---
title: Aid never works
summary: Some aid has failed, and economists still argue about how much aid raises countries’ growth. But specific, well-measured programs, from smallpox eradication to oral rehydration and cash transfers, have saved and improved millions of lives.
verdict: 'false'
conditions: [measurement-gap, story-bias]
sources:
  - title: Can Foreign Aid Buy Growth?
    publisher: William Easterly, Journal of Economic Perspectives 17(3)
    year: 2003
    url: https://www.aeaweb.org/articles?id=10.1257/089533003769204344
  - title: 'Counting Chickens When They Hatch: Timing and the Effects of Aid on Growth'
    publisher: Michael Clemens, Steven Radelet, Rikhil Bhavnani and Samuel Bazzi, Center for Global Development working paper 44, published in The Economic Journal 122(561)
    year: 2012
    url: https://www.cgdev.org/publication/counting-chickens-when-they-hatch-timing-and-effects-aid-growth-working-paper-44
  - title: The Moral Imperative toward Cost-Effectiveness in Global Health
    publisher: Toby Ord, Center for Global Development
    year: 2013
    url: https://www.cgdev.org/publication/moral-imperative-toward-cost-effectiveness-global-health
  - title: 'The Short-term Impact of Unconditional Cash Transfers to the Poor: Experimental Evidence from Kenya'
    publisher: Johannes Haushofer and Jeremy Shapiro, Quarterly Journal of Economics 131(4)
    year: 2016
    url: https://doi.org/10.1093/qje/qjw025
  - title: Insecticide-treated nets for preventing malaria (Cochrane systematic review)
    publisher: Joseph Pryce, Marty Richardson and Christian Lengeler, Cochrane Database of Systematic Reviews
    year: 2018
    url: https://pmc.ncbi.nlm.nih.gov/articles/PMC6418392/
review: draft
---

## Why people believe it

Aid failures are real, documented and memorable, from [PlayPumps](/record/case-studies/playpumps/) to the slow [rebuilding of Haiti](/record/case-studies/haiti-earthquake-reconstruction/). Serious economists have been sharply critical. Successes are harder to see, because a success is often a death that didn’t happen.

## What’s true

Whether aid makes whole countries grow is a live debate. In 2003 the economist William Easterly argued that the evidence that aid buys growth is weak, and that aid agencies underinvest in scientific evaluation. He urged more modest goals: “helping some of the people some of the time.” A later reanalysis by Michael Clemens and colleagues of three influential studies found that increases in aid were followed, on average, by modest increases in growth, with wide variation between countries and smaller gains at high levels of aid. And some programs fail outright or cause harm.

## What’s false

The word “never.” Judged program by program, some aid has worked spectacularly. Smallpox was eradicated through a [global campaign](/record/case-studies/smallpox-eradication/). Drawing on the official history, the philosopher Toby Ord puts its total cost at about $1.5 billion in 2013 dollars, against more than 100 million lives saved. He also cites estimates that global health efforts against diarrhea, malaria, smallpox and vaccine-preventable diseases have each led to at least 2.5 million fewer deaths a year. Child deaths from diarrhea fell by millions a year as [oral rehydration therapy spread](/record/case-studies/oral-rehydration-therapy-spread/). In randomized trials pooled by a Cochrane review, [bed nets](/record/interventions/insecticide-treated-nets/) cut child deaths from all causes by about 17 percent. A randomized trial of unconditional cash transfers in Kenya found higher household consumption and large gains in psychological well-being.

The fair reading is that “aid” is not one thing. Some programs work very well, some do nothing and some do harm, and the difference can be measured.

## What to ask instead

Which program, for whom, and what is the evidence? Ask what was compared with what, and whether failures were published as well as successes. See [Open Problem 20, When Charity Harms](/open-problems/when-charity-harms/), and the [Failure Archive](/record/failure-archive/).