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Corruption &Funding &Health Systems Bill Brieger | 25 May 2009 09:49 am

to aid or not to aid

While Cheney and Obama are debating approaches to national security in the US, the international community is still debating whether development aid should continue or not.  In the latest salvo, Jeffrey Sachs wonders at the fact that critics of aid themselves have benefited from such aid … “I certainly don’t begrudge any of them the help that they got. Far from it. I believe in this kind of help. And I’d find Moyo’s views cruel and mistaken even she did not get the scholarships that have been reported … I begrudge them trying to pull up the ladder for those still left behind.”

According to the Zambian EconomistDambisa (Moyo) is tired and frustrated by the aid apparatus that has not only come to “trap” poor and indebted African states but is, in her view, the root cause of poverty.”  It is unlikely though that the huge apparatus of international development aid is going to disappear at the wishes of doubters like Moyo.  But is aid doing what it is supposed to do without the unintended consequences critics note?

Moyo’s views do touch a chord.  A colleague from Africa wrote to me today, “I often think that countries like (mine) do not really deserve any aid in view of the magnitude of corruption among their leaders. I never read any good news about my country. It is one case (or another) of a leader carting billions of dollars away .”  We have certainly witnessed embezzlement of GFATM money, but should we throw up our hands and admit that aid is defeated?

In the case of malaria, progress seen in places like Rwanda, Zanzibar, and Ethiopia would not have been possible without GFATM, PMI and other aid programs.  One can still ask if such progress is sustainable.  Watching donor disease control efforts over the years – guinea worm, onchocerciasis – one feels some dis-ease about whether such programs, no matter how much they contribute to human development, are really wanted. What are national priorities – do governments tolerate big infusions of money for special projects simply because they are big?

Is this aid by fad, and can donor fatigue be prevented until the big diseases are eliminated? And does aid corrupt and large aid corrupt absolutely?  Does aid build systems or simply help with cash flow?  Where is there accountability – not just can recipients account to donors – but also can donors account to the people they are trying to serve?  Aid that does not enable a voice for people and communities is really nothing more than well intentioned cash flow.

It would be tempting during these economic hard times to let the aid naysayers win the day.  The challenge therefore is to build a system that not only uses aid in a way that helps people now but ultimately sets the stage for generating new local and appropriate resources that may one day replace that aid.

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