Development Aid Is Working

06/03/2010 06:59 pm ET | Updated May 25, 2011

As the world crawls out of the Great Recession, there has been much hand-wringing about the plight of the world's poor: how during the crisis the number of hungry people has soared over 1 billion for the first time, how the scourge of HIV/AIDS, malaria and other diseases are still killing millions, and how the lack of education dooms the next generation to falling further behind.

These are all serious and troubling issues, and at first glance they appear to be cause for despair. In fact, as the United Nations prepares to mark the 10th anniversary of the Millennium Development Goals (MDGs) - an ambitious agenda to make concrete, measurable progress across on a range of health and development outcomes - they are even sparking calls that development aid is ineffective and should be cut back heavily at a time of fiscal crisis in many rich countries.

This argument dismisses a stunning and little-reported fact: while the problems remain urgent, the world has witnessed greater absolute improvements in health, wealth, and education in the past decade than in any comparable period in human history.

Economic growth in China and India has been the primary engine of this improvement, but real progress has happened all over the world. A greater focus on results and accountability means that overall aid spending has been getting smarter, more focused and more effective. Increasingly, taxpayer dollars are spent on proven interventions that are saving and improving lives.

The first MDG, which aims to cut in half the proportion of people living on less than $1 a day, was initially seen as unrealistic. But it will almost certainly be met by the 2015 deadline. That means hundreds of millions of people will have overcome extreme poverty. Or take child mortality; the global MDG of a reduction by two-thirds is off track, but overall childhood deaths have fallen from 12 million a year in 1990 to less than 8 million today. That's an incredible achievement. Or take education; while the goal of universal primary enrollment has not been met, 47 million more children were in school in 2007 than were in 1999. Even HIV/AIDS, devastating though it continues to be, is seeing reductions in infection rates and millions of people are now on life-saving anti-retrovirals.

This progress even includes many places in Africa. Countries like Mozambique, Ethiopia, Ghana, Rwanda and Tanzania have all more than doubled their per capita income since 1990, reflecting even larger overall economic gains given the continued rise in populations. Malawi has seen its child mortality rate drop by 50 percent and Niger by 42 percent since 1990. Tanzania has seen school enrollment rise from 49 percent to 99 percent and Guinea's has risen from 43 percent to 71 percent just since 1999. Burkina Faso has seen access to water rise from 36 percent to 72 percent since 1990, while Ethiopia has gone from 13 percent to 42 percent. And the list goes on.

Of course, there are still vast problems. But even in the very poorest countries, progress is happening. Momentum is supported by smart, strategic donor investments working in tandem with developing country commitment and resources.

Even on the hunger front there is progress to celebrate. While it is true that the spike in food prices in 2008 followed by the recession in 2009 pushed 100 million more people into hunger, the world is responding. Last year the G20 committed to spend $22 billion over the next three years to support agricultural development rather than traditional short-term food aid. These investments will support developing countries that are taking the lead in tackling the issue themselves. Ethiopia, for example, now invests over 15 percent of its national budget in agriculture. The country's cereal yields rose 25 percent between 1995 and 2008. Undernutrition dropped 35 percent over the same period.

So as we reflect on the first decade of the Millennium Development Goals, we should celebrate how far we have come. There is a clear route to our final destination with good models for how even the poorest countries can ultimately meet each of the goals. The real challenge is to scale what works and continually improve effectiveness through rigorous measurement and evaluation. Most importantly, we must ensure that donor countries do not pull back their support at the moment their aid contributions are helping millions of men, women and children all over the world transform their lives for the better.

Mark Suzman is acting president of the Global Development Program at the Bill & Melinda Gates Foundation.