Killing With Kindness

Jasson Urbach & Julian Harris | 27 Sep 2023
The UN convened this week in New York to discuss its Millennium Development Goals and the aim of "ending poverty by 2015." Delegates and a rock star boasted of billions of dollars transferred to African governments, while failed schemes prompted activists to call for even more money. Donors re-branded the failed Roll Back Malaria scheme and promised US$3 billion.

Donors already spend over US$600 million a year in Africa to fight the disease, with the US President's Malaria Initiative (PMI) alone set to devote another US$1.2 billion over the next five years. Yet, while some progress is being made, malaria is still the leading cause of child mortality in sub-Saharan Africa, where a child dies from the disease every 30 seconds.

Rather than trumpeting more aid, the UN and its cheerleaders should ask why so many African countries have failed over decades to control preventable diseases that other nations have successfully defeated.

Today, 90% of malaria infections occur in sub-Saharan Africa--but the disease was rife in Europe, America and Russia until the middle of the last century. Historical figures as diverse as Saint Augustine and George Washington suffered from malaria, while the largest pandemic to date occurred in the northern Soviet Union in the 1920s. Yet all these regions overcame the disease. Why then is Africa struggling, in spite of billions of dollars in aid?

One unique trait of sub-Saharan Africa is exactly that--the level of aid it receives. And the aid industry continuously and successfully lobbies for more. Sadly, though, these funds are notoriously fungible and allow recipient governments to spend their own resources on anything they want without accountability. In the more corrupt countries, this raises obvious concerns about the wider socio-economic impact of aid--which effectively subsidises weaponry and luxury cars.

According to Transparency International, 50 out of the 52 African countries in its index suffer from "rampant" corruption or levels that present a "serious challenge." TI also identifies health aid as being especially prone to corruption. It is therefore little wonder that in Ghana, for example, less than 20% of donor funds make it to patient care.

History shows that malaria most rapidly declines in countries experiencing economic growth. From the late 1800s, malaria declined in most of Europe and the United States as mosquito-breeding areas were drained for farmland. People could afford better housing, with windows, screens and shutters, and to treat the disease with effective drugs. One of the main reasons for the success of these economies was the rise in economic freedom, boosting growth.

These days we can measure economic freedom from studies such as the World Bank's "Doing Business 2008," released this month: it shows Africa as the least free region in the world. Africans face "greater regulatory and administrative burdens, and less protection of property and investor rights" than anyone else: "countries with burdensome regulation have higher unemployment rates and slower economic growth."

The correlation between economic oppression and bad health can be observed in southern Africa. Both Zambia and Zimbabwe had malaria under control until oppressive regimes made them "rampant" with corruption, and Zimbabwe the most economically-oppressive country in the world. Now that Zambia has restored stability it has shown rapid improvement since 2006. Meanwhile, South Africa keeps malaria well under control thanks to economic development and well funded programmes that are independent of aid.

British ex-Prime Minister Tony Blair wrote this week that "all they need is the help and commitment from the rest of us": in fact, after US$2.3 trillion (at current value) in aid over the last 60 years, many Africans are worse off. They need something far more important and lasting than aid.

Africans can cure themselves of malaria if they are allowed to prosper, to enjoy economic growth and to develop healthier living conditions. There will be no sustainable change until their governments lift their economic oppression: instead of setting arbitrary targets at the UN, delegates and donors should demand real freedom for Africans.