Did the slick animations in the Girl Effect video that’s been viewed 3.6 million times compel you to buy soccer cleats for a South African girl? Maybe Matt Damon persuaded you to invest in Water.org so you can supply clean water and toilets to the world’s poor. Perhaps you’ve bought something (RED) to fight AIDS?
If you haven’t, you’ve missed out on a big trend. Overseas
development assistance is going private. More and more, private
charities, foundations and nongovernment organizations are
joining or displacing government organizations such as the U.S.
Agency for
International Development and multilateral groups
like those of the United Nations to help the poorest of the
poor. Celebrities vouch for various projects, and the Internet
makes giving simple. From 2005 to 2010, overseas aid from U.S.
private groups jumped by 164 percent, while official development
assistance grew by only 8 percent, according to figures tracked
by the Organization for Economic Cooperation and Development.
Apart from making Americans feel good, does the money they
donate to global causes ($22.8 billion in 2010) actually do
good? The results of a study published last month highlight how
surprisingly hard it is to answer that question. It involved
measuring the effects of installing innovative cookstoves in
2,600 households in 44 villages in India’s Orissa state.
The clean-cookstove movement has considerable momentum.
Championed by Hillary Clinton and Julia Roberts, the Global
Alliance for Clean Cookstoves has raised $135 million to reduce
smoke exposure from cooking indoors with primitive stoves or
open fires: The World Health Organization estimates that such
exposure causes 2 million premature deaths a year. The alliance
hopes to distribute 100 million smoke-reducing stoves, which
come in endless varieties, by 2020.
The researchers behind the study, Rema Hanna of Harvard,
and Esther Duflo and Michael Greenstone of the Massachusetts
Institute of Technology, expected to confirm the health benefits
of the $12.50 mud-based, chimneyed cookstoves installed in
Orissa. In laboratory experiments, clean cookstoves have been
shown to release fewer pollutants and burn more efficiently than
traditional cooking methods. However, such tests can’t predict
what will happen in the real world. That’s where a well-designed
randomized trial is irreplaceable.
In Orissa, households were randomly assigned to three waves
of stove construction, and researchers measured a meaningful
reduction in smoke inhalation in the first year after a stove
was installed. Over a longer period, however, they saw no health
benefits and no reduction in fuel use. That’s because once the
stoves and chimneys developed cracks, the villagers generally
chose not to fix or maintain their new devices but instead went
back to their old, smoky ways of cooking.
This doesn’t suggest the clean-cookstove campaign should be
abandoned so much as slowed down. It would be wise to test
various designs in real-life settings, and, where necessary,
take more time to human-proof models. Clean-cookstove advocates
need to develop incentives for families to stick with the
stoves, and they need to study why many villagers in the India
trial embraced the devices yet continued using their
conventional cooking fires as well. Otherwise, the innovative
stoves of today could wind up in the same junk piles as models
from efforts decades ago.
Those castoffs are a reminder that, however well-
intentioned, many assistance programs for the developing world
can prove fruitless. One obvious area for similar rigorous
evaluation is microcredit, the fastest growing field in global
poverty reduction. According to the Microcredit Summit Campaign,
the number of families receiving microloans grew from 7.6
million in 1997 to 137.5 million in 2010. A handful of studies
on whether these programs ultimately reduce poverty have come up
with ambiguous findings, pointing to a need for more, and
longer-term, trials. A related initiative that needs field-
testing is insurance for the poor against sickness or economic
calamity -- for example, insufficient rainfall for farmers.
The purpose is not to debunk the idea of helping poor
countries. On the contrary, such work bolsters the case for aid
by ensuring that dollars are well spent. Generally, such trials
point out the need to alter, not ditch, assistance programs.
Frequently, they shine a light on programs that have proved
successful beyond expectation. A series of trials in Kenya, for
instance, showed that young adults who had been dewormed as
children were more productive and earned more than peers who
didn’t get the treatment.
Groups such as Duflo’s Abdul Latif Jameel Poverty Lab and
Innovations for Poverty Action are dedicated to such studies.
Their work deserves support, and their conclusions demand
attention. Long the standard for medical programs, randomized
trials can help sort promising projects in foreign aid from
truly effective ones, and speed our way toward a better world.
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