Global Health and Foreign Policy

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

The foreign-policy rationale for aid has been clearly reflected in historical trends in development assistance. Since the end of World War II, large donor states have tended to focus bilateral and multilateral aid to support countries judged to be strategically linked to national security and economic interests (11) (12) (13) (14) (15) (16) (17) (18) . The basic institutional architecture for multilateral development aid-the World Bank, the International Monetary Fund, and the United Nations, along with specialized United Nations agencies such as the World Health Organization (WHO)-were created after World War II with the immediate goal of rebuilding and modernizing war-damaged societies and safeguarding the security of Western powers (19) . Between the 1960s and the 1980s, aid from the United States and other Western countries ''reflected anti-communist Cold War tensions'' and focused on ''containing Soviet influence in Latin America, Southeast Asia, and Africa'' (20, p. 2) . Promises of substantial US aid packages to Egypt and Israel facilitated their signing of the 1978 Camp David peace agreement, and since 1978 these 2 countries have ranked at the top of the list of recipients of US foreign assistance (21, 22) . The top 6 recipients of US aid in 2008 were (in descending order) Israel, Afghanistan, Egypt, Jordan, Pakistan, and Iraq, indicating a clear preference for aiding strategically important partners instead of the poorest states (20) .