Afghanistan’s progress against mortality reflects the success of providing health aid that differed radically from the bulk of American aid to Afghanistan during the war. The USAID program that contributed to the decline was a multilateral effort coordinated by Afghanistan’s own Ministry of Public Health. Results were verified by random sampling, and some funding was linked to measures of performance. This internal policy experiment, however, was destined to provoke resistance. More surprising is the source of resistance to an aid program that attempted to stop simply throwing money at a problem and focus on building sustainable systems: auditors.
In this note, CGD senior policy analyst Alexis Sowa outlines three recommendations for US development assistance to Pakistan: name the leader of US development efforts, clarify the mission, and finance what is already working.