Dead Aid: Dead Wrong
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This is cross-posted from Think Progress’ Wonk Room.
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It’s hard keeping up with the avalanche of inaccuracies and misinformation coming from Dambisa Moyo, the Zambian-born banker turned aid critic and now author of “Dead Aid.” You can see the growing catalogue that ONE has compiled here.
Yesterday, we caught wind of a Q and A she did with Fast Company magazine where she confirmed what we’ve long suspected: that Moyo has little understanding of the health and poverty fighting programs she routinely criticizes. This time it was PEPFAR, the US anti-AIDS program, which has put over 2 million Africans on life-saving treatment. Here’s what she had to say:
Let’s talk about Pepfar. They’ve increased it to $30 billion for 15 countries. Say every country roughly gets $2 billion. Zambia has 10 million people, so that’s roughly $200 a person. That’s approximately the per-capita income of Zambia — you’re roughly doubling the per capita income. But that has had no meaningful impact on the health sector. $2 billion and you can’t overhaul the system? That seems to me completely absurd. African governments have completely abdicated their responsibility.
If Ms. Moyo had any basic knowledge of the program – or had done a simple Google search — she’d know that last summer the U.S. Congress approved $39 billion in funding over five years for HIV/AIDS, malaria and tuberculosis programs under both PEPFAR and the Geneva-based Global Fund to fight AIDS, TB and Malaria. Together, these two programs fund projects in over 137 countries.
PEPFAR is not a perfect program and its supporters have historically been its loudest critics, but no one with any basic knowledge of the program would doubt its groundbreaking (and lifesaving) achievements in just five years. By the end of 2008, PEPFAR was supporting treatment for more than 2 million people in Africa; care for more than 10 million people with HIV worldwide, including more than 4 million orphans and vulnerable children; and providing antiretroviral treatment for pregnant women, allowing nearly 240,000 infants to be born HIV free.
Furthermore, consider that just 10 years ago it cost $10,000 per person per year to treat a patient with AIDS. Treatment is now available for $140 per person per year, a breathtaking improvement in efficiency.
Moyo goes on to say that only a fifth of PEPFAR money reaches the ground.
The dollar amount [of PEPFAR] that hits the individual is 20 cents on the dollar if you’re lucky.
We tend to agree with Ms. Moyo that not enough aid money is hitting the ground, but her suggestion that only 20 cents on the dollar in PEPFAR money is hitting the ground has no basis that we are aware of. We challenge Ms. Moyo to provide evidence of her assertion. Where is the evidence? Rather than making up numbers and misleading the public, we wish Ms Moyo would join us in supporting the new aid transparency initiative we’re backing called Publish What You Fund.
Moyo’s comments would be laughable if the subject matter wasn’t AIDS and the question wasn’t whether the United States and others should continue these successful, life saving programs.
-Ben Hubbard, Chief of Staff, ONE
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April 6, 2009 at 1:37 pm
Interesting response Mr. Hubbard, but isn’t one of the main arguments by Dr. Moyo the fact that aid has seriously allowed African governments to be non-responsive to their citizens when it comes to basic responsibilities of healthcare, clean water, education etc. When will these governments be helad accountable? What happens if the US government can’t subsidize African governments anymore? Shouldn’t organizations like ONE be actively pushing the same agenda as Dr. Moyo, which is to ensure Africans can stand on their on two feet and be productive members of the global society. Or is their something I’m missing?
April 6, 2009 at 4:19 pm
Ridiyen,
What Mr. Hubbard was pointing out was the mounting factual inaccuracies, which are rampant throughout the book and increasingly called out in book reviews.
Unfortunately, Moyo has this big rug called “charity-based aid” which she likes to sweep any inconvenient and obvious examples (MCC, PEPFAR) of effective aid focused on measured results, centered on transparency, and on reform. As Michael Gerson said in his review of the book last Friday in the Post: either she’s trying to say *some* aid is bad – which is nothing new, or that aid in general is bad which seems silly at best and cynically opportunist at worst.
here’s the Gerson op ed for reference:
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/02/AR2009040203285.html
April 6, 2009 at 5:33 pm
Christian,
I saw Dr. Moyo speak twice, and also in numerous interviews. She clearly states the Aid she is referring to is Govt to Govt Aid. Not disaster Aid, nor Charitable Aid, Govt to Govt. I’ve heard her state this repeatedly, and even Gerson’s column ignores those facts. She’s obviously stepped on some toes, but I think the people she is taking to task is the African governments, not really the self righteous organizations that feel some need to pity the ‘poor’ Africans. I, and many other Africans, are tired of this pity party. Sure we need help, but if after 60 yrs of Aid, Africans aren’t standing on their own two feet and competing in the world, something is gravely wrong.
April 6, 2009 at 8:29 pm
Thanks Ben for this additional information – it will come in very handy in the future.
ALWAYS FOREVER, ONE – debbie
http://www.mpwn-uganda.org
April 8, 2009 at 4:30 pm
Ridiyen,
Why does Moyo criticize PEPFAR if it isn’t what she’s talking about? Why does she criticize bednet programs if it isn’t what she’s talking about? Why are you so sure she’s being consistent rather than hiding behind undefined language?
I’ve heard her say the same things you’re referencing, but I am guessing a former white house official (gerson) didn’t drop an op-ed in the washington post without doing some research (or more likely having it done for him) about a topic he’s leading expert on. His credibility on these issues is well established and I find it hard to believe that he, other policy experts and ONE are all just “misinterpreting” her book. You shouldn’t give ONE the benefit of the doubt, but I’d encourage you to hold Moyo to the same standard.
-Henry
April 9, 2009 at 10:45 am
Henry,
Let me first thank you for a civil discussion. This topic, understandably, has ruffled some feathers, but its great that in all the negativity we can have a genuinely productive discussion. Without speaking for Dr. Moyo, I believe when she discusses PEPFAR, bed net programs and any other programs which have been successful on the continent, her concern is chiefly that these programs absolve the African governments from providing the services whcih they should be providing. For example, as long as they depend on PEPFAR, they have no incentive to establish their own programs, which I believe fosters a horrible dependancy syndrome.
I read the Gerson article too, but again, like a lot of the critics he seems to ignore the fact that at some point Africa has to stand up on its own two feet. This has to happen and more people and organizations should be working towards this if African countries are to become serious players on the global stage. We had a good discussion at the CATO Institue with Dr. Moyo, which also included the Gerson article.
My only issue with ONE is that it seems to engage in underhanded tactics, when it should be above that considering its role. The latest of these tactic is the sponsorship of a link to ‘Dead Aid is Dead Wrong’on the Google search results for ‘Dead Aid’. To me it just seems the should be more constructive in their approach. Dr. Moyo certainly has some flaws in her arguments, but I think healthy debate, rather than cheap tricks, can be had by both sides.
April 9, 2009 at 3:39 pm
Thanks Ridiyen. I think an important assumption for this conversation is that there isn’t anyone out there that doesn’t believe that the only way Africa will achieve long term economic growth is through a healthy market system. Sachs, arguably someone, who believes quite the opposite of Moyo in terms of how poverty should be ended… writes extensively about what the precursors are to the market taking over for aid — that’s the goal for aid and he cites the marshall plan as well. In that sense, I don’t think Moyo is original.
She says in no uncertain terms that aid is the cause of poverty rather than just ineffective. I have lots of respect for Mr. Easterly, who’s a vocal critique of aid, but his analysis is different (aid is ineffective, not the cause). The second piece of Moyo critique has been the subject of much discussion (how much and what aid to cut).
My point in binging up pepfar and bednets is that they are effective, but she uses them as examples of ineffective aid. She has clarified that she’s not talking about cutting them, but that only confuses me more. To your point, I think you’d have trouble finding aid proponents who don’t want to these countries to stand on their own two feet… that’s rhetorically powerful, but not necessarily helpful in assessing the best solution. I hear another type of critic of aid (I don’t put moyo in this category at all) that says cut it off and “let them die.” They have the same premise… and the same goal.. just a different means. I mention this only to point to the fact that having a noble goal doesn’t make everything that preceded it as noble. I would like to hear from Moyo about what she considers government to government aid (and how much money she’s actually talking about cutting).
Finally, I certainly can’t speak for ONE, but I think they have a point of view on what she’s saying. In the same way that Moyo is going around selling her book called “Dead Aid” (which lacks nuance) generalizing left and right about the efficacy of aid they might be doing the same thing – I think that’s a media strategy. But I will point out that they didn’t do it when Easterly’s book came out, this book is different, and the Gerson’s and the Sachs of the world seem to agree. I for ONE, take those critiques pretty seriously. That said, I think this discussion is great… and think ONE deserves some credit for creating a forum for it (as well as provoking a conversation — even if it was in a partial way.