Simply Giving Money Is Not Aid

IRIN News-- Africa: Donors call the shots in HIV/AIDS Sector (link)

This article discusses some of the problems regarding the lack of efficiency in the current foreign aid structure and practice. One of the problems raised by the author is the misconduct and lack of accountability of the donors, including PEPFAR's "shoddy record-keeping," the Gates Foundation's investment in pharmaceutical companies that have placed high prices on antiretroviral drugs, and the Global Fund's executive director's excessive spending in his business expense. Another problem is the fact that because most African nations are over-reliant on the donors for their HIV/AIDS program operations. Because of this imbalance in power structure, even when the priorities of the donors and the recipient countries do not match, the recipient countries have been hesitant to raise their voices. PEPFAR's focus on A & B in its ABC approach reflects the prevalence of this kind of problems, in which the ideology of the donor organization wins over the recipient priorities because of financial reasons.

The author brings up another interesting point that donors still rule the decisions regarding HIV/AIDS program in recipient countries partly because there is more money than the local capacities can handle. Again, a mismatch between the donor and the recipient culture is the main source of this problem. Accoding to Transparency International's report, the donors are propelled disperse money quickly without enough contemplation because the "'performance' of a grant is odten assessed by how rapidly it is distributed," while recipient countries lack the infrastructure and human resources to keep track of the large sums of money. The Global Fund's Country Coordinating Mechanisms for allowing local control over grant use was an attempt at fixing this problem, but the failure of this CCMs approach tells us that what donors need to do is not to simply dump the money on the recipient countries but to help create sufficient public health infrastructures in local governments and organization to effectively use the grants. This is exactly Stephen Lewis 's point in his argument in the Harvard speech.

The uncertainty of the future of grants also place recipients in a difficult position. Donors typically have 5-year funding cycles, and the arrival of grants is not always punctual. Recipients also have to follow a spending schedule, which means if they cannot spend the money by a given deadline, they must return the money to their donors. If money comes late, yet they still need to spend money by a certain time, how can recipient organizations and countries make a well-contemplated, rational decision regarding the use of their funds?

Recipients will continue to need the financial support from donor organizations as the HIV/AIDS epidemic also continues to grow. If these problems are left untouched, the damages from the epidemic will be left to multiply while damaging effects of HIV/AIDS simply remain as topics of people's conversations around the world. Now it's time to take action instead of simply talking about taking action. When donors and recipients increase transparency about where the money is coming from and how it is being spent--not only between the immediate donors and recipients, but amongst all donors and recipients-- and learn to voice their concerns and act on them promptly, we can finally talk about foreign aid in the real sense.