global health is everyone’s responsibility and human right

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(photo credit: WHO)

From the UN Declaration to Amnesty International, between Paul Farmer and William Easterly it seems that everyone has a different understanding of what constitutes a basic human right and the cause of its absence. Michael Keizner has been building the discussion on health and human rights on Change.org’s Global Health blog while NYU Professor, William Easterly has recently entered the debate as a response to Amnesty International’s position on poverty related to human rights. This fueled a response from Amnesty International, which stated that Easterly was “pretty off base.” Easterly followed his Amnesty International response with an end to his “human rights trilogy” by asking Paul Farmer who should be held responsible for satisfying the right to health care?

The World Health Organization (WHO) states health as a human right as:

“the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”

It seems that Easterly’s human rights criteria is trapped in an old international law paradigm where there must be someone at fault or someone to blame. He also forgets that health is directly linked to food. You cannot have good health and not have food. Effective aid, not seen in today’s aid schemes, based in sustainable practices (not just buzzword reporting) that supports an individual’s right to develop themselves should look comprehensively towards the needs of a community of individuals. The ideas of human rights, foreign aid, and development should be less focused on international systems and more focused on building strong communities that meet their own human needs: health care, food, water, etc.

Within this debate of health and human rights, where does SCOUT BANANA fit. As an organization that makes and stands behind the statement that:

“global health is everyone’s responsibility and every individual’s human right”

Paul Farmer has the right idea, as Easterly quotes from his Tanner Lecture in 2005:

“only a social movement involving millions, most of us living far from these difficult settings, could allow us to change the course of history….troves of attention are required to reconfigure existing arrangements if we are to slow the steady movement of resources from poor to rich—transfers that have always been associated… with violence and epidemic disease… whether or not we can say “never again” with any conviction—will depend on our collective courage to examine and understand the roots of modern violence and the violation of a broad array of rights, including social and economic rights”

This is exactly similar to SCOUT BANANA’s understanding of health as a human right and a responsibility. It is a right where we do not attempt to place blame or hold the past accountable because those become frivolous exercises that produce no results. When we delve deeper into the root causes of issues, for example the driving forces of slavery, we must focus on a responsibility to not repeat the past and make ourselves accountable in the future.

There is no way that the entire European population and its descendants can be held accountable for the evils of the slave trade. While the same ideas of human rights did not exist in the time period of slavery, it is similarly difficult to place blame on systems (and populations) that drive the causes of poverty and lack of access to health care. Many people that I work with on development projects feel guilty that they are so privileged and wealthy compared to the communities that they work with that are so poor. SCOUT BANANA teaches its members to not feel guilty, but instead to feel responsible. Understanding personal privilege related to the oppression of certain populations within societal structures can assist in creating positive impacts. Human rights don’t necessarily have to be about placing blame, but rather developing an understanding of responsibility.

So Professor Easterly when you ask who is responsible for satisfying human rights: it is you, it is me, it is all those who dream of making a difference, and it is also those who lack the very human rights that we hold dear. Placing blame is not a concrete step forward, learning from history and recognizing where our privilege fits can be a first step towards effective actions. I too see Paul Farmer’s vision of a movement of millions, near and far, taking actions to shape a better future where human rights are everyone’s responsibility and every individual’s human right.

From the Article 25 of the Universal Declaration on Human Rights:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

 Written for the SCOUT BANANA blog.

the week in african health

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“No weapons” MSF in Nasir, Upper Nile State, South Sudan

More:
A Tale of Two Refrigerators
Fighting has renewed in southern Sudan, but its not just between militant groups – aid groups fall victim to needless fighting as well. Diane Bennet writes on William Easterly’s Aid Watch blog about the 2001 peace in Sudan and how it was a ripe time to treat disease and build health infrastructure. Unfortunately internal bureaucracy and politics became the largest hurdle.

Sudan: Darfur – Thousands Flee to African Union Safety
More recently, South Darfur has become the seen of violent clashes between government forces and militants. It is important to never forget the impacts that conflict has on health services.

Africa: Public Health Care Must Lead

Oxfam International has released a report [access here] “challenging the myths about private health care in developing countries.” The report emphasizes the role that private health care can play in developing countries, but reminds us that there is no way a scale-up of private health services will reach poor people in need. Key recommendations are to increase funding for free universal health care infrastructure, rejecting ineffective practices of the past, and combining efforts to fuel effective initiatives – sounds a lot like SCOUT BANANA

Global Health: Mobile Phones to Boost Healthcare

Revolutionizing access to health knowledge, the efforts of the Mobile Health Alliance (mHealth), supported by the Rockefeller Foundation, the UN Foundation, and Vodafone Foundation are making a mark across the African continent boasting 51 existing or to-be-implemented programs in 26 countries around the world. Harnessing the potential of growing technology in ‘developing’ countries for the purpose of health can only signal a major shift in access to health care across Africa.

Getting the Continent on Obama’s Agenda

It appears that Obama’s administration is stacked in the favor of Africa and in favor of better international development practices all around. With Susan Rice serving as Ambassador to the UN action against genocide may be bolstered, Gayle Smith more likely than not will be tapped as USAID Director, she was a major proponent of the HELP Commission creating a cabinet level position for foreign aid, and a well known name among insiders and outsiders in African affairs, Johnnie Carson, is expected to be named head of the Bureau of African Affairs of the State Department. The future of US relations in Africa has incredible potential and hope to change.

Zimbabwe: Staff Return to Hospitals, But Not to Work

As a massive cholera outbreak tears across the country, medical staff have returned to their posts, but the nature of their strike, that began in 2008 over poor working conditions and wages, is now “more like a sit-in.” In a country so crippled by Western exploitation and resulting politics, a strike of the health workers in the face of a rampant disease outbreak does not bode well for a vulnerable population.
More:
Too Much Cholera, Too Little Food
Over 80,000 Zimbabweans Infected with Cholera

Africa: U.S. Naval Engagement Offers Health Dividends

Imagine the potential of the US’ military might if it was dedicated to coordinating naval and health care workers from 13 countries to bring aid and health services to communities in need. This becomes a reality with the African Partnership Station Initiative and Project Handclasp. I can only dream of a day where initiatives like this are more a norm than a surprising gesture of good will.

Mali: Raising Money and Hygiene Standards

One of the most innovative programs that I have read most recently is the work the Dutch based Gender and Water Alliance which is employing women to make soap as well educate and use it to increase hygiene and combat preventable diseases. Health benefits, a source of income and empowering women!

Food Crisis Over, Say Experts

Supposedly the global food crisis of last year is over! Agricultural experts from Africa and Asia are saying that we are no longer in a food crisis and that there needs to be an increased production of rice in Africa in order to keep the food crisis at bay. In my opinion, as long as we continue our unsustainable and capitalist practices that commodify a basic human need, we will remain in a global food crisis affecting both the US and Africa.
More:
Rwanda: Food Production Up, Thanks to Green Revolution
Thankfully the increase is not due to the ‘Green Revolution,’ but instead to increase in practices that are focused on protecting the environment.

South Africa: Treasury Blamed for Shortage in Aids Drugs

Years of controversy seem to have brought the blame down on the South African Treasury. With an extensive bureaucracy, it is no wonder that the ARV roll-out program has taken much longer than it should – as many die without the proper medications. While the numbers of people enrolled in the ARV program has increased significantly there still exists a problematic policy of access. Access hinges on wealth, CD4 count, and location. To access the government’s ARV program your CD4 count has to be less than 300, which is at a point where you are already very vulnerable. This creates an issue of sustained treatment because it forces an irregular regimen. If your CD4 count is above 300, you will have to pay. Many cannot pay and if you live far from a government hospital access is just that much more difficult because of taxi fare and time sacrificed for travel. It seems the health and wellbeing of its citizens is not a high budget priority of the South African government.
More:
Rapid HIV evolution avoids attacks
Much like the flu virus, HIV mutates and evolves in response to treatments. This really exposes the South African ARV program as highly ineffective.
Duncan discusses HIV/AIDS in Morocco
Little known to the world, the HIV/AIDS crisis grows in Morocco.

Originally posted on the SCOUT BANANA blog. 

the quest for development; aid to the rescue in ghana

Poverty: a state of being extremely poor; inferior in quality or insufficient in amount; our generation’s greatest problem; the world’s worst disease; a trap. The definition of poverty is one that is not difficult to grasp, yet so many do not understand how or why it plagues our world of riches. Our world is plagued by poverty and, contestably, Africa is the hardest hit due to it’s historical status of being relegated to unimportance. While poverty continues to take lives day after day the power wielding countries, institutions, and agencies argue over a solution. That solution is called development. Leaders, institutions, philanthropists all argue as to how development should be facilitated, what the best facilitator is, and how aid should be implemented. Is aid the best facilitator of economic development to bring an end to poverty?

Almost two years after Ghana’s President received word from the Group of 8 that aid would be increased to Africa, Ghana will celebrate being the first independent African country. Ghana is an African country that was very near economic collapse, but through the process of reform, gained economic stability. The current President is expected to step down after serving two years and it looks as though Ghana’s days of coups and unrest will long be over. Ghana has become an economically stable country by way of economic reform, which brought in foreign aid from the institutions and investment from the rest of the world. This is seen as a limited success as far as African countries. Ghana has shown itself to be a good reformer and much of that success has been attributed to aid. But why is Ghana such an isolated case of the success of aid from institutions?

The Trap or A Missing Right?

Jeffrey Sachs, the director of the Earth Institute at Columbia University, claims that there is a poverty trap and that the only way to get out of it is by climbing up the ladder of development. He states that this is the greatest tragedy of our time; that one-sixth of the world is not even on the development ladder. The reason that one-sixth of the world is not on the ladder is because of the ‘poverty trap.’ They are trapped because of many reasons: disease, isolation, climate, etc., but why? Sachs tells us that this one-sixth is trapped because their families and governments lack the financial means to invest in their own development. The world’s poor need to get a foot up on that ladder, but how? How does one invest in themselves?

Capital is the answer to the poor’s problem – at least that is what Hernando de Soto believes. In his research on the ‘mystery of capital’ de Soto claims to have found that all the poor need is access or ability to use the land and property that they reside on. They have material things, but cannot use their land as a resource to create capital. De Soto says that, “Capital is the force that raises productivity of labor and creates the wealth of nations.” The problem here is that governments have to open up their property systems to the poor and many are not inclined to do so. The processes for land ownership are lengthy and difficult in many LEDCs, so for many people owning property is not worth their time. De Soto fights for an impractical approach to bringing the world’s poor out of poverty. Balaam and Veseth note that de Soto’s argument for property-rights reform could not alleviate LEDC poverty, however such as step may be necessary for the success of ‘the beautiful goal.’

De Soto’s argument is supported in a slightly more practical manner by C.K. Prahalad, who says that there must be a goal to ‘democratize commerce.’ He supports his claim by giving examples of the poor as micro-producers. Prahalad argues that, “We know aid is not the answer to that kind of mass poverty. Subsidies, grants, and philanthropy may have a role to play, but the real solution is local development of the private sector. That requires specific actions that take into account the historical background of the country at hand.” Prahalad makes an excellent point at that there needs to be an understanding of country situations. He tells us that aid has a place, but where is that place?

Property rights are seen by many to be central to investment and the economy of development. Like de Soto they argue for its quick implementation. In regards to property ownership and its use to become developed it seems that Ghana eased from communal to individually owned land system. In the Ghanaian culture property held high importance and even though Ghana had to move from a communal model to individualistic, it was smooth. Property rights were granted to those who had planted or cultivated certain sections of land. This changeover of property rights was facilitated by stable, well-defined laws and customs in regards to the governing of land. The courts also recognized the existence of ‘family land’ and land belonging to larger kinships. This preset tradition of land ownership allowed Ghana to easily transition and permit people to use land as a means of creating capital.

Whose Consensus Should We Use?

Governments can hinder development, people are restricted from development, and societal institutions push the criteria for development. The Washington Consensus is the list by which all must abide in order to receive foreign aid. The Consensus promotes a strong neo-liberal agenda to deregulate economy, privatize government enterprises, create low inflation, low government debt, and open to domestic and international markets. The institutions use the Consensus in a fair amount of disagreement in regards to implementation. The Washington Consensus was a form for economic development that pushed free trade and capital mobility. The issue of free trade versus fair trade is a complete other paper, but the for ‘free’ forces LEDCs to spend funds on making reforms as opposed to implementing programs to serve its people. This causes poverty to continue in LEDC and although the Consensus made an irresistible possibility within reach it also brought the possibility of devastating collapse and risk.

The International Monetary Fund and World Bank are very often criticized and reforms within the institutions are called for. However, outside the institutions stand NGOs who fill the gap and many times create longer-lasting and more effective results for the poor of the world. Easterly is a strong critic of the aid agencies and he makes a very strong and compelling argument against them. Ghana has received a large number of loans and aid from the institutions. Easterly notes that in many recent cases of heavy involvement by the aid agencies end in collapses into anarchy. Stiglitz tells us that the Washington Consensus assumes perfect information, perfect competition, and perfect risk markets – an idealization of reality has little relevance to LEDCs.

Sachs writes about Ghana’s poverty reduction strategy. He notes that the government of Ghana reached the conclusion that a major scaling up of the public investments in the social sector and infrastructure, which estimates a required donor aid around $8 million. The Ghana strategy was well designed and argued, but the donors dropped and rejected the plan. Sachs argues that there needs to be a harmonization of aid. The many bi-lateral aid groups need to work together for larger projects, but for smaller-scale projects a more specified aid is required.

The Downside of Backward

Aid has become a dangerous word in today’s globalized, polarized, prioritized world. Another problem is that aid, as a term, is a very broad topic. For the purposes here, aid refers to financial support to increase economic development. The ‘grandiose’ plan of making poverty history or ending poverty brings about the desire to create the ideal aid agencies, administrative plans, and financial resources. Over the past sixty years the West has pushed reform schemes, agencies, and numerous plans all to end poverty. This has created a massive $2.3 trillion failed push by the aid industry to meet this ‘beautiful goal.’ William Easterly has argued that, “this evidence points to an unpopular conclusion: Big Plans will always fail to reach ‘the beautiful goal.’ Easterly tells us that Planners will always fail and their plans will always fail because they ask the question of what does the end of poverty require of foreign aid? When instead we should be searchers and ask, “What can foreign aid do for poor people?”

Balaam and Veseth tell us that the nature of aid flows has drastically changed from the time of the Cold War until now. During that time less aid was given because of security reasons, but now multilateral aid is channeled through institutions such as the World Bank. In the 1990s the World Bank changed its priorities to “fill in the gaps” due to many projects being funded by the private market and non-governmental organizations (NGOs). This shift made less economically developed countries (LEDCs) more dependent on other sources of funding.

If a LEDC has to depend on another source of funding besides the established institutions, as flawed as they may be, they will most likely look for the easiest way to get that funding. Ghana recently received, in June of 2006, a $66 million loan from China to fund its development projects. This is an extremely different and what some would call ‘backward’ step for Ghana. The Ghanaian experience with foreign aid has been to adopt reforms and partner with the institutions. In this case Ghana has strayed from the accepted conventions of the foreign aid industry. China is seen as a rogue aider in that they are undermining the development policy of the foreign aid institutions. By not placing restrictions on aid usage or democratic reforms, China is taking the foreign aid market by storm, as the World Bank is put out of business. China is not the only supplier of rogue aid, but it is the most prolific. What does this all mean for the aid industry?

It can only mean one thing and that speaks to the effectiveness of the aid institutions and the aid suppliers of the West. Ghana the star of economic reform, democracy in Africa, and years of peaceful independence is seeking rogue aid – there is no place anymore for utopias and institutions and big plans.

Utopia is Not Possible?

If the big plans won’t work than what will? Easterly says that the big problem with foreign aid is that is aspires to a utopian blueprint to fix the world’s complex problems. This is where we must refer back to Easterly and his explanation of a ‘searcher.’ Easterly helps us to understand that, “A planner thinks he already knows the answers; he thinks poverty as a technical engineering problem that his answers will solve. A searcher admits he doesn’t know the answers in advance; he believes that poverty is a complicated tangle of political, social, historical, and technological factors. A searcher hopes to find answers to individual problems only by trial and error experimentation. A planner also believes outsiders know enough to impose solutions. A searcher believes only insiders have enough knowledge to find solutions, and that most solutions must be homegrown.” Easterly pushes for giving more assistance and aid to searchers and not planners because the utopian plan is not possible.

Sachs states that, “One of the weaknesses of development thinking is the relentless drive for a magic bullet.” This is very ironic because at the end of Sach’s book he argues for a big plan to end poverty, a magic bullet? Sachs outlines four main points for what a donor should do. However he seeks to create an overarching plan for all developing countries to escape the poverty trap. Sachs criticizes the aid agencies as well as promotes their reform and continuation. Easterly on the other hand calls for the West to build a willingness to aid individuals rather than governments. He tells us in his book that the ideas thought to be crazy are the ones that work best and reach the people in need of aid. He outlines a plan for how aid should be used for development starting with development vouchers, which the poor could turn in at any NGO or agency for a vaccine, food, health check-up, etc. Easterly strongly emphasizes getting feedback from the poor on development progress and pushes for aid groups to go back to the basics and be accountable for individual, feasible areas of action.

In her Foreign Policy article, Esther Duflo notes that a good many people have qualms about foreign aid, but that we need to fund what works. “Governments and citizens of poor countries resent the us of aid as a means of buying political support, their lack of control over it, the development fads to which it is subject, and the administrative burden that accompanies it.” This idea of funding what works makes sense and many in the development field advocate for a focus on people.

Many people would like to advocate for the big push, an increase in foreign aid, to eradicate poverty throughout the world, however unfortunately the track record of aid institutions and aid in general shows otherwise. If we are to be donors and fighters of poverty, then we need to understand poverty’s complexity and understand that a pragmatic and effective approach is needed. We need to adopt more the idea of Easterly and support the searchers in their quest to actually save lives.

What does this all mean for Ghana? The country will continue to receive large aid packages from the foreign aid institutions for its stability and rogue aid states for their economic successes. Ghana has become a stable economy and even though the Ghanaian people’s pride is very strong they remain chained to the aid institutions and donors when it would be better for sustainability for their development to have their searchers be supported. Aid funding needs to be linked to the implementation of a successful program to avoid waste by governments. Creating an accountability for foreign aid that provides results will justify the increase of aid to LEDC and Ghana. Today’s society has the access and ability to distribute effective aid that actually helps those in need. The greatest problem that we will face is if our government will have the political will to restore confidence in the abilities of foreign aid. Ghana is a success story of Africa as far as economic development and building a stable government, their success was backed by foreign aid from institutions, and yet many of their people remain unserved. The direction and continuation of poverty reduction in Ghana will depend on the country’s ability to recognize and support searchers with effectively implemented aid.

Bibliography:

Anonymous. “Chinese PM announces Ghana loan.” BBC News, 19 June 2006. . (accessed 3 May 2007).

Anonymous. “Proud Ghana still depends on aid.” BBC News, 15 June 2006. . (accessed 3 May 2007).

Balaam and Veseth. Introduction to International Political Economy. Pearson Education Inc, New Jersey: 2005.

Besley, Timothy. “Property Rights and Investment Incentives: Theory and Evidence from Ghana.” The Journal of Political Economy. The University of Chicago Press, 1995. . (JSTOR accessed on 3 May 2007).

De Soto, Hernando. The Mystery of Capital. Basic Books, New York: 2000.

Doyle, Mark. “Can aid bring an end to poverty?” BBC News, 4 October 2006. . (accessed 3 May 2007).

Duflo, Esther. “Fund What Works.” Foreign Policy Magazine, May/June 2007. 43

Easterly, William. The White Man’s Burden. The Penguin Press: 2006.

Naím, Moisés. “Rogue Aid.” Foreign Policy, March/April 2007. . (accessed 3 May 2007).

Sachs, Jeffrey. The End of Poverty. The Penguin Press, New York: 2005.

Stiglitz, Joseph E. Making Globalization Work. W.W. Norton & Company, New York: 2006.

Tsikata, Yvonne M. “Aid and Reform in Ghana.” World Bank. Preliminary Draft Working Paper, May 1999.

Prahalad, C.K. “The World for Sale.” Foreign Policy Magazine, May/June 2007. 50

Index of blog post series on Ghana.

is philanthropy good for africa?

The big question recently revisited, yet again, by the involvement of Oprah and Western celebrities conducting what some call “super-philanthropy”: is philanthropy good for Africa’s long-term development? My answer is yes, but a certain use of philanthropy. When the West tries to help the Rest (Africa) with a big fix or big plan there is most often failure and cynical backlash. Big plans do not work, as the economist William Easterly has helped me realize through his new book, The White Man’s Burden. He writes that the Planners need to give more power to the Searchers. Searchers being the people who look for the small-scale, community-based, effective projects that actually reach people in need. Searchers are the people on the ground implementing programs that actually get the $4 bed nets to families that need them and the easily accessable medicines for preventive diseases. I would categorize Oprah as a Planner, a celebrity Planner at that. She has heritage and roots in Africa and so she thinks she has a good reason to use her massive amounts of capital to shove solutions in the face of Africans.

On the BBC this question is asked and a dialogue has been opened to get the views of readers. One commenter thanks Oprah, but then says, “But you know what? Your deed is like throwing a gallon of water on the Sahara desert.” A beautiful metaphor for the Planners approach. What philanthropy needs is the opposite approach – pumping a gallon of water to the people in need of water in the Sahara desert. More effective investment philanthropy is needed if philanthropy in Africa is to get a better wrap. Many commenters expressed the thought that they would rather see no giving as opposed to seeing funds given to goverments. This takes us back to Searchers idea, give the funds to the people and organizations implementing effective programs that reach people.

This brings me back again to the work of the Acumen Fund supporting social entreprenuerial projects that are based in communities. Read one of the Acumen Fellows’ blog. Partners in Health implementing programs building health infrastructure in countries where the infrastructure is inadequate and in need of philanthropic support to reach people in need. As for the question, I believe that philanthropy is good for Africa’s long term development as long as it is directly aiding the people who truly need it. I cannot speak for a continent, but I would say Africa does not need celebrity Planners with big ideas to try misguided efforts. What Africa needs is a commitment by Planners to support searchers who are African and who are making sustainable advances for their communities. Likewise we need potential Western aid-givers, organizations, and foundations to work with African communities to invest in effective projects.

I highly recommend reading The White Man’s Burden by William Easterly to receive a great critique of Western aid agencies and efforts to aid. The book also gives a great presentation of what needs to be supported and implemented. It tells compelling stories of those who need the help and can benefit from the West’s effective philanthropy and engagement.

aid bureaucracy?

Recently I read an article on the African BBC News about the effectiveness of development aid. Experts are arguing that it is trade not aid that brings people out of poverty. With the time ticking down until 2015 when poverty is supposed to be halved, the debate is more than necessary. Some want to argue that more aid is not needed, but I would say these people are more interested in using their excess money for self-interest than to use it to help others. Trade and not aid? Trade is dominated by wealthy countries and the corporations within those countries, aid is also dominated by the wealthy countries.

A book released by an NYU economics professor, William Easterly, calls into question the role of international aid bureaucrats. Easterly writes that there are ‘searchers’ and ‘planners.’ ‘Searchers being the people who struggle and strive to make a living through the market and ‘planners’ being the army of aid bureaucrats such as the International Monetary Fund (IMF), UNICEF, the World Health Organization *WHO), and various development banks.

These planners attempt to create ‘grandiose’ plans and try to do too much, which in the end leads to doing nothing. Easterly says that aid agencies should act more like private companies to satisfy their customers. These customers being the world’s poor. If aid agencies think of the those they help as customers instead of human beings in desperate need then I believe we are in trouble. Calling the world’s poor customers is taking away the basic human emotion and essential element of compassion. I feel that the real problem is bureaucracy. These large aid agencies are all in the business of setting regulations and standards which do more harm than good for the world’s poor and those most in need of the agencies help. However aid encompasses both large aid agencies and small non-governmental organizations (NGOs). Professor Easterly is less critical of the NGOs than he is of the aid bureaucracies. The key to aid development to to cut regulations and standards of large bureaucracies and governments. It has been proven to expand and foster dramatic economic growth. Isn’t there an old saying that less is more. Easterly says, “The best tonic for poverty is growth, and the growth has come where the government has de-controlled and allowed competition and enterprise to flourish.” I would also agree with Professor Easterly when he says that he would rather see rich countries give monetary aid to private NGOs and let them run effective programs than to see the rich countries give money to governments.

What is the underlying issue of aid? What is the real solution to the aid dilemma? I can’t say that I am an economics major or that I am an expert in the way of development for the world’s poor, but I can say that I have a fair understanding of how aid should be administered and where it should go. Through my experience I have found that small scale NGOs that work on the ground are key to creating growth and sustainable development of communities in poverty. Large aid bureaucracies are not concerned with people and are more concerned with presenting a false picture of real aid success when in reality people are not being helped. Those who are on the ground doing the hard work need to be funded properly instead of large aid agencies and governments because the small NGOs are the ones who will create the real and lasting change and will impact people in the communities that most need the help.