Jamie Rubin: Now, one of the standard and particularly effectively criticisms of foreign assistance is that much of the money in these big projects goes to governments in the third world or the developing world, and that a lot of those projects involve corruption or bribery or payoffs.
Jeff Sachs: And not just on our side.
Jamie Rubin: (Laughs) What is your view as to whether [there] is a new approach to foreign assistance where that kind of corruption and problem can be avoided?
Jeff Sachs: I'd say that, again, Americans think that since we're giving so much and we don't quite see the results, there must be that huge black hole sucking up the money. And a realistic sense would say, first of all, let's be a little bit more calm and dispassionate. It's not that we're losing all that money, it's that we haven't really invested that much in many of these utterly needed programs.
What's also true is that whether a program works or not depends on whether it's well-directed. Are we giving money to a thug because that thug may happen to be our thug, or are we giving money to a government that doesn't really need it, but it's an ally of ours, so we want to give it a "thank you." Or are we giving money [to] others [who] really try to focus on the great challenges facing the poorest of the poor. When we do that, we actually see a lot of results.
Americans certainly don't begrudge the pennies that they put in the UNICEF canisters on Halloween night. Because they know that that money is going to immunizations, it's going to help children in school. If more of our foreign assistance were directed at the health emergencies, at helping to fight AIDS, at helping to fight malaria and tuberculosis, to immunize children, to make sure that in these impoverished countries, half a million mothers now die in child birth because they don't have a skilled attendant with them, or that there are nearly three million deaths per year from diseases that could be prevented by immunization, if they felt that the money were going towards those needs, I think that they'd be much more eager to support.
Jamie Rubin: You've suggested that the Administration and the Congress are now more open to spending greater sums on foreign assistance for places like Cambodia. How much farther do we have to go, in your opinion, to be at the right number?
Jeff Sachs: We're spending a penny out of every $10 right now. Maybe two pennies out of $10, maybe three pennies out of $10 will be what it takes in the end. It's not going to be much more than that, in fact, because even that small amount, given how rich we are, would mean some extra tens of billions of dollars a year when combined with the other rich countries' contributions, which would be sufficient to actually change the course of these countries.
When I headed a project for the World Health Organization in the last couple of years, we asked the question, "What would it take to help provide the life saving interventions for the poorest of the poor to really fight AIDS?" Not just to talk about it, but to really fight AIDS. To fight malaria, TB, the diseases which kill children, the provision of skilled attendants at childbirth.
And we found out something absolutely remarkable: that eight million lives a year could be saved, eight million, if in each of the rich countries another one penny out of $10 was put aside for health in the poorest countries. So for an extra penny out of $10, we could save eight million lives a year.
Jamie Rubin: That sounds easy, but let's face it, that means a doubling or a tripling of our foreign assistance budget. Do you see any signs that members of Congress, members in the Executive Branch, are prepared to even consider doubling or tripling our aid?
Jeff Sachs: When one starts out with tiny amounts, then a doubling still leaves a very, very small amount. So I think if it were put to the Americans eight million lives a year saved by an American effort in which we set aside another penny out of $10, if Americans believed that that would really work, I think they'd jump at the chance. They know the difference that that would make for their hearts and souls, and also for the stability of the world and for the chance that Africa, that Cambodia, that other impoverished places in the world could have a future. And I think Americans absolutely would go for it.
Jamie Rubin: But would the Congress? I mean, there's no constituency for foreign assistance. It isn't like a farm bill, it isn't like a military program which is built in a specific district. What would transfer the support of the American people into real change in Congress and the Executive Branch?
Jeff Sachs: Well, of course I think the biggest issue right now is that Congressmen think this is a dangerous vote. "How can I vote for foreign assistance?"
Jamie Rubin: To double it!
Jeff Sachs: My constituents are going to be all over me!" And that, I think, is not the right political calculation actually. That may have seemed right five or ten or 20 years ago. After September 11th, I don't believe that there's that risk there. I think Americans would like to see the leadership help to steer us to a safer world. When President Bush proposed a modest, and yet historic up turn in foreign assistance. Historic because it was the first time in a generation, he didn't face a huge cacophony of criticism. He didn't face the Conservative Right saying, "Why would you ever do that?" In fact it went so smoothly in part because, after all, when we're talking about pennies on $10, it's really a small amount. We are spending so much more one week to the next, whether it's farm subsidies or some other issue, that we're talking about very small amounts that could change the world in a way which Americans would dearly love.
Jamie Rubin: Now, do you think the argument the President put forward when he made this modest increase that poverty breeds resentment and can breed terrorism is a compelling argument? Do you think it's true in Cambodia? Is it true in some places or in all places? How, how do you view the poverty-breeding terrorism argument?
Jeff Sachs: People have said, "Well, the terrorists were middle class, even rich, so what is this poverty/ terrorism link?" I think it's a misunderstanding. Where poverty played its role was in the failure of politics in Afghanistan, which left such a vacuum that the Taliban were able to consolidate power and provide a base for terrorist operations.
Jamie Rubin: A home for terrorists.
Jeff Sachs: So what the president has rightly said: It's not that the impoverished are the terrorists, but impoverishment creates conditions in which all sorts of ills of immediate concern to Americans can take hold. Deals can be terrorism, they can be drug trafficking, because boy, do we see a lot of impoverished or failed states where you
get the foothold of international narcotics trafficking. They can be the spread of disease, because when you have prominent infectious disease, whether it's tuberculosis with its new resistant strains or whether it's AIDS itself, these can spread all over the world if they're not being attended to in the pockets where you have so much disease burden. So what impoverishment does is provide a general seed bed for all sorts of terrible things to happen. Not just the terrible things in the lives themselves, which could be enough of an argument, after all, because Americans as a generous and humane people don't want to see that anyway. But it also creates the opening for the violence, for the civil war, for the youth gangs, for the narcotics traffickers, and, yes, for the terrorists as well.
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