Americans sometimes wonder whether all that foreign aid does any good. Laurie Garrett, an old WRM friend and colleague who does a lot of work on global health issues recently had one of those odd experiences that Americans meeting with foreigners sometimes have: somebody thanked her.
A few years ago at a medical conference in Madrid I met a German physician and her husband, and we chatted over plates of tapas. She told me that she had learned her excellent English by reading tiny scraps of paper. I did not understand, of course, so she explained that after World War II ended she found herself, at the age of 10, trapped in the part of Berlin controlled by the Soviet Army, surrounded by bomb devastation and unable to find her parents. Starving, alone, she scrambled through rubble in search of food and items she could sell on the black market. Then the United States Air Force began dropping CARE packages, small parcels loaded with food and hygiene products, and the ten-year-old girl learned to spot the planes and race past the Soviet tanks to snap up boxes packed with food she could eat, and supplies she could sell.
That experience led her to share some thoughts on the subject of American aid. Anticipating the current International AIDS Conference, she shares a vision of peoples of many nations shouting “thank you!” to America for her tax dollars that helped save lives all over the world.
Laurie isn’t expecting this to actually happen. As usual many of the AIDS conference delegates will spend time kicking Uncle Sam and berating him for his stinginess, imperialism and general all round shortcomings. Our European friends will sigh and shake their heads and wish we could somehow be as moral and enlightened as their own wonderful selves.
But there are extraordinary effects of American foreign aid that Laurie refuses to let pass unnoticed:
[F]olks in Kansas City, Memphis, Selma, El Paso and all across America need to know that you are, indeed, keeping nearly 6 million men, women and children alive with your tax dollars. Actually, the total is much larger than that, America, because 6 million is just the number of people that are every single day taking anti-HIV medicines that they receive through programs that you fund. Most of them are parents, so your keeping them alive means that they are around to care for their children — more lives you are saving.
And your dollars pay for HIV prevention campaigns in countries all over the world — millions more lives are saved, thanks to your generosity, because they never get infected with the awful virus in the first place. Oh, it gets better: Your tax dollars paid for the scientists that invented some of the medicines they are swallowing, and the diagnostic tests and much more.
Rather than arriving as bricks of money or wire transfers, American foreign aid at its most effective has always taken on varied forms — like those air-dropped CARE packages in Cold War Berlin. A lot of it comes from the private sector. For hundreds of years, America’s religious organizations have taken the lead in foreign aid. Not just famine relief or other bandage projects, but universities, hospitals, and the like. Going back to the 19th century, education in particular remains America’s most important form of aid; giving foreigners the opportunity to study here while erecting schools and colleges abroad has changed the world and enriched millions of lives.
This history underlines and crucial fact about foreign aid: it tends to work best when given from people to people and from one civil society institution to another. Aid exchanged from bureaucracy to bureaucracy has a much spottier record. Government based foreign aid has its place, however, and — as in federal support for health research that helped humanity understand and begin to cope with the AIDS pandemic — work originally done to help us at home also helps people overseas.
Finally, while some in the foreign aid lobby will probably never understand this, America’s most generous and most effective form of foreign aid has been our military might—winning WWII and the Cold War, recovering Europe through the Marshall Plan, and extending similar security umbrellas over many across the world today. Laurie’s story about the woman from Berlin captures this, and provides her the moment of gratitude—the quiet “thank you”—that so rarely comes. In addition to the Hershey’s Kisses that American children wrapped up and sent as CARE packages, Germans benefited from forty years of steadfast American military and political support that prevented Stalin’s troops from turning the whole country into a gulag and ultimately allowed the German people to regain full control of their own territory and to tear down that wall.
America sometimes gets a rap from the foreign aid lobby and certain self-righteous Europeans about the small percentage of aid in our national budget (meanwhile, some of our politicians complain we give way too much). But factor in what private giving does, and add the value of the military security we provide, and America shoots up to the head of the class.
Which is exactly where we should be.






