Quotes from The White Man's Burden, by William Easterly


- ‘United Kingdom Chancellor of the Exchequer Gordon Brown is eloquent about one of the two tragedies of the world’s poor. In January 2005, he gave a compassionate speech about the tragedy of extreme poverty afflicting billions of people, with millions of children dying from easily preventable diseases. He called for a doubling of foreign aid, a Marshall Plan for the world’s poor, and an International Financing Facility (IFF) against which tens of billions more dollars toward future aid could be borrowed to rescue the poor today. He offered hope by pointing out how easy it is to do good. Medicine that would prevent half of all malaria deaths costs only twelve cents a dose. A bed net to prevent a child from getting malaria costs only four dollars. Preventing five million child deaths over the next ten years would cost just three dollars for each new mother. An aid program to give cash to families who put their children in school, getting children like Amartech into elementary school, would cost little. Gordon Brown was silent about the other tragedy of the world’s poor. This 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.’ (3-4)
- ‘All the hoopla about having the right plan is itself a symptom of the misdirected approach to foreign aid taken by so many in the past and so many still today. The right plan is to have no plan.’ (5)
- ‘This is not to say that everything should be turned over to the free market that produced and distributed Harry Potter. The poorest people in the world have no money to motivate market Searchers to meet their desperate needs. However, the mentality of Searchers in markets is a guide to a constructive approach to foreign aid.’ (5)
- ‘The Planners have the rhetorical advantage of promising great things: the end of poverty. The only thing the Planners have against them is that they gave up the second tragedy of the world’s poor. Poor people die not only because of the world’s indifference to their poverty, but also because of ineffective efforts by those who do care. To escape the cycle of tragedy, we have to be tough on the ideas of planners, even while we salute their goodwill.’ (7)
- ‘Political leaders from around the world specifically agreed then on the Millennium Development Goals (MDGs). The right MDGs for 2015 are (1) eradiate extreme poverty and hunger, (2) achieve universal primary-school enrollment, (3) promote gender equality and empower women, (4) reduce child mortality, (5) improve maternal health, (6) combat HIV/AIDS, malaria, and other diseases, (7) ensure environmental sustainability, and (8) develop a global partnership for development. These are beautiful goals.’ (9)
- ‘Helping the poor today requires learning from past efforts. Unfortunately, the West already has a bad track record of previous beautiful goals. A UN summit in 1990, for example, set as a goal for the year 2000 universal primary-school enrollment. (That is now planned for 2015.)  A previous summit, in 1977, set 1990 as the deadline for realizing the goal of universal access to water and sanitation. (Under the Millennium Development Goals, that target is now 2015.) Nobody was held accountable for these missed goals.’ (9-10)
- ‘The new military interventions are similar to the military interventions of the cold war, while the neo-imperialist fantasies are similar to old-time colonial fantasies.’ (10)
- ‘The evidence points to an unpopular conclusion: Big Plans will always fail to reach the beautiful goal. I am among the many who have tried hard to find the answer to the question of what the end of poverty requires of foreign aid. I realized only belatedly that I was asking the question backward; I was captive to a planning mentality. Searchers question the right way around: What can foreign aid do for poor people?’ (11)
- ‘We will see in this book that aid agencies cannot end world poverty, but they can do many useful things to meet the desperate needs of the poor and give them new opportunities For example, instead of trying to ‘develop’ Ethiopia, aid agencies could devise a program to give cash subsidies to parents to keep their children in school.’ (11)
- ‘A follow-up survey found nearly universal use of the nets by those who paid for them. By contrast, a study of a program to hand out free nets in Zambia to people, whether they wanted them or not (the favored approach of Planners), found that 70 percent of the recipients didn’t use the nets. The ‘ Malawi model’ is now spreading to other African countries. The Washingtonheadquarters of PSI, much less the Davos World Economic Forum, did not dictate this particular solution. The local PSI, much less the Davos World Economic Forum, did not dictate this particular solution. The local PSI office in Malawi (which is staffed mostly by Malawians who have been with the program for years) was looking for a way to make progress on malaria. They decided that bed nets would do the job, then hit upon the antenatal clinic and the two-channel sales idea. This scheme is not a magical panacea to make aid work under all circumstances; it is just one creative response to a particular problem.’ (14)
- ‘Social engineering experiments have been applied since then in such diverse contexts as compulsory resettlement on Tanzanians into state villages and Communist five-year plans to industrialize in the Soviet Union and Eastern Europe. Ironically, social engineering surfaced again as ‘shock therapy’ in the transition from communism (after the five-year plans had failed) to capitalism, which eschewed the alternative of ‘gradualism.’ Social engineering showed up in Africa and Latin America in the eighties and nineties as IMF/World Bank-sponsored comprehensive reforms called ‘structural adjustment.’ Military intervention to overthrow evil dictators and remake other societies into some reflection of Western democratic capitalism is the extreme of contemporary utopian social engineering. The plan to end world poverty shows all the pretensions of utopian social engineering.’ (14-15)
- ‘Burke and Popper recognized the economic and political complexity of society. That complexity dooms any attempt to achieve the end of poverty through a plan, and no rich society has ended poverty in this way. It is only when rich-country politicians gaze at the non-voters in the rest of the world that they become Planners. This is another clue to the likelihood of planning: outsiders are more likely to be Planners, while insiders are forced by their fellow insiders to be Searchers.’ (15)
- ‘The critique of the Big Plan mainstream comes from dissidents on both the Left and the Right. The right-wing dissident says that hope for the poor will come mainly from homegrown markets and democracy. The left-wing dissident doesn’t like the Western imperialists trying to remake the poor in the West’s image. Both right-wing and left-wing dissidents are on the right track. The Searchers in the middle agree that neither the Big Plans of the Left nor those of the Right (neither foreign aid nor foreign military intervention) can end poverty in the Rest – let’s just find some specific things that help poor people.’ (18)
- ‘The fondness for the Big Goal and the Big Plan is strikingly widespread. It’s part of the second tragedy that so much goodwill and hard work by rich people who care about the poor goes through channels that are ineffective.’ (18)
- ‘The setting of utopian goals means aid workers will focus efforts on infeasible tasks, instead of the feasible tasks that will do some good.’ (20)
- ‘A shift in language (and also in thought) occurred after World War II. Verbiage about racial superiority, the tutelage of backward peoples, and people not ready to rule themselves went into the wastebasket. Self-rule and decolonization became universal principles. The West exchanged the old racist coinage for a new currency. ‘Uncivilized’ became ‘underdeveloped.’ ‘Savage peoples’ became the ‘third world.’ There was a genuine change of heart away from racism and toward respect for equality, but a paternalistic and coercive strain survived.’ (24)
- ‘Cameroonian lawyer and journalist Jean-Claude Shanda Tonme protested in a July 2005 New York Times Op-ed column about the Live 8 concert organizers that ‘they still believe us to be like children that they must save’ with ‘their willingness to propose solutions on our behalf.’ ’ (26)
- ‘The Gang of Four – Hong Kong, Korea, Singapore, and Taiwan – went from third world to first over the last four decades. China, India, and the Gang of Four did this through the efforts of many decentralized agents participating in markets (the ideal vehicle for feedback and accountability) without significant Western assistance as a share of their income, with some efforts by their own governments (as their own top), and without the West telling them what to do.’ (27)
- ‘Acknowledging that development happens mainly through homegrown efforts would liberate the agencies of the West from utopian goals, freeing up development workers to concentrate on more modest, doable steps to make poor people’s lives better. Idealists, activists, development workers of the world, you have nothing to lose but your utopian chains. Let’s give more power and funds to the many Searchers who are already working in development. You don’t have to immediately eliminate [sic] world poverty, bring world peace, or save the environment.’ (29)
- ‘This book will offer plenty more suggestions for experimental improvements to Western assistance, but don’t expect a Big Plan to reform foreign aid. The only Big Plan is to discontinue the Big Plans. The only Big Answer is that there is no Big Answer.’ (30)
- ‘Few of the small interventions that I will describe have been rigorously evaluated, which the book will argue is necessary to make progress. But few things have been rigorously evaluated in foreign aid, period. We have to start somewhere to get ideas on things that could work.’ (33)
- ‘The full version goes like this: The poorest countries are in a poverty trap (they are poor only because they started poor) from which they cannot emerge without an aid-financed Big Push, involving investments and actions to address all constraints to development, after which they will have a takeoff into self-sustained growth, and aid will no longer be needed. This was exactly the legend that gave birth to foreign aid in the 1950s; it is exactly the legend that the advocates of a massive aid increase are telling today.’ (38)
- ‘When we do a test for the stagnation of income over the subsequent half century for the poorest fifth of countries in 1950, we decisively reject the hypothesis of stagnation.’ (39)
- ‘When I break the sample in half into those poor countries that had above-average foreign aid and those that had below-average foreign aid, I find identical results for 1950-2001 in both halves as with the above tests of stable income. Over 1950-2001, countries with below-average aid had the same growth as countries with above-average foreign aid. Poor countries without aid had no trouble having positive growth.’ (39)
- ‘Among the poorest countries, there were individual poor countries that failed to grow. Chad had zero growth from 1950 to 2001. Zaire /Democratic Republic of Congo (DRC) actually had negative per capita growth over this period. Aid still has a role to play to help those unlucky enough to be born into a stagnant economy – even if it doesn’t help the overall economy escape stagnation. The stagnant economies were offset by such success stories as Botswana , which was the fourth poorest in 1950, but which increased its income by a factor of thirteen by 2001.Lesotho was the fifth poorest in 1950, but increased its income by a favor of five over the half century. Two other subsequent success stories who were among the poorest in 1950 are China andIndia .’ (40)
- ‘The evidence that Jeffrey Sachs adduces for the poverty trap in his book The End of Poverty is from this later period. So, from 1985 to the present, it is true that the poorest fifth of countries have had significantly lower per capita growth that other countries, about 1.1 percentage points lower.’ (40-41)
- ‘Aary Kraay and Claudio Raddatz, in a January 2005 paper, studied the savings rate in all countries with data and found that that saving does not behave the way the poverty trap requires at low income. The reason countries stay poor must lie elsewhere. It is still possible that some countries are in a poverty trap; it is just that the average poor country is not.’ (41)
- ‘With so many possible kinds of traps, it is not possible to definitively prove [sic] or refute the existence of traps in general. I can only test the specific form of the poverty trap discussed in the aid debates on the poorest countries, which predicts that being poor means a country will not grown without external assistance. This the data can reject.’ (41)
- ‘While poor countries did worse, it’s also true that the twenty-four countries with bad governments in 1984 had significantly lower growth from 1985 to the present: 1.3 percentage points slower than the rest.’ (42)
- ‘When we control both for initial poverty and for bad government, it is bad government that explains the slower growth. We cannot statistically discern any effect of initial poverty on subsequent growth once we control for bad government. This is still true if we limit the definition of bad government to corruption alone. The recent stagnation of the poorest countries appears to have more to do with awful government than with a poverty trap, contrary to the UN/Sachs hypothesis.’ (43)
- ‘There is another piece of evidence that we have to consider that looks like it does support the poverty trap story. Over the last two centuries, there has been a widening gap between rich and poor nations.’ (43)
- ‘Maddison gives an estimate for per capita income in the continent as a whole in 1820 – per capita growth in Africa from 1820 to 2001 is 0.7 percent per annum, a 3.5-fold increase, not a poverty trap.’ (43)
- ‘The latter results would suggest that poor countries grow faster than rich countries if they have a good government (using democracy as a proxy for good government) – contrary to the Millennium Project idea that ‘many reasonably well governed countries are too poor to make the investments to climb the first steps of the ladder.’ ’ (44)
- ‘The literature got new life in 1996 with a paper by London School of Economics economist Peter Boone, who found that aid financed consumption rather than investment. (Financing consumption of a few poor people is not so bad, but the Big Push hoped for the society-wide transformation that would come from aid financing investment and growth.)’ (45)
- ‘Even controlling for possible reverse causality, Boone found aid to have zero effect on investment. Similarly, controlling for reverse causality, he found aid to have zero effect on growth.’ (45)
- ‘In many of [Burnside and Dollar’s] tests, they found that when a country both got more foreign aid and had good policy, growth went up. They summarized: ‘We find that aid has a positive impact on growth in developing countries with good fiscal, monetary, and trade policies but has little effect in the presence of poor policies.’ (47)
- ‘A study I did with Ross Levine (Brown University), and David Roodman (Center for Global Development) used the exact same techniques and specifications as Burnside and Dollar, but added new data…We found no evidence that aid raised growth among countries with good policies, indicating no support for the conclusion that ‘aid works in a good policy environment.’ Our study was published as a comment on Burnside and Dollar in the American Economic Review. The original researchers and other researchers may have tried many different statistical exercises, but the aid policy community is tempted to select the study that confirms its prior beliefs (known as ‘confirmation bias’) – even though other statistical exercises may have found no evidence for it.’ (48)
- ‘They have also considered some alternative explanations as to why foreign aid does not raise growth. One well-justified complaint about aid is that it is often tied to the purchase of goods and consultants from the donor country, which may prevent the aid from bringing much growth to the recipient country. Another possibility is that the donor country gives the aid for political reasons, which again may limit the aid’s effectiveness. There is one simple test of these explanations – only aid from national aid agencies (bilateral aid) is tied, while aid from the World Bank and regional development banks (multilateral aid) is not. Similarly, bilateral aid is far more politicized than multilateral aid.’ (49)
- ‘In the CRB [Clemens, Radelet, Bhavnani] study, their category of aid had a zero effect on growth when it reached 8 percent of the recipient’s GDP, and after that the additional aid had anegative effect on growth. This feature of their results directly contradicts the Big Push reasoning, which is that small sums don’t help because you need a sufficiently large mobilization of aid to fix all the problems simultaneously (that’s why it had to be a Big Push).’ (50)
- ‘There is good data on public investment for twenty-two African countries over the 1970-1994 period. These countries’ governments spent $342 billion on public investment. The donors gave these same countries’ governments $187 billion in aid over that period. Unfortunately, the corresponding ‘step’ increase in productivity, measured as production per person, was zero. Perhaps part of the reason for this was such disasters as the five billion dollars spent on the publicly owned Ajaokuta steel mill in Nigeria , begun in 1979, which has yet to produce a bar of steel.’ (50-51)
- ‘If we define ‘takeoff’ as a one-time shift from zero growth to sustained positive growth, there are surprisingly few countries whose development experiences fit this description. Most countries that escaped from extreme poverty did so with gradually accelerating growth, sometimes punctuated by crises of zero or negative growth, sometimes punctuated by crises of zero or negative growth. Japan is the only rich country that became rich by means of a takeoff. In more recent data, there are only eight countries (all in South and East Asia) that had a takeoff in the period 1950-1975: China Hong KongIndia Indonesia Singapore South Korea Taiwan , and Thailand .’ (51)
- ‘In a thorough review of both firm-level and macroeconomic data, Beck, Demirguc-Kunt, and Levine found no evidence that SME [small and medium enterprise] promotion created economic growth or poverty reduction.’ (55)
- ‘Feroza Yasmin Shahida is a nineteen-year-old Bangladeshi girl from a poor peasant family. She got a scholarship from a program run by USAID and the World Bank to finish secondary school. Now she is a bicycle paramedic responsible for 515 families in the countryside around SavarBangladesh . She is the only health worker these 515 families have. She earned twenty-five dollars a month working for…the ‘People’s Health Center .’ [The People’s Health Center ] is the brainchild of Dr. Zafrullah Chowdhury…a Bangladeshi doctor who returned from Britain afterBangladesh won its independence in 1971. Dr. Zaf trained teenage girls to treat common ailments, deliver prenatal and postnatal care to pregnant women, and refer any emergencies to the hospital that he built. Foreign donors and the Bangladeshi government gave Dr. Zaf money, but he also charged his poor patients modest fees to pay for services further.’ (56)
- ‘Maternal mortality in the area covered by [the People’s Health Center ] is one fourth of the national average. In Feroza continues to be one of Dr. Zaf’s best paramedics, she will be promoted to supervisor, with a raise to one hundred dollars a month and a scooter instead of a bicycle.’ (57)
- ‘Microcredit is not a panacea for poverty reduction that some made it out to be after Yunus’s discovery. Some disillusionment with microcredit has already come in response to these blown-up expectations. Microcredit didn’t solve everything; it just solved one particular problem under one particular set of circumstances – the poor’s lack of access to credit except at usurious rates from moneylenders.’ (59)
- ‘This book arrives at a paradoxical finding: free markets work, but free-market reforms often don’t. To explain this paradox, this chapter will discuss how introducing free markets from the top down is not so simple. It overlooks the long sequence of choices, institutions, and innovations that have allowed free markets to develop in the rich Western economies. It also overlooks the bottom-up perspective on how markets often don’t function well in the low-income societies of AfricaLatin AmericaAsia, and the former Communist bloc. Markets everywhere emerge in an unplanned, spontaneous way, adapting to local traditions and circumstances, and not through reforms designed by outsiders.’ (60-61)
- ‘It’s a little unnerving that almost all recent cases of collapses into anarchy were preceded by heavy World Bank and IMF involvement. Although I don’t think the IMF and the World Bank caused the Ivorian [Coast] collapse into anarchy, it would be hard to argue that their involvement in the country had a positive long-run effect.’ (67)
- ‘The backlash against free markets is unfortunately now gaining strength in Latin America, with free markets tarnished by the utopian expectations of structural adjustment.’ (72)
- ‘No Planner is necessary to process the enormous amount of information required to decide how much pasta, rice, cheese, and takeout cuisines of various cultures to supply to the people of New York. This great achievement of markets is achieved through Searchers.’ (73)
- ‘Adam Smith celebrated the social good achieved in this system, even though each of us is operating out of self-interest.’ (74)
- ‘The question becomes why markets don’t make all societies rich. This book is not suggesting a simple recipe for national success; the point of this chapter is the opposite: no recipe exists, only a confusing welter of bottom-up social institutions and norms essential for markets. These evolve slowly on their own from the actions of many agents; the Western outsiders and Planners don’t have a clue how to create these norms and institutions.’ (77)
- ‘Nor are markets of much help to those who are now very poor – after all, the poor have no money to motivate any market Searchers to meet their needs. The hope for the poor depends on the same dual forces this book emphasizes throughout: (1) homegrown, market-based development that will lift up both rich and poor (which this chapter further argues is way to complex a task for Western assistance); and (2) Western assistance for meeting the most desperate needs of the poor until homegrown market-based development reaches them.’ (77)
- ‘[Knack and Keefer] found that low-income societies have less trust than rich societies, and societies with less trust have less rapid economic growth.’ (79)
- ‘Ethnic specialization is not as ubiquitous in rich countries as in poor countries because there is an impersonal solution in rich countries to establishing a reputation for quality and fair dealing: creating a large corporation.’ (85)
- ‘Social norms also seem to be stronger among rich people than among poor people, as a rich person loses more economic opportunities and income from social disgrace. This is why you can usually be sure an executive in a suit will not mug you.’ (88)
- ‘Perhaps the story of the Western state is just that warlords sorted themselves out, as the strongest warlord put down the rest and gradually evolved into more benevolent, accountable governments.’ (89)
- ‘White people are not the only ones to push others around.’ (90)
- ‘One example of how not to do it is having Western lawyers and accountants rewrite the legal code overnight from the top down, as the West tried in Eastern Europe after 1990. In Eastern Europe, chief recipients of foreign aid were the Big Six accounting firms in the West.’ (94)
- ‘What looks like opportunistic behavior could be the mingling of private property with traditional values, which place obligations to kin above those to strangers or banks. By imposing land titling on such complex social customs, ‘private property rights’ may actually increase the insecurity of land tenure rather than decrease it. Perhaps chastened by these experiences, formal land law in Kenya is now moving back toward recognizing customary rights. The government is allowing the paper titles to lapse. Reformers who want to increase the security of property rights have to search for what works in each locality. A more likely way forward for formal law would be building on the customary law rather than contradicting it.’ (96-97)
- ‘ Australia Canada New Zealand Pakistan Uganda , and the United States are examples of former British colonies that have well-developed property rights protection for their level of income. Algeria ColumbiaHaiti , and Nicaragua are examples of former French or Spanish colonies that have poor property rights protection for their level of income.’ (98)
- ‘The main moral of the story is that free-market opportunity depends on bottom-up social choices that Planners usually don’t begin (or try) to understand. When researchers try a little harder (as did many of the hardworking researchers on whose work this chapter draws), there is hope for gradual, piecemeal reform and spontaneous efforts by Searchers among poor people themselves.’ (101)
- ‘Poor people are resourceful despite the screw-ups of Planners.’ (101)
- ‘Despite Africa’s economic stagnation, this is not to say that life in unchanging. New technologies have been spreading, giving Africans more information, more entertainment, more choices. The number of TV sets on which to watch Nollywood [Nigerian Hollywood], following the previous explosion of radios.’ (102)
- ‘Whereas in 1996 the typical African country had only one Internet user for every 27,000 people, in 2003 there was one for every 138 people, and it is still climbing rapidly. Although the ex-Communist countries also started with virtually no Internet users in 1996, the rate of adoption has climbed steeply there and now surpassed Latin American and the Caribbean (even though the latter region has also had rapid Internet expansion).’ (105)
- ‘One of the least known problems of poverty is indoor smoke from cooking…The death toll is around 1.8 million a year worldwide.’ (109)
- ‘The Shell Foundation is experimenting with a market-based approach, in which dozens or even hundreds of microenterprises produce and distribute stoves, adapting them to local consumer wants.’ (110)
- ‘What makes Bolivia so poor and ungovernable? Maybe 450 years of a white elite ruling a majority Indian nation has something to do with it.’ (112)
- ‘Certainly my own government is no paragon when it goes around invading other countries for unconvincing reasons, violating human rights of prisoners in the war on terror, and financing political campaigns with corporate payola.’ (115)
- ‘After the failure of free-market reforms, the next step in the escalation of the White Man’s Burden (mainly in the nineties) was to attempt to foster ‘good intentions.’ ’ (116)
- ‘Even after removing the effect of per capita income on each outcome, democracy is highly correlated with government effectiveness on delivering public services.’ (118)
- ‘Democracy is a bottom-up system that rewards local, specialized knowledge in a similar way to free markets. In a democracy, the squeaky wheel gets the grease. Whoever complains most vociferously about their local problems, which usually is related to how severe the problem is, will attract the attention of politicians and get a remedy.’ (119)
- ‘Alas, democracy is not a quick fix for poor countries, just as free markets are not a quick fix.’ (119)
- ‘The U.S. Constitution and its amendments guarantee every citizen basic rights such as voting and freedom of speech; usually honest Supreme Court justices enforce the Constitution.’ (120)
- ‘American democracy is not utopia; it is just a system that has worked pretty well.’ (120)
- ‘Social norms may be the most difficult part of building a democracy – many poor countries are far from such norms. A staple of elections in many poor countries is to harass and intimidate the opposition so that they don’t vote.’ (120)
- ‘Aghion, Alesina, and Trebbi found that checks on the majority’s executive power (and even democracy in general) were statistically less likely with higher ethnic heterogeneity.’ (120)
- ‘A recent study found that democracy, as usually defined by Polity IV, does not lower the probability of the most extreme violation of minority rights of all: state-sponsored mass killings (even genocide). A more complete definition of a democracy would include protections for minorities.’ (120-121)
- ‘A populist majority could still vote for high taxes on the rich, stunting future development prospects.’ (121)
- ‘The rich gave in more easily to democracy in Britain and America because the design of the new democratic system had some checks against the redistributive powers of the majority.’ (123)
- ‘Thus perpetual oligarchy is more likely in unequal agrarian or mineral societies than in more equal industrial societies, as Latin America demonstrated for most of the nineteenth and twentieth centuries.’ (124)
- ‘The big successful Communist revolutions occurred in poor agrarian societies – Russia in 1917 and China in 1949 – not in industrialized societies, as Marx has predicted.’ (125)
- ‘Democracy in unequal agrarian societies tends not to last, as it alternates between populist demagogues attempting redistribution and the rich striking back with military coups. Democracy is indeed negatively associated with the share of agriculture in the economy in cross-country data (although the share of agriculture could just be a proxy for income), controlling for the size of the middle class (which remains an important statistical predictor of democracy).’ (125)
- ‘Wantchekon shows that new democracies have succeeded in Africa mainly in resource-poor places such as Benin, Madagascar, and Mali, while oil-rich states such as Algeria, Cameroon, Gabon, and Libya still have dictators.’ (125-126)
- ‘The Future of Freedom, has brought to wide attention the idea of ‘illiberal democracy.’ Why do democracies sometimes produce awful government despite free elections? A big problem with democracy and development, particularly with uneducated voters, is that the politicians cold appeal to voters’ gut instincts of hatred, fear, nationalism, or racism to win elections. Edward Glaeser of Harvard had the insight that politicians will promote hatred when it helps achieve other unrelated political goals. A politician who wants to avoid redistribution to the poor will preach ethnic hatred toward a poor minority that happens to be ethnically distinct. Thus, for example, rich white leaders in the American South defeated populism in the late nineteenth century by persuading poor whites to hate poor blacks. (This is one way that an oligarchy can keep power even in a democracy.)’ (127-128)
- ‘Researchers have documented links between ethnic divisions and poor schooling and infrastructure, between ethnic divisions and poor-quality government, and between ethnic divisions and lower spending on public services.’ (128)
- ‘Ethnic hatreds are at work even when politics are not democratic. For example, Arab leaders may preach incessant hatred of Israel because that hatred justifies a powerful army, which also come in handy to suppress political dissidents and preserve the autocrats’ hold on power.’ (128)
- ‘Even this superficial sketch of democracy and its vulnerabilities has uncovered several reasons why good government may not take hold – elite manipulation of the rules of the political game, weak social norms, landed wealth, natural resources, high inequality, corruption, and ethnic nationalism and hatreds. Unfortunately, the aid agencies have had little idea how to fix these problems from the outside when they have tried to change bad governments into good governments.’ (129)
- ‘So many countries of the Rest have corrupt and undemocratic governments. Badly governed countries are poor countries.’ (130)
- ‘The writers of the original charters of the IMF and the World Bank – mainly the United States and the United Kingdom – decided that they could operate only through governments in the recipient countries.’ (132)
- ‘Another problem is that foreign aid is used as a political reward to allied governments, no matter how unsavory they are. U.S. military aid to a poor country, presumably a measure of strategic importance to the United States, helped predict whether that country received IMF and World Bank structural adjustment loans. However, strategic geopolitics explains only a small portion of the variation in aid receipts across countries; many bad governments of no strategic importance whatsoever still get a lot of aid. So we had the world’s twenty-five most undemocratic government rulers (out of 199 countries the World Bank rated on democracy) get a sum of $9 billion in foreign aid in 2002. The top fifteen recipients of foreign aid in 2002, who each got more than $1 billion each , have a median ranking as the worst fourth of all governments everywhere in 2002 (ranked by democracy, corruption, etc.).’ (132-133)
- ‘Aid shifts money from being spent by the best governments in the world to being spent by the worst.’ (133)
- ‘Similarly, there was no association between aid given to a country and how democratic it was, either in 1996 or 2002, controlling for per capita income and population size.’ (133)
- ‘There have been some cases of foreign aid supporting reform and good government. One happy example is with the aforementioned Botswana…The government managed both aid and diamond revenues wisely enough to foster economic growth, with the result that the economy expanded at 10 percent every year…The government expanded rural villages’ access to clean water, health clinics, and good roads. It decentralized government functions to local authorities to increase democratic accountability. The government was not perfect – it failed to prevent one of the world’s worst AIDS crises – but its accomplishments give a hint of how much development was possible in Africa with good government.’ (134-135)
- ‘There are other cases of good government breaking out even without much donor involvement. Aid researcher Judith Tendler at MIT wrote a great book called Good Government in the Tropics, about the success story of the Ceara state government in northeastern Brazil. Traditionally one of the most corrupt and backward states in Brazil, Ceara had two reformist governors alternating in power from 1987 to 2001 – Tasso Jereissati and Ciro Gomes. They had the State Department of Health do a new preventive health program using community health workers. Only a few years after the beginning of the program, vaccination rates for measles and polio had increased from 25 percent to 90 percent. Infant mortality in Ceara fell by one third. It would be too simplistic to attribute these success stories just to governors Jereissati and Gomes. Part of the success of the Ceara programs was the way they built in feedback from the poor. The state publicized the new programs, leading the local communities to expect more from (and to monitor) the government workers, such as the new health workers. The health workers themselves felt motivated by community approval when they got good results, and they got rewarded for such approval.’ (135)
- ‘More recent studies have found that there is also an ‘aid curse’ – probably for the same reasons as the oil curse. High aid revenues going to the national government benefit political insiders, often corrupt insiders, who will vigorously oppose democracy that would lead to more equal distribution of aid.’ (135)
- ‘Simeon Djankov (of the World Bank), Jose Montalvo (of Pompeu Fabra University in Barcelona), and Marta Reynal-Querol (World Bank) similarly found that high aid caused setbacks to democracy over 1960-1999. They found aid’s effect on democracy to be worse than the effect of oil on democracy.’ (136)
- ‘Diplomatic donors also put a positive spin on awful recipient governments by asserting that while things are bad, they are getting better.’ (138)
- ‘Governments – together with foreign aid – do not have a universal record of failure in Africa. One success was the steady expansion of education, represented by the huge leap in adult literacy rates from 1970 to 2000. Another accomplishment has been in reaching girls for education, as the ratio of female-to-male literacy has climbed steadily over the last thirty years.’ (140-141)
- ‘There were also upward trends in electrification (provided by state-owned utilities) until 1990, although this stagnated afterward. Electric production per person increased by 50 percent from 1973 to 1990. Again, there are some quality problems, with power outages common, but the increased quantity indicates that some progress is being made.’ (141)
- ‘To the aid agencies, participation is an apolitical technical process of consulting the poor. As Daniel Patrick Moynihan said about a similar participation idea in the 1960s: ‘The socially concerned intellectuals…seemed repeatedly to assume that those who had power would let it be taken away a lot easier than could possibly be the case if what was involved was power.’ ’ (144)
- ‘Ironically, the way the donors implement ‘participation’ sometimes contradicts existing democratic mechanisms. In Tanzania, the democratically elected government had already devised a National Poverty Eradiation Strategy in consultation with its parliament, but the IMF and World Bank insisted upon a new process for the Poverty Reduction Strategy Paper anyway.’ (145)
- ‘This is not to automatically canonize [sic] democratically elected governments. They, too, can make terrible choices – this reinforces the main point of this chapter: it is awfully hard to get democracy working well. And the IMF and World Bank could conceivably take a stand for unpopular positions that are the best thing for the country. Yet outside interference doesn’t have a great record on improving matters, on making governments do the ‘right’ thing.’ (145)
- ‘Haiti has known some degree of democracy for only five recent years out of its two hundred-year history (1990, 1994-1998); for most of that history it had the worst possible democratic rating on a scale of zero to ten. After almost two hundred coups, revolutions, insurrections, and civil wars since independence, Haiti today still has one of the world’s most undemocratic, corrupt, violent, and unstable governments. The IMF didn’t check the history: how much could it help a state that had been dysfunctional for two centuries?’ (147-148)
- ‘The IMF and World Bank finally cut him off in 1990, twenty-five years into his misrule. Altogether, the country had received twenty billion dollars in foreign aid during Mobutu’s tenure. Of course, Mobutu was a cold war protégé of the West, but the IMF and World Bank claim to be apolitical.’ (150)
- ‘Note that ‘post-conflict reconstruction’ means you have to do deals with even worse gangsters than under peacetime conditions. And what incentives does it create to give aid money to the men of violence in post-conflict societies, many of whom committed war crimes, while shunning peaceful democratic politicians?’ (151)
- ‘These are extreme examples that illustrate the IFI’s [International Financial Institute’s] worst cases: coddling awful gangsters who just call themselves a government. The poor population was going to be liable for IMF loans that were never going to reach them.’ (152-153)
- ‘The IMF does show some willingness to lend less to the most awful governments. Unfortunately, once governments get out of the worst tenth, there is no further tendency to penalize bad governments.’ (153)
- ‘Although convinced that bad government was not the problem, the UN report did rule out aid to the four most awful rulers in the world. The report identifies these four governments – Belarus,MyanmarNorth Korea, and Zimbabwe – as beyond the pale. This is a pretty small number for bad governments of the world. Even a dictator like Saparmurat Niyazov of Turmenistan, who so terrorizes his country that he has renamed the months of the year after himself and his late mother, can’t get into the UN bad despots club.’ (154)
- ‘Aid agencies have to face reality: Is money given to a bad government going to reach the poor?’ (155)
- ‘The U.S. Millennium Challenge Corporation gives aid only to governments that meet certain standards, such as democracy, investing in their people, freedom from corruption, and freedom from government interference in markets. It is a welcome step compared with giving money to gangsters, and it will be interesting to see how it plays out. However, there are some potential pitfalls. Can outsiders really tell when government is good and when it is bad?’ (155)
- ‘As the awful examples in this chapter illustrate, the official aid agencies simply don’t know how to change bad governments into good governments with the apparatus of foreign aid. Bad government has far deeper roots than anything the West can affect. To make things worse, the aid agencies need the poor-country government, even a bad government, to fill the role of aid recipient to keep money flowing.’ (156)
- ‘Let’s hold fast to opposing shock therapy and universal blueprints, even for the country of foreign aid. Any of these changes should be tried in a gradual, piecemeal, experimental way, and the answers will be different in different countries and different sectors.’ (156)
- ‘The principle is nonintervention. Don’t reward bad governments by working through them, but don’t try to boss them around or overthrow them either.’ (157)
- ‘Foreign aid donors spent two billion dollars in Tanzania during the past twenty years building roads. The road network did not improve. Roads deteriorated faster than donors built new ones, due to lack of maintenance.’ (165)
- ‘The ‘growth industry’ in Tanzania is actually bureaucracy.’ (165)
- ‘The tragedy of poverty is that the poorest people in the world have no money or political power to motivate Searchers to address their desperate needs, while the rich can use their money and power through well-developed markets and accountable bureaucracies to address theirs.’ (167)
- ‘If the government does something that really pisses off the majority of the population [in a democracy] scream loudly enough that the government changes its behavior.’ (168)
- ‘These problems become a nightmare under the Planner’s mind-set, where there is some utopian objective such as ending world poverty. The rich-country could judge the aid agency based on the overall poverty outcome – but that assumes a known relationship between foreign aid efforts and poverty reduction. On the contrary, because the poverty outcomes in the Rest depend on many factors besides the bureaucracy, the aid agency’s contribution in the field is invisible.’ (170)
- ‘When nobody can tell whether aid agency efforts make a difference, the aid agency managers have only weak incentives to exert effort.’ (170)
- ‘This is the flaw in exercises in international cooperation such as the Millennium Development Goals. All the rich-country governments and international aid agencies are supposed to work together to achieve the MDGs. So when the goals are not attained, no one agent can be held accountable.’ (172)
- ‘The analysis points to possible improvements: Have aid agencies specialize more in solving particular problems in particular countries, rather than having each agency responsible for everything. Then hold each agency responsible for progress on its particular problem, which might encourage it to cut red tape.’ (175)
- ‘Foreign aid likely contributed to some notable successes on a global scale, such as dramatic improvement in health and education indicators in poor countries. Life expectancy in the typical poor country has risen from forty-eight years to sixty-eight years over the past four decades. Forty years ago, 131 out of every 1,000 babies born in poor countries died before reaching their first birthday. Today, 36 out of every 1,000 babies die before their first birthday. Kids enrolled in primary school in the typical poor country went from 65 percent of their age group in 1960 to 100 percent today. (There are a number of countries below 100 percent enrollment, but more than half of poor countries have 100 percent enrollment – hence the ‘typical’ poor country has 100 percent enrollment.) The corresponding rations for secondary school were even more dramatic: only 9 percent in 1960, 70 percent today.’ (176-177)
- ‘Maybe aid even works on average in some sectors, such as health, education, and water and sanitation. For example, maybe aid agencies had something to do with the improvement in water and sanitation in Africa. From 1970 to 2000, the percentage of the population with access to clean water went from 20 percent to 60 percent, and the access to improved sanitation went from one sixth to two thirds in the typical African country. Attributing these successes to aid is conjectural because there has not been enough of a scientific attempt in aid agencies to evaluate the impact of aid projects, but at least it lends some suggestive hope that aid can sometimes work.’ (178)
- ‘We bureaucrats will perform better when we have tangible, measurable goals, and less well when we have vague, ill-defined dreams.’ (179)
- ‘Perhaps health interventions are more successful because the outcomes are specifically defined and easily observable – you can keep track of deaths from disease.’ (179)
- ‘The health field may also benefit from having a large organization with the narrow goal of improving health – the World Health Organization (WHO). Where there are visible indicators of success, even top-down efforts can work. The WHO’s vaccination campaigns, which get part of the credit for the fall in infant mortality, involved a lot of top-down control, but there was feedback from the bottom through measures of vaccination coverage.’ (180)
- ‘When the contribution of the agency to development output is unobservable, the agency planners try to advertise the volume of their inputs to development. One visible indicator of input that foreign aid agencies advertise is the volume of money they disburse.’ (181)
- ‘Longtime World Bank president Robert McNamara cut his teeth in a previous life on the combined military intervention and aid program in Vietnam.’ (181)
- ‘The rich-country monitors of aid agencies should disqualify aid disbursements (and the spending they finance) as a measure of success.’ (183)
- ‘Aid agencies are rewarded for setting goals rather than reaching them, since goals are observable to the rich-country public while results are not. An unintended side effect of the increased activity of NGO issue lobbies has been to expand even further the set of goals that foreign assistance has been trying to achieve.’ (185)
- ‘Although this book stresses the virtues of feedback and accountability, it is feedback from the intended beneficiaries that is the desideratum; feedback from rich-country lobbies that don’t represent the poor could make things worse rather than better.’ (186)
- ‘The aid agencies drive the recipient governments and their own frontline workers insane when they declare each objective to be priority number one. Reaching as many poor as possible would dictate that greater effort go to goals with low costs and high benefits, and that little or no effort go to goals where the costs are very high relative to the benefits.’ (187)
- ‘Economists since Adam Smith have also stressed the efficiency gains from specialization, which suggests that organizations and individuals should focus on a few things and not do others.’ (187)
- ‘For decades, aid reports bewailed the neglect of operating supplies and maintenance after infrastructure projects were completed. Donors consistently refuse to finance maintenance and operating supplies, with the idea that this is the responsibility of recipient governments, even though there is intense client demand for these goods.’ (189)
- ‘Here is one way to make aid work better: aid donors should just bite the bullet and permanently fund road maintenance, textbooks, drugs for clinics, and other operating costs of development projects.’ (190)
- ‘World Bank researchers Deon Filmer and Lant Pritchett estimate that the return on spending on instructional materials in education is up to fourteen times higher than the return on spending on physical fitness, but donors continue to favor more observable buildings over less observable textbooks. This has undercut the donors’ success on increasing education enrollments noted earlier. Quantity of education has gone up, but quality remains low.’ (190)
- ‘Rich-country donors restrict some part of aid to purchases from their own country’s exporters (‘tied aid’). The United States requires recipients to spend the aid products from American companies for about three quarters of its aid.’ (192)
- ‘A good part of technical assistance aid is simply flowing back to some rich-country consultant handing out the kind of deep insights that come from two weeks’ acquaintance with a poor country.’ (192)
- ‘After September 11, 2001, agencies gave new aid to allies in the war on terror, such as Central AsiaPakistan, and Turkey.’ (192)
- ‘Even when internal evaluation points out failure, do aid agencies hold anyone responsible or change agency practices? It is hard to find out from a review of the World Bank’s evaluation Web site. The OED in 2004 indicated how eight ‘influential evaluations’ influenced actions of the borrower in thirty-two different ways, but mentioned only two instances of affecting behavior within the World Bank itself (one of them for the worse).’ (193)
- ‘The way forward is politically difficult: truly independent scientific evaluation of specific aid efforts; not overall sweeping evaluations of a whole nationwide development program, but specific and continuous evaluation of particular intervention from which agencies can learn. Only outside political pressure on aid agencies is likely to create the incentives to do these evaluations. A World Bank study of evaluation in 2000 began with the confession, ‘Despite the billions of dollars spent on development assistance each year, there is still very little known about the actual impacts of projects on the poor.’ ’ (194)
- ‘It just shows how stubborn bureaucratic incentives are that the chosen vehicle for bottom-up participation is a detailed central government plan (the PRSP, Poverty Reduction Strategy Paper, already mentioned).’ (195)
- ‘The officials who talk about ‘participation’ and ‘local ownership’ can’t seem to let themselves shift power to the locals – the bureaucratic incentives against it are too strong.’ (196)
- ‘Consider the following explanation by the UN Millennium Project of how it goes about implementing the MDGs (which it describes as ‘open and consultative, involving all key stakeholders’). The head of the UN Millennium Project denied to me in person that this is a top-down plan, so I quote from it at length so you can judge for yourself: ‘In each of these countries, the Project and local research partners built upon international best practices to identify…the input targets that would be needed for the country to achieve the MDGs by 2015. These estimates cover hundreds of interventions…that need to be provided to meet the Goals....The second stage of the planning process will be for each country to develop a long-term (10-12 year) framework for action for achieving the MDGs, building upon the results of the MDG needs assessment….This MDG framework should include a policy and public sector management framework to scale up public spending and services, as well as a broadly defined financing strategy to underpin the plan. The third stage of the planning process will be for each country to construct its medium term (3-5 year) poverty reduction strategy (PRS) and, where appropriate, its Poverty Reduction Strategy Paper (PRSP) based on the long term MDG plan…and should be attached to a Medium Term Expenditure Framework (MTEF)….Fourth, both the 10-year framework and three-year PRS should include a public management strategy….Bringing together a wide variety of inputs from expert resources, the Millennium Project secretariat has been coordinating a multi-step process to develop a methodology for country-level MDG needs assessments.’ ’ (196-197)
- ‘At some point the donors just have to trust the recipients to be self-reliant enough to follow their own interests, to seize the opportunities created by aid.’ (197)
- ‘Scholarships or matching grants for poor individuals or entrepreneurs could promote true ‘participation’ in which the poor make their own choices. If you really want to put the poor in the driver’s seat, aren’t there any ways to do so directly? Could you give many more scholarships to poor students? Could you give matching grants to poor entrepreneurs who put their own money at stake to start a new business? Could you have village elections that select (or reject) aid projects?’ (198)
- ‘What makes the UN worse than other aid bureaucracies? Conditions for bureaucratic behavior are even more unfavorable for the UN because an unwieldy General Assembly with ‘one nation, one vote’ runs it. Answerable equally to 191 members states (many of whom are undemocratic), the UN has an especially severe problem of multiple principles and collective responsibility.’ (204)
- ‘Except for a few high-profile things that the rich countries want the UN to do, the UN is operating in the attic.’ (204)
- ‘Consider ways that aid agencies (including NGOs) could compete to supply development services, so that those who were best at doing a particular something in a particular country would ‘win the contract’ to do that something.’ (205)
- ‘Sixty years after the foundation of the World Bank and IMF, independent evaluation is long overdue.’ (205)
- ‘Businessmen are also a great untapped resource for aid watching. One can imagine schemes for giving private business a stake in aid outcomes, so that they formed part of the army of watchers for good results. Think of what could happen if an army of independent aid watchers, including those from inside the country receiving the aid, were keeping tabs on the aid agencies.’ (206)
- ‘Throw into the trash can all the comprehensive frameworks, central plans, and worldwide goals. Just respond to each local situation according to what people in that situation need and want.’ (206)
- ‘It hasn’t worked to tell the poor what to do. Just screen aid recipients to select those likely to act in their own interest, give them incentives and opportunities to better their lives, and then trust in their self-reliance, with no further strings attached. Programs like this are already working. The Food for Education program in Bangladesh lets poor families choose whether to keep their daughters in school, making this choice more possible by offering the families food and money to do so.’ (206)
- ‘There should be much further exploration of mechanisms that give control of aid resources directly to the poor and let them choose what they most want and need. Participation should mean more buying and voting power in the hands of the poor in aid, not strategies or frameworks. This is not easy, but I suspect this is the future of foreign aid.’ (206)
- ‘On balance, the IMF has done useful short-term bailouts of poor countries experiencing financial crises, but it has done worse at promoting long-term development.’ (212)
- ‘The International Monetary Fund, headquartered in Washington, D.C., is the West’s most powerful agency for dealing with many poor countries.’ (213)
- ‘The IMF has a lot of money. It has $157 billion in resources available to lend, of which $96 billion was actually out on loan in August 2004. It gets its money from subscriptions by all of its members (most countries of the world) and then keeps the money rotating among borrowers.’ (213)
- ‘The IMF has had some notable successes. It helped South Korea and Thailand with financial squeezes in the 1980s, after which they had rapid growth. The IMF bailout of Mexico in 1994-1995, although much criticized at the time, worked well. The Mexican government repaid the loans in advance, and economic growth resumed. Most recently, the IMF handled the 1997-1998 East Asian financial crisis with some success, especially, again, in South Korea. The IMF recruits talented Ph.D.’s in economics, who observe strong norms of professional analysis. It has been an outstanding research department, as well as other specialized departments that provide valuable technical advice to poor countries on their fiscal and financial systems.’ (214)
- ‘The IMF then gets involved in how the government is spending the money (i.e., which items to cut). It often forces the government to do unpopular things, such as cut subsidies for bread or cooking oil.’ (216)
- ‘Quito is a favorite destination of IMF staff, who gave Ecuador sixteen standby loans over 1960-2000. In the year 2000, the latest IMF loans austerity measures induced reductions in teacher salaries and increases in fuel and electricity prices.’ (217)
- ‘The government dispersed a demonstration of teachers in the capital with tear gas and riot police.’ (217)
- ‘Ecuador was not alone in protesting against the IMF. In the first nine months of 2000 alone, there were demonstrations against IMF programs in Argentina, Bolivia, Brazil, Columbia, Costa Rica, Honduras, Kenya, Malawi, Nigeria, and Zambia.’ (217-218)
- ‘The moral of the story is that IMF prescriptions about how much to cut central bank credit and government deficits are often based on shaky foundations. The IMF should give up its pretensions that it understands the whole complicated system of financial equilibrium – this is another strain of the disease of utopian social engineering.’ (225)
- ‘The failure of debt relief to spur growth was a problem because the failure of the original loans to spur growth was what had caused the debt problem in the first place. We have already seen that Africa, a favorite destination of repeated IMF and World Bank lending, also failed to have the growth that would have enabled it to service its debt. This is a general pattern: the growth in program countries fell short of the IMF’s own targets.’ (231)
- ‘Calling a loan to the poorest countries a ‘loan’ has become ever more fictional. The World Bank, which is an aid agency, should just give the poorest countries grants, not loans (this was one of the better ideas of the Bush administration on foreign aid). The IMF, which is not supposed to be an aid agency, should get out of the business of loaning money to the poorest, least creditworthy countries altogether. Is there any reason to keep bailing out countries that chronically fail to stay bailed out?’ (232)
- ‘The IMF was deeply involved in the elusive quest for Argentine financial stability, with fifteen standbys from 1958 to 1999. After unhappy decades of financial chaos, Argentina had a decade of financial stability after 1991. It was the star pupil of the IMF, even as other IMF clients such as MexicoRussiaBrazil, and the East Asian countries experienced crises. But Argentina began to get into trouble in 1999.’ (232)
- ‘The only effect of the August 2001 package was to postpone by a few months the Argentine default on eighty-one billion dollars owed to foreign bondholders. Argentina defaulted on its debt in stages in November – December 2001. Riots in late 2001 spread from the provinces to Buenos Aires. Rioters smashed store windows and looted. The president resigned. Political farce ensued, as three interim presidents took office and resigned in the space of ten days.’ (233)
- ‘The IMF sometimes plays a useful role in the world’s financial system – it helps countries facing a temporary shortage of cash get off their backs. The world needs some kind of an international financial crisis manager like the IMF.’ (234)
- ‘The IMF’s natural niche seems to be the emerging markets, not the poorest countries. The latter includes most countries in Africa, where the IMF should just head for the exit and let traditional aid agencies operate. Second, the IMF needs to find a way to get rid of its intrusive and complex conditionality.’ (235)
- ‘South Africa is the most recent casualty of its spread. Thirty percent of pregnant women in their twenties test HIV-positive in South African antenatal clinics. A third of the adult population is now HIV-positive in BotswanaLesothoSwaziland, and Zimbabwe. In other eastern and southern African countries, between 10 and 25 percent of the adult population is HIV-positive.’ (239)
- ‘The breakdown of the aid system on AIDS is a good test case of the paradox of evil in foreign aid. It reflects how out of tough were the Planners at the top with the tragedy at the bottom, another sign of the weak power of the intended beneficiaries. It shows how ineffective Planners are at making foreign aid work. It is hard to imagine anything more in the interest of the poor than preventing the spread of a fatal disease. Today, the Western aid community has finally woken up to AIDS. Now that community has moved from inaction to ineffective action. Aid for AIDS still appears mismatched to the choices of the poor.’ (240)
- ‘A vaccination campaign in southern Africa virtually eliminated measles as a killer of children. Routine childhood immunization combined with measles vaccination in seven southern African nations starting in 1996 virtually eliminated in those countries by 2000. A national campaign in Egypt to make parents aware of the use of oral rehydration therapy from 1982 to 1989 cut child deaths from diarrhea from 82 percent over that period. A regional program to eliminate polio in Latin America after 1985 has eliminated it as a public health threat in the Americas. The leading preventable cause of blindness, trachoma, has been cut by 90 percent in children under age ten in Morocco since 1997, thanks to a determined effort to promote surgery, antibiotics, face washing, and environmental cleanliness. Sri Lanka’s commitment to preventing maternal deaths during childbirth has cut the rate of maternal mortality from 486 to 24 deaths per 100,000 births over the last four decades. A program to control tuberculosis in China cut the number of cases by 40 percent between 1990 and 2000.’ (241)
- ‘Many of these programs benefited from donor funding and technical advice. In Egypt’s fight against childhood diarrhea, for example, it was a grant from USAID and technical advice from the World Health Organization (WHO). In China’s campaign against tuberculosis, it was a World Bank loan and WHO advice. In Morocco, the drug company Pfizer donated antibiotics to fight trachoma.’ (242)
- ‘An article in 1991 in the World Bank/IMF quarterly magazine predicted that thirty million people would be [HIV] infected worldwide by the year 2000 if nothing was done. The actual figure would turn out to be forty million, but the point is: more than a decade ago many knew that a catastrophic epidemic was under way.’ (244)
- ‘The 1992 report closed with the curious admonition that ‘AIDS should not be allowed to dominate the Bank’s agenda on population, health, and nutrition issues in Africa.’ Raising this issue early in the epidemic is strange, when an ounce of prevention is worth a pound of cure. Now AIDS work has crowded out treatment of other equally lethal threats to Africans because its spread was not averted. The best way to have kept AIDS from ‘dominating the Bank’s agenda’ was to have prevented its spread.’ (244)
- ‘Discussion of African beliefs in witchcraft is taboo in aid agencies, as nobody wants to reinforce ill-informed stereotypes. Unfortunately, political correctness gets in the way of making policy, as conventional public health approaches may not work if people do believe that witchcraft causes illness and turn to traditional healers…Moreover, many American evangelicals believe divine intervention can cure illness.’ (248)
- ‘AIDS-prevention efforts would do much better to work with traditional healers on fighting HIV transmission than to ignore beliefs in witchcraft because of political sensitivities.’ (248)
- ‘Africa’s AIDS crisis is leaving a generation of undereducated, undernourished, underparented orphans who will soon be adults.’ (249)
- ‘This political pressure led Planners to fixate on the goal of treatment even when the costs were so prohibitive that it diverted money from cheaper actions that Searchers had found to save many more lives.’ (250)
- ‘The UN General Assembly Special Session passed a resolution calling for AIDS treatment. This used to be impossible for low-income African AIDS patients, because of high drug prices (ten thousand dollars a year per patient). However, competition from a growing number of generic HIV/AIDS drugs has cut prices, which are now as low as $304 per year patient.’ (250)
- ‘A well-established public health principle is that you should save lives that are cheap to save before you save lives that are more expensive to save. That way you save many more lives using the scarce funds available. Prevention and treatment of these others diseases cost far less than AIDS treatment.’ (251)
- ‘In a 2002 article in The Lancet, Andrew Creese from the World Health Organization and co-authors estimated that AIDS-prevention interventions such as condom distribution, blocking mother-to-child transmission, and voluntary counseling and testing could cost as little as one to twenty dollars per year of life saved, and twenty to four hundred dollars per HIV infection averted (even though this study may overstate the confidence that these things always work). Other studies come up with similar estimates.’ (251-252)
- ‘The medicines that cure TB cost about ten dollars per case of the illness. A package of interventions designed to prevent maternal and infant deaths costs less than three dollars per person per year. Worldwide, three million children die a year because they are not fully vaccinated, even though vaccines cost only pennies per dose. One in four people worldwide suffers from intestinal worms, though treatments cost less than a dollar per year. A full course of treatment for a child suffering even from drug-resistant malaria costs only about one dollar.’ (2520
- ‘The $4.5 billion the WHO plans to spend on antiretroviral treatment for one more year of life for three million could grant between seven and sixty years of additional life for five times that many people – fifteen million.’ (252)
- ‘The WHO expects the added years of life for AIDS patients from antiretroviral treatment to be only three to five years – not exactly a miracle cure.’ (253)
- ‘Should the West impose its preferences for saving AIDS victims instead of measles victims just because it makes the West feel better?’ (253)
- ‘In a fit of religious zealotry, Congress also required organizations receiving funds to publicly oppose [sic] prostitution. This eliminates effective organizations that take a pragmatic and compassionate approach to understanding the factors that drive women into prostitution. Programs that condemn prostitutes are unlikely to find a receptive audience when they try to persuade those prostitutes to avoid risky behavior. To make things even worse, the religious right in America is crippling the funding of prevention programs to advocate their own imperatives: abstain from sex or have sex only with your legally married spouse. Studies in the United Stats find no evidence that abstinence programs have any effect on sexual behavior of your people, except to discourage them from using condoms. The evangelists’ message has not convinced American youth, so the evangelists want to export it to African youth.’ (254)
- ‘The religious right threatens NGOs that aggressively market condoms with a cutoff of official aids, on the grounds that those NGOs are promoting sexual promiscuity. Pushed by the religious right, Congress mandated that at least one third of the already paltry PEPFAR prevention budget go for abstinence-only programs. The Vatican is also pushing its followers to oppose condom distribution in Africa because of religious doctrine that forbids the use of birth control.’ (254)
- ‘Instead of spending ten billion dollars on treatment over the next three years, money could be spent on preventing AIDS from spreading from the 28 million HIV-positive Africans to the 644 million HIV-negative Africans. Thailand has successfully implemented prevention campaigns targeting condom use among prostitutes, increasing condom usage from 15 percent to 90 percent and reducing new HIV infections dramatically.’ (255)
- ‘If money spent on treatment went instead to effective prevention, between three and seventy-five new HIV infections could be averted for every extra year of life given to an AIDS patient. Spending AIDS money on treatment rather than on prevention makes the AIDS crisis worse, not better.’ (255)
- ‘It is the job of economists to point out trade-offs; it is the job of politicians and Planners to deny that trade-offs exist. AIDS campaigners protest that AIDS treatment money is ‘new money’ that would have been otherwise unavailable, but that just begs the question of where new money is best spent.’ (256)
- ‘If you want priorities and trade-offs, you can get them in the WHO itself. The WHO’s 2002 World Health Report contains the following common sense: ‘Not everything can be done in all settings, so some way of setting priorities needs to be found. The next chapter identifies costs and the impact on population health of a variety of interventions, as the basis on which to develop strategies to reduce risk. The next chapter in the WHO report actually states that money spent on educating prostitutes saves between one thousand and one hundred times more lives than the same amount of money spent on antiretroviral treatment.’ (257)
- ‘A political campaigner giving a graphic description of AIDS patients dying without life-saving drugs is hard to resist, making the trade-offs described earlier seem coldhearted. But money should not be spent according to what the West considers the most dramatic kind of suffering.’ (257)
- ‘In countries where corruption is as endemic as AIDS, health officials often sell aid-financed drugs on the black market. Studies in CameroonGuineaTanzania, and Uganda estimated that 30 to 70 percent of government drugs disappeared before reaching the patients.’ (259)
- ‘To scale up antiretroviral therapy for HIV without ensuring infrastructure, including trained practitioners, a safe and reliable drug delivery system, and simple but effective models for continuity of care, would be a disaster, leading to ineffective treatment and rapid development of resistance.’ Sande and Roland, Journal of the American Medical Association (261)
- ‘Spending money on a mostly futile attempt to save all the lives of this generation of AIDS victims will take money away from saving the lives of the next generation, perpetuating the tragedy. The political lobby for treatment doesn’t mention that no amount of treatment will stop the crisis. The only way to stop the threat to Africans and others is prevention, no matter how unappealing the politics or how uncomfortable the discussion about sex. The task is to save the next generation before it is again too late.’ (261)
- ‘Donors should have asked, ‘How many people have we prevented from becoming HIV-positive?’ ’ (262)
- ‘The politicians and aid agencies didn’t have the courage to confront the uncomfortable question of how to change human sexual behavior. The AIDS failure shows that the bureaucratic healers too often settle for simply handing out pills.’ (262)
- ‘It used to be that everybody agreed that colonialism was bad. Frustration with disastrous postcolonial outcomes in Africa has led many to imagine a colonial past of peace and prosperity.’ (271)
- ‘A Belgian professor described Belgian colonial administrators in the Congo as: ‘too young and incompetent; they are sent out, without knowing the native language, without serious training, without a probationary period, to a distant place where they are usually alone. Isolated, powerless, able only with difficulty to leave their headquarters, they do not travel enough in their district, they do not get to know the villages.’ (274)
- ‘Like today’s donors and postmodern imperialists, the colonizers were outside Planners who could never know the reality on the ground. Like their modern-day counterparts, colonizers often unwittingly destabilized the balance of internal power.’ (276)
- ‘In Freetown, the British resettled slaves their warships had intercepted in transit. Christians back in Britain gave donations to support the Sierra Leone settlements. Like Save the Children later, the charity stressed the person-to-person link. For a gift of five pounds, the missionaries would baptize the freed slave on the receiving end with the name of the donor.’ (278)
- ‘Only seventeen Congolese in 1960 had a university degree.’ (287)
- ‘From August 1998 to November 2002, an estimated 3.3 million Congolese died as a result of the war, making it the world’s deadliest conflict since World War II.’ (289)
- ‘the income of the average Congolese today is the equivalent of twenty-nine cents a day. The World Bank has lent $1.5 billion to the Congolese ‘government’ since 2001. It’s not clear what benefits the money brought to the Congolese people when channeled through the warlords and autocrats. As many as 3.4 million Congolese are still refugees.’ (289)
- ‘The political crises that make the headlines today, such as the Israeli-Palestinian conflict, the war in Iraq, the Kashmir dispute, the war on terror, and brutal civil wars in Africa, have some roots in past Western treatment of peoples as ‘pawns in a game.’ Look behind a modern-day headline and often you will find the machinations of some long-forgotten colonial planner.’ (291)
- ‘Former colonies with a high share of partitioned peoples do worse today on democracy…, government service delivery, rule of law, and corruption. Highly partitioned countries do worse on infant mortality, illiteracy, and specific public services such as immunization against measles, immunization for DPT (diphtheria-pertussis-tetanus), and supply of clean water.’ (292)
- ‘Nevertheless, the American government enthusiastically backs the Pakistani government again today as a reward for the alliance in the war on terror, showering it with World bank and IMF loans and U.S. foreign aid. Pakistan was the world’s largest recipient of foreign aid in 2002: some $2.1 billion. The Americans tactfully overlook unpleasant things such as suppression of democracy, intelligence agencies linked to terrorists, and nuclear proliferation.’ (301)
- ‘On January 1, 1956Sudan became independent….A civil war lasted until a settlement in 1972, killing five hundred thousand Sudanese.’ (303)
- ‘The West should learn from its colonial history when it indulges neo-imperialist fantasies. They didn’t work before and they won’t work now.’ (305)
- ‘As our commerce spreads, the flag of liberty will circle the globe and the highway of the ocean – carrying trade to all mankind – will be guarded by the guns of the republic. And as their thunders salute the flag, benighted peoples will now that the voice of liberty is speaking, at last, for them…that civilization is dawning at last, for them.’ Senator Alfred Beveridge, 1898 (311)
- ‘USAID gave a contract in 2003 to the KPMG consulting firm Bearing Point to create a free market from scratch in Iraq. A twenty-four-year-old American named Jay Hallen was put in charge of launching Iraq’s new stock exchange.’ (312)
- ‘Even without recent rhetoric, military intervention is too perfect an example of what this book argues that you should not do – have the West operate on other societies with virtually nofeedback or accountability.’ (312)
- ‘Nicaragua failed to recover despite the boatloads of aid money that arrived in the nineties: aid inflows averaged 40 percent of Nicaragua’s income from 1990 to 1999.’ (322)
- ‘Henry Kissinger expressed concern about the proxy standoff in December 1975 in Angola, featuring Soviet-backed and American-backed independence movements: ‘I do care about the African reaction when they see the Soviets pull it off and we don’t do anything.’ (323)
- ‘In 1975, after a socialist government came to power in Portugal, the colonizer hastily handed over power in Angola to whoever would take it, leaving the guerilla movements to fight it out among themselves. The white community fled en masse back to Portugal, amputating most of Angola’s economy. Angola has never recovered from the double blow of civil war and settler exodus.’ (325)
- ‘The subsequent civil war [in Angola] became more destructive because of the intervention of the Soviets, the Americans, and the South Africans in Angola.’ (326)
- ‘The civil war kept on, by the end killing 750,000 Angolans (7 percent of the population) and displacing 4.1 million people.’ (329)
- ‘Provincial capitals [in Angola] have been without electricity for ten or more years. Twenty-six percent of children die before reaching their fifth birthday, the third highest rate in the world. AIDS already infects 5.5 percent of the adult population. It is spreading rapidly.’
- ‘Historian Hans Schmidt noted, ‘US Navy ships visited Haitian ports to ‘protect American lives and property’ in 1857, 1859, 1868, 1869, 1876, 1888, 1889, 1892, 1902, 1903, 1904, 1903, 1906, 1907, 1908, 1909, 1911, 1912, and 1913. Finally, tired of all those round trips, the U.S. occupied Haiti from 1915 to 1934.’ (330-331)
- ‘After the fall of the Duvalier family, a mixture of military regimes tried to stave off the coming to power of the populist Jean-Bertrand Aristide, who was finally elected president in 1990. Another U.S. military intervention in 1994 restored Aristide to power after a coup.’ (331)
- ‘As far as promoting democracy, one study on the historical record of American nation-building says that it doesn’t usually work. Carnegie Endowment for International Peace scholars MinxinPei and Sara Kasper analyzed sixteen American nation-building efforts over the past century. Only four were democracies ten years after the U.S. military left – Japan and Germany after resounding defeat and occupation in World War II, and tiny Grenada (1983) and Panama (1989). Besides those already mentioned, the long list of twentieth-century intervention disasters includes Cuba (1898-1902, 1906-1909, 1917-1922), the Dominican Republic (1916-1924, 1965,1966), Nicaragua (1909-1933), and Panama (1903-1936).’ (332)
- ‘The argument for humanitarian intervention presumes an omniscient and disinterested military force coming from outside. The triple tragedies on UN peacekeeping in BosniaSomalia, andRwanda in the 1990s showed that such a force does not exist.’ (333)
- ‘The French (motivated by their strategic interest in maintaining a French zone in central Africa, which was allegedly threatened by English-speaking Tutsi rebels) played a shameful role in Rwanda, shipping arms to the Hutu extremists even after the genocide began in April 1994, the French evacuated from Kigali their embassy staff and citizens, some allies in the Hutu elite, and even the embassy dog, but left Tutsi employees of the embassy to their fate. Clinton eschewed American or UN military intervention in Rwanda in 1994 to kowtow to right-wing critics of ‘nation-building,’ but a few years later, when it became a useful rationale for occupying Afghanistan and Iraq, the right decided it liked ‘nation-building’ after all.’ (333)
- ‘After presiding over debacles like Rwanda, virtually the entire peacekeeping department of the UN ascended to run the whole organization when Kofi Annan (the former head of peacekeeping) became secretary-general.’ (334)
- ‘Thirty-nine percent of Ugandans are malnourished. Malnutrition in children and teens causes fatigue, listlessness, reduced immunity to disease, swollen gums, decaying teeth, painful joints, slow growth, and trouble paying attention in school. A pregnant woman who is malnourished is more likely to have a low-birth-weight baby, who has a smaller chance of survival. Some studies estimate that 60 percent of all deaths of children under five are directly or indirectly related to malnutrition.’ (337)
- ‘It is possible that the American post-World War II occupation is one of history’s rare examples of top-down transformation of a society by outsiders. If this is true, the example doesn’t lend itself to much replication since it took complete annihilation to get the chance to remake Japan. However, most of the evidence points to homegrown factors – the Americans were at most reconstructing an economy that was already advanced. (The same was true of the much-abused example of the Marshall Plan.)’ (345)
- ‘Most of the recent success in the world economy is happening in Eastern and Southern Asia, not as a result of some global pan to end poverty but for homegrown reasons.’ (346)
- ‘As recently as 1974, there were three times as many Singaporeans with no education as there were Singaporeans with a university education. Today, the proportions are reversed. The Organization for Economic Cooperation and Development (OECD) in 1996 certified Singapore’s graduation as a developed country. Singapore is the first tropical country to officially become [sic] a rich country, according to the OECD.’ (348-349)
- ‘China is the most remarkable success story of the last two decades: a very poor nation propelled into an economic powerhouse that scares the Chinese-made underpants off Western companies and other poor countries alike. It is an unconventional homegrown success, failing to allow any Western blueprint for how to be modern. It combines lack of property rights with free markets, Communist Party dictatorships with feedback on local public services, and municipal state enterprises with private ones. After the market-based reforms started in 1978, what was $59 billion in industrial production in 1979 became $844 billion in 2003. Exports of $44 billion in 1982 became $428 billion in 2003.’ (354)
- ‘To be sure, the ultimate economic test of a society is not rapid growth but attaining a high level of income. China’s per capita income is still only one sixth of that in the United States. The lack of democracy and the remaining inefficiencies caused by state-owned enterprises, banking-system problems, and other state-induced distortions in the economy are still major worries. The bubble may burst, or China may continue its amazing boom, but change is coming from exploration within.’ (355)
- ‘From 1970 to 1995, the share of manufacturers in Turkey’s exports rose from 9 percent to 74 percent. Turkey’s manufacturing sector as a whole has grown at a robust 5.6 percent per year from 1966 to 2003. Turkey is one of the success stories of the twentieth century. Never colonized or occupied by the West, it recovered from the collapse of the Ottoman Empire and a war withGreece after World War I. It has known steady growth ever since. Notwithstanding periodic macroeconomic crises, conflicts with the Kurds, and military coups, Turkey is today a stable democracy. Students get from the country are flooding the graduate schools of the United States, getting top faculty positions at prestigious American universities, or going back to Turkey to teach at very well regarded universities there.’ (359)
- ‘In 1968, the South African company De Beers discovered significant diamond deposits in BotswanaBotswana’s government negotiated a partnership agreement with De Beers. Whereas other governments with valuable minerals usually nationalized them, Botswana’s government acted shrewdly in enlisting De Beer’s expertise at diamond mining and marketing. In 1976, the De Beers Botswana Mining Company (Debswana) discovered another huge diamond pipe at Jwaneng, in southern Botswana, the largest diamond discovery in the world since the original South African discoveries at Kimberly. Botswana renegotiated the original agreement with De Beers, giving it close to 80 percent of the profits from diamonds. In 1986, Botswana sold to De Beers its stockpile of diamonds (previously withheld from the world to keep prices high) in exchange for cash and an unprecedented 5.2 percent of the shares of De Beers itself, including the right to name two directors of the De Beers board. Botswana’s economy grew at the world’s fastest rate over the last four decades, despite its dependence on diamonds.’ (360)
- ‘Botswana shows that if Africans can get good government from their rulers, the abundance of natural resources can be turned into a blessing.’ (360-361)
- ‘Chile is an exception to the current Latin American travails. After Salvador Allende’s socialist detour in 1970-1973, the brutal military government of Augusto Pinochet instituted free-market reforms. Macroeconomic crises plagued the military regime, but the free-market reforms eventually paid off in the 1980s. Democracy returned.’ (361)
- ‘Foreign aid, the World Bank, and the IMF were never more than trivial players in Chile during its discovery of a free-market democratic model.’ (363)
- ‘Even when the West fails to ‘develop’ the Rest, the Rest develops itself.’ (363)
- ‘We know that gross violations of free markets and brutal self-aggrandizing autocrats usually preclude success. Beyond that breathtakingly obvious point, there is no automatic formula for success, only many political and economic Searchers looking for piecemeal improvements that overcome the many obstacles described in chapters 3 and 4.’ (363)
- ‘As development workers Dennis Whittle and Mari Kuraishi once asked, what would the World Bank and IMF shock therapists advise if foreign aid were a country? They would probably abolish state ownership, do rapid privatization and downsizing, let the market work, and put an end to bureaucratic central planning.’ (367)
- ‘Don’t try to fix governments or societies. Don’t’ invade other countries, or send arms to one of the brutal armies in a civil war. End conditionality. Stop wasting our time with summits and frameworks. Give up on sweeping and naïve institutional reform schemes. The aim should be to make individuals better off, not to transform governments or societies.’ (368)
- ‘Remember, aid cannot achieve the end of poverty. Only homegrown development based on the dynamism of individuals and firms in free markets can do that.’ (368)
- ‘Put the focus back where it belongs: get the poorest people in the world such obvious goods as the vaccines, the antibiotics, the food supplements, the improved seeds, the fertilizer, the roads, the boreholes, the water pipes, the textbooks, and the nurses. This is not making the poor dependent on handouts; it is giving the poorest people the health, nutrition, education, and other inputs that raise the payoff to their own efforts to better their lives. (Just like a National Science Foundation fellowship to get a Ph.D. once increased the payoff to my own efforts to pursue a career.) I don’t mean to imply that all aid should be for projects. Other ideas of aid agencies’ possible comparative advantage could include distilling practical knowledge on operating banking systems or stock markets, giving advice on good macroeconomic management, simplifying business regulations, or making piecemeal reforms that promote a merit-based civil service.’ (369)
- ‘Fix the incentive system of collective responsibility for multiple goals. Have individual accountability for individual tasks. Let aid agencies specialize in the sectors and country they are best at helping. Then hold the aid agencies accountable for their results by having truly independent evaluation of their efforts. Perhaps the aid agencies should each set aside a portion of their budgets (such as the part now wasted on self-evaluation) to contribute to an international independent evaluation group.’ (369-370)
- ‘Called PROGRESA…, the program provides cash grants to mothers if they keep their children in school, participate in health education programs, and bring the kids to health clinics for nutritional supplements and regular checkups.’ (372)
- ‘The academic findings confirmed that the program worked. Children receiving PROGRESA benefits had a 23 percent reduction in the incidence of illness, a 1 to 4 percent increase in height, and an 18 percent reduction in anemia. Adults had 19 percent fewer days lost to illness. There was a 3.4 percent increase in enrollment for all students in grades one through eight; the increase was largest among girls who had completed grade six, at 14.8 percent.’ (372)
- ‘Aid agencies must let their staff gain experience in a particular local setting on a particular problem, and then let the experienced staff decide on the ground what is working and what is not. Instead, we see aid bureaucracies shifting staff around before they can gain enough experience, with the result that those agencies are full of generalists without local or specialized knowledge.’ (375)
- ‘Let me say that I do not have the next utopian scheme to fix aid, because there isn’t any.’ (379)
- ‘One idea that is too quickly dismissed is for foreign aid to just give [sic] cash grants targeted to the poorest people. This would be the purest solution to letting the poor choose for themselves what they needed. Although there are many potential pitfalls, it’s surprising that aid agencies have not experimented with this approach in any serious way. This would be a promising area in which to do a randomized controlled trial.’ (380)
- ‘The main mechanism for feedback and accountability for public services in the West is democracy. Could aid agencies find democratic mechanisms for local communities to vote on what services and project they wanted?’ (381)
- ‘It is strange that aid agencies talk so much these days about ‘good governance’ in the recipient countries without worrying about ‘good governance’ of their own aid projects.’ (381)
- ‘The only Big Answer is that there is no Big Answer.’ (382)

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