The development plight of Africa and the tensions between donor and recipient countries regarding aid for development will once again take center stage during the G-8 nations meeting in Canada, June 2002. During this meeting, the G-8 nations will engage African leaders on how to meet the financial and technical requirements for a massive, African-inspired and led initiative known as the New Partnership for Development (NEPAD). The NEPAD initiative seeks to reengage the donor community in a mutually beneficial compact that recognizes and respects indigenous initiatives while meeting international requirements for transparency, the rule of law, and democracy. African leaders estimate that for NEPAD to be successful, the continent needs at least $64 billion annually in investments to ensure sustainable growth (CNN.COM, March 26, 2001).

However, the G-8/Africa parley on NEPAD will be conducted in an atmosphere of tensions regarding the relationship between donor and recipient countries on aid for development. The first salvo of this tense relationship was fired at the 2002 Monterrey conference on financing for development The "Monterrey Consensus" negotiated by the United Nations in advance of the conference resolved "to address the challenges of financing for development around the world, particularly in developing countries. Our goal is to eradicate poverty, achieve sustained economic growth and promote sustainable development as we advance to a fully inclusive and equitable global economic system." (Draft outcome of the International Conference on Financing for Development: Monterrey Consensus, United Nations, A/AC.257/L.13, January 30, 2002). The Monterrey Consensus seeks a developing world of sustained debt relief, freer trade, enhanced foreign investments, better mobilized domestic resources, more and better directed foreign aid, and more democratic and efficient governments.

However, the parade of African leaders that took the podium in Monterrey bemoaned the current state of aid for development in Africa. President Obasanjo of Nigeria in his address to the gathering of heads of state and government, ministers, corporate titans and civil society gurus in Monterrey indicated that he is yet to receive a "single cent" from donor countries in Nigeria's quest to ease its debt burden of more than $28 billion (Nigeria Guardian Newspaper, March 23, 2002). President Mbeki of South Africa in his address appealed for a drastic revision of the International Monetary Fund's Highly Indebted Poor Country (HIPC) Initiatives stating "Unless we can staunch the outflow of scarce capital from the poorest countries, we will never enable governments in poor countries to marshal the resources to improve on the quality of public services or to address the infrastructure needs." (Ferial Haffajee article on www.tbwt.com, March 22, 2002).

The donors, principally the United States and European Union, while promising additional $12 billion in aid for development had tough words on what is expected of developing countries, especially African nations. President Bush in his keynote address in Monterrey stated "For decades, the success of development aid was measured only in the resources spent, not the results achieved. Yet, pouring money into a failed status quo does little to help the poor, and can actually delay the progress of reform." (White House Press Release, March 22, 2002). In promising new aid monies, President Bush stated that "these funds will go into a new Millennium Challenge Account, devoted to projects in nations that govern justly, invest in their people and encourage economic freedom."

The Monterrey conference raised unresolved issues regarding aid for development programs, especially in Africa, which the G-8 conference may not address. At the core of these unresolved issues is the nature of the relationship between donor and recipient countries regarding aid for development. These lingering issues are crucial for Africa since critics of aid for development suggest that despite billions of dollars in development assistance, the continent remains mired in poverty. On the other hand, defenders of aid for development in Africa point out that these aid programs have suffered from undue political and economic control by the donors.

Confronting the Tough Choices on Aid for Development
Sooner rather than later, Africa and the donor countries will have to confront tough choices regarding the purpose, scope, and objectives of aid for development. These tough choices revolve around critical questions and issues:

1) Are Western conditionalities for aid meeting the felt (not perceived priorities) of African nations?
2) What is more important, meeting donor conditionalities or saving lives and/or improving the quality of life in recipient countries?
3) Should people living in desperate poverty suffer because their governments are either not performing or meeting donor conditionalities?
4) Who determines whether a government is efficient and democratic?
5) What should happen to governments that have subverted the will of their people through sponsorship of political violence, corruption and economic mismanagement?

These questions remain unresolved despite popular rhetoric by donor and recipient nations as I had indicated in previous articles on donor/recipient relationships (The Growing Influence of Non Governmental Organizations (NGOs) in International Health: Challenges and Opportunities, Journal Royal Society of Health, April 1998; Community Participation in International Health: Practical Recommendations for Donor and Recipient Organizations (Special Report), Pan American Journal of Public Health, March 1999).

To begin the process of providing a guideline for responding to these unresolved issues in aid for development, especially as it relates to Africa, I identify five broad-based themes that deserve critical review:

1) Identification of Need and Setting Aid for Development Priorities
2) Establishing Measurable Indicators on Aid for Development Programs
3) Monitoring and Evaluating Aid for Development Programs
4) Sustaining Aid for Development Programs beyond External Funding Cycles
5) Assessing the Catalytic Effects of Aid for Development Programs

For each broad-based theme, I am proposing a series of questions that may allow for a critical review of aid for development programs, in this case, Africa.

Identifying Need and Setting Priorities
Who sets the agenda on aid for development and why in (a) donor countries, (b) recipient countries? What are the parameters for reconciling aid priorities of recipient nations with that of donor nations? How are the foreign policy interests of donor countries and recipient nations reconciled in aid for development programs?

Who identifies the development priorities of Africa? Is it the donor nations, multilateral agencies, the Organization for African Unity (OAU), individual African governments or civil society? In recipient countries, who chooses the target population in aid for development programs and why? In both donor and recipient nations, who determines whether identified development priorities are the felt or perceived needs of the target population? In donor countries, who determines/approves the target population in recipient countries and why?

Measurable Indicators in Aid for Development Programs
What are the parameters for identifying the total cost of aid for a specific country in Africa? Should the cost of aid to a specific African country include project costs incurred in donor countries? How should recipient countries cost aid tied to specific charges in donor countries?

Who sets measurable indicators in aid for development programs and why in (a) donor countries, (b) recipient countries? What constitutes "success" in aid for development programs? Are the "success" indicators similar in donor and recipient countries, and if not, why? In conflicts regarding "success" indicators between donor and recipient countries, who arbitrates and based on what parameters? What is the role of the target population in recipient countries in designing and evaluating "success" indicators in aid for development programs?

Who sets conditionalities on aid for development programs and why in donor countries? What are the relationships between aid conditionalities, the priorities of recipient nation government, and the needs of the target population in recipient countries? What are the triggers that reconcile aid conditionalities with the needs of the target populations? At what threshold will the needs of the target population supercede aid conditionalities? If a recipient country resists aid conditionalities, is it based on verifiable consultations with the target population? If recipient country resists aid conditionalities at a time of great need, who arbitrates and based on what parameters?

Monitoring and Evaluating Indicators for Aid in Development Programs
Who sets the monitoring and evaluation indicators and protocols for aid programs? Are these protocols set to meet legal and political requirements in donor countries or to improve the living conditions of target populations in recipient countries? What is the role of the target community in the design and implementation of monitoring and evaluation indicators and protocols?

Who represents the interests of target communities in Africa? Is it the local government, national government, civil society organizations, traditional rulers? Can civil society organizations in recipient countries represent the interest of the target community? Who are the monitors and evaluators of aid for development programs, and what interests do they represent?

Sustaining Aid for Development Programs beyond External Funding Cycles
Did the donor and recipient nation agree on the parameters for ending external assistance before the commencement of aid for development programs? What are these parameters? What is the role of the target community in deciding whether an aid program will continue at the end of external funding cycle?

Catalytic Effects of AID for Development Programs
There is a mutual meeting of minds by donors and recipient countries regarding the use of aid for development programs as a springboard to advance the socioeconomic conditions of the target population. However, the devil is in the details. As shown by the structural adjustment policies of the International Monetary Fund and the World Bank in the 80's and early 90's in Africa, donor imposed priorities, can heat up the fragile economic systems of African countries and create significant social and political dislocations in countries that adopted these policies.

A consistent soft underbelly of the present aid for development strategies according to its critics such as Drop the Debt, Jubilee USA Network, Oxfam and Reality of Aid, is the lack of sustained improvements in the socioeconomic conditions of Africans. According to both the World Bank and the Economic Commission for Africa, nearly half of all Africans currently live on less than one dollar a day. By 2015, while global poverty levels will reduce to 11 from 22 percent current levels, at least 37 percent of Africans will still be living in poverty.

I will briefly pose critical questions on the catalytic effects of aid for development programs in Africa. Some of these questions are already undergoing rigorous review in multilateral agencies, academic institutions, think tanks and policy oriented advocacy organizations.

Economic Effects
What is the cause-and-effect relationship between aid for development and poverty reduction in Africa? What are the parameters of market oriented economies in Africa and who set such parameters? How does aid for development enhance external private investment in Africa? How does aid for development programs spur entrepreneurial activities in Africa? What is the relationship between aid for development and trade in Africa? What is the relationship between aid for development and retention of agricultural subsidies in donor nations? What is the relationship between aid for development and debt repayment in Africa?

Political Effects
What is the relationship between aid for development and the enthronement of democratic traditions in recipient nations? What are the parameters for "governance" in aid for development programs and who set these parameters and why? Who determines the democratic credentials of African governments and based on what parameters?

For autocratic governments in Africa, who determines their fate? Is it the donor nations, the civil society of recipient nation or citizens of that country? Who determines when autocratic governments in Africa are "making progress" in democracy and efficient government, and based on what parameters? What are the triggers for ending aid for development programs in politically volatile recipient countries?

Cultural/Spiritual Issues
What are the direct and indirect consequences of aid for development programs on (a) cultural, and (b) spiritual mores of recipient nations? On aid for development initiatives for information, education and communication (IEC) programs, who determines the message, the messengers, and target audiences? In conflicts between the cultural/spiritual mores of a target community and an urgent need for development assistance, what are the parameters for resolving these conflicts?

Environmental Issues
What is the relationship between aid for development and sustainable development in recipient nations? Who sets environmental priorities for recipient nations? Should there be different environmental standards for transnational corporations in donor and recipient countries? What is the role of the target community in the design, implementation, monitoring and evaluation of environmental policies?

Conclusion
The Monterrey conference on Financing for Development effectively put the aid for development agenda back in the mainstream of the emerging relationship between donor and recipient countries, including African nations. The 2002 G-8 conference in Canada will mark a major milestone in donor and recipient countries relationships as African leaders present a concrete proposal on how to move their continent forward in the 21st century. After more than 50 years of development assistance, G-8 leaders and their African counterparts have enough historical evidence to seriously evaluate the relationship between donor and recipient nations. With African leaders now mobilizing around NEPAD, the stage is set for a serious dialogue between donors and Africa on the best way forward regarding aid for development. To meet the UN Millennium Goals for Development in Africa by 2015, the leaders of donor nations and Africa must ask tough questions and look themselves in the eye regarding the best answers.

About the author: Chinua Akukwe is an adjunct professor of public health at the George Washington University, Washington, DC (cakukwe@att.net, cakukwe@gwu.edu) and is a member of the Board of Directors of the Constituency for Africa, Washington, DC. Dr. Akukwe is a former Vice Chairman of the National Council for International Health (NCIH), Washington, DC, now known as the Global Health Council.