I am admittedly a novice in my understanding of the generation and dispersal of foreign aid to low income countries, but nonetheless, was taken aback when reading the KFF’s “The U.S. Government Engagement in Global Health: A Primer.” The reading elicited multiple ethical quandaries that have landed in an uncomfortable, gray zone in my mind.
First of all, the KFF piece discusses the breakdown of U.S. federal agency involvement in foreign aid, which includes the foreign assistance structure and the public health structure. The Department of State, which falls into the former category, functions as a key to the generation and dispersal of aid, but in almost contradictory fashion, also functions to promote the maintenance and implementation of U.S. aims globally. The difficult part to reconcile is the possibility that foreign aid will be leveraged to push forward the U.S. agenda internationally. In such a case, a lower income country may be forced to decide between critically needed funding and U.S. objectives that may not be in alignment with their own values.
The second intriguing point that presented itself, after discussing the KFF piece with the team, was on the part of the government donor. Taking everything I laid out in the above paragraph completely out of this discussion, there is potential gray zone when a donor government provides aid to countries with whom it does not share specific domestic practices (discrimination, imprisonment, torture, etc of its own people). On one hand, a donor government would not want to imply that such practices are acceptable, but would also not want to withhold much needed aid from citizens who likely have little to do with the continuation of such policies.
Both of these concepts represent unexpected complications when dispersing foreign aid. Personally, I don’t know what the right conclusion is for either of these quandaries, they still exist in the gray zone for me.