I am doing a series of articles on the book “Rethinking Canadian Aid” (University of Ottawa Press, 2015), and now it’s time for “Chapter 3: Revisiting the Ethical Foundations of Aid and Development Policy from a Cosmopolitan Perspective” by John D. Cameron.

The absorption of CIDA into DFATD and explicit subordination of aid policy to broader foreign policy suggests two possibilities for how we analyze aid and development policy. The first is to abandon any expectation that aid is connected to or inspired by moral concerns for the well-being of other people and to employ realist methodological perspectives that analyze aid purely as an instrument of foreign policy. […] The alternative […] is to re-examine the ethical basis for aid and to analyze aid in the context of a more theoretically consistent and coherent normative framework that draws attention to the broader range of government policies that affect developing countries.

I admit that I’m excited by the idea of putting aid ethics in a larger ethical framework, and while the first is an easy throwaway, the second argues for looking at policy coherence. I’m interested to see how deep he goes in defining coherence because there’s an assumption out in the literature, and particularly in many NGOs, that aid policy and foreign policy or more accurately trade policy are incoherent. They trumpet examples such as giving $40M in aid to a country while clawing back $25M in tariffs as obviously “incoherent”. Except that they haven’t first defined what they mean by incoherence, or which is the starting point and which is the ending point.

For example, if your opening “framework” was that you deal with all countries for trade on an equal playing field, and if they don’t support human rights, labour laws, environmental sustainability i.e. if they race to the bottom that unfairly “subsidizes” production by not incurring costs that more responsible producers incur, then that country pays tariffs (the above mentioned $25M), then you have a perfectly coherent trade policy. If you then say, “But wait, that’s a poor developing country that needs our help”, and the government turns around and gives them $40M in aid, including for human rights, labour, social development, education, governance, and the environment, it’s tantamount to giving them their $25M back and giving them an extra $15M. Still perfectly coherent trade policy — taxing the exploiters and pushing the country to raise its workplace regulations to match international standards. It even is perfectly coherent aid policy — helping those who need it, giving them money to help while still engaging them in trade which will pull them into the international community, laying the groundwork for long-term economic sustainability.

However, what is missing from the original complaint is “policy coherence for something” — you need an overriding policy that is the dominant one to resolve conflicts if/when conflicts arise. The Dutch and the OECD looked at this in the early 2000s and quickly found multiple levels/types of policy coherence — simple coherence where two policies conflicted (i.e. one said to do A, another said to do B), almost an administrative coherence; moderate coherence where two policies could work together for a common goal; or true coherence for a specific policy objective and everything that didn’t directly meet that objective was changed. This is what Cameron refers to as “policy coherence for development” and too often those last two phrases are left out, so I’m glad to see it so strongly highlighted.

What intrigues me too is that Cameron looks at two frameworks while studiously ignoring a third possibility — that while the humanistic portrayal says “poverty reduction”, there are many ways to meet that need, some of which are perhaps better delivered by Foreign Affairs and Trade than other forms. For example, if one of the priorities is economic development, and one of the sub-areas is private sector development, there are lots of micro-credit experts in development, but very few who know much about building coalitions of companies to advise governments what their negotiating strategy or positions should be at the WTO. That’s mainly Trade Commissioner territory. Put another way, there is another framework that says not just that there are “other policies” but one that says “other approaches are perfectly valid forms of poverty reduction, even approved as such by the OECD Development Assistance Committee”.

Ethical consistency and political responsibility suggest that scholars of aid should give equal consideration to positive and negative ethical duties. In practical methodological terms, this would require the expansion of our analytical frameworks beyond aid as an expression of positive duties to also include greater examination of the potential harms caused by both aid and non-aid aspects of development policy, in particular the ways in which other policies might undermine the impacts of aid.

While Cameron is quick to assume that we review the benefits of aid, and both the benefits and costs of non-aid, there are serious risks to the aid side too that are difficult to measure and evaluate, but no less concerning. Greater integration into the world economy opens those countries to shocks, building human rights institutions and strengthening rule of law helps stabilize aspects of governance but can also create new tensions that fragile governance systems are ill-equipped to manage. We do projects that are gender-sensitive, respect the environment, don’t displace Aboriginal communities, emphasize education and health, all with the latest tools. Except if the culture was not like that to begin with, there is a piece of it that must adapt or die. If that seems too esoteric, too remote, then let’s look at the number of projects that in conflict-torn regions provided mobile health services, complete with a vehicle so that the doctors and nurses could get to the injured. Sounds simple, right? Except that a week after the vehicle arrived, it was suddenly gone — and look, the military has a new troop carrier of the same size and shape, allowing them to attack farther afield. Not all development projects go according to plan, not all outcomes are foreseen. I wrote on Chapter 2 about the challenges of infrastructure projects (Critique of Rethinking Canadian Aid – Chapter 2 – Refashioning Humane internationalism) and the long-term unintended consequences. If you go farther back and look only at the “good intentions” of development projects, early projects that looked a lot like modern “Manifest Destiny” didn’t have very positive outcomes for Aboriginals. And all done with the best of intentions.

While the OECD/DAC emphasizes policy processes to enhance policy coherence for development, the Commitment to Development Index focuses explicitly on six non-aid policy areas (as well as aid itself) in its analysis of rich country development policies. Those six policy areas are trade, investment, migration, environment, security, and technology transfer (CGD 2013).

Having witnessed a number of the early discussions of the CDI, I am not as optimistic of the interpretation given to it. Most countries seemed to interpret it as “simple coherence” that eliminated externalities only, few were willing to go deep into the analysis. I love the idea of expanding to other areas, but I wish there was more “meat” to Cameron’s initial call to arms.

Take migration for example. The example given early is how Canada steals the medical professions from other countries, thus undermining their original health care system. It seems simple, seems obvious. So much so that many harp on it repeatedly and use it to beat the drums of injustice. Except there are three very big questions that any ethical framework would have to address, beyond those simplistic terms.

First, the UN Conventions on Human Rights (economic, social, political, civil) have mutually re-inforcing clauses that say labour mobility is a human right. A human right, full stop. Yet, the NGOs who advocate for strong human rights want foreign governments to limit a medical professional’s right to labour mobility because the origin country needs them. Some who are quite well-versed in labour mobility call that being held hostage; those more aggressive in their rhetoric call it slavery or at the very least indentured servitude. The ethical framework has to resolve that, or it cannot stand.

Second, there is a practical issue. How do you address the economic disconnect? There is a reason the doctors and nurses want to leave their home country. Not because they don’t like it, not because they hate their families, not because they don’t want to stay where they are — they leave because there aren’t enough paying jobs to sustain their families and they can make more money elsewhere. While the first part is purely on the “pull” factor of countries like Canada recruiting abroad, this is the internal push factor.

Eveline Herfkens used to tell a story of her first trip abroad as the Development Minister for the Netherlands. She went to Ghana and was going to renew a project that sent Dutch doctors to Ghana for sabbaticals basically to work and train new doctors in Ghana. When she announced to the Minister of Health the renewal, she asked why he didn’t seem happier. He said that sending a Dutch doctor was welcome but would cost her $200K. For the same money, he could pay maybe 4 doctors $50K more a year or even 10 doctors $20K more a year, and get 4-10 doctors instead of just one. Brilliant, she thought, so she changed the project, cancelled the Dutch doctors and agreed to fund the Ghanaian doctors. It seems like a no-brainer, doesn’t it? Except that the next day, in the Dutch papers, the headlines read, “Herfkens kills African babies”. Because the reality was that she wasn’t going to send the Dutch doctors anymore, and they had the support to go plus wanted to go, and they wouldn’t get the results that they had before. Maybe similar results, or maybe different, but not the same. Was the headline inherently racist in its assumptions? Of course, but hiding in the weeds is that the only way to get the Ghanaian doctors to stay is to pay them more. They want to stay, few want to leave a stable home if the country isn’t going to pot, and many want to stay even if it IS going downhill (maybe even more so). But the ethical framework has to figure out how to remove a strong economic incentive to move. Oh, and by the way? There are some who view it a lot like paying polluters not to pollute — you’re paying them to “do the right thing” and not leave their country. It’s a bit messy.

Third, and perhaps most important, you’re going to have a framework that decides (on some basis, maybe GDP?) what is “best” for the origin country. It sounds simple, at first blush, stay and save people. Except here’s the kicker. What’s the biggest challenge? Poverty. How do you fix that? An influx of capital. What do all those medical professionals do when they start working elsewhere? Send home remittances. Money from outside the country.

In fact, back in 2002-2003, African countries put on their collective website of the African Union articles about the same topic, how foreign countries were stealing their medical professions. What happened? Other countries told them to take them down and shut up. Because a couple of the countries had looked over at the Philippines, realized that they too had little to develop to “export” other than people, and started investing in medical training. So they too could send their newly trained citizens abroad and get the remittances coming back. There are numerous countries in the world where remittances outpace trade, development and several other types of flows in/from the countries. Some OECD countries have even proposed the remittances count as development assistance.

So, that ethical framework that says Canada can’t steal health professionals needs a broader context to resolve not only the “why” but how to measure the impact. And, more pointedly even, who decides — the individual who wants to exercise their mobility rights and earn money for their family; the origin country’s government that wants them to send money back, have factored future remittances into their development plans, and doesn’t have the money to pay them themselves; the host country that wants and needs their skills; or the NGO or academic who thinks it’s wrong?

As with my previous infrastructure examples, the ethical framework has to be able to deal with really complex messy issues, some with no clear answers. I’m not sure the call to arms in Chapter 3 gets us there, but it’s a start.