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On October 30, 2006, Nancy Birdsall spoke at the Hilton Humanitarian Prize Symposium on Democracy and Development in New York City. Her speech entitled, Aid, State Formation and the Missing Middle, centers around the following questions: "What is the connection between political and human rights and the role of the middle class in a country's economy?" and "What does that connection have to do with foreign aid?"
To address these questions, she suggests the following:
1. That there are powerful reinforcing links among political and human rights and democracy on the one hand, and economic “rights” in market economies and the middle class on the other.
2. That the implications of those links for the management of foreign aid – both aid managed by the U.S. and other official government and international agencies, and aid managed and delivered by non-governmental organizations.