Despite record levels of foreign aid for health, almost no progress is being made in improving child mortality in the poorest parts of sub-Saharan Africa.
Many countries are going backwards. This is not surprising. The UN and British government – egged on by NGOs and activists – has bet the house on the daft idea that if western governments transfer enough money to governments in poor countries, health systems will magically improve and medicines will get to sick kids. As far as strategies go, this is a turkey.
Once it makes it to the recipient government, what happens to that money is anyone's guess. There is almost no data on how aid money makes its way through recipient health systems.
We do know, however, that much of it is lost to corruption – from ministers skimming off their share of grants, to local health workers charging patients for nominally "free" services. Then the Western consultants and NGOs need to take their cut.
When some aid money does make it to local clinics, World Bank research shows it is most often the educated, urban classes who benefits, rather than the rural poor for whom it is really intended. To cap it all, the influence of Western NGOs on donors has also meant that "fashionable" diseases such as HIV get the lion's share of funding, to the detriment of less high profile problems such as pneumonia, which kill many, many more.
In the short-term, donors could spend taxpayer's money more wisely by bypassing governments altogether, instead putting health services out to competitive tendering amongst the voluntary or private sectors. In the long term, we can't hope to improve child mortality by simply beefing up aid. There is no way western aid agencies can fund a clean water supply, health services and a decent daily meal for every child in Africa. Even if such a thing were logistically possible, such large inflows of hard foreign currency would wreak havoc on fragile local economies.
In the end, the only way to solve child mortality is by fostering economic growth.
The author is Senior Fellow at the International Policy Network. This is taken from the Independent's World Vision blog: The Aid Debate