Posted by Joe on: 03.05.2009 /
I’ve been having a very stimulating read of William Easterly’s book White Man’s Burden as recommended by Andy.
William comes at the issue of aid and development from a position as an academic and practitioner over many years and concludes that too often aid doesn’t work. Too often we (and maybe we on this blog have been guilty of this as well) talk loudly of MAKING POVERTY HISTORY or TACKLING THE AIDS EPIDEMIC without really stopping to consider a) whether these goals are even achievable b) whether the money ever reaches those that need it and c) how to create feedback from the recipients so they get what they need rather than we think they need from thousands of miles away. I’d recommend reading his blog for more in this vein.
But as Easterly points out, the annual cost of $1500 per patient for the drugs is extremely high when you might have large numbers of people earning $600 per year. With the best will in the world, you can only help so many people with this, the drugs are only effective in certain circumstances (with high levels of people not correctly taking the medication in western countries, how can we expect those living in poor conditions to do any better?), and only offer a limited further life expectancy - of the region of a couple of years. In fact, it would be considerably easier and cheaper to focus on prevention in vulnerable groups, such as prostitutes. And how does this policy affect the treatment of other diseases that kill even more than AIDS - such as those associated with dirty water?
Sadly it seems that our cultural screamishness about sex has lead us down blind alleys and made the epidemic even worse.
I can’t discount the possibility that I have oversimplified, misunderstood, accepted without thinking or pacified my guilt with cash on other issues. Certainly, my overseas experience since starting to post on this blog suggests that my money is best used by small struggling hidden groups I’ve met rather than via large corporate charities in this country. There, even a small amount makes a difference. Here, large amounts are spent on staff costs, admin, publicity, advertising etc.
So, as I wave goodbye and wish good luck to the community here, I’d just like to say that I was probably wrong a lot of the time, and will be concentrating on small actions that actually make a difference to real people rather than broad-brush campaigns which ultimately appear to do very little. Do well my friends.
Comment by: Andy
1I read the chapter about spending money to treat HIV/AIDS after getting to know children in Cambodia who are alive because of ARVs. I found his reasoning understandable but hard to accept. Certainly, I would personally pay to keep a child who I love alive.
I’m biased, but his argument may have some weaknesses.
1. People don’t give money for efficiency. They give because they connect with a need. Maybe governments and agencies should heed his advice, but even then they must consider what makes their donors stay engaged.
2. Somewhere I read an article saying that treatment for AIDS needs to be part of the overall strategy. That person was arguing that treatment programs give people hope, and that motivates people to get testing (and go to the hospital, etc.).
I fully agree with the point about getting smaller, which I picked up from Shane Claiborne, who got it from Mother Theresa.
So where are you going? Will you continue blogging at your other site?
Comment by: Joe
2Andy - I suspect the problem is knowing how to allocate limited resources. If prevention would have saved more than treatment - which seems likely - then it is more than a little stupid to spend so little on it.
That said it obviously does not help those people who have AIDS nor those who catch treatable water-borne diseases which have had their funding cut.
I’m not sure where I will blog. I’m not totally convinced I have anything much worth saying.
Comment by: Andy
3Be free not to blog. Seriously, there are so many ways to spend limited time. I’m sure there will be times when you have things to say, and there will be ways. All the best.
Comment by: Joe
4Well, I find twitter involves a lot less thought than blogging…
Comment by: Seren
5I once heard a speaker at Friends’ House in Perth, who had been working for years to end slavery in south Asia. Of aid, he said, the less you give, the less damage you are likely to cause.
Tongue in cheek, of course. But it made his point.