The humanitarian sector needs to adapt to the profound geopolitical change that is currently underway, according to head of the International Rescue Committee and former UK politician David Milliband.

Speaking at a conference at Chatham House, in London, Mr Milliband said the world was going through “a moment of genuine geopolitical flux” citing the Trump Administration as both a symptom and a cause of the change.

“The trouble is that while it is clear what we are inflecting from, a world in which the US was the anchor of the global system, it is not clear what we are inflecting to,” he said.

“We know that America retains global interests but is more unilateralist; that China is a superpower, but it still calls itself a developing country; that Europe and Japan have been steadily losing their share of global economic wealth and rely on the multilateral system for political sway; that countries like India, Saudi Arabia, Brazil, South Korea, Turkey have all grown economically, but political power in the UN system is out of sync with the distribution of economic power, to the rising resentment of those denied a full say.

“But there is also a lot we don’t know. How much global responsibility China is willing to take on. Whether immensely wealthy Middle East powers want to take on responsibility beyond their own region. Whether and what sort of African solutions can be brought to scale to address African problems. Whether Europe has to sort out its internal economic and social problems before it becomes a global power, or whether it can only sort out domestic problems by becoming more powerful globally,” Mr Milliband said.

He argued for broadening the base of aid donors.

“The G7 group of industrialised democracies constitutes 30 per cent of global GDP and 75 per cent of foreign aid. It is legitimate to point out that the combined income of the BRICS countries is equivalent to US GDP, with nothing like the US aid contribution, and to call on newly wealthy countries, notably in the Gulf but also elsewhere, to play their full part in helping those left behind by globalisation,” he said.

Mr Milliband also called for a focus on the macroeconomic context of development.

The COVID pandemic was disastrous for health and education budgets in the developing world and a saw an increase in debt burdens.

“Rising interest rates and bond and loan repayments meant that nearly $200bn flowed out of developing countries to private creditors in 2023. Aid cannot fill this gap. That’s why we need new imagination about how to reduce debt burdens, including the idea of humanitarian debt swaps that IRC is trying to support to shift resources from paying off debts to investing in humanitarian action. The idea of climate debt clauses that the UK has championed is relevant here,” he said.

Mr Milliband said aid was most needed in the poorest countries, with the largest concentrations of very poor people, the highest levels of humanitarian needs, and the least capacity to meet those needs.

“The aid effort in these places needs to be better funded, and the funding also needs to go further. So, it’s the old formula of “investment and reform”: invest in scalable, high-impact interventions, and deliver them in the most cost-effective way,” he said.

Mr Milliband set out an agenda for the global humanitarian sector.

He called for a ‘prioritization drive’.

“Evidence of impact as well as need should drive prioritization. For example, acute child malnutrition is the apex of the humanitarian pyramid. 45 million under-5s suffer acute malnutrition and it is the leading contributor to death in about half of all mortalities. Yet 80 per cent of acutely malnourished under-5s in conflict states today don’t get the appropriate help.”

Mr Milliband also called for a ‘cost-effectiveness drive’.

“In the malnutrition case, IRC showed how to achieve 20 per cent cost efficiency gains. More broadly, IRC has conducted around 400 cost-effectiveness and cost efficiency studies over the last ten years. There are big gains to be had,” he said.

“We think that just lengthening the life cycle of grants from less than a year to multi-year could deliver 30 per cent efficiency gains.”

He also called for an ‘innovation drive’.

“From farmer information systems to education for kids on the move, IRC’s own research has shown how AI holds out the prospect of quite striking advances. We can use AI to make the aid sector more proactive and less reactive, for example, using IRC’s “Follow the Forecast” model of anticipatory action for intervening with aid before a flood or drought hits,” Mr Milliband said.

“We can also make the system more personalised: for example, we are developing an AI-powered offline functional app for frontline health workers to rapidly diagnose mpox by analysing photos of lesions. And we can make it more accountable,” he said.

Mr Milliband said global risks, technological revolution and geopolitical fragmentation are combining to break up old systems.

“That is nowhere more true than in the drive to help the poorest people in the world. There are big dangers, but also opportunities for leadership,” he said.

“I have been inspired by the commitment, innovation and value for money of the aid sector that I have seen over the last ten years. I don’t believe that responsibility from richer to poorer should be cut back. But we will only rebuild it with an agenda that is clearer, more impactful and more focused. I hope that is the debate we can now have.”

Read the full speech: “The world has changed: How does aid need to change?” Speech by David Miliband, President and CEO, International Rescue Committee. Chatham House, London. | International Rescue Committee (IRC)