“This one time, I was in a meeting of African health ministers, and they were being lectured by a group of very well-meaning Europeans and Americans (who, by the way, are very keen on lecturing Africans in general). Finally, the health minister of Cote-d’Ivoire (Ivory Coast) had had enough of this,” Mark chuckles, “so he stood up and said, ‘It might have escaped your notice but you stopped running this country 50 years ago.’ The American and European delegation was pretty quiet after that – I think they were a bit lost for words!”

“That’s an anecdote but that is the strain that underlies a lot of international development assistance. There’s the whole long-standing argument about who really does know best,” explains Mark. “The Americans are pretty overt about saying they know where they want their money spent. The Europeans try, at least on paper, to say that they want to support sovereign governments and what they want to do – but, in fact, of course they also interfere.”

This is indeed a fundamental question about development assistance: To what extent should the countries that provide the development assistance decide what the priorities are for that money? Mark emphasises that there are no simple answers to this very big question. “I think it’s undoubtedly true that in most developing countries, the poorest of the poor – who are the target of the development money in most cases – are not politically powerful. There are, of course, exceptions, but they’re not going to be the natural political constituency that has to be appeased. This is the case even in industrialised countries… The rich have been getting richer and the poor poorer even in the U.S.!” says Mark.

Mark thinks if western governments do want their money to be focused on the poorest of the poor, then they’re going to have to be fairly proactive about saying that’s what they’re giving the money for – and that will inevitably cause resentment. “By the way, even when the poorest of the poor are in control, it may not mean the donors are any happier with they where their money’s going. Just because the historically most disadvantaged are now in charge, it’s not a recipe for excellent government spending. I’m sure you can think of several examples,” Mark says with a wry smile, reminding us that the issue is not black and white, and that preconceived notions and assumptions simply don’t cut it when it comes to the dilemma of development assistance.