by Alex Perry
But these quiet confessions were the exceptions. In September 2009, the World Bank’s Zoellick was still talking up the impending disaster. “The poor and most vulnerable are at greatest risk from economic shocks,” he said. “Families are pushed into poverty, health conditions deteriorate, school attendance declines, and progress in other critical areas is stalled or reversed.”10 Aid organizations also maintained the chorus of concern. Ritu Sharma, president of Women Thrive Worldwide, a US-based NGO that campaigns to lift women out of poverty, said: “Many people in developing countries . . . are eating less than they were before.”11 Donations had to rise, said Oxfam America president Ray Offenheiser, and “it is crucial that this is additive and not deducted from current aid budgets.”12
I found it hard not to conclude that the aid world, or part of it, sees crisis as opportunity. That, after all, is the dynamic of aid. A crisis occurs. Aid agencies ask for money to fix it. And this is how it should be, with two provisos, the first of which is if the crisis is real. And second, if the aid agencies actually fix it.
Most aid workers are conscientious, well-motivated people prepared to endure some rough living. As individuals, their sincerity is rarely in question and the horrors they can witness beyond doubt. They have achieved some unquestioned triumphs, particularly fighting disease. The eradication of smallpox. The near eradication of polio. Successful battles against epidemics of syphilis, measles, tetanus, flu, and iodine deficiency. The mass treatment in the 1950s of the tropical skin and bone infection yaws—barely remembered today but at the time an affliction for fifty million to a hundred million people around the world. They’ve had success outside medicine too. The feeding of tens of millions. The education of tens of millions more. The financing of vital infrastructure such as roads, waterways, and airports. The preservation of some of the world’s oldest artifacts and monuments.
Anyone contemplating a global war on malaria would want to replicate those successes. But aid’s critics are voicing increasing doubts about whether aid agencies tell the truth not just about the need but also about how helpful they actually are. For all aid workers’ good intentions and past achievements, aid can be terrible value for money. In 2002, basing his calculations on the World Bank’s own figures, New York University professor of economics William Easterly discovered it took $3,521 in aid to raise a single poor person’s income by $3.65 a year.13 Many others have noted that countries that receive aid often don’t develop. Despite hundreds of billions of dollars in donations, the number of Africans living on less than $1 a day doubled between 1981 and 2001, from 164 million to 316 million.14 Aid agencies counter that because you find aid in poor places doesn’t mean that aid causes poverty—rather it shows aid is going to the right places. That has some merit. But with each passing year, if places receiving aid continue to have little to show for it, it has less and less.
Ineffectiveness bankrupts the case for aid. Aid is, in effect, a censure of a foreign government. It says you are doing an unacceptably poor job. We, the world, can and must do better. But if aid can’t or doesn’t do better, then the argument falls apart. Ineffective aid is unjustifiable aid. And aid’s frequent failures bolster the view, common among African governments, that it is little more than Western arrogance in a white SUV.
And if the problem is ineffectiveness, the cause, very often, is aid’s ambiguous position: a profession that is increasingly a business but that operates outside normal commercial strictures. Aid started simply, as compassion. But it has grown into a giant industry of tens of thousands of nongovernmental organizations together worth an annual $120 billion15—about the same as the annual output of the twenty poorest of the forty-eight countries in sub-Saharan Africa. Aid workers today plot well-rewarded careers from African village projects through to aid agency regional headquarters and on to the UN in New York or Switzerland. Aid agencies operate increasingly like competing businesses: advertising, submitting bids for aid contracts, exploring opportunities for expansion. The UN even has its own airline, running to two hundred to two hundred fifty aircraft for its peacekeeping operations alone.
But aid’s transformation from benevolence to business has been incomplete, and that creates problems. In some ways, these are unavoidable because of aid’s peculiar nature. One immutable difference between aid and business, for instance, is that aid is paid for by people who do not receive it. That is generous, no doubt. But at a stroke it also erases consumer rights: aid’s recipients have little say in what they receive and no interest in what it costs.
The distance between product and consumer is reflected in other awkward ways. When businesses export, they do so through satellite operations in importing countries whose primary job is to integrate the product into the local market—to shed its foreignness—as much as possible. Aid is exclusively an export business. But its satellite operations are almost always run by expatriates on short-run contracts whose level of integration is more akin to the foreign diplomats they so closely resemble.
Distance also means that while aid agencies are theoretically subject to the same public scrutiny and advertising regulations that govern business, they rarely are in practice. The separation—by thousands of miles and poor communication—of a project from its funders or an advertising campaign from the place it depicts means it is hard to call out an aid agency—or even the entire aid industry—when it misleads you by, say, talking up a nonexistent emergency.
Some of the differences between aid and business are less nature than nurture, however. A good business should never die. But a good aid agency always should, since the ultimate goal of any aid project should be the day it is no longer needed. In practice, that turns out to be a principle nearly all aid agencies are happy to ignore.
Similarly, many aid groups reject as inappropriate, even offensive, standard business tools for measuring performance such as return on investment, deadlines, and cost-benefit analysis. Aid workers’ pursuit of social improvement and disdain for personal profit can make that seem like an admirable personal choice, and often it is. Their use of rules and guidelines as substitutes also has its merits: aid needs regulation as much as business does. But removing the discipline of the market can have damaging effects. As Chambers understood, the inequalities created by the pursuit of profit are not, as many aid workers believe, an argument for discarding business methods—rather they are an argument for applying those methods to aid to achieve similar success. Not using performance assessments allows aid agencies to sidestep many of the normal checks on business behavior and leaves adherence to regulations an agency’s only measure of its success. And staying within the law tells you nothing about real achievement, only that minimum standards have been met. Moreover, strict regulation can usher in an inflexibility that makes it hard to adjust to conditions on the ground.
These structural conundrums, these missing incentives, can sound academic, even obscure. My work as a correspondent in Africa revealed them as anything but. On reporting trips across the continent, I found a highly bureaucratic trade had evolved, managed by a confusing army of actors who might be international or national, independent or state, giant or tiny—a situation that inevitably led to waste. And because it was rarely measured, performance was often poor. I saw the wrong aid arrive in the wrong place, or late, or costing too much. Again and again I saw money spent on fleets of cars and ranks of furnished offices and villas rather than actual assistance—until the mere sight of a white Toyota Land Cruiser was enough to spark an instant surge of anger. Little of any of this was assessed. The results of some projects were never measured, and few were compared for their relative returns.
A business that consistently delivers subpar results, or misses deadlines, or cannot account for money spent will eventually go bust or at least stop winning tenders. Not so in aid, where good projects were trumpeted but bad ones, I learned, merely downplayed. Individuals were rarely judged by performance. Failure was sad, but it didn’t cost anyone their job. Aid was often ineffectiv
e simply because efficiency was not the priority.
Worryingly for those proposing a global malaria campaign, these problems were bigger inside the larger agencies. Businesses, driven by the need to carve out a niche in the market, focus on different sectors. Likewise, there were hundreds of smaller aid agencies in Africa and Asia concentrating on one area or a particular type of relief—specialized groups that were often the most effective. But the more established agencies found that since no one measured their performance or judged where their skills lay, they didn’t have to specialize. Far from folding once an aid project was completed, they did the opposite: expand in every possible direction. The core proposition of today’s aid Goliaths—the various UN humanitarian agencies, as well as Oxfam, Care, Goal, World Vision, and so on—is an indiscriminate offer of help: in one country they might be digging wells, in another running a school, in a third distributing medicine, in a fourth advising on microfinance. They bid for a project not so much because they are expert in it—they might be, they might not—but because that is where the money is. What specialization occurs is so minor as to be all but meaningless. UNICEF and Save the Children confine themselves to the world’s youth. The WHO restricts itself to global health.
For anyone contemplating a global war on malaria, the big agencies would be essential. But from observing them across Africa, I had gathered plenty of real-life warnings about the pitfalls of big aid. Southern Sudan was one example of how inefficiency explained why some countries that attracted the most aid also continued to be the poorest. In 2005, the international community set up a $526 million Southern Sudan Multi-Donor Trust Fund administered by the World Bank to pay for roads, running water, agriculture, health, and education for eight million to nine million southern Sudanese. The south was due to secede from the north in a referendum in 2011, and, with almost none of the institutions, infrastructure, or economy that would normally define an independent country, there was an urgent need to build at least the skeleton of a nation. I visited in February 2010 with the vote on independence less than a year away. A high-level World Bank delegation was also there to investigate why there had been so little development in the past five years and in particular why its staff had dispersed only $217 million of the Fund. One key reason: the southern Sudanese initially had no bank account into which the Bank could pay the money, and it had taken an entire year before a World Bank representative flew to Nairobi with a counterpart from the southern Sudan authorities to show him how to open one.
Ethiopia illustrated another type of big aid ineffectiveness: how helping a country can cripple its ability to help itself and even institutionalize crisis. In 2008, I spent weeks reporting a giant famine in East Africa, watching food aid being handed out at feeding centers from Tanzania through Kenya and Somalia to Ethiopia, an emergency that took in close to twenty million people. Bizarrely, at the center of the disaster, southern Ethiopia, the hills were green, the livestock healthy, and the fields freshly plowed. This was hunger caused not by a natural disaster but by humans. While decades of Western food aid had stopped people from going hungry in the short term, in the long term it ensured they did: free food undercut and ruined African farmers, who were not working on a charitable basis but a commercial one.16
Humanitarian aid operations in response to natural disasters—like the 2004–2005 Asian tsunami, the earthquakes in Kashmir in 2005 and Haiti in 2010, or the 2010 floods in Pakistan—illustrate a similar phenomenon. Disasters require a humanitarian response, no doubt. But the provision of food, blankets, and shelter can only ever mitigate a crisis in the short term, not solve it in the long term. That requires a country—or more specifically its government—to raise its ability to look after its own. But governments that never learn those skills because they are sidelined by foreign aid agencies risk being forever dependent on handouts. After the tsunami and the Kashmir earthquake, foreign humanitarians managed to put millions of people into tents, but no one—not they, not the government—had a plan to get them out again. Likewise in Haiti, 1.5 million were still living under canvas ten months after the earthquake there when the first outbreak of cholera hit.
Tending to human suffering in response to human-made disasters—war, ethnic cleansing, a coup, a dictatorship—but ignoring their political causes can also mean the problem is never solved because it is never addressed. Humanitarian operations can even make the situation worse. In Darfur, the militants who prompted the exodus of two million refugees hid out, regrouped, and recruited in foreign-funded feeding camps before heading back out to continue fighting. They knew aid workers, sworn to the humanitarian’s code of neutrality, wouldn’t refuse them. Likewise in eastern DRC, after the 1994 genocide in neighboring Rwanda, humanitarian aid workers fed and clothed the Hutu militants who had killed eight hundred thousand Rwandans before fleeing over the border. Philip Gourevitch, chronicler of the genocide, describes that as not so much fixing the crisis as “catering it.”
To anyone who has ever visited a refugee camp, the confused incentives of modern aid are manifested memorably in another practice the agencies have borrowed from business without the attendant accountability: branding. Humanitarian aid groups have taken to hoisting giant flags over displacement centers, clothing refugees in T-shirts emblazoned with logos, and flying more flags from their Land Cruisers. Once this was about indicating neutrality. Today it is just as symptomatic of an industry that does not have to deliver results. What, in the end, is the incentive to fix a crisis when managing it is the business? Far more important to underline your ownership rights to the situation by branding it.
A global malaria campaign would have to overcome these flaws if it was to work. Of even bigger concern was the failing that had sullied aid’s name more than anything else: corruption.
As well as being misused or poorly spent, aid money goes missing. Montek Ahluwalia of India’s Planning Commission reckons corruption is so bad in India that only 16 percent of the money intended for the poor under the country’s food distribution scheme actually reaches them.17 Drugs were a commodity especially prone to theft. In Uganda in 1999, 73 percent of all drugs in the public health system were stolen by health administrators and sold privately.18 And as every aid worker knows, public outrage at corruption is capable of halting entire aid efforts in their tracks. A year after the Asian tsunami of 2004, the Aceh Anti-Corruption Movement calculated 30–40 percent of all the $4.5 billion in aid received by Indonesia was tainted by corruption. Oxfam and Save the Children both suspended operations in the country when the movement revealed the two agencies had employed builders who erected substandard houses or simply disappeared.19
Aid workers’ behavior can encourage such corruption. The new four-wheel drive cars, housing allowances, tax-free salaries, and workshops in faraway five-star resorts that are the staple of a career in foreign aid may not cost more than what is spent on actual assistance. But flashy cars, big houses, and all-expenses-paid foreign trips are the most visible part of aid—and unsurprisingly this fosters the widespread belief in the developing world that aid is corrupt.
And in a sense, it is. Aid workers raise money by highlighting the conditions of the world’s poorest. Then they use millions from that pot to fund their own first-world lifestyles. If you combine a UN salary—in January 2011, wages ranged from $48,627 to $143,929 for a staffer and from $139,074 to $204,391 for a manager—with cost of living and hardship adjustments, a $75,000 car, several thousand dollars a month in rent or hotels, tens of thousands of dollars once a year in business-class flights home for all the family, children’s school fees, and tens of thousands more dollars on expenses (satellite phones, health insurance, flying to meetings in Geneva or New York, or conferences across the region), a mid-ranking UN worker can easily burn through half a million dollars a year.20 Those tempted to defend that in the name of being able to recruit the best should remember that President Barack Obama earns something similar—a salary of $400,000 a year plus $169,000 for travel and other expenses—whi
le at $226,575, British prime minister David Cameron is paid far less. To see the consequences of paying such high wages on painful display, a trip to Goma, eastern DRC, a long-established aid agency base, is instructive. There, wood-shack stores stock Congolese staples—rice, salt, sugar, manioc—and three types of extra virgin olive oil. Refugees get by on staples in the camps while, come evening, expat aid workers choose between low-lit restaurants serving pizza, Mexican, and French along Goma’s main drag. Almost all the graceful villas along the shore of Lake Kivu are rented, for thousands of dollars a month, by aid groups. One Sunday in late 2008, I returned to Goma after a week watching the Congolese army rape and murder its way through the hills to the north to witness a group of aid workers water-skiing on the lake behind a scarlet speedboat playing loud rock music, carving out turns in front of the refugees they’d come to help.
The unease surrounding aid is reaching a crescendo. The United Nations is beginning to censure its own. In September 2010, Radhika Coomaraswamy, UN special representative on children and armed conflict, published a report that examined the construction at the heart of much of modern emergency aid: the refugee camp. Contrary to the widely held belief that underpins the construction of hundreds of tented cities from Colombia to Cambodia, she says that “there was no child more vulnerable in the world” than one in a refugee camp. Children in aid camps face discrimination, are denied documentation or basic rights, and are “at higher risk for becoming victims of grave violations, recruited to be child soldiers [and] at high risk of sexual violence and harassment.”21
