How US funding cuts are reshaping aid in Africa

Pibisi podcast on suurin jääntä. Katsotaan, että se on koko suurin jääntä. Dr. Hattal Goende. Sitten on aina eri jääntä. Sitten on aina lägosin näitä. Sitten on aina jääntä. 60.000. 1.000. We are dying. During childbirth. 60.000. 60.000. We are dying. Yes. Of every 1.000. Childbirth. The modus or the children. That's tough. Yes. Very very tough, I think. Now it's much better. Well that's one example in Sierra Yone. USAID Money, of course, not involved in that case. I should add. Amy, you can hear examples like this again and again across the continent. When you talk about the individuals who work for these agencies on the ground, who are for the large part professionals who add a lot of value, I have a lot of support and time for them. On the other hand though, I don't think you can any aid organisation or any NGO say that they have been responsible for lifting a country out of poverty, so we're creating a great number of jobs on the ground. I think in very specific, acute situations, aid makes sense. I think as a long term palliative, that in some ways alleviates government from their responsibilities to their people. I think aid can become very damaging. Right, so there's a difference between emergency aid and sort of development aid. That's basically what you're saying. Dr. Bajari, I mean, you've worked in the prevention of HIV/AIDS. That's only happening right as a result of the input, the finance of many major global aid programmes. You were saying this already, USA was a big part. Describe in detail what you have seen since those aid cuts came in last year. I am managing an organisation that was supporting young people who are on treatment to transition from youth clinic into other clinic. And I was also supporting children who are on treatment already. These programmes have been closed. In addition to laying off 20 staff who were working in three offices in the areas that I mentioned under the US-funded Afejango programme. So that means that I lost this staff, but also the young people who we were supporting to transition into other clinic are no longer being supported, they're likely to be lost in the system and same as the children who are supporting to understand why we are taking medication but also supporting their parents better health, the children. Okay, so I mean, just just to be clear, Dr. Gowendi said earlier, didn't he, that he thought hundreds of thousands of lives will be lost in the first year? Would you say specifically that you think lives have been lost but as a result of these cuts to your programme? Yes, yes, I'm not sure how many we currently undertaking some surveys to document that but certainly some lives have been lost. It's only the question of being able to document who and where. But the numbers doesn't matter here. What matters is the life of somebody who has been supported by this funding for the last 20 years and only now have to succumb to death. Dr. Pudrari, I think the work you do is tremendous and I think it's really important but saying that we have depended on foreign aid for 20 years to save lives is a very worrying statement. To the extent that USAID goes into developing a business or enabling the development of factories that can manufacture aid strokes in various countries in Africa and then the after 20 years that investment has paid off, the drugs are being manufactured locally and therefore there is no more dependence on international aid. This would be an aid success story. And to be honest, I think a lot of people in Africa as devastating as some of the impacts of this reduction in aid can be feel that this reduction in aid -Mirjoittamme ja ajattelin. -Doktu, kai. -Jari, mitä on tietysti? I kind of disagree in a way that, you know, the cut was so abrupt in a period of, say, next week you're off. So there cannot be a sustainability in such an abrupt cut. It could have been a better transition if it was given a or two for the programs to be adjusted. Okay, well listen, I think that the abrupt question is a good one and I want to come back to that in a second. The biggest donor, of course, and the biggest cuts by far have come from the US. That's not to say there hasn't also been an erosion of European aid budgets in recent years from the UK, Germany, France and other EU nations. This is Matthew Bartlett. He was appointed to the State Department by President Trump during the first presidential term of Mr. Trump. He told us why he thought the president had been so open to closing down the agency last year. The United States is not a global charity. USAID is not a charity. You know, it should be, is this in the interest of the United States taxpayer? Because we are $38 trillion in debt. There's always been a skepticism around foreign aid in the Republican Party in terms of efficacy and rationale of creating a culture of dependency to the notion of taking money away from poor people in the US and giving it to wealthy elites in other governments around the world. I think you then had the Biden years, which you saw an explosion of money, of millions and billions of dollars across the board. And that's what led to Elon Musk, who eventually fed USAID into the wood shipper. That's Elon Musk, of course, who led the cuts program, the Department of Government Efficiency last year. So former USA coordinator, Matthew Bartlett there, he despite his connections with the Trump White House says he thought the speed and severity of the cuts had been too fast. Amy, Jettosimi, what's your take on this? The ripping off the band aid, so to speak? I think the effects on the ground, depending on where you are, in some cases, has been abrupt, in some cases has been lesser abrupt. I still think that's missing the point, though, even if it took two years to ramp down the aid, the aid is not going towards developing systems on the ground that would enable the organizations on the ground to continue to operate and deliver the service without the aid. The dependency has been on two sides, but the money goes into American organizations, it pays for American medicines, it pays a lot of American personnel, and then the dependency on the African side might be because the assumption is that these organizations are coming into a zero-sum game. So nothing on the ground in Africa, no capabilities in Africa, so we're going to power shoot in everything. As opposed to assuming that there are people and facilities and systems in Africa that just need a little bit of help to be built up so that they can stand on their own. I fully agree in a sense that the aid building local sustainability was one of the challenge, and so there is a direct funding, but there's no mechanism to build local sustainability in financing itself, so that when the aid ends, the system are built and organizations are strong enough with possible mechanism to find themselves. You're listening to Business Daily on the BBC World Service. Their company's success helped build a nation. The company is such a bit part of Korean economy, but who are the family behind one of the world's tech giants? The major corporate empire that we now know today. Samsung. Inheritance Samsung from the BBC World Service explores the real-life dramas of the Lee family and their company, Samsung. All episodes available now. Search for inheritance Samsung wherever you get your BBC podcasts. 30 years after two civilian airplanes were shot down, why is the US government now bringing charges against the former Cuban President Raoul Castro? 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I mean, this is pretty bleak stuff, Amy. I appreciate that your argument is sustained decades long aid has not proved efficient, but the suddenness of those loss, that loss of life does sort of bring you up short, doesn't it? Those studies are for the most part assuming Africa's capability to respond to these cuts is at zero, which is just not the case. Similarly, during COVID, it was assumed that African countries would be devastated because we had no ability to respond. We had no systems on the ground, so they applied the worst possible outcome. I think that it will be devastating in the short term, but I think in the medium term, in a year or two, I genuinely think most countries, most governments will respond and adapt. Okay, Peter Bajari, I mean, in Tanzania, did the speed of the budget cuts force the government to step up and perhaps do more of what it should have been doing already? It's a public health specialist and also in the health sector, the governments adjustment and stepping up is in to meeting what is required. In terms of, for instance, we had health practitioners, doctors and laboratory clinicians, arm nurses being finessed by the aid, and after the aid, they had to be with it drawn, and many of those has not been absorbed within the government system. So there was a shortage already. There's now a double shortage. And this means the HIV, TB and maternal weight programs are already suffering. Amy Jardas-Seamy, you are basically arguing, I think, that aid money has effectively distorted African economies over decades. Is that your opinion and if so, how is that working? I think without doubt that's what's happened. The aid industry creates the status quo that enables in in equalities and iniquities and government failures to continue for decades. Whereas if you have a situation where the government has no choice but to step in, government will step in, of course they will. And in some ways you could say that three decades, four decades of international aid have artificially created a status quo that delays the ability of many African countries to develop for themselves these solutions which will be sustainable and which will benefit their people much more than the trickle of aid that has been coming in historically. The challenge here has probably been that the aid does not necessarily have to do what is the top priority. So sometimes the aid comes with predetermined areas or focus. But admittedly, I think and I have seen that the coming of the aid has done much more than we have seen including for instance, and you have been able to reduce its maternal mortality in the last 10 years. So I think there are reserves that we have seen that comes from aid. But I think they are also areas where our own leaders and government have not taken responsibility. As I mentioned on the health sector allocation, it's still low even though they committed. And so we may blame the aid, but I think we also need to say that the aid did cover what was important that our own government had not been able to cover. There's a lot of Africans do complain about poor governance in their country. I don't think governance issues can any longer be hung around the neck of African governments as if we are exceptionally poor at governing ourselves. Governance is of course a necessary component of delivering poverty alleviation and delivering good health care. But if you look at how that is applied at the local level, we don't have to rely on a particular minister to do his job correctly. We just have to have a strong civil society. We have to have strong local systems in place, strong regulatory systems, strong laws. And then the people have to be empowered to make sure that they get what they are entitled to. And in a quiet way, that is happening certainly in Nigeria and cuts to aid actually empower the local people and drive the local people to demand that the services that they are supposed to be getting are actually delivered to them by the government. government. Dr. Bajari. I think we have a challenge on the governance systems over country. In Tanzania last year, you know, people are demanding their right and then they are should to do it. So I think there are challenges on the governance of our own government. Sometimes health is not a priority for instance. Sometimes the community health is system that she mentioned. I think I'd agree with that. They are not financed by the government and so who empowers the people, governments in Africa, they do not finance civil society organizations in any way, Europe and America, they do that. So where does the civil society organizations get resources, probably from the private sector and that isn't really the way from what I see happening on the ground. Okay, Peter, let's just go to the broad big picture now. Whatever we think of these aid cuts, we are simply are we not at a point where they have become inevitable. We have had decades and decades, tens of billions and billions of dollars pumped in to Africa. It has not seen the growth levels in Africa that were perhaps forecast by the people giving that aid in previous decades. No US or European administration right now is going to reverse them it would seem. I mean the politics of high income nations suggests that this money is not going to be coming back at the levels that we saw before. Africa is one way or another just going to have to adjust, isn't it? Yes, it's going to have to adjust. I think there was a problem the way the aid is structured in itself to allow local priorities to be scaled up. But also we know and I know from Tanzania that the government did allocate some money to begin to come in and address the shortages. However, the man has not been raised on the private sector and government and non-government organizations. We already exploring ways to raise resources within our own to be able to do the minimum. But as I said, it was an abrupt in a way that you do not know what to do. I had to lay off a staff and many organizations had to lay off staff because the funding is cut in a month or two and as much as you can do, you cannot raise money in a month or two. Not even a year sometimes. You need time to make those adjustments. I do think we have begun talking to our government, thinking about local solutions, thinking about what can we do by ourselves to maximize the impact of little sources that we have. Amy Jada Seamy, we referred to the Lancet report one way or another. We're talking about potentially hundreds of thousands, maybe millions of lives lost in the short term. Are you basically saying that may just be a price that has to be paid for a transition that you think is inevitable and necessary? I think the numbers from the Lancet are an exaggeration based on faulty assumptions. However, there will be lives lost. One life lost is too many, but this wake-up call was always going to come. What matters now is what we do. And there are many things we could do different to the Western solutions that have basically been imposed upon us by these aid agencies. For example, women don't have to come to hospitals to give birth. The majority of births in Africa take place at home. So how can we make it safer to give birth at home instead of forcing women to come to clinics to get injections? Let's empower them. So let's have models that suit the lifestyles of the people that we're treating. And let's have systems that are developed based on how our communities are currently set up, what people can currently afford. And the good thing is there are many, many solutions in the West that we can pick and choose from and apply in a way that suits our environments. Do you think access to affordable credit is more important than aid then? For African economies, I mean, affordable credit has been the long complaint, hasn't it? So for a company like Ladol, 100 percent yes. We're a growing company. We do a lot of international business. We run a huge port. We have like an industrial town. To talking in terms of credit makes sense. What the average Nigerian needs, I don't want to speak to all Africans, is reliable systems. They need community level systems. They need to know that when they go to school, their children will be safe and students can go to university and the universities will teach them where they can then leave and get good jobs. At the level we're talking, which is a kind of governmental systems and NGOs. It's about putting in place infrastructure people to do that in a sustainable way. Okay, Dr Peter Bajari, Tanzanian public health expert, my thanks to you and of course my thanks to Dr Amy Jada Seamy of the business hub Ladol in Lagos in Nigeria. Thanks to you all for listening as well. That's it for this double take edition of Business Daily for me Ed Butler and the rest of the team. Take care. The company is such a big part of Korean economy. But who are the family behind one of the world's tech giants? Samsung. Inheritance Samsung from the BBC World Service explores the real-life dramas of the Lee family and their company Samsung. Search for inheritance Samsung wherever you get your BBC podcast.