A reader writes:
I was thrilled to see the aid debate come up on your blog, as it’s a discussion well worth having for a large forum. Aid itself is a brilliant idea, and one with far-reaching and lasting effects, but there are basically no metrics for ROI, and nobody is acting to direct it intelligently. This happens because of the phenomenon Easterly notes, wherein people truly donate to feel good, not to actually effect change (which requires much more work).
For every successful vaccination program, we have extravagant shenanigans like “spreading Internet,” or other nonsense. Paul Farmer is a fundraising machine, and after over a decade in Haiti, the public health situation is actually worse there due to a set of diseases that are shockingly easy to treat and prevent: diarrheal illness.
Now I’ll admit that this is my personal area of work, so I’m biased, but the fact of the matter is that diarrhea is still the number-one infectious disease killer in the developing world, with HIV/AIDS so far off in the distance as to be virtually irrelevant. But money is still flowing in gobbets to a project that while compelling emotionally, is functionally useless in comparison.
Aid has to be intelligent, or it’s just rich people quacking about how great they are.
One of the most effective and economical tools against diarrhea and other water-borne illnesses in the developing world is the biosand filter, demonstrated in the above video. A jaded reader writes:
I was a Peace Corps volunteer in Bahrain and then spent 23 years as a foreign service officer with USAID. In my opinion, 90 percent of all projects are crap. One hundred percent of the assistance given to Israel and Egypt is crap. We need to fix the United States before we run around the world “fixing” other places.