Dead Aid is a provocative look into the failure of aid to Africa over the past 60 years. The author Dambisa Moyo, originally from Zambia, provides a first-hand account of the efforts of the West. Her resume is quite impressive; she holds a bachelors degree in Chemistry and an MBA in Finance from American University, a Masters from Harvard and a PhD in Economics from Oxford. She has worked for both the World Bank and Goldman Sachs. Earlier this year Time magazine named her as one the top 100 most influential people in the world.
The first half of her book describes the reasons why aid has failed to awaken the African continent. She argues that not only has it not helped, but it has exacerbated the problems in Africa. She believes that the primary reason why aid does not work is that it promotes government corruption. Leaders of autocratic regimes quickly become accustomed to receiving large lumped sums of cash from foreign governments. Because they are not expected to pay back the loan, they feel no need to use the money wisely. Much of it is simply funneled out of the country into the corrupt leader’s foreign bank account. Zaire’s president Mobutu is purported to have taken nearly US $5 billion. The rest of it is squandered in ineffective government programs. Very little of it is ever seen by the citizens of the country for which the money was intended. The prospect of overthrowing the corrupt leader to take control of the aid channels causes frequent civil wars. The atmosphere created by the corrupt politicians makes foreign and domestic investment unattractive. Without these investments the country descends deeper into dependency on foreign aid.
According to Dambisa Moyo, the first step to fixing Africa is cutting all aid to the continent. She believes that this will open up greater possibilities for foreign direct investment. She spends a significant portion of the book describing how China is already leading the way in investments in Africa. While much of China’s actions are the result of its need for oil, it has provided much needed infrastructure to several African countries. Many Africans see China’s influence as more positive than the US. Moyo also proposes the institution of micro-credit organizations patterned after the Grameen Bank in India as well as decreasing taxes on African remittances, allowing funds to be transferred directly to the people who need it most.
While the data that Dambisa Moyo offers makes it quite apparent that aid is part of the problem, it is difficult to believe that all aid is detrimental. Employees of the non-profit group where I am interning have indicated that the malaria programs in African have been some of the most effective programs in utilizing foreign aid. Very real successes have been achieved in the country. Malaria rates in each of the 15 target countries of the President’s Malaria Initiative have been reduced. This has allowed families to dedicate their resources to economic growth rather than pills to kill the malaria parasite.
This doesn’t mean that malaria programs are flawless. The administrative pyramid of the President’s Malaria Initiative is extremely complicated. Several layers of bureaucracy separate the source of funding and center of disease control from the African child receiving his or her first dose Artemisinin pill. A reduction of levels and additional correlation meetings between the non-profit organizations using the funding could greatly improve the efficiency with which the funding is used.
Dambisa Moyo also points out that when giving aid to Africa, foreign governments have a tendency to give finished products directly to the people putting many local producers out of a job. Manufacturing plants producing bednets in America can easily undercut start up groups in Africa. When considering an increase to the funding for combating malaria, American organizers should divert funds to local producers whenever possible in order to stimulate economic growth while simultaneously promoting better public health.
Fantastic book. Quick read. Find it. Read it. Love it. Live it.
Mark Honigsbaum’s Book The Fever Trail is extremely comprehensive look at the first efforts to find a cure for malaria. The story begins in 1638 with the mysterious cure of the Spanish princess Dona Francisa Henriquez de Ribera. While visiting Peru she contracted what appears to have been malaria. A Jesuit priest that was passing through the area heard of her illness treated the disease with an infusion bark from the cinchona tree. She quickly recovered from the disease and returned to Europe to spread the news.
The quinine extracts from the bark effectively lower the temperature of the body enough to prevent the reproduction of the parasite in the body, breaking the cycle of fevers. Unfortunately the species of tree from which this powerful drug was derived was only found in Peru and Bolivia along the Andean fault line. A few British scientists recognized the value of transporting the seeds to Europe where mass production could begin. Among them were Richard Spruce (1817-1893), Charles Ledger (1818-1905), and the Sir Clements Markham (1830-1916). Several attempts were made by each to acquire the seeds. They were often foiled by the South American winters, sickness, and the governments of Peru and Bolivia that carefully protected the rare crop of trees. The bulk of The Fever Trail centers on these travels.
Each of these men hoped to accrue great wealth from the developing a crop of Cinchona trees in the West. After great personal hardship Spruce managed to transport a small quantity of seeds to India where a small plantation was developed. To his disappointment the British government offered him little in compensation. As the plantation matured, it was discovered that the variety of tree that Spruce had bought back was ill suited to the conditions and produced very little quinine.
Ledger’s seeds switched hands a few times before ending up in the possession of the Dutch. With time it was discovered that the variety was far superior to Spruces. By the early 1900s the Dutch plantation in Java was producing nearly 66% of the world’s supply of quinine and reaping significant returns on its investment. After years of petitioning on behalf of Ledger, the upper class Markham succeeded in convincing the Dutch to offer the poverty stricken finder of the tree a small yearly sum of £100. Honigsbaum hopes to give these men their long-due credit for finding the first cure for malaria.
The one downfall of this book is that it was published in 2001. A lot has changed since then in the field of malaria. Honigsbaum indicates toward the end of the book that the Plasmodium Falciparum strain of malaria is beginning to show signs of resistance to quinine. Over the past eight years this level of resistance has increased significantly. Pharmaceutical companies have been forced to seek other treatments to combat the disease. Artemisinin is at the top of the list. While Chinese natural healers have been using the drug for over a thousand years, it has only recently been mass produced to treat malaria. This new drug has been shown to clear the parasite faster than any other drug yet discovered. The plant from which the drug is derived is Artemisia annua, which grows in many parts of the world, including along the banks of the Potomac River in Washington DC.
The use of combination therapies has also become much more common since Honigsbaum finished his book. This is the practice of using multiple drugs in tandem to combat the malaria strain. The benefits of this strategy are that the parasite is killed more rapidly and the development of resistance is slower. Artemisinin is commonly combined with sulfadoxine/pyrimethamine or lumefantrine, depending on condition of the patient. The use of Artemisinin or its derivatives Artemether or Artesunate as a monotherapy is strictly outlawed by the World Health Organization for fear that resistance will render this compound ineffective. Signs of early resistance have already been seen in South Asia. Pharmaceutical companies continue to seek new treatments. While there have been some attempts to develop a vaccine to the disease, none have been successful.
