TCS Daily

The Other Tsunamis

By Duane D. Freese - January 7, 2005 12:00 AM

The great tsunami that washed across Indonesia, Sri Lanka, Thailand, India and other Indian Ocean nations has left in its wake more than 150,000 dead and several million homeless.

The outpouring of emergency support, both public and private, has hardly been "stingy." It will no doubt reach record levels. Promised government emergency aid -- including $350 million from the United States and $500 million from Japan -- has topped $3 billion. Debt relief on the victim countries' $270 billion in foreign debt is also expected -- possibly doubling actual donations. And private giving promises to triple it.

Overall, the aid could well exceed what the United States provided in foreign development aid in 2000, before George W. Bush became president and increased such assistance by half.

At one level, the generosity provides a true reflection of the world's compassion. At another, though, it demonstrates the power of pictures. For the tsunami story has been nothing if not filled with videos, both of the disaster and its aftermath.

No one should begrudge the aid going to the survivors. This natural disaster is one of the worst in the last half century, behind only the 1970 cyclone in Bangladesh that took 300,000 lives and the 1976 earthquake in China that killed 255,000.

But some are pointing out, as tragedies go, it pales in comparison to the annual deaths -- mostly in developing and Third World nations -- from infectious and parasitic diseases. They stand at great multiples of the Dec. 26 event, with:

        · Measles, 611,000 deaths, 4 times greater.

        · Malaria, 1.3 million, 8 times.

        · Tuberculosis, 1.6 million, 10 times.

        · Diarrhea, 1.8 million, 12 times.

        · Perinatal conditions, 2.5 million, 16 times.

        · AIDS/HIV, 2.8 million, 18 times.

        · Respiratory infections, 4 million, 24 times.

These health tsunamis have been reported on sporadically, but like daily traffic accidents rarely make the front pages of newspapers or become the lead stories in network new coverage unless some big 18 car pileup, such as the tsunami, occurs.

At that point in time, there is a not unwarranted grab for attention for these other calamities, as in a Washington Post editorial on Jan. 4:

"But this extraordinary outpouring of generosity ought to prompt a reexamination of the rich world's relationship with far-off misery. If donors can find $2 billion in the space of one week, why does total government assistance to fight continuing development disasters run at just $60 billion or so per year? Now that we know the world's pockets are this deep, couldn't they be opened more frequently?"

Boulder, Colo., lawyer Christopher Brauchli was even more pointed in an article on, calling the United States "The Empire of Misers" and particularly condemning the Bush administration for its measly commitment of U.S. resources to development aid.

There are, of course, many who on the flip side of this can point to the United States being far more generous than official numbers and statistics would give its people credit for.

Carol Adelman, a former U.S. Agency for International Development official, has written about how official foreign aid -- $9.9 billion under a generous President Clinton in 2000 and about $16 billion under the miserly Bush this year -- represents only the tip of American giving. A lot of government direct aid to countries, such as Israel, Russia and Eastern bloc countries, along with aid to international development banks, goes uncounted. So, too, do private donations -- in the form of foundation grants, nongovernmental organizations activities, educational scholarships and personal remittances. Together these more than triple total U.S. foreign assistance.

Bruce Bartlett of the National Center for Policy Analysis, meanwhile, noted in the Christian Science Monitor how pharmaceutical companies here and abroad have by themselves given $2.1 billion in assistance with their donations of and discounts for drugs, payment for transportation and other costs in delivering health aid in the Third World.

And defenders of the Bush administration can point to the president's $15 billion AIDS/HIV initiative and Millennium Challenge Grant program, among other measures, as advancing foreign aid.

But the implication of such debate about the level of giving presupposes that more aid -- or at least more of some form of aid -- will make the poor world a better place. But does it?

Not according to a study by Tomi Ovaska, an assistant economics professor at the University of Regina, in the Cato Journal in 2003. He found that there was a

"negative relationship between development aid and economic growth. In particular, it was found that a 1 percent increase in aid as a percent of GDP (Gross Domestic Product) decreased annual GDP per capita growth by 3.65 percent."

Worse, the effectiveness of aid didn't improve with the quality of government, something that development economists had postulated for years.

Ovaska wasn't the only one to come to make that finding. William Easterly, a professor of Economics at New York University and a senior fellow at the Center for Global Development, found that aid to African nations increased as percentage of their GDP, growth per capita plummeted and even turned negative.

Easterly's point wasn't to dump on all aid. He noted that some aid had produced good results -- the eradication of small pox and river blindness and the growth of Taiwan and Korea. But too much spending is just "the moving of money," Easterly noted, quoting Judith Tendler from three decades ago:

"'A donor organization's sense of mission ... relates not necessarily to economic development but to the commitment of resources, the moving of money.' "

Easterly makes a sensible point about lowering expectations about what aid will accomplish.

"In virtually no other field of economics do economists and policymakers promise such large welfare benefits for modest policy interventions as 'we' do in aid and growth. The macroeconomic evidence doesn't support these claims. There is no Next Big Idea that will make the small amount of foreign aid the catalyst for economic growth of the world's poor nations."

But that doesn't mean he thinks moving more money around would do any better.

"[T]he appropriate goal of foreign aid is neither to move as much money as politically possible, nor to foster societywide transformation from poverty to wealth. The goal is simply to benefit some poor people some of the time."

To do that, though, he suggests, "improving quality of aid should come before increasing quantity." That makes sense. And it is a lesson taught in the aid being delivered to provide relief for victims from the great tsunami.

The Australian branch of Doctors Without Borders moved Jan. 4 to turn down additional aid. Why? "We can only send a certain number of people at a time. We can't rush more over because we have to co-ordinate with MSF teams from other countries," Dorothy Griffiths told the Sydney Morning Herald.

There are only so many doctors, only so many people who can deliver aid appropriately, and only so much aid that will do any good.

Such practical and ethical realities also affect how the world can deal with the great health tsunamis afflicting poor countries.

As TCS host James Glassman, has written: "Very simply, wealth makes health." But how can poor nations make wealth? Foreign aid has not thus far proven to be the answer. And as Easterly has argued, it is unlikely to do so.

What is? Well, again as Glassman wrote: "The question is how to improve the economies of poorer nations, and the answer is to end government corruption, advance democracy, and promote free-market place ideas."

In the interim, though, that leaves us dealing with both natural and the even larger health tsunamis as they arise -- not with any grandiose hope of lifting any nation from poverty, but from a compassionate concern to ease what suffering we can in ways that don't do more harm than good.


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