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Winning hearts and minds, one aid dollar at a time

PEPFAR branding appears on hospital in South Africa.
PEPFAR branding appears on hospital in South Africa.

There is plenty of debate over whether aid can help countries grow economically, but there is new evidence showing that it affects public opinion in a recipient country. Programs that provide targeted, sustained, effective and visible aid can lead to positive views of the donor countries.

While the money that US spends on aid programs in other countries helps people, it also serves a foreign policy goal. On one hand, the US stands to benefit from a safer, healthier and more prosperous world. On the other, it can generate good will towards the US.

“By doing good, a country can do well,” says Yusaku Horiuchi, an associate professor at Dartmouth College.

Benjamin Goldsmith of the University of Sydney, Terence Wood of the Australian National University and Horiuchi published a paper that proves how foreign aid can be a positive force for winning the hearts and minds of individuals. While the impact has been claimed for some time, they say that there was no evidence base, only anecdotes and claims by aid proponents. They undertook a  comparative, cross-national perspective using data from a variety of countries to evaluate how the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by the Bush administration in 2003, has impacted views on the US.

The initial $15 billion commitment from 2003 to 2008 has seen PEPFAR develop into a much touted and well supported global health program. Even while a divided Congress bickers over the federal budget, both sides continue to sing the praises of PEPFAR and easily fund the program. It has also come under criticism and controversy. A rule that forced PEPFAR funding recipients to explicitly opposed prostitution was struck down by the US Supreme Court in June.

Unlike other forms of humanitarian aid, PEPFAR is a long term program that deals with a specific problem (HIV/AIDS). The team set out to compare the attitudes of African countries, as measured by the annual Gallup World Polls, against PEPFAR spending. The period of time included the final two years of the Bush administration and the first two of the Obama administration to ensure that attitude changes were not solely due to a change in leadership.

Their analysis found that a doubling of per capita PEPFAR spending led to an increase in the ratio of approve and disapprove percentages by about 30%. In other words, approval of the US increased as spending went up. Similarly, there were no significant changes in attitudes for other countries, such as China, Russia and the UK. The researchers suggest that it may be due to the fact that the US is such a significant donor on HIV/AIDS and other nations might not devote as much resources to countries already befitting from US support for the problem.

“Our findings suggest that policy debates about PEPFAR and similar programs should consider not only their efficacy in achieving direct goals such as fighting HIV and AIDS, but also their value in improving the donor country’s global or regional standing,” conclude the authors.

The research may be useful for aid advocates, but skeptics will argue that focusing on the US benefits could skew towards more targeted approaches like PEPFAR. Policy makers concerned with the rising influence in China will be happy to know that the public can be won over through such efforts. What remains unanswered is whether or not the approach to a problem like AIDS should be dealt with through larger health care reforms in a given country or thorough a single-issue program.


About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]