471LEADING ARTICLES

How We Can Best Help

THE LANCETLONDON 27 FEBRUARY 1965

IN a sensible world, aid for the developing countrieswould present few problems. They would be givensubstantial credits to spend at will on

"

developed "

exports, thus at once relieving the world liquidityshortage and enabling the affluent countries to give helpwithout impairing their balance of payments. For the

long term, affluent countries would contribute, in

proportion to their wealth and growth-rate, to an

international fund for the support of economies on thebasis of need, and of projects on the basis of expectedresults. None of this will happen while aid is a cold-warweapon, a means to dominate former colonies, a dis-honest synonym for export credits, or an excuse for

usury. Neither within nor between nations have the

poor ever advanced their cause by waiting on the altruismof the rich; and only an organised, united " thirdworld " of poor nations could exact the concessionswhich the poor classes in the rich nations obtained longago. Britain cannot interfere with the way that othernations discharge their obligations, but we can applyour own limited aid humanely and rationally.As the largest of ex-colonialists (if also perhaps the

least reprehensible), Britain has an extensive dutytowards countries she once administered. Yet in 1962official donations to underdeveloped countries were lessthan 0-3% of our national income: larger than the WestGerman contribution, but far smaller than France’s

(1’5%). In a typical year a further 0-3% goes as moreor less " soft " loans, for twenty years or more, from theBritish Government; and another 0-3% from privatecapital movements, though as good business rather thanaid. The British balance of payments is far more

precarious than the French, German, or American.Even given rapid growth, we are unlikely to afford by1970 more than L 100 million per annum as officialdonations and El 50 million as Government developmentloans, and the very growth that makes this possible will’keep private capital, formerly sent to poor countries, inBritain instead. The British record on the terms ofGovernment loans is better than most, but the sum of

genuine aid is so small that its proper use is essential.The United States can underpin the military show ofSlobovia or the corrupt politicos of Ruritania, confidentthat the very size of their outlay on development willbring some return. Britain cannot. The underlyingcriterion for non-political aid (and ultimately only thiswill bring results, either economic or political) must be

the greatest possible increase in economic welfare: whichis crudely measured by income per head. Britain, indefault of international guidelines, should concentratemainly on areas where poverty is greatest, where therisk that more British aid will mean less aid from else-where is least, and where there are special reasons whywe should help. The criteria may conflict, but there areareas where all criteria concur. One such area is theIndian subcontinent. There about 1 child in 7 diesbefore its first birthday and fewer than 1 in 4 adults areliterate. In India and Pakistan the chief shortages areforeign exchange (and the capital goods it can buy) andskilled personnel. The administration of aid for bothcountries is in the hands of an international consortium,and more British aid will probably mean more, not less,from other sources. Moreover, British administrative andresearch experience, and the good will we still enjoy, placeus in a better position to help than many other countries.Aid must be concentrated on projects that will relieve

need, quickly become self-sustaining, and initiate growth.For instance, in a country at present dependent onagriculture, development expenditure should supportagriculture, for only a big initial increase in agriculturalproductivity will enable workers to be transferred fromthe land to modern industrial pursuits. A prior revolu-tion in rural tenure, credit, and, above all, technologyhas been a feature of economic progress in almost everydeveloped country-including the United States and theU.S.S.R., which now compete to offer poor countriessteel mills that they cannot yet use properly. There ismuch need for research, in which medical, economic,agronomic, and anthropological techniques should com-bine, for we simply do not know the relative importanceof such things as poor nutrition, amoebic dysentery, andrural credit systems in reducing output per acre andper manhour; and hence we do not know the properpriorities for rural change. Pending further researchthere are plenty of projects held up only by shortages offoreign exchange and domestic skills. Meanwhile, weshould clear our minds of any impression that schemesto be supported by Britain should be formulated hereand then " sold " to the recipient country. Instead weshould select schemes originating in the developingcountries-though British advisors working overseas atthe request of the various Governments may properlyinfluence the form and scope of the plans. Whateverschemes we do select, the countries concerned shouldbe encouraged to recognise that these are largely theirown responsibility-perhaps through the introductionof a system of " matched costs " under which donor and

recipient each makes a contribution.The goal of aid is to increase human happiness-

indicated, however crudely, by income per head-andnot the number of people who barely manage to survive.One implication of this is that the control of the debili-tating, work-stopping diseases, such as amoebic dysen-tery, trachoma, schistosomiasis, and filariasis, should notbe neglected for attacks on more obvious killers. Thesum of the help Britain can offer is not large, but its

power for good is immense.