt to solve this organisational problem exists in countries such as Singapore and others such as Finland and Venezuela have tried having 'joint ministers' or a whole group of vice-presidents with different remits.
After holding the post, Cecilia Vaca Jones has moved to the Bernard van Leer Foundation to encourage the spread of better, smarter policies between countries. As program director, she is overseeing early childhood projects in Brazil, India, Israel, Peru and Ivory Coast as well as working on potential help for refugee children in Jordan and Lebanon. She spoke to Apolitical about helping people before they've even been conceived, why civil servants need to win the public debate and how hard it is for them to act on good new ideas.
Can you give a practical example of why it's useful to bring together different departments?
The ministry of health used to check up on children under the age of five by expecting that they would come to the health services. We were able to do it the other way around. The professionals from the ministry of health did the tests at the offices of social welfare and education, where they were already, so we weren't expecting the children to come once they were ill, we were attending children before that happened.
We would have social cabinet meetings to decide on multisectoral programs and I remember the minister of health saying, 'We need health to be part of all social policies, so we need the ministries of education, sports and housing to commit to health, we need the school curricula to commit to health, because otherwise we're not going to be able to create a preventive system.'
Why is switching to prevention so important?
It's the only way to ensure a good standard of living. For example, we still have a high rate of malnutrition - 23% of children under the age of five suffer from stunting. So that's one complex problem that requires multisectoral preventive solutions. Most of these children are going to our services anyway, so there's potential for a big impact. And in this work on early childhood, we're putting a lot of attention on teenagers, because Ecuador has a really high rate of teen pregnancy.
So you're tackling childhood problems so far upstream that it's before the children are even born?
Exactly. We realised that if we can emphasise family planning and improve sex education and start working with them on nutrition, we can prevent many other things before and during pregnancy as well.
What is more difficult: devising good new ways of doing things or moving them up to a large scale?
Scaling up with good quality is definitely the biggest challenge. I think we were very successful in scaling up our programs, but we still need to work on the quality of those programs. So of course we've done everything possible, investing in materials, training, infrastructure, the centres, but there's still a big challenge. Having good quality information on government's programs is the best asset for improving policies.
Why is scaling up so hard?
I would say mainly because of costs, but not only costs. Also you lose the commitment that you might have on the small scale. So many programs are successful because it's easy with a small group to have everyone completely committed to what we're doing. But once you scale up, you have all different types of people, and a lot of these solutions depend not only on resources but also on the people administering them and how you monitor their work.
So I always feel that in order to have real change you don't only need the legal framework, you need political will, not just politicians but social leaders supporting the idea. You need to mobilise people and there's no way you can scale up without it making a kind of social pact.
How do you mobilise people behind social programs?
Some topics are easy - pretty much everyone's concerned about small children for example. But not many people are conscious of how important it is to invest from a very early stage, so they think about education but not about infant care programs. The way to mobilise people is to share information, to share innovative information.
But you've said before that it's very difficult for senior civil servants to listen to new ideas.
You're just so committed to your own process. You have advisors and people who are constantly telling you good innovative things you could do but in reality you have very little time even to do some research or try something, because you're running just to do the things you need to get done. You know you're just going to be there for a very short time and you've got to do as much as you can if you really want to change something.
I've seen many people staying in power forever but taking very little time to reflect on what they're doing and get advice from experiences in different contexts that have shown good results and could easily be replicated. The whole world is so globalised and we have access to so much knowledge, but sometimes it's so difficult just to get real information about the what's working and replicate it. We need to find a way to institutionalise learning.
You've decided to take a break from government; do you think that's important for public servants?
That's a very personal point of view, but I do think it's very important. I love my country and I'll be going back, I just need to learn more and refresh my mind and spirit. I'm happy and grateful for the opportunity I had to serve my country - I think public service is great and the best way to really promote change. In Ecuador we have a completely different country from ten years ago. But I do think that I myself need to learn more and share more and go back when I'm ready. There are many things that you learn just from sharing thoughts and ideas and materials with other people.