When Americans are asked what percentage of US government spending goes to foreign aid, the median answer is 25%. The correct answer is 1%. No wonder, then, that when President Donald Trump justifies cutting aid on the grounds that other countries need to step up because they are not paying their fair share, many people believe him.
The truth is that it is the United States that is not paying its fair share. Long ago, the United Nations called on rich countries to raise their foreign aid to 0.7% of their gross national income (which of course is very different from government spending). In 2016, according to OECD figures, the United Arab Emirates, Norway, Luxembourg, Sweden, Denmark, Turkey, the United Kingdom, and Germany reached that level. In contrast, official US aid amounted to only 0.18% of gross national income, or 18 cents for every $100 dollars earned.
In absolute terms, the US still spent more on foreign aid than any of the countries that met the target. But Germany, despite having an economy less than a quarter the size of the US, was only a little less than $9 billion behind. If Trump’s proposed cuts are implemented, while Germany maintains its aid spending, the US would no longer be the biggest donor, even in absolute terms.
Another significant comparison is with the UK, which is clearly not as wealthy as the US – its per capita GDP is 31% lower. Yet a few years ago, with bipartisan support, it reached the recommended 0.7% level – more than three times the proportion of gross national income spent by the US. It has since maintained that level.
Nor is all US aid directed to those with the greatest need. The three countries receiving the largest shares of US development assistance are Afghanistan, Jordan, and Pakistan. These choices are obviously based on what are perceived to be US geopolitical interests, not on the acuteness of countries’ need for development aid.
Those who know what the US aid cuts would mean to some of the world’s poorest people are dismayed by the prospect. Alex Thier, who managed multibillion-dollar US government aid programs before becoming executive director of the Overseas Development Institute in London, was visiting a health clinic in Buikwe, Uganda, when he received the news of Trump’s budget proposal, which would mean deep cuts to such facilities.
The Buikwe clinic, which treats 33,000 people, scrapes by on a monthly budget of $150. On the day Thier visited, there were 40 confirmed malaria infections, and malaria remains the leading killer in the district, despite the fact that it can be treated for about $3.
The glaring discrepancy between the cost of treating illness and preventing death in Uganda and the US makes Trump’s proposed reduction in aid spending – especially on global health programs – indicative of deep disregard for the lives and wellbeing of people beyond the borders of the US. When one considers the low proportion of its gross income that the US gives as foreign aid, Trump’s decision becomes even more shameful.
It is sometimes said that we should not give aid because it creates dependence. Let’s be clear: Trump’s proposed aid cuts would cause many people to die, and many more to face additional suffering from illness and disability that could have been prevented with better health care.
To use the possibility of creating dependence to justify the cuts, we would need hard evidence, not only that some aid programs have created dependence, but that specific global health programs adversely affected by the cuts really are creating dependence. In the absence of such evidence, an unproven hypothesis is insufficient reason to cause people to die or to increase their suffering.
Uganda seems to be an example of a country that receives a significant amount of aid, and at the same time, contrary to the hypothesis that aids creates dependence, is making rapid economic progress. The number of Ugandans living in extreme poverty, as defined by the World Bank, fell from 53% in 2006 to 34% in 2013. Indeed, many African countries are increasingly sharing the burden, by collecting much more of their own revenue and spending it on items like health and education. These efforts to raise more resources are also supported by donors, including the US. In Trump’s budget proposal, however, the US share of this support would be eliminated.
The proposed US cuts to global health programs will save the government about $2.3 billion. With total estimated federal government spending for 2017 of around $4 trillion, that amounts to about $1 for every $2,000 that the government is likely to spend. In terms of doing good, these global health programs may well offer the best value of any federal government program. All the aid cuts, to global health and other programs, as well as to diplomacy and peacemaking efforts, amount to $19 billion, still less than 0.5% of federal government expenditure.
There are welcome signs that some Republicans in the US Congress will resist Trump’s proposed deep cuts in US aid. Let’s hope that they do. Foreign aid – especially aid that saves lives and reduces human suffering – should not be a partisan issue.