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Foreign Aid or Trap?
Beware Pakistan: Lessons from USAID programs in Bangladesh and India by Sophia Barkat The Population Explosion & USAID As health care improvements and better nutrition push up fertility and reduce child mortality rates, one is left with a faster than ever growing world population, and most of it is happening in Asia. Birth-control Think Tanks are concerned that Asia’s population growth is not slowing down enough. Coming to the aid, so to speak, is the US and its many donor organizations. In the last thirty years, USAID programs either directly or indirectly funded the health care budgets of poor nations. As a result of the USAID’s intervention, Bangladesh, for one, is touted as having made considerable progress in reducing it’s population growth rate. The success of Bangladesh has resulted in it’s Government delegations – full of private sector and public sector experts – offering advice to China and most recently, Pakistan. The poster-child for the USAID’s population control success, Bangladesh, will most likely send Senior Advisors to the Pakistani Government to help President Musharraf’s design a swift path to population and health care reform. Previously not on the USAID map of operations, Pakistan is opening it’s doors. It’s as though the resistance from the Ulemas is being met by an equal pressure from the US, and the result is an admission that the nation’s population is on a suicidal path. "Pakistan is a country with persistently high population growth rates As the USAID and friendly nations head to Pakistan to reform it’s population policy, one wonders what the nation can expect. A Look at USAID spending in Bangladesh Perhaps, the best forecasts of what Pakistan can expect will depends on what it is willing to do and also what the USAID has done in other nations. The example of Bangladesh is important, as Bangladeshi Advisors are likely to be part of the delegation. The Population Council, which has been in Bangladesh for over 30 years, providing research and technical assistance to the Ministry of Health and Family Welfare and non-governmental organizations, had this to say: In 1997 the government of Bangladesh adopted a plan to shift from home-based family planning services to an approach in which family planning and other reproductive health services are integrated with clinic-based primary health care. The plan called for a wider range of reproductive health services provided as part of an "essential services package" (ESP). Also in 1997, the U.S. Agency for International Development (USAID) launched a program supporting non- governmental organizations (NGOs) enacting the ESP approach. The NGO program is designed to both improve quality of care and increase cost recovery for services. The USAID concurred (See 2): "The goal of USAID's population and health efforts is to enhance the quality of life of the socially and economically disadvantaged people of But, according to the Population Research Institute (PRI), none of this is true. The PRI, which has built a Map of Shame to mark USAID activities in poor nations, claims that the USAID has done nothing more than market US pharmaceutical drugs in the name of "improving quality of care" in poor nations like Bangladesh and that the Governments of such nations have allowed this to happen. According to the Population Research Institute (see 3): "In 1997, 60% of all requested funds by the USAID for Bangladesh were Is Bangladesh really the poster child for family planning success or is it purely a marketing ground? If actual services to help women and children has only improved by a pittance, how can we make this claim? Making sense of USAID spending in Bangladesh The bulk of USAID aid to Bangladesh is for health care and population control. According to the USAID Budget Statements $40 million was spent on Family Planning, Child Survival and AIDS/HIV in 2001 and 2002 out of a total aid package of $97 million in 2001 and $96 million in 2002. Food Aid accounted for $39 million and $31 million, respectively,though to date, one has never heard of such measures reaching the poor (See 4). One is still left to wonder about where the money is going. Is it being spent entirely on billboard advertisements and paying for international and national demographers? Or is it being siphoned into the public payroll? After all, the Government of Bangladesh has given it’s approval to the USAID all the way. The fact that only $10,000 was actually spent on clinics in 1998 out of a budget of $20 million, should raise alarm about the activities of the USAID in Bangladesh and also about the Bangladesh Government’s complicity. Or perhaps there was pressure? After all, the USAID is touting birth control pills and such made in the US to poor nations. Perhaps they are using the aid money to twist the arms of poor nations, and if so, US tax-payers, who think their country is actually doing some good in poor countries, should be horrified. For the aid package seems nothing more than a way of making US tax-payers buy birth control pills that they themselves don’t get for free. Why are US Tax-payer monies being spent on US drug companies but not for Americans? A closer look should be given to what kind of products the USAID program and Population Council program are promoting, and why this subversion is necessary. There are many conditions barring US Tax-payer money being spent on US tax-payers. US domestic health care limits the ability for women of child bearing age to receive government subsidized health care due to strong insurance lobbies corrupting members of the Congress and State and local officials. The Health Lobby is one of the top four lobbies in Washington DC., giving more than $209 million to the campaigns of Congressmen and women in 2001 alone, right before the 2002 elections (See 5). And then, the type of products being given to Bangladesh in the USAID packages are not ones Americans would like to use. According to the USAID’s Program Data Sheet, 388-001 (See 6): Performance and Results: During the fourth full year of the program, results exceeded expectations. The program expanded access to It seems as though the USAID had increased aid for clinical services not without gain. Norplant, the IUD that had gained usage as a result of the new project, is the reason why the USAID’s expenditure on clinical services in Bangladesh has gone up. The Population Council, distributor of Norplant to over 50 countries via the USAID programs, mentions that "Though approved by the FDA in 1990, Norplant is not currently available in the US. This contraceptive implant was confirmed to be effective for 7 years by the World Health Organization (See 7). Indeed, the World Health Organization, a part of the United Nations, is also involved in this covert drug trafficking business. The World Health Organization likes Norplant, and says, "Implants work well when tested on women in poor nations," (See 8). In a report titled Contraceptive implants come of age, WHO however shows how once again the drug is being tested on poor women first: An estimated six million women currently use Norplant. These women may well be reassured by the report, published in 2001, of a surveillance In contrast to both the Population Council and the WHO, Population Research Institute has asked the FDA to ban Norplant, for which the organization was dubbed "anti-population" by RNMag.com, a magazine for Registered Nurses. (See 9). RNMag reports: An anti-population control group is asking the FDA to take Norplant Analyzing the relationship between Donor and Poor Nation To understand how such drugs might make it into Bangladesh despite obvious problems, once has to look at the relationship between Bangladesh and the US. When US President Clinton and Bangladesh’s Prime Minister Sheikh Hasina met in October of 2000, a joint statement was made by both to the Press, reiterating the Bangladesh Government’s openness to trade with the US (See 10): The Prime Minister and President noted with satisfaction the significant This pretty much symbolizes how the Bangladeshi leadership plans for economic development. And the thinking is not particular to Hasina’s Awami League. Khaleda Zia’s BNP also cannot imagine economic development without US foreign investment or trade. In fact, her delegation, headed by AQM Badruddoza Chowdhury was here to meet Collin Powell in 2001 to literally beg that the US reconsider taking away business from Bangladeshi garments workers, to which Collin Powell gave a tactful cold shoulder. The quotas were reassigned to India, (See 11): During the meeting the Foreign Minister presented the overall economic Unfortunately, the power that the US has been able to establish through it’s donor and investment programs, such as the USAID, on the Government of Bangladesh, is a sign that the sovereignty of nations is being easily compromised. The fact that the USAID budget for Bangladesh is larger than the fiscal budget of Bangladesh is alarming that such the US has direct control of the nation, whether through legitimate spending or by fostering corruption in the Government and Public Sector. And the story does not end here. Bangladesh is but a dot in the Map of Shame of the USAID. It’s activities and budgets are quite the same in India, Indonesia and Nepal to name a few, and surprisingly with such activities is present a liberalization of trade. India : Home-base of USAID Asia Operations India is in the act of stripping itself of all barriers to trade and embracing the WTO, whether under Vajpayee’s BJP or Sonia Gandhi’s new Congress I Government. On the issue of India’s vision of Americanization, Indian Ambassador to the US, Lalit Mansingh, said it well (See 12) "Let me dwell for a moment on a not so well publicised side of the story The US has great plans for Indian -- destroying it’s agriculture and using it’s natural resources being one of them (See 13) and perhaps the population growth problem in India has been a very important way of breaking the countries protectionist philosophy. The Population Research Institute reports (See 14): India is the home of USAID’s largest family planning program. This comes as no surprise as India is projected to become the world’s most populated country, surpassing China in the year 2025. What’s surprising is that even though India’s population is almost ten times that of Bangladesh’s population, in 1998 the Government of India got 2/3 of the USAID aid that Bangladesh got. Why so? From Vandana Shiva’s book Bio-piracy: The Plunder of Nature and Knowledge we can understand that India’s pharmaceutical industry is not only large it rivals the US counterpart in the manufacture of drugs to cure HIV/AIDS and most generic drugs. In fact, Shiva explains India adversary role to US patent supremacy of generic drugs and most certainly for HIV and AIDS, as India's laws do not allow food or medicine to be patented. It seems that having this competition has delayed the level of influence the USAID has had on India’s health care policy, and it remains to be seen if the issue is up for compromise in the Congress I Government of Sonia Gandhi. Lessons for Pakistan Though India has opened up to trade and allowed the USAID in, it's domestic health care industry has prevented it from becoming the poster child marketing ground that Bangladesh has been. A look at the studies of the Population Research Institute and USAID and Population Council for Nepal and Indonesia also point to large marketing expenses, more clinical expenditure in the last seven years, and more marketing and testing of Norplant and other dangerous IUDs. Those are for the reader to investigate. But for now, the lessons that these nations leave for Pakistan are crucial. If possible Pakistan should be strict about what the USAID brings to the table, even if the pressure from the US government is paramount. About the Author(s): See under Our Contributors to find out about the Author(s) of this article. |
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