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‘Dead Aid’: how foreign aid is making Africa sicker

While some US$50 billions of dollars continue to inundate African coffers each year, overwhelming evidence demonstrates that Africans are getting poorer and sicker. While reports of misappropriation of foreign aid funds and subsequent corruption are increasing at dizzying rates, donor nations stand idly by while taxpayers continue to foot the ever-increasing “humanitarian” aid bill.

In rural Tanzania, nearly four out of five children who died of malaria sought, but didn’t find, medical care from modern healthcare facilities, reported a 2008 study. In Uganda, a direct observation study found a whopping 37% of Africa’s frontline providers, mainly doctors, were chronically absent from their primary health clinics. These grim observations help to explain why the African “people stop looking for health care because they know they wont get it”, reports The Vancouver Sun.

These dismal observations, among many others, are rooted in what the World Bank calls “quiet” corruption, when public servants fail to deliver services or inputs that have been paid for by the government. This unique form of corruption manifests itself in “the absence of diagnostic equipment, drug pilfering, provider absenteeism and very low levels of diagnostic effort”, reports The Vancouver Sun. In a 2010 report, the World Bank reports that this form of corruption is rampant and present in a large share of public sectors. At the frontline of public service provision is the healthcare sector, which figures among the hardest hit despite the billions of dollars in foreign aid injected yearly in Africa, intended to directly develop this sector.

Experts are increasingly dubbing foreign aid a humanitarian disaster that is fueling this silent and lethal form of corruption, which explains why healthcare systems continue to crumble despite increasing foreign funding aimed at developing them. Although estimating the degree of resource and leakage in health care is very challenging, the World Bank has noted that considerable foreign aid funding increases have not resulted in improved human development indicators in Africa due to corruption and poor governance, which disproportionately hurts the sick, the poor, but even also the average African. Despite such dire observations, “no serious efforts have been made to wean Africa off this debilitating drug” that is foreign aid, states Dambiasa Moyo, a former economist at Goldman Sachs and author of “Dead Aid: Why Aid Is Not Working and How There Is a Better Way for Africa”. Yet this “free” aid keeps rolling in at ever-increasing rates.

Adding to this grand scheme of corruption is the majority of donors’ deafening silence in demanding liability from its aid recipients. In most countries, the World Bank reports that aid recipient governments do not state how much of their budget is apportioned to healthcare inputs. This is in turn deprives analysts of vital data to assess the exact degree of aid resource leakage. One thing however is sure: most Western donors seem to be handing their aid recipients a virtual carte blanche and appear largely to be unwilling in calling for real accountability about the use and misuse of these aid funds. By blindly providing aid with few or no strings attached, “it has been all too easy for these funds to be used for anything but the developmental purpose for which they were intended”, says Diambiasa Moyo.

An urgent demand for a paradigm shift in foreign aid is increasing. Tackling this problem will require extraordinary efforts in combining strong and committed leadership, policies and institutions to increase accountability of aid donor and aid recipient nations. As the Associate Justice of the United States Supreme Court Louis Brandeis famously said in 1914 in reference to the indisputable benefits of transparency in the public sector:

“Sunlight is the best disinfectant.”

 

(Featured photo: AttributionNoncommercialNo Derivative Works Oxfam International, Creative Commons, Flickr)

About Asmae Toumi

Asmae is 3rd year undergrad McGill student, majoring in Microbiology and Molecular Biotechnology, with a minor in Social Studies of Medicine. She volunteers as a first responder for St. John Ambulance and works as an emergency department coordinator at the Jewish General Hospital in Montreal. She is an aspiring physician, with interests in health, science and politics.

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25 comments

  1. “Foreign sucks because of greedy African leaders” is the crux of this piece. I dearly hope that the author attends the debates and listens to Prof. Soske (in particular) talk about how the failures of foreign aid rest in the West and that the actions of various African leaders are a reaction to how the West and their foreign aid/humanitarian efforts have undermined and impeded the African attempts to building a legitimate government/state for decades now.

  2. “Foreign sucks because of greedy African leaders” is the crux of this piece. I dearly hope that the author attends the debates and listens to Prof. Soske (in particular) talk about how the failures of foreign aid rest in the West and that the actions of various African leaders are a reaction to how the West and their foreign aid/humanitarian efforts have undermined and impeded the African attempts to building a legitimate government/state for decades now.

  3. “Foreign sucks because of greedy African leaders” is the crux of this piece. I dearly hope that the author attends the debates and listens to Prof. Soske (in particular) talk about how the failures of foreign aid rest in the West and that the actions of various African leaders are a reaction to how the West and their foreign aid/humanitarian efforts have undermined and impeded the African attempts to building a legitimate government/state for decades now.

  4. Thanks for your comment wizun! do you believe african leaders are the sole party to blame for this complete failure we’re witnessing? I found it very alarming as I was doing my research to discover donors demand little if no accountability and responsibility about the aid money they’re giving, which by extension encourages these nations to spend this money as they see it fit. what do you think about this?

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

    • I think that’s a good example that illustrates exactly why discussions about the ineffectiveness of aid cannot stop at merely “African leaders are corrupt”. There are a multitude of factors, including the lousy policy making of groups that give aid, that permit these funds to be used ineffectively. The question then becomes: why do these groups allow their funds to be so carelessly managed? There is expansive literature that deals with neoliberal policies (including SAPs as another commenter noted) that act as a type of neo-colonialism, intent on keeping the developing countries in their cycle of dependence on the West. NGOs, IOs and Western governments all have economic and political incentives to keep Africa under-developed.

      • Very interesting remarks Wizun. Just to be clear, when I addressed the problem of the West turning a blind eye to the blatant misuse of aid funds I definitely wanted to make the crux of this piece more than just “African leaders are corrupt”. As you’ve pointed out there are a multitude of factors behind this. To push this discussion a little further, I doubt that the goal of aid is to keep Africa under-developed and ever dependent on the West, but this is of course is very arguable. First, I find it very disturbing and nonsensical that an African country would increasingly welcome western “aid” with open arms when it knows very well that, historically, dependence on aid has never, ever guaranteed economic success. And aid is surely not their only option. Middle Eastern and Asian markets (esp. China) have shown real interest in the economic growth of Africa via lucrative partnerships vs. throwing their money away as “aid”. Aid is really not Africa’s only option, yet it continues to want MORE aid from the West. The real question becomes, why would Africa want to stay in this ever-dependant state? And why would the West be interested in a dependant, debt-laden, war-torn, politically unstable and highly unattractive to investment continent that has no prospect whatsoever of ever repaying its loans, debts or this “free” aid in other ways? I fail to see how the West would gain something from such a situation. What are the political and economic incentives you speak of?

      • Very interesting remarks Wizun. Just to be clear, when I addressed the problem of the West turning a blind eye to the blatant misuse of aid funds I definitely wanted to make the crux of this piece more than just “African leaders are corrupt”. As you’ve pointed out there are a multitude of factors behind this. To push this discussion a little further, I doubt that the goal of aid is to keep Africa under-developed and ever dependent on the West, but this is of course is very arguable. First, I find it very disturbing and nonsensical that an African country would increasingly welcome western “aid” with open arms when it knows very well that, historically, dependence on aid has never, ever guaranteed economic success. And aid is surely not their only option. Middle Eastern and Asian markets (esp. China) have shown real interest in the economic growth of Africa via lucrative partnerships vs. throwing their money away as “aid”. Aid is really not Africa’s only option, yet it continues to want MORE aid from the West. The real question becomes, why would Africa want to stay in this ever-dependant state? And why would the West be interested in a dependant, debt-laden, war-torn, politically unstable and highly unattractive to investment continent that has no prospect whatsoever of ever repaying its loans, debts or this “free” aid in other ways? I fail to see how the West would gain something from such a situation. What are the political and economic incentives you speak of?

      • Very interesting remarks Wizun. Just to be clear, when I addressed the problem of the West turning a blind eye to the blatant misuse of aid funds I definitely wanted to make the crux of this piece more than just “African leaders are corrupt”. As you’ve pointed out there are a multitude of factors behind this. To push this discussion a little further, I doubt that the goal of aid is to keep Africa under-developed and ever dependent on the West, but this is of course is very arguable. First, I find it very disturbing and nonsensical that an African country would increasingly welcome western “aid” with open arms when it knows very well that, historically, dependence on aid has never, ever guaranteed economic success. And aid is surely not their only option. Middle Eastern and Asian markets (esp. China) have shown real interest in the economic growth of Africa via lucrative partnerships vs. throwing their money away as “aid”. Aid is really not Africa’s only option, yet it continues to want MORE aid from the West. The real question becomes, why would Africa want to stay in this ever-dependant state? And why would the West be interested in a dependant, debt-laden, war-torn, politically unstable and highly unattractive to investment continent that has no prospect whatsoever of ever repaying its loans, debts or this “free” aid in other ways? I fail to see how the West would gain something from such a situation. What are the political and economic incentives you speak of?

      • Very interesting remarks Wizun. Just to be clear, when I addressed the problem of the West turning a blind eye to the blatant misuse of aid funds I definitely wanted to make the crux of this piece more than just “African leaders are corrupt”. As you’ve pointed out there are a multitude of factors behind this. To push this discussion a little further, I doubt that the goal of aid is to keep Africa under-developed and ever dependent on the West, but this is of course is very arguable. First, I find it very disturbing and nonsensical that an African country would increasingly welcome western “aid” with open arms when it knows very well that, historically, dependence on aid has never, ever guaranteed economic success. And aid is surely not their only option. Middle Eastern and Asian markets (esp. China) have shown real interest in the economic growth of Africa via lucrative partnerships vs. throwing their money away as “aid”. Aid is really not Africa’s only option, yet it continues to want MORE aid from the West. The real question becomes, why would Africa want to stay in this ever-dependant state? And why would the West be interested in a dependant, debt-laden, war-torn, politically unstable and highly unattractive to investment continent that has no prospect whatsoever of ever repaying its loans, debts or this “free” aid in other ways? I fail to see how the West would gain something from such a situation. What are the political and economic incentives you speak of?

        • I’m sorry, but “AFRICA WANTS AID” is a highly simplistic argument. Economic flows can come from three places: private/uni-lateral government investment (China, as you mentioned), international organizations such as the IMF or WB and finally, aid. I’ll address each of these:

          1. Chinese (and most Western) investment is highly contained; The Chinese bring their own employees over (because it’s not as if they’re investing in Africa or have any need for Africa’s labour pool) and re-invest zero into the community of African economies. They certainly have an interest in keeping African underdeveloped so that they can continue enjoying preferential treatment and near-to-no regulation when it comes to human rights or environmental protection. Same goes for most of the Western natural resource companies.

          2. African countries are highly skeptical of accepting aid from the WB or IMF because almost always they are contingent on the adoption of neo-liberal policies which do nothing more than hurt the average-person. Neo-liberal policies focus on controlling inflation (interests of the elite businessmen) rather than employment (interests of the average-person).

          3. Certain African countries have no option BUT to accept aid. They are reluctantly accepting it because there is no viable option. It’s either accept aid, or stop paying government employees and risk a coup or something. If the West really wanted to help Africa out, the first thing they’d do is stop subsidies to their farmers and actually give Africa a chance to start selling internationally on their own terms. But of course, this will never happen.

          The African continent is seen as a resource extraction center to be toyed with by the West, and not an economy and people to be respected.

          I should also highlight that I am generalizing extremely right now. The state of various African economies differ widely The above arguments apply more to states on the lower end of the economic dynamism/political stability scale such as Somalia, DRC, CAR etc which have more primary-resource based economies and not so much to North-African states.

        • I’m sorry, but “AFRICA WANTS AID” is a highly simplistic argument. Economic flows can come from three places: private/uni-lateral government investment (China, as you mentioned), international organizations such as the IMF or WB and finally, aid. I’ll address each of these:

          1. Chinese (and most Western) investment is highly contained; The Chinese bring their own employees over (because it’s not as if they’re investing in Africa or have any need for Africa’s labour pool) and re-invest zero into the community of African economies. They certainly have an interest in keeping African underdeveloped so that they can continue enjoying preferential treatment and near-to-no regulation when it comes to human rights or environmental protection. Same goes for most of the Western natural resource companies.

          2. African countries are highly skeptical of accepting aid from the WB or IMF because almost always they are contingent on the adoption of neo-liberal policies which do nothing more than hurt the average-person. Neo-liberal policies focus on controlling inflation (interests of the elite businessmen) rather than employment (interests of the average-person).

          3. Certain African countries have no option BUT to accept aid. They are reluctantly accepting it because there is no viable option. It’s either accept aid, or stop paying government employees and risk a coup or something. If the West really wanted to help Africa out, the first thing they’d do is stop subsidies to their farmers and actually give Africa a chance to start selling internationally on their own terms. But of course, this will never happen.

          The African continent is seen as a resource extraction center to be toyed with by the West, and not an economy and people to be respected.

          I should also highlight that I am generalizing extremely right now. The state of various African economies differ widely The above arguments apply more to states on the lower end of the economic dynamism/political stability scale such as Somalia, DRC, CAR etc which have more primary-resource based economies and not so much to North-African states.

        • I’m sorry, but “AFRICA WANTS AID” is a highly simplistic argument. Economic flows can come from three places: private/uni-lateral government investment (China, as you mentioned), international organizations such as the IMF or WB and finally, aid. I’ll address each of these:

          1. Chinese (and most Western) investment is highly contained; The Chinese bring their own employees over (because it’s not as if they’re investing in Africa or have any need for Africa’s labour pool) and re-invest zero into the community of African economies. They certainly have an interest in keeping African underdeveloped so that they can continue enjoying preferential treatment and near-to-no regulation when it comes to human rights or environmental protection. Same goes for most of the Western natural resource companies.

          2. African countries are highly skeptical of accepting aid from the WB or IMF because almost always they are contingent on the adoption of neo-liberal policies which do nothing more than hurt the average-person. Neo-liberal policies focus on controlling inflation (interests of the elite businessmen) rather than employment (interests of the average-person).

          3. Certain African countries have no option BUT to accept aid. They are reluctantly accepting it because there is no viable option. It’s either accept aid, or stop paying government employees and risk a coup or something. If the West really wanted to help Africa out, the first thing they’d do is stop subsidies to their farmers and actually give Africa a chance to start selling internationally on their own terms. But of course, this will never happen.

          The African continent is seen as a resource extraction center to be toyed with by the West, and not an economy and people to be respected.

          I should also highlight that I am generalizing extremely right now. The state of various African economies differ widely The above arguments apply more to states on the lower end of the economic dynamism/political stability scale such as Somalia, DRC, CAR etc which have more primary-resource based economies and not so much to North-African states.

        • I’m sorry, but “AFRICA WANTS AID” is a highly simplistic argument. Economic flows can come from three places: private/uni-lateral government investment (China, as you mentioned), international organizations such as the IMF or WB and finally, aid. I’ll address each of these:

          1. Chinese (and most Western) investment is highly contained; The Chinese bring their own employees over (because it’s not as if they’re investing in Africa or have any need for Africa’s labour pool) and re-invest zero into the community of African economies. They certainly have an interest in keeping African underdeveloped so that they can continue enjoying preferential treatment and near-to-no regulation when it comes to human rights or environmental protection. Same goes for most of the Western natural resource companies.

          2. African countries are highly skeptical of accepting aid from the WB or IMF because almost always they are contingent on the adoption of neo-liberal policies which do nothing more than hurt the average-person. Neo-liberal policies focus on controlling inflation (interests of the elite businessmen) rather than employment (interests of the average-person).

          3. Certain African countries have no option BUT to accept aid. They are reluctantly accepting it because there is no viable option. It’s either accept aid, or stop paying government employees and risk a coup or something. If the West really wanted to help Africa out, the first thing they’d do is stop subsidies to their farmers and actually give Africa a chance to start selling internationally on their own terms. But of course, this will never happen.

          The African continent is seen as a resource extraction center to be toyed with by the West, and not an economy and people to be respected.

          I should also highlight that I am generalizing extremely right now. The state of various African economies differ widely The above arguments apply more to states on the lower end of the economic dynamism/political stability scale such as Somalia, DRC, CAR etc which have more primary-resource based economies and not so much to North-African states.

        • I’m sorry, but “AFRICA WANTS AID” is a highly simplistic argument. Economic flows can come from three places: private/uni-lateral government investment (China, as you mentioned), international organizations such as the IMF or WB and finally, aid. I’ll address each of these:

          1. Chinese (and most Western) investment is highly contained; The Chinese bring their own employees over (because it’s not as if they’re investing in Africa or have any need for Africa’s labour pool) and re-invest zero into the community of African economies. They certainly have an interest in keeping African underdeveloped so that they can continue enjoying preferential treatment and near-to-no regulation when it comes to human rights or environmental protection. Same goes for most of the Western natural resource companies.

          2. African countries are highly skeptical of accepting aid from the WB or IMF because almost always they are contingent on the adoption of neo-liberal policies which do nothing more than hurt the average-person. Neo-liberal policies focus on controlling inflation (interests of the elite businessmen) rather than employment (interests of the average-person).

          3. Certain African countries have no option BUT to accept aid. They are reluctantly accepting it because there is no viable option. It’s either accept aid, or stop paying government employees and risk a coup or something. If the West really wanted to help Africa out, the first thing they’d do is stop subsidies to their farmers and actually give Africa a chance to start selling internationally on their own terms. But of course, this will never happen.

          The African continent is seen as a resource extraction center to be toyed with by the West, and not an economy and people to be respected.

          I should also highlight that I am generalizing extremely right now. The state of various African economies differ widely The above arguments apply more to states on the lower end of the economic dynamism/political stability scale such as Somalia, DRC, CAR etc which have more primary-resource based economies and not so much to North-African states.

          • “Africa wants aid” was not my argument. It was more of a question I was asking (“why would Africa want to keep accepting aid when it has other options”) and the resulting hypothetical “arguments” (they’re not) were designed to keep this very interesting conversation going. Your generalizations are interesting, thanks for your input! I can definitely pinpoint some truths in your remarks but as always, Africa being a highly diverse continent, the incentives differ on a case-to-case basis. I’m very happy this article instigated this spirited conversation. We definitely need more commentators like you to challenge and push conversations deeper. Thanks again and I’m sorry you find my “arguments” simplistic.

  5. We mustn’t forget that the World Bank itself is corrupt in its ties to structural adjustment. Seems obvious, but it’s worth pointing out.

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