When very bright foreign aid experts on health, agriculture, logistics and education gathered at the 7th Aid and International Development Forum in Washington to talk about humanitarian aid in war, drought, earthquake and famine, they learned that we are in an age of austerity.
The global financial crisis has made foreign aid a target for budget cutters who often hear from voters "keep our aid money at home."
To get more bang for less buck, aid agencies such as the U.S. Agency for International Development (USAID) are cutting the number of costly Western aid workers sent overseas and instead hiring locals at a tenth the cost.
"Austerity will become an increasingly common part of our vocabulary as we talk about financing for development and humanitarian relief," said Patrick Fine, a senior U.S. aid official with the Millennium Challenge Corporation, in the keynote address to the June 6-7 forum.
"Iraq and Afghanistan that created billions of dollars worth of work for development and humanitarian aid organizations are winding down. I don't think we'll see anything like that again."
Fine served as USAID mission director in Afghanistan in 2004 when billions were spent on schools, midwives, agriculture, roads and clinics. He warned that by 2015, one third of U.S. foreign aid -- which stood at $27 billion this year -- will be delivered through developing country governments and aid workers.
"As a result, expect the environment to become even more competitive," Fine told the aid workers at the forum. "If you are looking for areas where you can make a contribution, come up with new cost-effective and workable approaches for monitoring work and evaluating impact."
Fine's warning underscored that deep cuts in jobs are coming.
Foreign aid from the U.S. and other donors reached an incredible peak in the past few years of $130 billion a year. That money employs millions of people from Western and from developing nations to deliver relief, save lives and improve living standards for hundreds of millions. But now the humanitarian industry is at a crossroads.
The impending aid cut was one of three powerful facts that leaped out of many hours I spent sitting on panels June 6 and 7 in Washington, and from chatting with providers of bullet proof jeeps, medical kits, efficient stoves, water purification systems and emergency tents and generators:
- Despite knowing in 2010 that a famine was coming, the world wasted six months before shipping food to the Horn of Africa, letting perhaps 50,000 people die.
- For the first time in history, more people now die of chronic diseases -- caused by obesity, smoking, alcohol and sedentary occupations -- than from infections and trauma. Prevention now can save more lives than medical treatment.
- Although millions of dedicated aid workers live with the dust and danger of Sudan, Somalia and Afghanistan, the financial crisis is forcing aid mangers to cut back on costly Western aid teams and instead hire local people, train them and hope all goes well.
At one point it occurred to me that the three or four hundred experts and suppliers of tents and generators at the forum probably have saved hundreds of millions of lives over the years. No wonder so many young people today are taking courses in international development or interning and seeking jobs in the field -- they see greater satisfaction in helping others rather than amassing wealth.
Dr. Adam Koons, who has been delivering aid for decades for the U.S. Agency for International Development and other agencies, said aid workers feared being accused of "crying wolf" in 2010, when drought and famine was first predicted in Horn of Africa countries: Somalia, Ethiopia, Kenya, Djibouti and Uganda.
"We knew in 2010 and acted in 2011," said Koons, who now works with International Relief and Development (IRD), one the largest non-governmental organizations delivering American aid overseas.
"We were plagued by the CNN effect" he said, meaning that only when CNN broadcasts starving children does the U.S. government and other donors decide to send emergency aid.
"Lesson one is you can't wait for the media to get there because then it is too late," he said.
On a global health panel, I sat next to silver-haired Cecil Wilson, president of the American Medical Association and soon to serve as president of the World Medical Association, representing nine million doctors in more than 100 countries.
"Chronic illness is now the leading cause of death in rich and poor countries," said Dr. Wilson. Cancer, heart disease, diabetes, obesity, sedentary lifestyles and the aging population have replaced infection and trauma as leading causes of death, he said.
He predicted a sea change in medical investment, training and direction as the world medical profession focuses on prevention and promoting healthy lifestyles.
The aid industry includes great diversity, Fine said, such as "those whose primary motivation is to serve humanity and those focused on serving their shareholders; researchers and practitioners; young people moved by compassion and the desire to do good in the world and those who are driven by wanderlust and a desire for adventure."
"The evidence shows that critics who say money spent on development is money down a rat hole are dead wrong," Fine said. "We have seen momentous progress, both for nation states and individuals, in terms of more income, better health and increased opportunities."