Claire McKenna speaks to the BBC's outspoken world affairs editor about Afghanistan, foreign aid and Health Unlimited

Maverick journalist John Simpson

Rio, 1992: excitement mingled with the sultry heat of a Brazilian summer as an unprecedented number of world leaders gathered at an Earth Summit to discuss the future of our planet. John Simpson CBE, BBC world affairs editor, describes the atmosphere at the time: "There was tremendous world excitement, real change in the world at last. There was a feeling that things had reached a critical mass, they were going to do something, they'd got to; how could they walk away now?" But, in an anticlimactic fashion, they turned their backs.

I met John in June 2002 when he spoke at a lecture for the charity Health Unlimited, of which he is patron. He used the example of the Rio Earth Summit to illustrate the familiar scenario where a consensus is reached that something must be done. Then after a series of promises, a whirlwind round of charity appeals and celebrities flying out to far flung destinations, invariably the world pats itself on the back, feels good, and moves on. John lamented that particularly human affliction of a short term memory.

All this is rather surprising from a media mogul, who specialises in the short term. But John explains his attachment, saying his work as patron of Health Unlimited is "so much the opposite of what I do in my daily life it has a powerful attraction for me. In the media it's all about drifting off and finding other subjects to concentrate on, which is the reverse of everything Health Unlimited do."

John is a wonderful patron for the charity. His charisma, silver haired bulk, and strong grip confer a statesman-like presence. He speaks passionately about Health Unlimited's work and is a brilliant raconteur. He was just back from reporting in Kabul when he spoke at the lecture. His tanned skin conveyed an image of health--only a slight jiggling of the knees betrayed the dysentery that he had picked up in Afghanistan. He gazed longingly at the green running man illuminated on the exit sign over the door, obviously wishing he could follow suit and sprint for the nearest toilet.

But what is it John loves about Health Unlimited? He explains: "It is an association that cares about the marginalised; governments can't boast about it, and it doesn't go for headlines." This is the essence of the charity. It is a small organisation with a small amount of money. The boss, Clive Nettleton, doesn't have a big penthouse office suite; rather he prefers to be in the back of a truck under tarpaulin being smuggled into countries--similar to John Simpson, who was smuggled into Afghanistan disguised in a woman's burka. The charity targets indigenous peoples in remote areas of Peru, the Brazilian Amazon, and Nicaragua, among others. It aims to teach skills as well as give, and it focuses on long term solutions.

John used the example of Afghanistan to show how national governments respond to aid situations. Aid agencies were rampant in Afghanistan before 1992, funded by government money given because of media focus on the country at the time. But when media interest waned, government interest waned, and aid agencies were forced to withdraw. Afghanistan was effectively dumped and forgotten about, leaving a vacuum in which one of the most extreme regimes of modern times, the Taliban, flourished. It was not until the richest country in the world was attacked in 2001 that Afghanistan suddenly made the agenda again; but public interest is already waning. John said: "The Bush administration's interests are purely military--interest will shift after this is gone."

Health Unlimited works towards sustaining communities. I talked to Jim Karstegl, a tiny Chilean dynamo who works alone in a remote area of Nicaragua. She is something of a latter day Che Guevara, trying to empower the people of Latin America.

Jim described her horror at what she found there: "Just before I arrived two children had died because they were so hungry they ate soil and a bug in it killed them. Women were giving birth on fields as they worked, cutting the umbilical cord with the machetes they were using, and of course the baby died from tetanus."

Five years later the villages Jim has touched are very different. She and local helpers have trained women in the villages as birth attendants, reducing the mortality of babies dramatically through knowledge of simple hygiene techniques. Water wells and stoves have been built so people can drink and cook without fear. Youth helpers are trained to talk to their peers about sexual health--they've even started a radio drama programme dealing with formerly taboo subjects such as rape, incest, and sexually transmitted diseases, which broadcast to up to 60% of the villages Jim works with.

This innovative project has been a hit with the Nicaraguans and they take it very seriously. Jim told me about how a man who worked in one of the villages had to play the part of an uncle who had committed rape on the radio station. The next week a women in the village called Jim and said: "I have to tell you, one of your workers is a rapist."

It's clear, then, why John Simpson is able to wax lyrical about the virtues of Health Unlimited. But he reserves harsh words for the world's richest governments. He calls their aid performance "shameful" and says that global aid programmes are failing the world's poorest people. Global programmes have resulted in short term options and more accessible populations being prioritised to meet targets. Millennium development goals that aimed to cut world poverty in half by 2015 have so far been met by an overwhelming lack of action.

Remember that Rio Earth Summit in 1992? Well, when I met John there was soon to be another one happening in Johannesburg, and John is understandably cynical about the amount of action that will come out of it. A G8 summit was held in Canada this summer (26-27 June), when the leaders of the world's richest countries came together to discuss world issues. Top of the agenda this year was meant to have been a development plan for Africa, the only continent where poverty is on the rise. When I spoke to him, John was worried that the Johannesburg summit would be hijacked by the "war on
terror" and Africa would be jammed into half a day. He is scathing about the Bush administration's latest soundbite "war on terror"
saying: "How can you have a war on an abstract noun?!"

What can be done to hold our governments and their fudged promises to account? The government needs to be held to account through the media. The hacks need to get out their previous coverage on world governments' litany of promises and make it politically advantageous for them to listen.

Betraying his statesman-like persona, John Simpson quotes another statesman who is not afraid to speak the truth. Nelson Mandela asks: "Will our legacy be more than a series of broken promises?