Comments

I think we create a problem in this discussion with the use of the word 'aid' which has a defined meaning in the DAC/OECD context and in the public mind. Rather, the word investment might be better - we invest in disease control, climate change mitigation and other examples that Stephen gives primarily for good self-interested and not humanitarian reasons. Australia invests in tfe Northern Territory in Biosecurity management to prevent the entry of damaging invasive species for Australian public good reasons It helps the NT but we would hardly call it aid. Our private sector invest in mining in Africa that will generate private returns but will deliver substantial economic and social benefits to the countries concerned. Would we define this investment as aid if done by a government agency? I think an interesting discussion emerges from the transition of countries out of aid. We lost a big opportunity when Korea almost overnight fell out of the aid category and an extensive set of cooperative partnerships built up in aid arrangements were lost through the absence of sustainable partnerships because we had no successor arrangements in place.

Hi Robert, Thanks for the comment. We all agree that economic growth and policy reform is key to development. I do have to take issue however with your characterisation of both Sachs and Easterly's perspective. It is a real misrepresentation of the views of both men. First of all, there is not much value dredging up and getting into this tired Sachs-Easterly debate. Fact is, the soundbites that both men use to promote their ideas aside, they probably agree on more than either would care to admit. To characterise Sachs as all about charity and as ignoring policy reform and economic growth is just wrong - based both on his writings and action. And to say that Easterly has been a strong proponent of "systemic policy reform" is a very kind representation of what he has done in his career. Of course policy reform is needed: at the local level, at the national level and at the international level. The issue is which reforms and how to galvanise action on those reforms. Some would argue that to get international action (for example on reducing agricultural subsidies or trade reform), you need big goals and commitments to get some movement. Others emphasise community leadership to reduce barriers to getting programs going. I don't know if the SDGs are needed or will work. I do know that the MDGs - while imperfect - have had real impact and galvanised more action on child health, agricultural reform, HIV treatment, on primary education and - yes - on getting money flowing to support these programs. And, as an example, after just under a decade where the HIV response was funded by donors, now, for the first time, over 50% of the funds being spent on HIV (treatment and prevention) in developing countries is coming from developing country governments themselves. The development arena is complex and we have to examine these issues with the nuance and care befitting such complexity. Reducing perspectives on aid to two diametrically opposed simplistic strawmen doesn't help further the debate.

Ben, Thanks very much for this positive response, and the additional information you provide. In the interests of accuracy, I would note that the authors don't talk of "evidence" that the new programs will lead to XDR-TB, but rather point to "threats" that, if not dealt with, might lead to this unfortunate outcome. That's a very different claim, and not one I think you'd disagree with.

Hi Robert, That's a very good argument. But the comparison to the US doesn't really work (why don't we give aid to the US). Doesn't work because, as Stephen noted in his post, most of the most acute poverty in most developing countries is an order of magnitude more severe than poverty in the US. cheers Terence

TB in PNG and Western Province is one of AusAID’s highest priorities and we welcome the debate on cross-border TB control. There has been real progress and commitment from PNG. With AusAID support, PNG TB experts such as Dr. Rendi Moke and his team have shown real leadership and drive. They are making a real difference in Western Province. (See http://www.ausaid.gov.au/HotTopics/Pages/Display.aspx?QID=677) AusAID is committed to long term support (10+ years) for TB services in Western Province, including broader support to Western Province’s health system. Our approach is in line with the World Health Organization (WHO) best practice guidelines for TB and addresses many of the issues raised by the authors. These include: the need for long term support to the PNG health system; ensuring access to primary health and appropriate hospital TB services; a strong focus on community engagement in controlling TB; and independent monitoring and evaluation. We have an initial $8.5 million program over four years to support the PNG Government to strengthen control of TB in Western Province and it will continue for as long as necessary. We also support Western Province primary and secondary health care services, essential for TB control, though improving the supply of essential drugs, training health workers and health infrastructure. This includes South Fly communities. We also provide core funding to the Global Fund for AIDs, TB and Malaria (GFATM) for PNG’s national TB program (total program US19 million) and core support to WHO - the global technical lead on TB and other communicable diseases. Our total package of support to PNG health priorities (including HIV) in 2011/12 was $113 million. Other Australian government agencies are responsible for health and TB services within Australia. AusAID’s mandate is to work within PNG borders. We are working to support cross border coordination, oversight and accountability through the Torres Strait Health Issues Committee (HIC). The blog authors note the risks of incomplete TB treatment within Australia, an issue <a href="http://www.abc.net.au/news/2011-11-26/who-warns-of-untreatable-tuberculosis/3696226" rel="nofollow">raised</a> by an independent WHO expert assessment in October 2011. WHO plans to undertake a substantive epidemiological risk assessment in September 2012 which will include a specific focus on drug resistant TB cases. AusAID support to the PNG South Fly TB program is based on <a href="http://www.who.int/tb/strategy/en/" rel="nofollow">established</a> WHO global standards for an effective TB and MDR-TB response. Our support seeks to ensure continuity of care through a strong community based response and appropriate hospital care. This approach, backed by WHO, is proven to work internationally and to have an impact. There is no evidence that “…the net outcome of these programs will be rapid emergence of XDR-TB.” There has been real progress and commitment from PNG. AusAID will continue to work closely with the PNG government, WHO and other Australian partners to monitor progress of our support and adjust accordingly. WHO will be undertaking an independent review of the progress of the strengthening of the TB services in the South Fly in November 2012.

Thanks Geoff, that's a very useful clarification. Economist, Lant Pritchett, has coined a handy phrase 'flailing state' to describe states where administrative capability is lagging. Announcing increases in funding and policy intent is the relatively easy party, implementing it through a labyrinth of legislation and layers of government is another.. These are the kind of issues that the public need to pay close attention to, supported by good policy analysis and monitoring. You may be interested in a research project that Devpolicy is doing with NRI. We are planning to conduct public expenditure tracking surveys in the health and education sectors--similar to those that the World Bank did in 2002. Potentially this research will highlight how much funding actually reaches to services at the end of the track, and what happens to fees and the quality of services. Devpolicy/NRI are just getting started and plan to conduct the surveys later this year. Thanks again for your comment. Perhaps we can tempt you to write a post for the Devpolicy blog..

For clarificaiton, the Government of PNG has not abolished fees for health care. The Public Hospital (Charges) Act 1972 and associated regulations which set charges for public hospitals and clinics is very much in force. As the National Government only has jurisdiction over national health with provincial governments having jurisdiction over rural health services (the bulk of the health system) they are not in a position to abolish fees for rural health even if the had the desire.

Robin, That's an excellent set of comments. And I must concede I have contradicted myself by asking what sort of aid might go to, say, Indonesia after it has graduated. What I should have written is what sort of aid we might give to Indonesia after it has graduated from a conventional aid program. The future of aid is very uncertain. Countries such as Thailand and Malaysia have been pretty much graduated. Will aid fade away all together from Asia if and when countries such as Indonesia graduate? I both hope not and doubt it. But it will be difficult. As you say, at the moment aid is such a useful tool for international action "because the funding pool is there [and], because it can be used for almost anything" Things will be more difficult if we lose that flexible funding pool. Still, my sense is that the need for funding around issues of common interest will remain strong, and that as a result somehow a way will be found through. I think you agree. What about the multilateral dimension? I agree with you that we will still need multilateral approaches. But these might fall short of binding treatries. Rather they might provide frameworks for bilataral and regional deals (as we are seeing in climate change). And for regional public goods we will continue to see purely bilateral and regional approaches.

Bob, Every country has the capacity to do more to reduce poverty. Because others should do more does nothing to reduce our own obligation. It seems odd to me to say "I'm not going to help you because someone else could or should." Isn't that called washing your hands? You might want to move away from questions such as how much aid we should give to Asia, but, as you concede, it is not a question the government can avoid. And there are several who think we should give less aid. It's a valid and important subject to engage in. We spend a lot of time arguing about specific aid themes and projects, but it is useful sometimes to step back and address the bigger questions, however difficult they are and however imperfect our answers.

To be able to help people in need is nothing wrong. Actually, it is part of our human natures However, when it comes to politics, it is a different story. Unlike churches, politics something puts its selfish thoughts above the justified folks need.

Thank you Michelle very informative,like Vanessa I must admit I am bit weary about reading blogs,tweets, facebook posts under pseudonyms, but I find Tavurvur's information through his tweets and blogs are informative. Looking forward to reading more.

Thank you for this illuminating discussion, Stephen. I suggest that we might look at the case for aid in different ways. The arguments to assist the poor are compelling but not sufficient. If poverty reduction is a major impetus for aid then we can ask why we aren't continuing to support the poor in Thailand or Singapore or, for that matter, the poor in the US? One answer is that these nations seem have the capacity to address poverty themselves. The question can also be asked in the case of Indonesia. Here there are large numbers of poor but also a large and growing affluent class of people. In your first blog you noted the success of Australian aid in tax reform that "... resulted in huge increases of revenue to the Indonesian government, much larger than our aid, collected in a relatively clean, non-corrupt way." Given the large population in Indonesia and presumably a very large number of people with incomes comparable to those in Australia, it seems reasonable to ask if this group is paying its share through taxation for poverty reduction and other public goods? Is it possible that this affluent group is numerically larger than the comparable group in Australia? Are they sharing an equitable responsibility for the financing of the development of their own country? The second way in which we need to look at aid is with a sharper focus. I think it is time to move away from big, complex questions such as ‘should we be giving aid to Asia’ towards more manageable and focused questions such as ‘should we be giving aid to Cambodia for education or to PNG for health’? This avoids mixing very different aid needs in the huge and diverse Asian continent. It may be more useful to focus more on the need for aid in identified areas such your excellent example of Indonesian taxation, or education, health, or security, and so on. Policy makers do have to deal with the bigger questions of the overall aid program. What I am suggesting is a bottom-up approach that aggregates more specific need in context, the evidence for supporting these needs and lessons learned about meeting such needs in those contexts. These are not arguments against aid, but arguments for aid where it is demonstrably needed, where it can be most effective, and where responsibilities for funding it are shared fairly.