While Elie’s been investigating the Carter Center, I’ve been scanning literature (mostly academic) on general questions about aid: what has worked in the past? What’s promising for the future? etc.
Rather than trying to come to an independent conclusion on each debate, I’ve been trying to establish which beliefs are supported by evidence that is largely undisputed among scholars (and where there is no agreement, get a sense of what each side believes and what its most frequently pointed to evidence is).
At this point I’ve looked in a lot of places (though I’m still far from done) and I’m going to start sharing where we stand (and what we’re still missing) on various questions. First I’ll discuss what I’ve read about the track record of aid to developing-world areas.
The vast majority of the large-scale “success stories” I’ve seen come from health initiatives (particularly “vertical” health initiatives, i.e., large-scale campaigns against particular diseases).
- Millions Saved: Proven Successes in Global Health (published by the Center for Global Development) seems to be the most frequently cited reference by authors seeking to point to “success stories.” It lists 20 large-scale case studies including the global eradication of smallpox and the Carter Center-led campaign against guinea worm.
- There is also a success stories compilation by the World Health Organization, though these case studies don’t provide data sources (and haven’t responded to our request for them) and in many cases seem to be discussing smaller-scale initiatives.
- Jeffrey Sachs’s The End of Poverty lists ten “significant examples of programs that have been scaled up massively to remarkable success” (pgs 260-265). They are again dominated by health interventions. My notes on them are available here (via our public email list).
The main non-health “success stories” I’m aware of:
- Philanthropic funding of agricultural research is often credited with a major role in catalyzing the emergence from poverty of many countries in Asia and elsewhere (an emergence often referred to as the “Green Revolution” because of the prominent role of productivity gains in agriculture). So far, efforts to expand the “Green Revolution” to Africa have largely been disappointing (overview on pgs 66-72 of Can the West Save Africa? (PDF) by William Easterly).
- There is “suggestive” evidence that education aid has resulted in increasing primary enrollments, though the effect of this increasing enrollment on growth/standard of living/etc. is unclear (overview on pgs 47-53 of Can the West Save Africa? (PDF) by William Easterly).
I don’t believe that any of the sources cited above are fully comprehensive (or necessarily fully reliable) as lists of large-scale success stories. We’re still looking for more.
Aid has also had major failures – but insufficient monitoring and evaluation means that few are thoroughly documented or discussed.
- Dissatisfaction with the accomplishments of aid to date is fairly widespread. The latest report on the Millennium Development Goals shows mostly inadequate/less-than-hoped-for progress (and no progress in many cases). William Easterly argues that
systematic testing would not just count the alleged ‘success stories’ of aid, but also the larger number that got the same amount of aid as the ‘success stories’ and failed: Guinea-Bissau, Somalia, The Gambia, Mali, Rwanda, Nicaragua, Burundi, Guyana, Zambia, the Central African Republic, Senegal, Suriname, Chad, Niger, Togo, Haiti, and so on. Further testing shows that these outcomes were not an artifact of selection bias or reverse causality.
- Yet while project-level evaluations provide scattered analysis of projects gone wrong (one example of a failed World Bank project here), we have not found well-documented “failure stories” along the lines of the “success stories” above – examining major humanitarian (as opposed to political) initiatives that had little or negative impact.
- Part of the reason may be the general lack of evaluation and documentation in international aid. The sentiments of this Center for Global Development paper, arguing that “very few programs benefit from studies that could determine whether or not they actually made a difference. This absence of evidence is an urgent problem,” are common; the Paris Declaration on Aid Effectiveness, an agreement between major aid agencies, includes an expressed commitment to more monitoring and evaluation.
I have the sense that failure stories in aid are common, but I continue to look for more concrete examples of what has gone wrong and how.
The relationship between aid and growth at the macro/country level has been extensively studied, but is not well established one way or the other.
Some believe in a moderate positive relationship, often with the caveat that aid works better where existing institutions are stronger (more below) or that aid has diminishing returns. Others believe that there is no relationship or that there is insufficient evidence. Two particularly accessible summaries: A Primer on Foreign Aid (from the optimistic side) and Macro Aid Effectiveness Research: a Guide for the Perplexed (from the skeptical side).
There are no established broad patterns in the sorts of environments where aid has worked, though many believe that aid works better where existing institutions are stronger.
A Primer on Foreign Aid states,
the view that aid works better (or in a stronger version, aid works only) in countries with good policies and institutions has become the conventional wisdom among donors, partly based on [empirical] research and partly due to development practitioners that believe this to be the case based on their own experience.
However, as this paper acknowledges, the empirical research has been questioned repeatedly (as in this paper, which claims that the statistical work underlying most such claims is excessively fragile). In addition, Millions Saved (the success stories compilation referred to above) gives examples that “Success is possible even in the world’s most underdeveloped and remote regions, in the face of grinding poverty and weak health systems” (quote available at this page).
One caveat to keep in mind about all of this analysis is that most academic literature focuses on official aid flows – aid from developed-world governments (or multilateral institutions such as the World Bank), which usually goes through developing-world governments. This sort of aid is different in many ways from private donations going through nonprofits.