The Case For A Significant Expansion of Foreign Aid

Foreign aid is good and tremendously underfunded

Richard Hanania recently wrote a very article about the folly of nationalists. It’s a bit like the folly of certain antiracists who, after rooting out genuine examples of widespread institutional racism, then went on the hunt for subtle, secret forms of racism, because they simply couldn’t accept that their cause was ascendant—that it had won. Nationalists spend lots and lots of time complaining about U.S. politicians pimping out the interests of Real Americans to aid those on the other side of the world. J.D. Vance summed up the view well, when he said:

You love your family, and then you love your neighbor, and then you love your community, and then you love your fellow citizens in your own country, and then, after that, you can focus on and prioritize the rest of the world. A lot of the far left has completely inverted that.

The problem is that this is batshit insane delusion. It’s one of those things that sounds good when said in a political setting, because it represent everything nationalists would hate if it was true. Such things tend to get applause even when they’re about as far from the truth as North Korea is from a functioning Democracy, or Cambridge is from a serious institution.¹ It is obviously and egregiously false for quite straightforward reasons!

As Hanania notes, less than 1% of the federal budget is spend on foreign aid. Foreign aid is absolutely dwarfed by entitlements and the military—even if you count military spending as being half for the interests of foreigners, then it comes out that less than 5% of government spending goes to foreigners. And this is an absurdly conservative assumption; if we were really so concerned about foreigners that we spent half the defense budget promoting their interests, we’d probably spend more than 1% of the budget on foreign aid.

When polled, Americans on average think that we spend about 25% of the budget on foreign aid. They tend to think that we should spend something more in the vicinity of 10%. I’m in agreement with most Americans about roughly how much we should spend on foreign aid—around 10% of the budget, if not more. So while I support radical increases to the foreign aid budget, I really adopt the same view about how much should be spent on foreign aid as the median voter.

The 25% estimate, and with it the notion that we’re generously overspending on foreign aid, is off by an order of magnitude. We spend quite a bit less on foreign aid than other developed countries; most spend about .7% of their GDP on foreign aid. Despite America being the wealthiest country in the world, we only spend nearer to .2% of our GDP on foreign aid.

This is what’s so utterly ridiculous about Musk immediately targeting foreign aid as the place to make cuts—throwing it in the woodchipper, to use his words. We have a budget that is mostly dedicated to entitlements and the military; that is where most of the waste lies. We spend more money paying factory farmers to torture animals than we do on foreign aid—many dozens of times more on each of social security, Medicare, Medicaid, and the military. If you want to get serious about waste, the programs that make sure poor children don’t die of disease while taking a tiny sliver of the budget is a completely insane place to start.

We are living in the nationalist’s world. Nearly the entire budget is spent on Americans. Children die who we could save for just a few thousand dollars because we’d rather spend the money giving handouts to rich old people. At this very moment, the richest man in the world—a man whose personal net worth is many times the entire USAID budget—is furiously at work slashing the few federal programs helping poor, starving disease-ridden foreign children. It’s evil taken to almost impressive extremes.

Hundreds of millions of people live on less than $2 per day—these people cannot afford shoes or medicine. They have to skip meals almost every day; their water is unsanitary. Homeless Americans have considerably more spending power than these people; if they get a disease which requires a hundred dollars to treat, they will die. We should all have compassion for such people. The programs helping these people are the ones that the Trump administration is presently slashing. The New York Times has a graphic showing some of the programs that have been shut off:

There are some kinds of foreign aid that we embarrassingly only minimally carry out, like the ones recommended by Givewell. It currently only costs about 5,000 dollars to provide enough malaria nets or medication to save a person’s life; something has gone badly wrong if we can’t spare even 2% of the federal budget on programs that help foreigners hundreds of times more effectively than programs that best help Americans. So even if you’re skeptical about the efficacy of actually existing foreign aid programs, you should still support radically expanding the foreign aid budget.

But you shouldn’t be opposed to actually existing foreign aid programs; they work extremely well. Some, like PEPFAR, have saved many millions of lives, while taking around .1% of the federal budget. Other foreign aid programs provide all manner of lifesaving care—providing food and lifesaving medicine to the poorest people on earth. They vaccinate children from horrible and infectious diseases, make sure that people have access to clean water, and do other things to make the lives of the global poor marginally longer and less horrible. The New York Times notes “Mortality rates in countries aided by U.S.A.I.D. drop faster than in other places.” A different NYT article reflects on the extent of the cataclysm left by Trump’s cutoff of foreign aid:

As the true scale of the fallout comes into view, African governments are wondering how to fill gaping holes left in vital services, like health care and education, that until recent weeks were funded by the United States. Aid groups and United Nations bodies that feed the starving or house refugees have seen their budgets slashed in half, or worse.

By far the greatest price is being paid by ordinary Africans, millions of whom rely on American aid for their survival. But the consequences are also reverberating across an aid sector that, for better or worse, has been a pillar of Western engagement with Africa for over six decades. With the collapse of U.S.A.I.D., that entire model is badly shaken.

…

Experts say the agency’s abrupt undoing will cost many lives by creating huge gaps in public services, especially in health care, where U.S.A.I.D. has poured much of its resources.

In Kenya alone, at least 40,000 health care workers will lose their jobs, U.S.A.I.D. officials say. On Friday, several U.N. agencies that depend on American funding began to furlough part of their staff. The United States also provides most of the funding for two large refugee camps in northern Kenya that house 700,000 people from at least 19 countries.

Ethiopia’s health ministry has fired 5,000 health care professionals who had been recruited under American funding, according to an official notification obtained by The New York Times.

“We are in disbelief,” said Medhanye Alem of the Center for Victims of Torture, which treats survivors of conflict-related trauma at nine centers in northern Ethiopia, all now closed.

Of over 10,000 U.S.A.I.D. employees worldwide, barely 300 will remain under changes conveyed to staff on Thursday night. Only 12 will remain in Africa.

Kenya, for instance, has enough drugs to treat people with H.I.V. for over a year, Mr. Opalo said. “But the nurses and doctors to treat them are being let go, and the clinics are closing.”

Concerned about influxes of refugees? Foreign aid reduces refugee inflows! It reduces infant mortality and positively impacts economic growth. One study that matched health outcomes between places nearer and more distant from foreign aid clinics, concluded, “The results indicate very clearly that geographical proximity to aid projects reduces neonatal, infant, and child mortality.” Another found that “aid comes to have a statistically significant and positive effect on infant mortality rate, as doubling of aid leads to an approximately 1.3% reduction in infant mortality rates.” While there is some dispute about the effectiveness of the median foreign aid program directed toward economic development, health aid (much of which is being slashed) is far less controversial. MacAskill writes:

Second, the vast majority of aid scepticism is aid aimed at economic development, rather than at global health. The track records of these two projects are very different. Though the track record of attempts to foster economic growth is arguably unclear, the track record of global health is astonishing. The eradication of smallpox has saved over 60 million lives since 1980 (more lives saved than if we’d achieved world peace in the same time period) and 1/3 of the funding of the eradication effort came from international aid.3 Globally, rates of death from measles, malaria and diarrhea are down by 70%.4 Indeed, even those regarded as aid sceptics are very positive about global health.5 Here’s a quote from Angus Deaton…:

Health campaigns, known as “vertical health programs,” have been effective in saving millions of lives. Other vertical initiatives include the successful campaign to eliminate smallpox throughout the world; the campaign against river blindness jointly mounted by the World Bank, the Carter Center, WHO, and Merck; and the ongoing— but as yet incomplete— attempt to eliminate polio

Taking into account the profound effectiveness—millions of lives saved, the possibility of saving lives for just a few thousand dollars, the preventing of horrible outbreaks—foreign aid starts to look quite good. The richest country in the world has an obligation to spend more than .2% of it’s GDP preventing kids from getting cholera. I think it is very obvious that saving the lives of several million people is worth a few percent of the federal budget, especially when a more stable and productive world is better for us.

One analysis, for instance, concluded that cuts to PEPFAR could kill about 6.3 million people over the course of a few years. That’s about the number of Jews that were killed in the holocaust. Those Jews were not Americans. Thus, provided you think it would have been worth spending a few billion dollars to end the Nazi holocaust, you should also think PEPFAR is worth it!

One thought experiment that I’ve given on various occasions to make the case for giving is the drowning child thought experiment. The basic scenario: imagine that you came across a child drowning in a shallow pond—you could pull her out of the pond, but it would require ruining the 5,000 dollar watch you have with a quite elaborate clasp that you can’t get off in time to save them. Obviously, everyone agrees, you’d be obligated to wade into the pond to save their life—a person’s life is much more important than an expensive watch.

But this is analogous to the situation we’re in with regards to aid. It costs just a few thousand dollars to save a child’s life. While the children are far away, that doesn’t seem morally relevant. If you could save a child’s life by pressing a button, but were on a train travelling away from them, your obligation wouldn’t progressively shrink as you got further away. If, in the scenario where you could pull the children out of ponds, they were foreign children, but you had really long arms that stretched all the way to Africa, you’d still be obligated to pull them out of ponds.

(Note for people currently rushing to the comments to talk about how the drowning child argument neglects the role of proximity: the above paragraph addresses this objection. Please, if you are going to respond by claiming that proximity is important, actually respond to the above arguments. While about a dozen people have commented on other articles raising the proximity objection, none seemed to read what I had to say about it or have objections. So please, don’t be like these people!)

Now, the common response to this is that while the drowning child argument would be right if there was just a single child, the world is filled with drowning children. If you saw drowning children constantly—on the way to work, at the busstop, and so on, each of whom would take thousands of dollars to save—then you wouldn’t be obligated to spend all your time and money saving drowning children.

I think there’s a grain of truth to this response! While I think it would be very virtuous if a person gave all their money to effective charities, I don’t think it’s morally required. But at the very least, if we were constantly bombarded with drowning children, I think we’d be obligated to do something to save those children. In a world where children were constantly drowning, while you wouldn’t be required to spend every waking hour pulling children out of ponds, surely you’d be required to pull at least a few children out of ponds some of the time!

(Before you comment “well, why are the children in ponds in the first place, shouldn’t we spend our time putting fences around ponds rather than pulling individuals out of ponds—that would get to the root cause of the problem,” I would like to remind you that that is not the point of the thought experiment! The point of the thought experiment is to describe what we should do if children were dying who we could save. It is stipulated, for the purpose of the thought experiment, that there isn’t a way to save them with fences (perhaps this is a world where there isn’t the technology to build fences, or pernicious aliens drop them into ponds from the sky), just like it is stipulated in the trolley problem that you cannot save the workers by calling out “hey, there’s a train, watch out!”)

In my view, this situation is like the actual world. There are many, many children dying horribly who we can save at minimal cost. In such a world of constant drowning children, while we perhaps shouldn’t spend the entire federal budget saving children, surely we should make it a major national priority. Surely at least 10% of the budget should be spent on pulling children out of ponds—on making it so that millions of children don’t die unnecessarily.

I think insofar as the government is to remain legitimate, it cannot just be a charity. It must serve, in large part, the interests of its citizens. But when people are living on 2 dollars a day—literally a thousand times less rich than the median American—and we can save lives for just a few thousand dollars, there is something utterly grotesque about not making helping foreigners a major priority. This is especially clear if you’re a Christian—the parable of the good Samaritan makes it quite clear that we have strong obligations to foreigners.

To think we should spend radically more on the federal budget—on the order of 10x as much—you don’t have to think that we have no special obligations to our own countrymen. You just have to think that we have some minimal duty of charity—some minimal duty to make sure children with diarrhea don’t die of dehydration and that people can afford to eat two meals in a day rather than one every two days.

Those who think that American’s problems come mostly from our policy of privileging the interests of foreigners live in delusion; we do not privilege the interests of foreigners, or even give them more than the most minute consideration. If you think helping foreigners is important, it should me a major budgetary priority, like social security, Medicare, Medicaid, and the military. There is little that’s more despicable than the richest man on Earth directing the richest country on Earth to cut the paltry federal spending that goes to helping the poorest people on Earth not die horribly of disease.

1. As an Oxford visiting student, I am compelled to take potshots at the low-ranking preschool that is Cambridge.