The exchange between Helen Epstein and my colleague Ken Ohashi about the role of aid donors in “subsidizing” what Epstein calls a politically repressive regime highlights the difficulty in linking politics at the top with poverty alleviation on the ground.
Even politically open regimes, such as India, have difficulty delivering basic services to poor people—the absence rate for teachers in Indian public primary schools is 25 percent; the rate for doctors in public primary clinics is 40 percent. Conversely, as Epstein points out in her reply to Ken’s letter, “poverty and disease have fallen sharply in some repressive societies, from Cuba to China…”
The reason it is difficult to develop a clear link is that the delivery of basic services such as health or education requires that the service provider be accountable, either to the policymaker at the next highest level or, if the latter is not well-intentioned, to the beneficiary of the service, typically a poor person.
Ethiopia has done well in reducing poverty and child mortality, and increasing primary completion rates because their system of delivering basic services has various elements of this accountability built in. Local districts receive resources based on clear, data-driven formulae that can be independently verified (by third-party civil society groups). The allocation of these resources within the district is decided in community meetings, with the final budget posted on a central bulletin board for the community to see. These service delivery innovations were supported by the donors precisely because they have been shown to work in other countries, a point that seems to have eluded Aid Watch.
Needless to say, the accountability mechanisms in Ethiopia’s “Protecting Basic Services” program are not perfect, and much more needs to be done. When visiting one of the districts, I asked to see the bulletin board where the district’s budget had been posted. It was a piece of wood nailed to a tree, and the budget had been washed out by the rain.