Global health and the 'war on terror': strange bedfellows

Last May, Andrew Natsios, the Administrator for the U.S. Agency for International Development (USAID), told leaders of the world’s non-governmental organizations (NGOs) that they should aggressively promote connections to the U.S. government and measure results of their work, or the Bush administration would find new partners for overseas assistance programs. Many beneficiaries, he complained, don’t know where the money is coming from, and therefore US-government funded NGOs should communicate explicitly their role as ‘arms of the US government.’ According to Interaction, a network of 160 NGOs, Natsios went so far as to say that if such organizations fail to make the connection to the US government crystal-clear, he would ‘personally tear up their contracts and find new partners.’

Following Natsios’ diktat would seem to imply that NGOs should be silent on US government policies. For it seems difficult to criticize the workings of the US government while aggressively profiling yourself as an arm of the same government. But, according to some, enforcing silence may be the point.

This week, Natsios is in the news again, claiming that poor countries like it when the US government links its spending on aid to the ‘war on terror’. They really enjoy the idea, according to Natsios, that the US gives aid not out of compassion or any other ethical imperative, but rather to prevent fragile states from disintegrating and becoming havens for terrorists and hence a threat to US national security. On a similar note, he argued that the US should devote funding to combat bird flu in developing countries, not primarily to reduce mortality and morbidity of non-American human beings, but because developing countries can be considered the ‘frontline of the epidemic’. Some people’s frontline is other people’s front yard.

Natsios has claimed insight into the needs and preferences of developing countries before. For those who may have forgotten, Natsios is famous for saying in 2001 that Africans should not receive antiretroviral treatment, because their ‘alternative conception of time’ would render them incapable of taking their medication properly.

Most of the US-funded NGOs in the developing world focus on health-related issues. It will be interesting to see how this new ideology – which brazenly links funding for health in the developing world to US national security interests – plays itself out in the coming years.