[Comment] The Democratization of Aid

from All Africa

Public Agenda (Accra)

By Jeffrey D. Sachs

The outpouring of aid in response to the Indian Ocean tsunami brought hope to a troubled world. In the face of an immense tragedy, working class families around the world opened their wallets to the disaster's victims. Former US President Bill Clinton called this response a "democratization of development assistance," in which individuals lend their help not only through their governments but also through their own efforts.

But, while more than 200,000 people perished in the tsunami disaster, an equivalent number of children die each month of malaria in Africa, a disaster I call a "silent tsunami." Africa's silent tsunami of malaria, however, is actually largely avoidable and controllable.

Malaria can be prevented to a significant extent, and can be treated with nearly 100% success, through available low-cost technologies. Yet malaria's African victims, as well as those in other parts of the world, are typically too poor to have access to these life-saving technologies. A global effort, similar to the response to the Asian tsunami, could change this disastrous situation, saving more than one million lives per year.

Herein lies the main message of the new report of the UN Millennium Project, which was delivered in mid-January to then UN Secretary General Kofi Annan. The Project, which I direct on behalf of the Secretary General, represents an effort by more than 250 scientists and development experts to identify practical means to achieve the Millennium Development Goals to cut extreme poverty, disease, and hunger by 2015. Our new report, entitled Investing in Development: A Practical Plan to Achieve the Millennium Development Goals (available for download at www.unmillenniumproject.org ), shows that these goals can be achieved.

The key to meeting the Millennium Development Goals in poor countries is an increase in investment in people (health, education, nutrition, and family planning), the environment (water and sanitation, soils, forests, and biodiversity), and infrastructure (roads, power, and ports). Poor countries cannot afford these investments on their own, so rich countries must help.

If more financial aid is combined with good governance in poor countries, then the Millennium Development Goals can be achieved on time. In short, our new Report is a call to action. Rich countries and poor countries need to join forces to cut poverty, disease, and hunger.

The reason that the Millennium Development Goals are feasible is that powerful existing technologies give us the tools to make rapid advances in the quality of life and economic productivity of the world's poor. Illness and deaths from malaria can be reduced sharply by using insecticide-treated bed nets to stop the mosquitoes that transmit malaria, and by effective medicines when the illness strikes. The total cost of battling malaria in Africa would be around $2 to $3 billion per year.

With around one billion people living in high-income countries, it would thus cost just $2 to $3 per person per year in the developed world to fund an effort that could save more than one million children annually. When child mortality is reduced, poor families choose to have fewer children, because they are more confident that their children will survive to adulthood. Thus, paradoxically, saving children's lives is part of the solution to rapid population growth in poor countries.

Malaria is an important example where specific investments can solve the problems of disease, hunger, and extreme poverty. Our report makes dozens of such practical recommendations.

Investments in soil nutrients and water harvesting could help African farmers double or triple their food yields. Anti-retroviral medicines can help save millions from death due to AIDS. Rural roads, truck transport, and electricity could bring new economic opportunities to remote villages in Latin America, Africa, and Asia. School meal programs using locally produced food could boost attendance by poor children, especially girls, and improve their ability to learn, while also providing an expanded market for local farmers.

These investments are an incredible bargain. Rich countries have long promised to increase their aid levels to 0.7% of national income (from around only 0.25% today). The promise of 0.7% means that the rich world would give developing countries a mere 70 cents out of each $100 of national income.

In recent weeks, many European countries have pledged to honor the 0.7% commitment, and five European countries (Denmark, Luxembourg, the Netherlands, Norway, and Sweden) already do so. It's up to the US and Japan to follow through on their promises as well. Moreover, with the "democratization" of aid now underway, we can look forward to increased private efforts alongside official development assistance.

Of course, not all developing countries are sufficiently well governed to use an increase in aid in an honest, effective way. The world should therefore start this bold effort by focusing on the poor countries that are relatively well governed and that are prepared to carry out needed investments in an efficient and fair manner. Ghana, Senegal, Tanzania, Kenya, and Ethiopia are on that list. It is urgent that we get started in these and similarly well governed poor countries this year.