WASHINGTON -- The broad American belief that foreign aid is stuffed down tropical rat holes has been recently reinforced by a young, Zambian, Oxford-trained economist named Dambisa Moyo. Her book, "Dead Aid," has launched her as a conservative celebrity, feted by Steve Forbes and embraced by the Cato Institute. 
And the book is something of a marvel: Seldom have so many sound economic arguments been employed to justify such disastrously wrongheaded conclusions.
Moyo is on firm ground in criticizing decades of direct foreign assistance to African governments. Such aid has often propped up corrupt elites, shielded leaders from the consequences of their own incompetence and delayed reforms necessary for the development of working markets. She is correct in emphasizing the decisive role of trade, direct foreign investment and local capital in the development of poor nations -- sources of opportunity that dwarf aid flows in size and importance.
I'd go further. Through most of the last several decades, the development of Africa has not even been the purpose of foreign aid. Europeans often provided money to elites in former colonies to assuage guilt. During the Cold War, Americans often used aid to reward loyalty. Most Westerners seemed to view developing nations as basket cases from which little could be expected anyway.
But Moyo does not take sufficient account of the broad reaction against this kind of direct aid beginning in the 1990s. The United States started taking a much more targeted and strategic approach. The Millennium Challenge Account directed new aid to nations willing to work as responsible partners, dedicated to reform and transparency. Initiatives on AIDS and malaria required and achieved measurable outcomes and have often worked through civil society instead of giving money directly to African governments.
Moyo dismisses these efforts, stating that her book is "not concerned with emergency and charity-based aid." But America's AIDS and malaria programs are more than "charity." They herald a new approach to foreign aid -- focused, centrally directed and results oriented. PEPFAR, for example, a program I advocated while I worked at the White House, has helped more than 2 million people get treatment for AIDS. The scale of the program has also resulted in the strengthening of African supply, management and human resource systems -- encouraging a professionalism that bleeds through an entire health system and beyond.
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