But Moyo does not take sufficient account of the broad reaction against this kind of direct aid beginning in the 1990s. The United States started taking a much more targeted and strategic approach. The Millennium Challenge Account directed new aid to nations willing to work as responsible partners, dedicated to reform and transparency. Initiatives on AIDS and malaria required and achieved measurable outcomes and have often worked through civil society instead of giving money directly to African governments.
Moyo dismisses these efforts, stating that her book is "not concerned with emergency and charity-based aid." But America's AIDS and malaria programs are more than "charity." They herald a new approach to foreign aid -- focused, centrally directed and results-oriented. The President's Emergency Plan for AIDS Relief (PEPFAR), for example, a program I advocated while I worked at the White House, has helped more than 2 million people get treatment for AIDS. The scale of the program has also resulted in the strengthening of African supply, management and human resource systems -- encouraging a professionalism that bleeds through an entire health system and beyond.
But it is perhaps for the best that Moyo did not write on these issues, because she knows little about them. Referring to America's AIDS program, she states: "In 2005, the United States pledged US $15 billion over five years to fight AIDS (mainly through the President's Emergency Plan for AIDS Relief). . . . But this had strings attached. Two-thirds of the money had to go to pro-abstinence programmes." The year of the pledge was 2003. And last year about one-thirteenth of the program was dedicated to both abstinence and marital faithfulness programs. It is not a small thing for an economist to be off by a factor of nine. And it is not a minor thing for Moyo to dismiss and distort the achievements of a foreign aid program that helped save her homeland of Zambia from social and economic ruin. In 2004, 7 percent of Zambians who needed AIDS drugs were receiving them. By September, that figure should exceed 66 percent. AIDS drugs, admittedly, do not guarantee economic growth. But I suspect that a generation of hopeless mass death would have undermined Zambia's economic prospects.
There are other limitations to "Dead Aid" -- its assertion that decimated global capital markets are a ready alternative to aid for African nations; its naive attitude toward Chinese engagement in Africa; its strange contention that African nations might be best served by "a decisive, benevolent dictator."
But Moyo's largest error is an overbroad condemnation of aid itself. "Aid fosters a military culture." "Aid engenders laziness on the part of the African policymakers." Surely there is a difference between aid provided to oppressive kleptocrats and aid given to faith-based organizations distributing AIDS drugs.