Foreign aid skepticism is skepticism concerning the impact of foreign aid programs.
Foreign aid skeptics such as Dambisa Moyo, William Easterly and Angus Deaton criticize foreign aid programs on various grounds. Three of the most commonly raised objections are that aid programs have been (1) extremely costly, (2) largely ineffective, and (3) often net harmful. The rest of this entry summarizes some responses to these criticisms.
Costly programs can still be cost-effective. Aid skeptics often object to the high costs of aid programs. For example, Moyo writes: "So there we have it: sixty years, over US$1 trillion dollars of African aid, and not much good to show for it." Similarly, Easterly writes: "the other tragedy of the world’s poor… is the tragedy in which the West spent $2.3 trillion on foreign aid over the last five decades and still had not managed to get twelve-cent medicines to children to prevent half of all malaria deaths. The West spent $2.3 trillion and still had not managed to get four-dollar bed nets to poor families. The West spent $2.3 trillion and still had not managed to get three dollars to each new mother to prevent five million child deaths."
To assess the cost-effectiveness of aid, however, one needs to consider not just the costs of aid programs, but also their benefits, represented by the number of people affected (over 400 million) and the period during which they were affected (sixty years). When these adjustments are made, it turns out that total aid spending in Africa has amounted to only $40 per person per year. A separate estimate concludes that the flow of external development assistance accounts for about 1% of developing world income.
Some types of aid are much more effective than others. Critics of aid have largely focused on economic development, rather than global health. But these two forms of aid differ greatly. The Smallpox Eradication Programme , funded in part by international aid, has saved over 60 million lives since 1980. UNICEF's Campaign for Child Survival is estimated to have saved around 12 million lives by the end of the 1980s. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has plausibly saved tens of millions of life-years. Other examples of successful aid programs include the Global Alliance for Vaccines and Immunization, the Polio Eradication Initiative, and the Onchocerciasis Control Program.
Even aid skeptics generally acknowledge these successes. Thus, Deaton writes:
[e]xternal aid has saved millions of lives in poor countries. UNICEF and other agencies brought antibiotics and vaccinations to millions of children, reducing infant and child mortality. The control and elimination of disease-bearing pests have made safe once-dangerous regions of the world. An international effort eliminated smallpox, and a current effort is close to doing the same for polio. Aid agencies have made oral rehydration therapy available to millions of children and are providing insecticide-treated bed nets to protect against malaria, a disease that still kills a million African children every year. Between 1974 and 2002, a joint effort by the World Bank, the World Health Organization, UNDP, and the UN Food and Agriculture Organization all but eliminated river blindness as a public health.
Similarly, Easterly writes:
There are well known and striking donor success stories, like the elimination of smallpox, the near-eradication of river blindness and Guinea worm, the spread of oral rehydration therapy for treating infant diarrheal diseases, DDT campaigns against malarial mosquitoes (although later halted for environmental reasons), and the success of WHO vaccination programmes against measles and other childhood diseases.
The forms of aid skeptics focus on are not as ineffective as these skeptics contend. Even if attention is confined to economic development (which, as noted, is a comparatively ineffective form of aid), the existing evidence fails to support the pessimistic assessment of the aid skeptics. As a leading expert on poverty notes, "an objective review of the evidence does not suggest that aid typically fails. Indeed, in contrast to the claims in [Angus Deaton's] The Great Escape, the best recent evidence suggests that aid has helped promote economic growth on average over the longer term."
Arguments about the effectiveness of foreign aid have little relevance for individual donors. Aid skeptics typically focus on bilateral or multilateral aid, rather than on the simple, targeted programs that GiveWell and other charity evaluators consider most effective. Moyo herself stresses that her book "is not concerned with emergency and charity-based aid", and objects to those who "conflate my arguments about structural aid with those about emergency or NGO aid." Similar remarks apply to Easterly, as Amartya Sen notes in a review of his book: the arguments of the aid skeptics should not "be read as a general skepticism toward the idea that one person can consciously and deliberately do good to another. This is not Easterly's position at all."
Thus, even if the criticisms are valid and generalizable to all forms of aid, they have very limited bearing on what altruistic individuals should do. As William MacAskill notes: "even if it turned out that every single development program that we know of does more harm than good, that fact would not mean that we can buy a larger house, safe in the knowledge that we have no pressing moral obligations of beneficence upon us. There are thousands of pressing problems that call out for our attention and that we could make significant inroads on with our resources." MacAskill goes on to note a number of ways in which individuals can use their resources to help others effectively: