Reply to Dr. Agnes Binagwaho
July 16, 2015
Jul 16, 2015
1 Min read time
Angus Deaton replies to Agnes Binagwaho.
Dr. Agnes Binagwaho, firing off in all directions, misses her target. I am not a racist, and that she would stoop to such libel only highlights the weakness of her case, indeed the absence of any argument at all. And her fury has blinded her to the logic of my argument.
My target is not the Rwandan people, nor even Paul Kagame; I have no doubt that Rwandan parents love their children, and that the improvements in health and healthcare in Rwanda are a good thing. Dr. Binagwaho can be justifiably proud of her part in this. I did not argue that Rwandans do not want good health, nor that Rwanda would be more democratic if it neglected its basic needs. No one in their right mind would ever make such claims, certainly not I. The attack on Kagame is general, not personal: autocrats without accountability to their citizens face no constraints to behave well and have no structural incentives to do good things for their people.
My targets, in addition to Peter Singer’s dangerous endorsement of effective altruism, are the Western aid agencies—official, multilateral, or international NGOs—and the ethical problems that come with their being prepared to ignore democratic abuse in order to get other things that they want. Today, the West wants an improvement in health, which is infinitely preferable to some of their past wants, from arguing that colonialism helped boost material development, under the (truly) racist assumption that Africans did not want political rights, to aiding Joseph Mobutu in Zaire to help contain the spread of communism, or to aiding Meles Zenawi in Ethiopia to help fight the war on terror. Yet the ethical dilemmas are much the same; to meet our aims, we are trucking with the devil. In the short run, that will often do good—and the improvements in Rwandan health are part of the good that is being done—but history—Italy and Germany in the late 1930s and China prior to the Great Leap Forward who all had impressive public health programs—suggest that the long run is different, and that improvements in public health can never be truly secure in non-democratic states.
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July 16, 2015
1 Min read time