Some readers are fed up with me!
“Don’t guilt trip me” is a refrain I heard from many readers of my recent columns from West Africa and South Sudan about children dying because of cuts in American humanitarian aid.
Let me try to address the kinds of concerns critics have raised in Times comments and on social media:
These may be tragedies, but they are not our tragedies. They are not our problems. I don’t mean to sound cold-hearted, but we are not the world’s doctor, and we can’t end all suffering.
True. We cannot save every dying child, or every mom hemorrhaging in childbirth. But our inability to save all lives does not imply that we should save none.
A starving child on the brink of death can be brought back with a specialty peanut paste, Plumpy’Nut, costing just $1 a day. And the anemia that often causes women to hemorrhage and die in childbirth can be prevented with prenatal minerals and vitamins costing $2.13 for an entire pregnancy.
Don’t those seem reasonable investments?
It’s widely acknowledged that there were problems in American humanitarian aid. Why should American taxpayers, already strained and facing rising debt, have to foot the bill for dysfunction?
I’ve followed the United States Agency for International Development for decades, and by far the worst dysfunction has been the chaos following U.S.A.I.D.’s dismantling this year.
A child dies of malnutrition-related causes every 15 seconds or so, even as 185,535 boxes of Plumpy’Nut are stacked in a warehouse in Rhode Island — already paid for by American taxpayers. Navyn Salem, chief executive of Edesia Nutrition, which makes the peanut paste and owns the warehouse, says the United States government owns the boxes but now doesn’t seem to know how to move them to where they’re needed.
Another 500,000 boxes of a similar peanut paste, also already paid for by taxpayers, are sitting in a warehouse in Georgia, according to Mark Moore of Mana Nutrition, which manufactured it. He says that with the shutdown of U.S.A.I.D., the government seems “confused” about what to do with it.
So the government accumulates storage costs for Plumpy’Nut as children die for want of it. Is there any kind of dysfunction more callous and capricious?
We have immense needs here in the United States. Families can’t get kids into pre-k, find child care or afford college. Millions of Americans can’t access health care for themselves. People are homeless in our cities. So why spend scarce resources on Sierre Leone children instead of American children?
I struggle in my own advocacy and in my personal giving to balance domestic needs against those abroad.
Three principles guide me. First, needs are simply greater abroad. This year, my annual win-a-trip journey, in which I take a university student along on a reporting trip, was in West Africa; my travel partner was Sofia Barnett, a foster child of Native American ancestry from Texas who just graduated with a four-point G.P.A. from Brown University. Sofia considered herself low-income — yet on this trip she told me how she sees that African poverty is of a different level, leading children to starve to death.
Second, money goes much further abroad. We talked to a mother in Liberia who lost a son earlier this year because she didn’t have $20 to buy anti-malaria medicine he needed; try saving a life for $20 in the United States. Third, while it’s natural to care more about people close to us, our empathy shouldn’t depend on someone’s skin color — or their passport color.
Until this year, American humanitarian aid saved about six lives each minute at a cost of only about 0.24 percent of gross national income, based on rough estimates from the Center for Global Development. That seems a bargain, and I doubt that it reduces help for American children.
You’re turning a blind eye to corruption and mismanagement abroad that is the real problem. The countries you visit have governments, so why don’t they address these needs? Instead of blaming President Trump, why don’t you hold other governments accountable for their failures?
True, many poor countries are plagued by corruption and misrule. The world’s worst humanitarian crisis is probably Sudan, and that’s because greedy generals are willing to fight a civil war to the last starving child.
That said, should we let Sudanese children perish because of their country’s awful generals?
And some countries do take governance very seriously. I took Sofia through Sierra Leone partly because I wanted to show progress as well as challenges. Sierra Leone is a fragile nation still recovering from civil war, but it has done an excellent job addressing health care and education; with support, it could become a bulwark of stability in the region.
We’ve been pouring tens of billions of dollars into other countries for many decades, and nothing changes. Global poverty and suffering are tragic, but they’re also inevitable.
I respectfully disagree. Maybe the worst thing that can happen to a person is to lose a child, and in 1950, 27 percent of children worldwide died before the age of five; now about 4 percent do. Just since 2000, the child mortality rate has fallen by more than half.
That’s because of vaccinations, oral rehydration therapy, breastfeeding promotion, the peanut paste I mentioned a moment ago — oh, and because of U.S.A.I.D. The United States has also slashed funding for U.N. agencies and nonprofits that orchestrated those gains. One of the greatest figures of the last century was James P. Grant, an American who led Unicef and ,with American funding, saved tens of millions of lives; shorn of budgets, Unicef and other agencies face agonizing decisions about what to cut.
Providing food aid may seem merciful, but it just leads to population increases and more people starving down the road. What America needs to provide isn’t food and medical assistance but family planning.
Yes, family planning is important, and it’s tragic that the Trump administration cut some funding for contraceptives as well as all support for the United Nations Population Fund, a major provider of family planning. But poverty drives large family size as much as the other way around. When parents aren’t sure their children will survive, they have more.
Yet as living standards improve and girls become more educated, birth rates plummet. I have a copy of a 1959 book uncomfortably titled “Too Many Asians,” predicting Malthusian disaster. But a woman in India now averages just two births, less than the 2.1 replacement rate needed to keep a population steady in the long run.
So by all means help women and men access family planning, but let’s not think of contraceptives as substitutes for food and medicine.
You make it sound as if we’re the only country in the world. What about Europe? What about the other rich countries? Why don’t they help?
Most of our peer countries donate more per capita to humanitarian aid than the United States does: Norway is the champion, donating more than four times as much per capita.
Many people would be willing to support the truly needy, but U.S.A.I.D. became a mismanaged left-wing pot of money to finance all kinds of liberal programs around the world that American taxpayers don’t like. Aid programs are just paying the price for liberal excesses.
Let me push back at that caricature.
It is true that U.S.A.I.D. was endlessly bureaucratic, but what it needed was reform; what it got was demolition. It’s also true that under Democratic administrations, U.S.A.I.D. funded liberal pet projects that weren’t always cost-effective or evidence-based, just as Republican administrations funded conservative projects that wasted money (such as abstinence-only education to prevent AIDS).
But here’s a metric to consider: In addition to keeping diseases at bay and promoting American soft power, U.S.A.I.D. may have saved more lives per billion dollars spent than any agency in government.
That seems to me not a failure, but a moral and management triumph.
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Nicholas Kristof became a columnist for The Times Opinion desk in 2001 and has won two Pulitzer Prizes. His new memoir is “Chasing Hope: A Reporter’s Life.” @NickKristof
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