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Marshaling Technology for Development: Proceedings of a Symposium (1995)

Chapter: Opportunities and Strategies by Sector

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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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Suggested Citation:"Opportunities and Strategies by Sector." National Research Council. 1995. Marshaling Technology for Development: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/5022.
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CHAPTER 3 Opportunities and Strategies by Sector Over the next four decades, a doubling of the population coupled with eco- nomic growth will more than double the demand for food. Economic investment will have to rise by a large factor in order to provide plants, equipment, and jobs. The prices of some nonrenewable resources, fuels, and materials that are not economically recyclable will increase, denying their availability to many devel- oping countries. The world's energy demands also will rise dramatically; in fact, in the next few years the expanding populations of India and China alone will account for two-thirds of the increase in total world energy consumption. In response to the growth in population, governments will be hard-pressed to pro- vide the education and basic health services needed by the larger numbers of people and to maintain social safety nets for the growing numbers of the poor. Finally, all this economic activity will exact a toll on the quality of air, water, soil, forests, and other natural resources. Yet the technological changes described here will present new opportunities for economic progress. Telecommunications, biotechnology, and materials sci- ence and technology will create new industries and new products-and thus new jobs. New fuels and new technologies for energy conversion will help to satisfy some of the demand. And other technologies will be applied to protect the envi- ronment. In fact, each of the major productive and social sectors of the economy This chapter draws substantively on the invited papers by Balzhiser (energy technology), Baruch (technological innovation and services), Harwood (agricultural development), Heath (electronic manufacturing technologies), Lesgold (educational technology), Shine (health technology), and White (sustainable development), as well as the discussions of the break-out groups. as

36 Marshaling Technology for Development will be affected in different ways. In every sector there will be new opportunities as well as new problems and in the mix a pathway for survival. AGRICULTURE Agriculture plays many roles in developing countries. It supplies food for rural and urban populations, generates export earnings, provides employment and forestalls migration to overburdened cities, and creates a critical interface be- tween human activities and the natural environment. No sector is so dependent on innovation and new technology to meet its goals as agnculture. Agricultural research is an integral part of the production system, and farmers in the developed countries are accustomed to relying on the research system and its representatives in the form of extension agents or the agents of commercial suppliers to aid in their constant struggle against weeds, pests, disease, and drought. Unlike, say, education, or even manufactunng, mod- e~n agriculture without innovation is difficult to imagine. To illustrate, for many years telephones were manufactured without significant modifications (and with no decline in volume or quality of communications), but without new chemicals or a new approach to pest management, crops would be destroyed by pests constantly evolving resistance to the old ones. Projections of future demand and supply of agricultural products depend critically on three important factors: popu- lation growth, income growth, and technology innovation. The first two are-diffi- cult enough to estimate on the basis of the factors involved, but the last can be extrapolated only from past rates of technical change. Ignoring it, however, cre- ates a falsely (up to now) pessimistic picture of future needs. As the demand for food continues to rise, together with the demand for other goods and services that depend on the same soil and water base, faImers world- wide, confronted with soil loss from erosion, will face powerful challenges re- quinng breakthrough technologies, some of which are not yet on the drawing board. Agricultural management strategies on the national and regional levels Because the world is facing a shrinking land base and growing demand for agricultural products, the output per unit area of the food and feedgrains, as well as starchy vegetables, must more than double over the next 25 years. While there is considerable scope for increasing yields within the existing genetic potential, scientific breakthroughs will be needed to fully achieve the needed yields. RICHARD R. HARWOOD

OPPORTUNITIES AND STRATEGIES BY SECTOR 37 also will have to be strengthened and revised, and many existing farms will have to be transformed. High-resource, productive soils occupy only a small part, perhaps 10 per- cent, of total land area, but on these lands are the farms that can benefit most from the introduction of new technologies to increase food production. These farms can be divided into two categories: industrial-style plantation farms and multicrop integrated farms, often combining livestock and field crops. Plantation farms are usually dedicated to producing commercial crops, often for export. For that rea- son, they are generally better informed about and able to adapt new technologies, but they account for a very small share of food crop production in developing countries. Integrated farms, which are in better ecological balance, accounted for most of the production increases associated with the green revolution. They adopted the new technology rapidly once it became available in the agro-ecologi- cal region in which they were located. The most successful of them are knowl- edge-intensive and use the most advanced technologies, plant varieties, and man- agement approaches, with on-farm sources of nutrients and pest control replacing many of the purchased fertilizers and pesticides. Much of the land area of developing countries is marginal, characterized by low soil quality, low water availability, steep slopes, or high winds. This land area either belongs to traditional farms or is under forest. Although these mar- ginal lands cannot support the continual cultivation of staple crops, millions of poor people depend on these lands for subsistence. Indeed, they carry the bulb of the rural population and must be kept viable until urban economic development can accommodate the excess labor force from these rural areas. Poverty in both urban and rural areas will place additional pressures on the land through the overexploitation and degradation of the fragile soil resource base. The nature of exponential population growth is such that the greater in- crease occurs later in any time period. During the next decade, then, the world's food supply is expected to be stable, with only modest price increases. After that, however, new technologies and new resources will be required to sustain growth. But it will not be easy; the amount of land most able to support culti- vated crops will most likely be decreasing because of soil erosion and such competitive uses as industry, housing, and roads. Increased food production to feed the growing population must come from yields. A new rice variety with up to 30 percent increase in yield was recently announced at the International Rice Research Institute in the Philippines. Yet much more research and development will be required to bring this technology to farmers' fields, and the inputs it requires must be provided without damaging the environment. Furthermore, if this can be done, then it must be done twice again in order to meet the demands of the mid-twenty-first century. And it must be repeated for other staples, starchy vegetables, and feedgrains. Since the plantation sector contributes little to devel- oping country food supplies, and in some places is suffering the inefficiencies common to large vertically integrated enterprises in the manufacturing sector,

38 Marshaling Technology for Development new technologies must be developed with the needs of the integrated farms in mind. It appears unlikely that much of the increased food required will be supplied by the oceans. Their present contribution to food supplies is less than 1 percent, and natural fisheries are in decline because of the misuse of technology and overfishing, as well as pollution from agricultural runoffs and other sources. It is hoped, however, that the expansion of aquaculture, aided by advances in biotech- nology, might fill part of the shortfall. Despite all the challenges facing agriculture, global trade patterns and com- munications technologies are creating opportunities for agroindustries in new geographic areas, including industries to produce industrial feedstocks from agri- cultural products. At the same time, science is developing substitutes for tradi- tional agricultural crops. For example, cacao plantations may become uneco- nomic because of a new, lower-priced, "artificial" substitute for cacao, but some of them may turn to producing palm oil as a feedstock for a kind of biodegradable plastic. For developing country farmers, it will be a matter of analyzing and experimenting with the opportunities to find those that fit their specific soils, climates, markets, and capabilities. Education, investment, and the global ex- change of information will be vital. MANUFACTURING AND SERVICES Manufacturing and services are among the sectors that have been most highly affected by radical innovations in computers and telecommunications. Manufacturing Among manufacturing industries, the electronics industry will probably be most transformed by advances in computers and telecommunications. It is, in fact, responsible for much of the new technology, and over the decades 1980- 2000, this industry will have grown by more than a factor of six. Electronics manufacturing keeps pace with changes in silicon and integrated circuit technolo- gies, which appear in the market as components or subassemblies. Most assembly plants use similar components, connectors, packaging, and power supplies- components that are seen at trade shows and traded openly to all manufacturers. Proprietary manufacturing technologies are less important, but knowledge of the technologies and of the market opportunities is crucial. They determine what is manufactured, as well as where, how, and by whom. Competition resides in design, including software, manufacturing capability, speed, and quality control- the first to market with a new product reaps much greater profits than the runners- up. This kind of competition is sometimes characterized as continuous creativity, continuous innovation, continuous productivity, or continuous learning. Because the lifetimes of electronic products are so short, the cost of materials is constant

OPPORTUNITIES AND STRATEGIES BY SECTOR 39 over the period and constant among different manufacturing firms. Thus the difference between a successful firm and its competitor is usually observed in the product design, product quality, manufacturing efficiency, and agility. Modern electronics manufacturing is typically an integrated operation, coor- dinated with computer technology (also known as computer-integrated manufac- tur~ng, CIM). Manufacturing establishments depend on suppliers and assemblers for a large part of the value added, up to 75-90 percent of the value of electronic products. Suppliers generally ship small lots at high frequency so that they arrive just in time for use in order to save inventory costs and time. Such an arrangement requires that suppliers become almost coproducers, with databases and schedules linked through long-term relationships with the manufacturers. Linkages among manufacturers and suppliers are independent of location that is, manufacturing plants in any country may depend on components and materials from suppliers in other countries, often on other continents. Integration is enacted through joint ventures, licensing, or foreign direct investment, and often involves technology transfer or other forms of alliances to share or jointly develop technology, even among firms in the same country. In the electronics industry, speed and demon- strated adherence to quality standards are vital, and computer-aided manufacture (CAM), high-performance teams of skilled workers, and automation may be more important competitive qualities than low-wage labor. Since electronic product cycles are measured in months, not years, there is a premium on getting the initial designs right. In the earlier manufacturing style, design, manufacturing, and marketing were separate divisions of a company. Now it is recognized that these three activities must be coordinated and that marketing and manufacturing specialists must participate in the design process. The computer-aided design (CAD) process encompasses the ability to design- for-manufacture (to facilitate component fabrication and assembly) or design In the developing countries, policies and regulations on trade policies, soft financing, economic offset, and duties and taxes on the flow of manufacturing elements can significantly affect the climate for manufacturing. Furthermore, the competitive complexion of a manufacturing entity is becoming increasingly dependent on its successful utilization and leverage of its global production network. Without the support of the developing countries themselves, the manufacturing operations will not be globally competitive. SIDNEY F. HEATH III

40 Marshaling Technology for Development for-environment (to reduce unrecyclable wastes or pollution in the manufacturing process). When the right factors are present, the most efficient solution might well be characterized as "design-for-developing country participation." It might be based on proximity to markets, access to raw materials, low wage rates, or new applications of products in developing country markets. Services Services usually defined as intangible and nonstorable goods, which are generally insulated from international competition but highly prone to regulation internally are being transformed by the changing nature of competition in ser- vice markets. Some new categories of services transborder services are ex- plicitly international; others are embedded in the value chains of international integrated manufacturing. Because the distinction between manufacturing and services is blurred by these categories of services with their strong international components, local regulation of services will likely become less effective. The growth in transborder services has stemmed from cheap computers, low wages, and low-cost, efficient telecommunications. The cost of electronic com Among the so-ca1~ledt services, a country's ability to manage and use information will be the single determinant of its rate of development. JORDAN J. BARUCH munication is becoming independent of distance, and the prices of memory and bandwidth are falling rapidly. Data-entry, translation, and financial services are examples of the services that have been exported from industrialized countries. For example, when an 800 number is dialed in the United States, the voice that responds often will come from the Caribbean. It is likely, however, that many of the present transborder services being performed in developing countries will decline in importance or disappear. For example, as voice recognition technologies become more effective, data-entry personnel or telephone operators will be replaced by a smaller number of "native speakers," and these types of services may move back to the developed countries or to those countries predominantly English-speaking. At the same time, the number of direct-order businesses for export may increase, favoring the develop- ing countries another blurring of the distinction between manufacturing and services. Some services such as translation, software development, insurance claims analysis those mostly requiring a skilled work force will not decline. Services that support foreign direct investment, or information networks, or inte- grated manufacturing will provide fresh opportunities.

OPPORTUNITIES AND STRATEGIES BY SECTOR 41 Embodied services are another class of service that is frequently performed in a developing country for clients in developed countries. Some embodied ser- vices are part of the integrated manufacturing process but differ from manufac- turing because the service firm performs none of the functions normally associ- ated with manufacturing such as design, marketing, or engineering. Research and development and custom manufacture on demand are examples. Particularly in the garment industry, manufacturing films outsource the actual fabrication of goods while retaining the design, engineering, and marketing functions. It is hard to distinguish custom fabrication of specified garments on order from the more traditional services such as cleaning and packing or transport. THE ENVIRONMENT AND ENERGY The earth's environment will never again be able to sustain the energy use, pollution, and resource waste that characterized the development of the industri- alized countries to their present levels of consumption. Today, most of the world's population increase, the highest rates of economic growth, and the resulting threats to the environment are occurring in the developing countries. But that is also where most of the humid tropical forests that help to sustain the balance of atmospheric carbon dioxide are located, and where the congested and polluted cities and the falling water tables have as yet found no remedy. In the past, environmental problems were considered the inevitable side effects of development. Some technologies were "cleaner" than others, but in- creased productivity was the primary goal, and any environmental damage was either taken care of separately or disregarded. Some of the excesses that occurred in the Soviet Union and the Middle East were consequences of that philosophy. Fortunately, the public's attitude has now changed; environmental science is a new discipline, and environmental technology is a $300 billion a year business worldwide. Manufacturers now "design for environment," using informatics tech- nologies, computer-aided design, and computer control of manufacturing. The results are processes that pollute less to make products that are easier to recycle. The present great wave of new technologies and technological concepts collectively represents a new environmental technological offensive. Properly directed and finned this ntLen.sive could ~. . , ~ ~ open pathways to an environmentally sustainable future as well as restore damaged environments. Technological innovation by itself is a necessary, but insufficient, means to that end. ROBERT M. WHITE

42 Marshaling Technology for Development One key to sustainable development development that does not cause per- manent degradation of the environment is the kind of energy source used for domestic and industrial applications. Energy sources can be divided into two categories: commercial sources and traditional or informal sources. Commercial energy includes electricity, refined engine and heating fuels, batteries, and other manufactured devices for producing energy. Traditional sources are firewood and charcoal, dung, water wheels, and animal traction. Half the world's people have little or no access to commercial energy. Modern commercial energy technology is capital-intensive, and most of it is driven by fossil fuels. The reserve-to-pro- duction ratios for the world's commercially proven reserves of oil and gas are currently around 45 and 65 years, respectively, while those for coal (from which gas and synthetic liquid fuels can be made) are over 200 years. Given these estimates, it is likely that abundant oil, coal, and gas will dominate the commer- cial energy picture for decades, barring some unexpected new source of energy. Today, the efficiency of power plants as well as that of electrical devices is climbing. The best gas-powered combined-cycle combustion turbines approach 50 percent higher efficiency than direct fossil fuel-fired power plants. Other technologies are based on coal, which constitutes 80 percent of the world's fossil fuel resource and is the main resource of the two largest countries, India and China. Integrated gasification combined-cycle (IGCC) technology first gasifies the coal, then removes the impurities in the gas, and sends the gas to a combined- cycle turbine. These turbines, manufactured worldwide, have relatively low capi- tal and fuel costs, low emissions, and a modular design. They are fabricated in a variety of sizes and shipped by railway. Other coal-based technologies, such as fluidized-bed power generators, also are relatively clean. For fossil fuel-powered electrical generation, the fuel is abundant and efficient technologies are available. The major constraint relates to the environment and to special situations in which access to fuel is difficult or expensive. The availability of modular units is changing the nature of power generation and distribution. Modular technologies are generally small, factory made (possi- bly including local components), and quickly installed. Moreover, they can be installed close to the load to minimize transmission and distribution costs. Simi- larly, new macro-electronic technologies for control over long power lines are under development, and small, dispersed generating units are an increasingly viable option. These technologies already are having an impact in the United States, where many utilities are redefining themselves as transmission and distri- bution companies. In fact, the energy industry appears to be heading in the same direction once taken by the computer industry, which passed from mainframes to desktops to laptops to networks of small units, which ultimately have the power to challenge the largest supercomputers. The main problem related to energy generation at present is its impact on the environment. The threat to soils and forests is a function of the continued use of the traditional biofuels such as firewood, charcoal, or dung, where electricity is

OPPORTUNITIES AND STRATEGIES BY SECTOR 43 unavailable or costly. Making electricity available to all populations is a major element of the long-term solution to deforestation and erosion. Another major environmental concern is global warming. Because of the difficulties and the costs associated with nuclear power for electricity generation and the inevitable production of carbon dioxide in fossil fuel combustion, the main long-term op- tion for stabilizing greenhouse gas emissions is renewable energy sources in the forms of solar power, wind power, and biomass energy. Presently, these sources are more expensive than fossil fuels, but their costs are dropping. In 15 years, the costs per kilowatt-hour for renewable technologies have fallen between 30 and 200 percent, depending on the technology. Although renewables may soon be commercially competitive everywhere, for the moment they are a realistic alter- native only in remote areas or where fuel costs are very high. Photovoltaic technologies have the greatest potential in the tropical regions. The units, which are modular, can be easily transported, assembled, and main- tained in isolated areas, as successfully demonstrated in Brazil, Indonesia, and other countries. Photovoltaics remains a promising area for research and develop- ment, part of the silicon revolution of rapid innovation. The present price is $0.30 per kWh, compared with the competitive price of $0.05 per kWh, but a new 20- kW system under construction in Arizona may approach $0.10 per kWh. Solar thermal generators use large collectors to concentrate the direct heat of the sun for conversion to electricity. Their size and capacity put them into compe- tition with fossil fuel combustion turbines, which are cheaper and more efficient. This technology might be competitive in a tropical region without coal or gas. Wind turbines, presently competitive in regions with persistent winds, are being used in the United States and parts of Europe. The variable-speed turbine is capable of producing electricity for about $0.05 per kWh, and the fierce compe- tition that currently characterizes the industry may result in even lower costs in the next decade. As the next century unfolds, the issue of global sustainability will begin to transcend the separate concerns of population, energy, economy, health, social welfare, and the environment. New means of achieving sustainable development will be required, and efficiency is likely to act as the backbone of all future strategies of sustainability. In this, electricity will be important in reconciling human . . . ~ . . aspirations with resource realities. RICHARD E. BALZHISER

44 Marshaling Technology for Development Solar and wind technologies produce energy when the weather is favorable, but much of the consumption takes place at other hours. Thus once energy stor- age is improved, renewables should be better able to compete effectively with advanced turbine technologies. Promising technologies for energy storage include fuel cells whose feedstock is produced with renewable energy, thermal storage devices, and advanced batteries. These devices are presently relatively expensive and inefficient, but they are a fertile area for research and development. Finally, sources of biomass for commercial energy generation are either waste products or crops grown specifically for energy production. In either case, this area may benefit from advances in biotechnology, both for higher productiv- ity of fuel crops and for more efficient conversion of the biomass to energy. The material can be either burned directly or converted to a biofuel such as ethanol or methanol, liquid or gas, for use in advanced engines and combustion turbines, although under present conditions this is not economically attractive. HEALTH The markets do not work well for health. In the health systems of most countries, the consumer the patient has very little knowledge, and therefore little basis for choice, of the type and quality of care received. Rarely are there alternate providers, and the costs of care are borne by a third party, either the government or an insurance company. For similar reasons, investments in health- related research and development do not respond directly to the needs of the patients in most countries or of most providers. Research and development are largely carried out by big international firms American, European, and Japa- nese pharmaceutical or equipment manufacturers that make half their profits in the United States. Moreover, the United States has a commanding lead in funda- mental research with an annual investment of $25 billion. It is not surprising, then, that most research efforts are aimed at the U.S. market. The situation is sharpened by the fact that the United States, mainly through its Food and Drug Administration, has a rigid and costly process for the approval of new technolo- gies- but one that emphasizes efficacy and safety and ignores cost-effective- ness and a legal system and tradition that awards high payments for liability claims against companies that produce health technologies. The result is that research and development in the health industry do not generate the technologies that serve the needs of the developing countries, mostly because those needs do not presently involve lucrative markets, although the number of affected people is large. Some developing country needs do coincide with areas of intense research and development efforts in developed countries, but the fruits of that research are not reaching Third World nations, possibly because they involve expensive, high-technology solutions that are beyond the means of poor populations. Some examples of these research and development needs are:

OPPORTUNITIES AND STRATEGIES BY SECTOR 45 · Reproductive health technologies. Developing countries especially need contraceptive technologies for men and women, as well as methods that simulta- neously protect women from infection since they bear the heaviest burden from sexually transmitted diseases. · Micronutrient supplementation. Cost-effective delivery systems are needed for providing vitamin A and other essential diet supplements to children, whose health is the most vulnerable to nutritional deficiencies. Vaccines. Immunizations will protect children against the most common childhood diseases and against diseases that carry large burdens of morbidity or mortality in the tropics. . . Primary health care. Expanded facilities are needed for primary and out- patient clinical care, including the use of cost-effective diagnostic and treatment technologies through telemedicine. Chronic diseases. Cost-effective interventions are required to control the growing prevalence of chronic illness heart disease, cancer, stroke, lung dis- ease, and diabetes and to reduce the use of tobacco, which exacerbates these . illnesses. · Information and surveillance technologies. Such systems could anticipate the emergence and spread of little-known or local diseases and drug resistance in common diseases. . HIV. Research could tackle the problem of behavior modification to pre- vent the spread of the disease and monitor new strains of HIV and different transmission patterns to complement the large research programs of the advanced countries. Another area in which current research is not addressing major problems in developing countries, or developed countries for that matter, is behavioral re- search. Many of the most serious threats to wellness in all countries involve behavior: addictive and hallucinatory drugs, mental disorders, and most espe- cially violence. Neuropsychiatric illnesses, together with cardiovascular diseases and injuries, deliberate and accidental, constitute half the disease burden of the developing countries. An instructive example of the bottom-line bias of today's health-related research and development is vaccine development. Vaccines are the most cost- effective technologies known, yet for technology companies they generate smaller profits and higher potential liabilities than treatment technologies that are used over a long period. This is illustrated by the decision of a consortium of U.S. pharmaceutical companies to make a united effort to develop antiviral agents against HIV infection rather than a vaccine to protect against AIDS. Similarly, research on contraceptive vaccines or devices badly needed in developing coun- tries is impeded by political opposition in the United States. In short, health care and health care costs-in the United States are dominated by expensive high-technology diagnostics and treatments. Thus these technologies and this

46 Marshaling Technology for Development system are not necessarily the most appropriate for transfer to the developing countries. This being said, the needs of the developing and developed countries have coincided for two advances that provide services to large populations at reduced costs and that have their origins in research areas touched by the computer and telecommunications revolutions. The first advance is improved outpatient ser- vices. Many procedures once requiring prolonged hospital stays are being per- formed in outpatient clinics with access to information resources, and average lengths of hospital stay, even in tertiary care facilities in developed countries, are dropping rapidly, driving down costs and decreasing risks of nosocomial infec- tions. Today, in fact, many hospitals are able to eliminate beds and replace them with ambulatory facilities and satellite clinics, supported by nearby lodging for patients and their families. The second advance is telemedicine, the name given to systems in which a central facility staffed by physicians is able to diagnose and treat patients in remote locations by means of computers and telecommunications technologies. Patients visiting the remote locations are "examined" by physicians through in- teractive video and communications equipment that allows them to view patients, receive diagnostic data and x-rays, and instruct attending physicians or paramed- ics in treatment procedures. In the future, virtual-reality technologies, combined with fiber optics and endoscopy, may enable physicians, working in a central facility and provided with global information resources, to perform surgery and other operations in remote locations. Even in the near term, in both developing and developed countries, the most appropriate health care model will be ambula- tory diagnostic and procedures rooms with a small number of hospital beds supported by high technology and remote telemedicine services. Investments in health research pay large dividends, but presently only 2 percent of health research is carried out in developing countries, despite the fact that 93 percent of preventable mortality is found in the Third World. Only one international health research center is located in a developing country, the Inter- national Diarrheal Disease Research Center in Bangladesh. Its operating cost is approximately $10 million per year, a small fraction of what the cost would be if it were situated in a developed country. EDUCATION In developing countries, the per capita expenditure on education is about half that of member countries of the Organization for Economic Cooperation and Development (OECD). School standards are low, and in many countries the goals of achieving 100 percent primary education and female literacy remain unful- filled. Modern technology, which is not usually a prominent feature of the class- room in any country, is scarcely used. Educators, however, often cite poorly prepared, overworked teachers and poorly equipped, crowded classes as the rea

OPPORTUNITIES AND STRATEGIES BY SECTOR 47 Because they often have more educational chores to accomplish and less money to invest, the developing countries especially could benefit from the technological leverage of learning. But because educational systems also are extremely stable and resistant to change, it is important to establish clearly whether a given technological contribution will sufficiently enhance educational productivity before undertaking any major effort to use it. ALAN M. LESGOLD sons why new technologies would not work and why therefore they should not be introduced. Some developing countries have noted as well that there are large numbers of computers and other technologies in U.S. schools, but that their influence on productivity has yet to be demonstrated. Education is highly sensitive to local culture and language. Educators know that they must build on what students already know and how they think, and that in most cases the students must be taught in their own languages. Countries can borrow tools and technologies from outside, but they must redesign them, inte- grating them with the local culture and knowledge base if the new techniques are to be accepted and sustained. It has been demonstrated, however, that some advanced technologies, interpreted in the broadest terms, can have important, cost-effective yields even though they may seem too exotic for developing coun- tries. Hardware development textbooks and computers is far ahead of soft- ware, but such soft technologies as theories of learning, educational standards, and translation and voice recognition programs can make important contribu- tions. Schools are generally resistant to technology-driven changes. Teachers are protective of their status in the classroom and their position within the system, and they must be fully comfortable that a technology will enhance their role, not supplant them, before they are likely to employ it willingly. Because they also are often overworked, teachers must be confident that a technology will work and will not cost them extra effort. Teacher training and equipment maintenance are therefore key requirements for the adoption of any hardware-based technological solution. As for the benefits of such solutions, electronic networking can provide teachers with practice and technological experience and put them in contact with other teachers. It also can provide materials they can use in the classroom, either prepared centrally on a national level, or, perhaps through the Internet, from international sources. Use of World Wide Web would be particularly valuable; it

48 Marshaling Technology for Development has found favor with teachers in developed countries and is a popular resource for students. The technologies appropriate for mass education such as radios must be readily accessible to all and like any new technology in the marketplace must be evaluated by the learning they produce. In general, low-maintenance technolo- gies that are easy to teach and easy to use work best. One example is interactive radio. Programs are designed to reinforce lessons by encouraging pupils to re- spond aloud. Pupils listen in a group and respond together to the instructions or questions on the program. This approach is especially comfortable to many chil- dren who like the oral approach and like to work in groups. Radios are ubiqui- tous, and this technique has been shown to be effective and cheap, with costs similar to those for standard textbook-based alternatives. Another useful technol- ogy is the computer-based printing system, linked to a central network. Such a system allows print masters to be made locally and large quantities of texts and other materials to be printed cheaply. And not to be forgotten, CD-ROM, com- bined with a laptop computer and a wireless modem, presents many possibilities, including low-cost video production and access to material via World Wide Web. The costs of these items have fallen drastically, which may make them realistic options, even for rural and remote area schools. Science education is a major part of producing a technologically literate citizenry. But competent science teaching requires knowledgeable teachers, the proper laboratory equipment, and a good syllabus. Technology can sometimes provide substitutes for all of these elements. For example, the National Science Resource Center of the National Research Council and Smithsonian Institution has prepared syllabus materials for the primary and secondary levels that provide units of experimental science and include low-cost materials and supporting in- formation for teachers. For universities, the concept of the virtual classroom allows developing country universities to take advantage of materials prepared at the best universities in the developed countries through multimedia technology resources. Many aspects of laboratory instruction can be simulated by computers for students. Most of the innovative technologies that are transforming the manufacturing and service sectors place a premium on the skilled, trained worker at the expense of the unskilled, low-wage worker who in the past has made many of the develop- ing countries competitive in the marketplace. Countries that hope to remain com- petitive or to enter new niches must therefore put a high priority on workplace training. Fortunately, many of the new technologies may themselves be used to enhance worker training. For example, firms can utilize their own computers and computerized tools in the workplace to train potential workers during the after- operations hours. Coached apprenticeship, which provides training and assis- tance to the worker at his or her own workplace, is sometimes called just-in-time training because the knowledge is imported at precisely the time and place it is needed and is thus most effectively absorbed and assimilated. A similar tech

OPPORTUNITIES AND STRATEGIES BY SECTOR 49 nique, intelligent coaching, also is computer based. It uses audio recognition of known text to enforce correct responses and to correct errors. The combination of these self-paced techniques with the guidance of a mentor may be the most powerful tool of all. The formal design and adoption of educational technologies, whether newly conceived or merely new for the country, will require research and development at the local level. Teachers should participate actively in these experiments, guided by experts, and share experiences with other teachers. Regional or na- tional centers, in collaboration with ministries of education, could effectively guide the process of adapting technologies to local use by mobilizing teachers, providing them with technical assistance and modest sums for materials, and analyzing the results. Once the new technologies are adopted, training teachers in their use should be built into the curriculum. Training already is an established field of research in which the private sector has played an active part. The field could expand to encompass even more innovation and technology transfer if firms had the incentives to invest in training activities. In many developing countries, though, fear of hijacking (recruitment of workers who have been trained at the expense of another firm) has discouraged training initiatives. Regulation (or deregulation) of the transferability of retire- ment and health benefits, as well as government-led initiatives to encourage cooperation among firms for training, would help to mitigate this problem. This chapter has described how advances in technology have affected vari- ous sectors, and where needed technologies are lacking. Changes in world mar- kets and the impact of new technologies are largely beyond the control of any authorities or governments, although some governments have influenced the pace of development and implementation of selected technologies through tax incen- tives, partnerships, and government-funded research and development. Gener ally, the private sector is leading the way in the technology revolution and controlling the application of new technologies. Thus in those sectors that are generally public notably education and, in part, health-even some of the tech- nologies available and clearly needed are not being applied. The final chapter is therefore devoted to some recommendations for action by governments, the pri- vate sector, the scientific community, and the development agencies, led by the World Bank, to ensure that a majority of the world's population benefits from the technology revolution.

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Recent technological advances, particularly in microelectronics and telecommunications, biotechnology, and advanced materials, pose critical challenges and opportunities for developing countries, and for the development banks and other organizations that serve them. Those countries that fail to adapt to the transformations driven by new technologies in industry, agriculture, health, environment, energy, education, and other sectors may find it difficult to avoid falling behind. This book represents a joint effort by the World Bank and the National Research Council to survey the status and effect of technology change in key sectors and to recommend action by the development organizations, government, private sector and the scientific and technological community.

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