Foreign Policy Digital

Good Health Supports Good Governance

Trump’s budget reopens old—and unnecessary—arguments about the efficacy of health aid.

International aid is once again becoming a political flash point. Boosters say that aid can support development. Detractors argue that it instead promotes dependency and undermines good governance. The renewed battle could spell trouble for global efforts to tackle some of the biggest health problems of our time, including AIDS, tuberculosis, and malaria. It is also unnecessary: The evidence suggests we do not have to trade health for governance.

For a time, it seemed that the debate over aid was over. Focus had shifted away from whether aid was bad or good to prioritizing the types of aid that seem to be working, including key global health programs. But in December 2018, U.S. National Security Advisor John Bolton unveiled the Trump administration’s . He decried a “longstanding pattern of aid without effect, assistance without accountability” and announced a shift to a “new path” for aid that would

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