“Aid never works”

Why people believe it

Aid failures are real, documented and memorable, from PlayPumps to the slow rebuilding of Haiti. 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. 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. In randomized trials pooled by a Cochrane review, bed 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, and the Failure Archive.