Foreign aid is often in the hot seat, but today the heat is cranked up especially high. The United States government, one of the world’s most influential donors, is considering dramatic cuts to health and development programs around the world. I understand why some Americans watch their tax dollars going overseas and wonder why we’re not spending them at home. Here’s my answer: These projects keep Americans safe. And by promoting health, security and economic opportunity, they stabilize vulnerable parts of the world.
This is a lesson I’ve learned myself. When I first got involved in health and development more than 15 years ago, the main motivation was to save and improve people’s lives around the world. That’s still true today, but over the years I have come to see the tangible ways in which American aid benefits Americans too.
For one thing, it helps prevent epidemics. The most recent Ebola outbreak in West Africa killed more than 11,000 people, but the death toll would have been much worse if the disease had spread widely in neighboring Nigeria, an international travel hub that’s home to 180 million people. What contained it? Among other things, a group of health workers who were stationed there for an anti-polio campaign. They were quickly reassigned to the Ebola fight, and their efforts helped stop the disease—and keep it from crossing the Atlantic to the United States.
The biggest public funder of anti-polio work has been the U.S. government, and for good reason. It is protecting Americans and helping us get ready for the next epidemic, which could be orders of magnitude deadlier than Ebola. To stop emerging diseases, we need the infrastructure built by consistent funding of well-run health programs.
Another example is America’s global HIV/AIDS effort, known as PEPFAR, which began under President George W. Bush and works with some of the world’s poorest countries. PEPFAR is an undeniable success. There are 11 million people with HIV who are alive today because of the medicines that it provides. Many more never got the virus in the first place because of prevention efforts supported by PEPFAR.
This is not simply a humanitarian accomplishment. For those countries it means more teachers, entrepreneurs, police officers, and health-care workers who can contribute to strong, stable societies. According to one study, political instability and violent activity in African countries with PEPFAR programs dropped 40 percent between 2004 and 2015. Where there was no PEPFAR program, the decline was just 3 percent.
Better health puts nations on the path to self-sufficiency. How? When health improves, people decide to have fewer children, because they’re confident that the children they do have will survive into adulthood. As family size drops, it gets easier for countries to feed, educate, and provide opportunity for their people—and that is one of the best ways to stabilize any vulnerable region.
A more stable world is good for everyone. But there are other ways that aid benefits Americans in particular. It strengthens markets for U.S. goods: of our top 15 trade partners, 11 are former aid recipients. It is also visible proof of America’s global leadership. Popular support for the U.S. is high in Africa, where aid has such a dramatic impact. When you help a mother save her child’s life, she never forgets. Withdrawing now would not only cost lives, it would create a leadership vacuum that others would happily fill.
Syria is a tragic example of what can happen when the key ingredients of stability don’t come together. Beginning in 2007, the country experienced the worst drought in its history, driving more than a million people from rural areas into the cities, stoking political tension, and laying the foundation for the horrific civil war that continues today. Of course there were many causes of that war, and not every country that has a severe drought collapses as badly as Syria did. But the world will not be a safer place if the U.S. stops helping other countries meet their people’s needs.
None of this is lost on our military leaders. More than 120 retired generals and admirals recently wrote a letter to Congress arguing that U.S. programs “are critical to preventing conflict and reducing the need to put our men and women in uniform in harm’s way.” Secretary of Defense James Mattis famously said, back when he was commander of U.S. forces in Afghanistan, Pakistan, and other hotspots: “If you don’t fully fund the State Department”—which runs many of America’s key programs—“then I need to buy more ammunition.”
Protecting Americans, preventing epidemics, strengthening markets, saving lives: aid delivers phenomenal benefits, and for a bargain. It represents less than 1 percent of the federal budget, not even a penny out of every dollar. It is some of the best return on investment anywhere in government. This money is well spent, it has an enormous impact, and it ought to be maintained.