While many in the West doubt the effectiveness of international aid, studies overwhelmingly show that while aid may not solve global poverty by itself, it will reduce misery.
By Mirjam Vossen
By investing heavily in education, the number of children in sub-Saharan Africa going to school rose by half between 1970 and 2018. (Photo: Emmanuel Ikwuegbu/Pexels)
1.
In Angola, yellow fever broke out in December 2015. After mosquitoes spread the disease, a small number of patients became ill – terribly ill. They got high fever, started vomiting and began bleeding from the nose, eyes and ears. Half of them died within days.
Concerns grew as the epidemic in Angola spread. By March 2016, yellow fever had arrived in neighbouring Congo. A disaster was imminent and quick action was needed; in Congo, September is the rainy season – the time of mosquitoes. If the epidemic was not contained in time, things would be beyond control. Besides, Kinshasa, a metropolis of 7.7 million people, was only 100 kilometres from the infection area.
It was time for action. The governments of Angola and Congo joined hands, together with 50 development agencies. The World Bank and Gavi, a fund for vaccinations, together donated $32 million. In April and May, 22 million people were vaccinated in Angola and Congo, mostly in rural areas with a combined area larger than Germany.
Then came Kinshasa. The omens weren’t good. Kinshasa is cluttered with slums that have more inhabitants than Berlin, Paris and Vienna combined. Normally, a vaccination campaign of that scale requires a preparation time of at least six months. There was no such time.
Moreover, there was a huge shortage of vaccines…
On 16 August, the vaccination campaign started anyway. The available vaccines had been diluted into emergency doses. Red Cross volunteers marched into neighbourhoods with megaphones to inform residents about the impending campaign. Behind them came the vaccination teams, trained by staff from Médecins Sans Frontières. UNICEF helped prepare vaccination kits with syringes. District by district, residents were vaccinated. The vaccination teams were followed by logistics staff from the World Food Programme, who helped clean up the rubbish.
No media reported on the success of the vaccination campaign. Sadly, successes in development aid rarely make the news
Within two weeks, the job was done. All residents of Kinshasa had been vaccinated. It turned out that there were not 7.7, but 10 million people living there.
In the months that followed, not a single case of yellow fever turned up in Angola or Congo.
Chances are slim that you have ever heard or read this story. When journalists reported on the outbreak, they focused on the few newly detected cases of yellow fever, suggesting there were still many more to come. They wrote about vaccine shortages and the trouble of getting them in time. They quoted alarming predictions about the possible number of victims.
Yet no media reported on the success – Africa’s largest ever emergency yellow fever vaccination campaign. Sadly, successes in development aid rarely make the news.
That is unfortunate, because the vaccination campaign in Angola and Congo shows that well deployed international aid can be extremely effective. Yet this is not the general picture people have of development aid. On the surface, it may enjoy warm acclaim. A poll by the European Commission in 2022 shows that a majority of Europeans believe their own government and the European Union should invest in development aid. In the Netherlands, four out of ten households give to international charities, according to research by Geven in Nederland.
But beneath that approval, support is faltering. Many voice doubts about the effectiveness of development aid and think it is not money well spent. For example, a British survey showed that 53 per cent of British people agree that most financial aid to poor countries is wasted and that corruption in developing countries makes it pointless to donate.
This goes hand in hand with the widely held but mistaken belief that there is no progress in developing countries. As many as 87 per cent of people in the world think that poverty in developing countries has remained as bad, or even become worse in recent years. It is what researchers call ‘the support paradox’: we give because we think we ought to give, not because we believe it really helps.
This brings us to the key question that has preoccupied scientists, politicians and ordinary people for decades: does development cooperation work? Does it really help reduce poverty and promote prosperity?
A majority of Europeans believe their own government and the European Union should invest in development aid. But beneath that approval, support is faltering
2.
The short answer is that the contribution of international development cooperation is both modest and very large.
To begin with, the contribution of international aid to development is modest. The big drivers are economic growth and trade. Calculations by the World Trade Organisation (WTO) demonstrate that countries which have rapidly become wealthier have nearly always opened up to trade. The more open countries are, the faster they develop. Trade liberalisation, the WTO concludes, generally makes a very positive contribution to poverty reduction. It enables people to be productive, promotes economic growth, inhibits ill-considered interventions by governments and protects countries from economic shocks.
With trade liberalisation playing such a huge role in fighting poverty and creating prosperity, the contribution of international aid seems small by comparison. Yet it is not. Modern development aid has enormous clout in providing opportunities for people to shape their lives. Development aid cannot drive economies, but it can provide people with the knowledge, skills and health to do so themselves.
This is done first by focusing on health care, ensuring that fewer people get ill and die. For example, the world has made significant progress in reducing infant and maternal mortality, thanks in particular to development cooperation. Over the past 30 years, according to the World Bank, mortality of children under the age of five fell by as much as 59 per cent: from 1 in 11 children in 1990 to 1 in 27 in 2020. Development organisations such as UNICEF have contributed to this by vaccinating – with development funding – some 100 million children against deadly diseases such as measles, diphtheria, whooping cough, tetanus and polio, year in, year out.
Decreasing infant mortality leads to reduced population growth in developing and emerging countries. Parents who know their children will survive invariably have fewer babies. After all, in poor circumstances, children are their parents’ old-age provision, and in a world where many children die, it makes sense to have enough so as not to jeopardise that old-age provision. Once it is clear that this will work even with two or three children, parents begin to use birth control.
On average, in 1967 five children were stillborn per woman worldwide. By 2017, that number had halved to 2.4. In sub-Saharan Africa, the decline started only recently. But by now it has clearly set in there too. In 1977, the average African woman gave birth to 6.8 children; in 2018, 4.7.
Development aid cannot drive economies, but it can provide people with the knowledge, skills and health to do so themselves
With declining infant mortality and better healthcare, life expectancy is now rising. Let’s look at some more numbers. Globally, life expectancy has gone up by 20 years since 1960. This includes Africa. Yet life expectancy in sub-Saharan Africa is still only 61 years, while the average European lives up to 81 years. So here too, there’s lots of room for improvement.
Another great success story that development cooperation can claim is education. In Europe, 97 per cent of all children have long completed primary school; in sub-Saharan Africa, the figure was only 46 per cent in 1970. By investing heavily in schools, teachers and teaching methods, that rose to 68 per cent in 2018.
Then there is the huge decline in poverty worldwide. This decline is mainly attributed to the globalisation that took off in the 1980s, but it might not have happened so fast without a commitment to education and health. In 1980, around 42 per cent of the world’s population was extremely poor. That means they were living on less than $1.90 a day, leading to hunger, sickness and lack of education.
According to the World Bank’s poverty measurement, the number of extremely poor has dropped to less than 10 per cent of the world’s population.
The huge decline in poverty worldwide since the 1980s might not have happened so fast without a commitment to education and health
There is no doubt that we must continue to push for more globalisation, more trade liberalisation and more economic growth in developing countries. But we must also continue to invest in development cooperation. No one claims that you can eliminate hunger and poverty, change power relations or make a country rich with development money alone. But development aid can certainly strengthen these processes.
The effectiveness of development aid should therefore not be measured by whether it achieves an ideal world in which everyone is healthy, free and prosperous, but by the extent to which it contributes to this. Then it turns out that with aid, however modest, you can achieve a lot.
Danish development economist Finn Tarp has been collating the research on aid effectiveness for years. Time and again, he concludes that development aid reduces poverty, promotes the expansion of modern industry, makes business investments more profitable and improves the effectiveness of government spending.
Another researcher, US economist Steve Radelet, argues in The Great Surge: The Ascent of the Developing World that aid is not a ready-made solution and that not all aid works out equally well. But most aid has led to saving countless lives, building schools, improving healthcare, fighting disease, mitigating the effects of natural disasters and rebuilding countries after war. According to Radelet, aid programmes save millions of people by fighting malaria, TB, HIV-AIDS, and diarrhoea.
Development cooperation cannot lift a country out of poverty, both Tarp and Radelet observe. But it can make people a lot healthier, safer and smarter, enabling them to do that job themselves.
Finally, there is research by Partos, the Dutch association for development cooperation. In 2015, Partos finished an 8,000-page independent study analysing the work of the Dutch development sector. A research team of 200 academics found that the work of non-governmental organisations (NGOs) was ‘effective and efficient’. The money spent, they concluded, proved to be excellent value for money.
Aid programmes save millions of people by fighting malaria, TB, HIV-AIDS, and diarrhoea
3.
However, a world that is becoming increasingly prosperous is not a dream scenario for everyone. Since the 1960s, the environmental movement has raised awareness that global prosperity growth has led to pollution, resource exploitation and climate change. If the Global South becomes richer, thanks in part to international aid, this could be disastrous for our planet.
Some even want aid to poor countries to stop. For example, nature documentary maker Sir David Attenborough said in The Telegraph that it is ‘barmy’ to keep sending food aid to famine-ridden countries, when the issue is that there are ‘too many people for too little land’.
Few advocate such drastic and immoral measures as stopping food aid in the face of famine. Yet concerns about the consequences of growing prosperity are understandable. However, contrary to popular beliefs, many of today’s environmental problems are caused not by rich countries but by emerging economies.
Let’s look at litter. In the northern Pacific Ocean alone, 96,000 tonnes of plastic floats around, with dire consequences for birds, fish and other marine animals. Globally, governments and environmental organisations want this plastic soup to decrease. In 2021, the EU restricted the sale of single-use plastic items such as plates, straws, cutlery and cotton buds.
This is a worthwhile measure, but it will do fairly little to change the plastic soup. For the problem is mainly caused by countries currently in the process of escaping poverty. While rich countries throw away much more waste, most packaging, however useless, ends up in containers, or is separated during waste disposal – services lacking in poor and upcoming countries.
Europe, North America and Central Asia collectively account for only 4.5 per cent of plastic waste in the sea. The poorest countries also contribute little to plastic pollution. Although their roadsides, fields and streams are full of leftover plastic, the sum total is small. All southern African countries together contribute only 9 per cent to the problem of marine litter.
The biggest polluters are places currently emerging as middle-income countries, especially in Southeast Asia. The coastal areas of China and Indonesia together account for more than half of plastic litter. Other big polluters are the Philippines, Vietnam and Sri Lanka. Their residents have more and more money to buy stuff and throw it away. Their factories produce more and more goods for the foreign market. At the same time, waste collection and disposal is not yet well developed.
Contrary to popular beliefs, many of today’s environmental problems are caused not by rich countries but by emerging economies
The production of litter is just one of many environmental problems in poor and emerging economies. These countries also struggle with biodiversity loss, polluted air and polluted water. In rural Africa and Asia, wood is the main source of energy, resulting in massive deforestation. Wastewater flows unfiltered into streams and rivers. In Latin America, the rainforest is giving way to new fields and pastures. In large parts of Asia, factories and cars are causing growing carbon emissions and massive air pollution: of the world’s 50 most polluted cities, 48 are in Asia.
These are by no means luxury problems. Unsafe water, poor sanitation, dirty air in cities, lead exposure and indoor smoke from cooking on wood fires account for almost a tenth of deaths worldwide. Particularly in mortality of children under five, these environmental problems play a major role.
And so when it comes to environmental damage, serious progress can and needs to be made in densely populated and emerging economies in Asia and Latin America. And in countries in Africa that will – hopefully – be emerging economies in a few years.
It is unrealistic to expect poor and emerging countries to spontaneously put the environment at the top of the agenda. For governments and residents, better healthcare, decent work and good education are far greater priorities. This is shown, for instance, by the United Nations’ myworld2030 survey. In it, people indicate which of the 17 Sustainable Development Goals (SDGs) they consider most important. ‘Climate action’ ranks 11th. Other environmental goals, such as ‘affordable and clean energy’ and ‘life below water’ hang far below.
This survey may not be representative: most votes come from developing countries like Mexico, Colombia, Mauritania and Mali. But they clearly indicate that the environment is not a priority for people in poverty, even though it is precisely they who could be most affected by the consequences of global warming. Yet if it’s up to them, problems in the here and now, from unemployment to poor health care, must be solved first. Only then can the problems of the future be solved.
In poor and emerging countries, better healthcare, decent work and good education are far greater priorities than climate action or clean energy
The myworld studies emphasise the importance of poverty reduction: poor and emerging countries only become interested in the environment when they have the mental and financial space to do so. Meanwhile, in many emerging economies, the commitment to a better environment is already starting to gain momentum.
In 2018, for instance, the Chinese government banned the import of non-industrial waste plastic. With this, China aims to reduce litter at home. Environmental awareness among Chinese consumers is also growing. For instance, the online meal service Ele.me has introduced a no-chopsticks option in its ordering app. This has now saved 43 million pairs of chopsticks.
Even the poorest countries are starting to take measures against litter, and sometimes faster than us. For example, plastic bags have been banned in Rwanda for longer than in the Netherlands.
These are encouraging trends. For this reason alone, rich countries would do well to accelerate that process – and to do so by investing money and knowledge in the development of current and future emerging economies.
Aid projects by themselves cannot pull countries out of poverty and grow economies. However, they do have a positive impact
4.
As advocates of poverty reduction, we should be fair and acknowledge that aid projects by themselves cannot pull countries out of poverty and grow economies. However, we should send the message much more forcefully that development cooperation has a positive impact. Aid can significantly reduce misery.
Nor should we shy away from taking a clear moral position. Whether you call it charity, international solidarity or social investment, development cooperation helps people around the world to be healthier, safer, smarter, more resilient and active, so that they can fully dedicate their lives to their own dreams and to the dreams of others. Commitment to development aid is intrinsically good. Although the rise of anti-globalists and populists suggests otherwise, ordinary citizens remain sensitive to a solid moral argument.
Development creates prosperity. Once people live more comfortable lives, they can start caring for the environment and take action against climate change. The more the resolution of acute concerns around extreme poverty, disease and hunger is in sight, the more space is available to causes such as reducing plastic waste, stopping deforestation and reducing carbon emissions.
Rather than holding back global development, promoting it by offering generous aid will ultimately benefit both people and the environment.
Mirjam Vossen is a social geographer and development expert from the Netherlands.