Aid Effectiveness on BRICS Nation

Submitted By:

Avijit Bardhan (PRN – 18060242014)

Dhritabrata Paul (PRN – 18060242020)

Vikrant Vardhan (PRN – 18060242066)

Introduction
BRICS nations—Brazil, Russia, India, China and South Africa represents around 25% of world‘s
gross national income, which is more than 40% of world‘s population and about 40% of global
burden of diseases. Due to the financial crisis in the year 2008, the political as well as the
economic structures went through profound changes and adjustments which led to the increase in
the national strength of the BRICS countries. During the annual summit in the Brazilian city of
Fortaleza in July 2014, the five leaders of the BRICS countries had launched the New
Development Bank (NDB) to support the funding of infrastructure projects in developing
countries. In the recent times, the bank has opened its headquarters in Shanghai and the Indian
national K.V. Kamath has taken up the role of president of the bank. Together with the newly
established Asian Infrastructure Investment Bank (AIIB) and the planned Shanghai Cooperation
Organization (SCO) Bank, the NDB is seen as a challenger of the international aid architecture
dominated by the United States and their allies in Western Europe and Japan. All these nations
are not new in this case, although they are often labeled as the ‗new donor‘ or ‗non-traditional
donor‘. China started its aid activities in 1950 whereas Brazil (the ‗youngster‘ among the BRICS
nations) started in the year 1969. Today, the combined aid budget of the five BRICS is still small
compared to the total amount of aid provided by established donors organized in the
Development Assistance Committee (DAC) of the Organization for Economic Co-operation and
Development (OECD). The rapid pace with which the BRICS‘ aid activities have grown in size
and scope has drawn significant public attention. Moreover, belonging to the global south, and
having been recipients of large number of developmental aids, the BRICS alliance are
reconfiguring the use of aid and development strategies for effective national growth and social-
economic advancement. This has sometimes come at the expense of global political norms of
democracy, good governance and human rights that have informed the foreign policy of
traditional donors, and underpinned global governance institutions.

Why BRICS?
Foreign aid has always been a factor in the relations between the developed nations and the
underdeveloped nations. In the post World War II period, when the nations were divided into
two hostile camps, the rich nations used to provide to aid to them with an intention to promote
foreign policy goals. Whenever a country gives economic or diplomatic aid to another country,
apart from economic reasons there are always political and diplomatic reasons. It is not only the
rich countries that use aid as a tool to pressurize the country, sometimes, indulge in these tactics,
but even some of the less developed countries when they extend aid to others, demand the same
obedience.
BRIC came into existence on 24th December 2010. After that, during the 3rd Summit in April
2011, South Africa joined their hands and the BRICS nation was formed. It was formed with the
following objectives:

 To be an alternate to the World Bank and the IMF to challenge US supremacy

 To provide self owned and self managed organization to carry out economic and
development plans together without being dependant on any other foreign agency. With
the initiative of BRICS bank, this demand has been fulfilled.
 To act as a bridge between developed and the developing countries. The BRICS group
plays an important role in assisting the countries in gaining an advantage in trade and
climate change negotiations.
 It was also formed with an objective that the countries should not only have economic
purposes. They should also be involved in exchanging platforms with respect to
education, culture and environmental engagement.

Brazil
Key Advantages:

 One of the fastest growing economies in the last centuries

 They are less dependent on imports
 Extremely rich in resources such as coffee, sugarcane, iron
 There has been a significant poverty reduction

The United States will continue to assist Brazil which will deepen their partnership to make
progresses on shared goals, enhancing security and law-enforcement cooperation. Brazilian
military officials will continue to receive training that will encourage closer cooperation and the
ability to implement shared strategies. Brazilian and U.S. security will be enhanced by
combating transnational crime, improving the rule of law, and strengthening counterterrorism
programs. Under the U.S.-Brazil Joint Initiative on Climate Change signed in 2015 and the
USAID-GOB Development Objective Agreement on Biodiversity Conservation signed in 2014,
the United States and Brazil are pursuing cooperation on environmental priorities, including
biodiversity conservation and climate change mitigation and adaptation.

Russia
Key Advantages:

 Russia has capability in technology sectors

 It accounts 20% of the world‘s oil and gas reservoir
 There has been a decrease in the number of people living under the below poverty line
  It is the third largest exporter of steel and aluminum.

India
Key Advantages:

 India has more than 1.15 billion people

 It is one of the highest growing economy
 It has the second largest labor force in the world
 It has abundant natural resources.

India has been identified as the highest recipient of the US economic assistance. Data compiled
by USAID (United States Agency for International Development) shows that India has received
approx. $ 65.1 billion economic assistance during the period of 1942 to 2012. US assistance to
India is currently around $ 100 million after Delhi embarked on the course of weaning itself
away from aid to trade in 1990s. With assistance, the United States is piloting a new model of
development, whereby partnerships and platforms created jointly with the Government of India
(GOI), private sector stakeholders, and civil society organizations are used to scale proven
solutions locally and globally. The United States and India are now working jointly to achieve
their shared development goals for India, the Asia Pacific Region, and global progress. New
commitments include initiatives to mitigate the impact of climate change, achieve global health
and food security objectives, and ensure continued regional integration and stability. U.S.
assistance in India is used to advance this shared agenda by engaging a range of stakeholders to
end extreme poverty - which affects 21.3 percent of India's population, according to the World
Bank - and increase citizens' access to quality health care, education, water and sanitation, and
energy.

China
Key advantages:

 It has a broad expansion of the educational achievement

 It is the third largest country with respect to land
 It has a rapid economic growth
 With respect to GDP, it is the biggest among the other BRICS nations
 It alone does exports to more than 30 countries
 The labor force there are very cheap

US assistance has helped the Tibetan communities improve livelihoods, promote sustainable
development and environmental conservation, and preserve cultural traditions. In addition,
foreign assistance funding also supports targeted programs that strengthen cooperation on
combating the spread of HIV/AIDS and other pandemic and emerging diseases as well as rule of
law programs. China is the largest export economy in the world and the 33rd most complex
economy according to the Economic Complexity Index (ECI). In 2017, China exported $2.41T
and imported $1.54T, resulting in a positive trade balance of $873B. In 2017 the GDP of China
was $12.2T and its GDP per capita was $16.8k.

South Africa
Key advantages:

 It is the new inclusion in the BRICS family.

 South African economy is the 23rd largest in the world
 25% of the goods produced in South Africa are exported to other nations
 South Africa is very rich in mineral resources.

As South Africa continues to exert leadership in the region of health, education system,
increasing corruption, mass unemployment, it is working with the United States and other donors
to address its social and economic challenges. U.S. investments, in line with South African
national development priorities, will target efforts where funding can catalyze innovative
approaches for reform and improve efficiency, helping South Africa sustain its democracy and
improve the lives of its people. The country has been facing challenges in case of lack of skills
due to which the economy is not growing with the pace of other developing nations and
shockingly, 48% of the population is still living below the poverty line.

Review of Literature
Asmus, G., Fuchs, A., & MMller, A. (2017) This paper provides an overview of the growing
literature and the bilateral aid activities carried out by the five BRICS countries. While these so-
called emerging donors are steadily gaining prominence in international development, they are
certainly not new to the field, with foreign aid programs started back as far as the 1950s. The
recent increase in both the size and scope of their development activities around the globe is
regarded by some as a threat to the international aid architecture dominated by the United States
and its allies in Western Europe and Japan. What do we know about the size, scope and
institutional design of the BRICS countries‘ aid activities? What can we learn about these
donors‘ aid motives by analyzing the pattern of their aid recipients and focal sectors? Does the
existing qualitative and quantitative literature allow us to draw conclusions about the effects of
BRICS aid on economic growth, other development outcomes, governance and conflict in
recipient countries? Moreover, how will BRICS aid affect the DAC-centered international aid
architecture and the way the so-called traditional donors provide aid? The paper also underscores
the considerable variation BRICS donors show in their aid approaches; they rarely act as a group
in international development cooperation.
Cao, G., Xu, F., Xie, S., & Huang, F. (4 July, 2018)With the rapid growth of economy and
social development among BRICS countries, the role of international health development
assistance in state capacity building is becoming more and more significant. This paper described
the management system, scale, recipient countries, mechanisms and characteristics of
international health assistance among BRICS countries. They aimed to learn about health
development assistance of BRICS countries by analyzing its amount, distribution, main
characteristics and management system in order to improve the international health development
assistance related to BRICS countries. They found out that it is necessary to set up a unified
international assistance management agency. Each BRICS country should use its own
comparative advantages and development experience to carry out international health assistance.
International health assistance data should be more transparent and open.

Emilio Dirlikov (2015) Here, the author examined the difference introduced by BRICS health
collaborations in an era of global health. Using the tuberculosis control as grounding example, he
wanted to show that BRICS collaborations prioritize state led solutions, particularly through
policies aimed at expanding universal health coverage; scientific and programmatic innovation;
experience and technology sharing; clear benchmarks for progress, based on current best
practices of control; and flexibility. Unlike international health, BRICS health collaborations are
not primarily concerned with preventing the importation of infectious disease across national
borders. They are not based on global health‘s concerns about global biosecurity or humanitarian
biomedicine. Rather, BRICS collaborative health efforts fall within the nation-state paradigm,
while also aspiring towards the global. They remain flexible in their operation which allows
BRICS to work within existing structures, while also establishing their own institutions from
which to change traditional assistance relationships.

Dr Morazan et al (2012) The role of BRICS as emerging protagonists in international

development cooperation is significantly and rapidly changing. Over the last decade, BRICS
have increased their financial as well as technical assistance and established distinct ways and
means of economic cooperation, especially through south-cooperation with Low Income
Countries (LIC). BRICS are striving for more political influence, thereby challenging traditional
western donors such as the EU. Busan Global Partnership strategy has considered obvious
changes in global development architecture more openly. The overall focus of development
cooperation lies on neighboring countries, regional integration and technical assistance.
Economic growth is perceived to be crucial for sustainable development; non-interference and
national sovereignty are guiding principles.

Geovana Zoccal Gomes et al (2018) The growing number of development stakeholders and
initiatives in developing countries has added complexity to international development
cooperation (IDC). Recipient countries have witnessed the increasing presence of emerging
countries such as the BRICS offering South–South cooperation as an alternative model for
development. This article discusses how the BRICS effect challenges established principles and
practices from the field of IDC, indicating at least three dimensions: (1) new positions beyond
the donor vs. recipient dyad (2) new modes of development cooperation and (3) transformation
of institutional architecture and governance mechanisms.

Morozkina Aleksandra(2018) This article assess the role of the BRICS countries in modern
development assistance framework. It has been divided into two sub parts. The first part
describes the volume if aid from BRICS countries, including in relation to total world flows. The
second part analyzes special features of the BRICS aid, including breakdown by sectors and
regions, as well as analysis of conditions. On the base of this analysis article concludes that ―new
donors‖, which include BRICS, are not a real alternative to the current system yet, instead, they
harmoniously complement it.

Methodology
Here, we are considering the BRICS (Brazil, Russia, India, China and South Africa) nation. Data
has been collected from World Bank database for 30 years within a range of 1990 to 2019. With
the data collected, a comparative analysis has been done to show the relationship between net
ODA received and the various health parameters.

Health Indicators:
Prevalence of HIV
Around 37.9 million people worldwide are affected by HIV or AIDS by the end of 2018. An
estimate of 0.8 percent of Adults of the age between 15 to 49 years are affected by HIV of which
1.7 million are children, 17.4 million are men and 18.8 million are women (WHO data). Out of
the total prevalence of HIV affected people in the year 2018, 9 lakhs are reported in Brazil, 2.1
million in India and 7.7 million in South Africa.

Prevalance of HIV (% of Total Population of

the age group 15 - 49)
20
% of Prevalence of HIV

15
Prevalence of HIV in Brazil
10
Prevalence of HIV in India
5

Prevalence of HIV in South

0
Africa

Year
After the disbursement of aid, there has been a 0.2% increase in the prevalence of HIV among
the citizens of the age 15 – 49 in Brazil since 1990 to 2017 (World Bank data). Thus, the
increase in prevalence of HIV is more or less constant. The reason behind this is the decline in
using intravenous drugs and the increasing use of condoms among the citizens of Brazil.
Statistics from UNAIDS reveals that incidence of HIV in the year 2018 was 0.26% of the entire
population of all age groups and the prevalence of HIV in the same period among the adults was
0.5%.

India has the third largest epidemic in the world. The incidence of HIV has declined by 27%
within the year 2010 and 2017. However, the incidence of HIV in the year has increased from
80,000 to 88,000 (UNAIDS). The reason for the same is due to the increasing use of intravenous
drugs among the youths in the North-eastern states and increasing cases of unprotected sex
(World Bank).

South Africa has the biggest and the most high-profile HIV epidemic in the World. As of 2018,
there were 240,000 new infections and 71,000 people died from AIDS related diseases. The main
reasons for these are the use of intravenous drugs among the youths and increasing cases of
unprotected sex. As of World Bank Report 2016, 17% of the people who inject drugs were living
in South Africa but people who injects drugs only accounts for 1.3% of new HIV infections in
South Africa. Prostitution in South Africa is very high. Given the poverty scenario, there are very
less career opportunities there. The sex workers are also exposed to drugs thereby increasing
their vulnerability to HIV infections. In South Africa, the orphan children are vulnerable to HIV
infection as these children have eco nomic and social insecurities. Thus, at times they are forced
to have sex in exchange for support.

Incidence of tuberculosis:

Tuberculosis is an opportunistic disease which is contagious in nature. Almost around 10 million

people has been affected by the TB disease in 2017 of which 5.8 million were men and 3.2
million women and 1 million children. Brazil has an Incidence of tuberculosis of 0.04% of its
total population in 2017. Two-third of the total population infected by TB was found to be
prevalent in eight countries out of which 27% of India, 9% of China and 3% of South Africa
were found (World Tuberculosis report, 2017).

The below figure shows the incidence of TB disease among the 4 BRICS nation excluding
Russian Federation (from the year 2000-2017).
 Incidence of Tuberculosis in the BRICS Nation
1200
Incidence of tuberculosis (per 100,000

Incidence of Tuberculosis in
1000 Brazil (per 1,00,000 people)

800
Incidence of Tuberculosis in
600 India (per 1,00,000 persons)
people)

400
Incidence of Tuberculosis in
200 China (per 1,00,000 persons)

0
Incidence of Tuberculosis in
2001

2012

2016
2000

2002
2003
2004
2005
2006
2007
2008
2009
2010
2011

2013
2014
2015

2017
South Africa (per 1,00,000
Year persons)

After the disbursal of Official Development Assistance or Aid - Brazil, India and China is
observed to have a similar pattern of the incidence of tuberculosis.

According to WHO data, 91 thousand of the total population (209 million) were newly infected
by TB in Brazil in the year 2017. Trend shows that the incidence of TB is declining. The rate of
decline in the incidence of poverty was found to be 3% between the year 1990 and 2010
(Pneumol, 2012). This was due to several programmes like the Bolsa Familia Programme (BFP)
of 2006 through which the Lactating and pregnant women were given direct financial assistance.
Another programme to tackle TB was the National Stop TB Partnership which was formed in
November, 2004.

An estimate says that almost 40% of the Indian citizens are affected by TB disease making the
country the highest burden of the same disease. According to the WHO estimate, in the year
2016 India had almost 2.79 million cases of incidence of TB (WHO Global TB Report, 2017).
The decline in the incidence of TB is primarily because of the launch of Revised National
Tuberculosis Control Programme (RNTCP) which was a five-year plan of the Government of
India (GOI) to fight TB in the country. RNTCP was launched in the year 1997 and was
responsible for free provision of diagnosis and treatment to TB infected persons. RNTCP was
later named as RNTCP II in the year 2006.

According to WHO, China has an estimated value of 1 million TB cases every year. There is an
estimated decline in the incidence of TB by 3.4% per year in China. This is due the Infectious
and Endemic Disease control Project launched by China in the 13 of its 31 main land provinces.
Around 1.56 million or 15.32% of the total incidence of TB were reported in China in the year
2015 (GBD Report,2015).
Interestingly, South Africa is observed to have a unique pattern of the incidence of tuberculosis
in the nation. This increase in the incidence of tuberculosis is mainly due to the increasing
prevalence of HIV in huge numbers among the citizens of South Africa (U.S. Department of
Health and Human Services). Since, HIV degrades the immune system of individuals, people are
more prone to diseases like tuberculosis.

Maternal mortality ratio (modelled estimate, per 100,000 live births)

Maternal mortality ratio is the ratio of the number of Maternal deaths during a given time period
per 1 lakh live births during the same time period (MDG Goal 5). Maternal Mortality Ratio has
been declining worldwide by a significant 38% for the last 20 years. The decline in MMR is due
to the improvement in health services over the time period. India among the BRICS nation has
the highest MMR of 174, followed by South Africa with a MMR of 138, Brazil with a MMR of
44, China with a MMR of 27 and Russia with a MMR of 25.

Maternal mortality ratio (modeled estimate, per 100,000 live

births) in BRICS Nation
600

500
Maternal mortality Ratio

400
Maternal Mortality ratio in Brazil

300 Maternal Mortality Ratio in India

200 Maternal Mortality Ratio in China

Maternal Mortality Ratio in South

100 Africa

Year

Maternal Mortality ratio in Brazil declined from 69 in the year 2000 to 60 in the year 2017. This
decline is due to the improvement in health care facilities and awareness spread among them
during the period the result of having protected sex.

Maternal Mortality rate has been declining in India by 22% since 2013. The MMR has declined
to 167 from 167 in 2013 to 130 in 2016. The decline has been most significant in Empowered
Power Groups (EAG) from 246 to 188. The main reason behind such vast declination is due to
missions undertaken by National Health Mission (NHM). The missions were augmentation of
infrastructure and resources, capacity building and Janani Shishu Suraksha Karyakram. (The
Wire, June 2018)

The MMR in China has declined with an Annual rate of 8.5% from 1996 to 2015.Since the
implementation of the programme Reducing Maternal Mortality and Eliminating Neonatal
Tetanus, also known as the Reducing and Eliminating programme, in 2000, the rates of decline
in maternal mortality ratio at the county level have accelerated in most of the counties in China.
This also shows the presence of good quality health and administrative service in China.

MMR in South Africa decline from 160 in the year 2000 to 119 in the year 2017. But this rate
increased since the year 1992 till 2005 which then started falling in the year 2017. The increase
was due to the greater incidence of TB and AIDS which resulted to greater complication among
the women during time of pregnancy.

Net ODA received by BRICS (Current US $)

Net ODA received by BRICS (current US $)

4E+09
3.5E+09
3E+09
2.5E+09 Net ODA received by Brazil
Net ODA received

(Current US $)
2E+09
1.5E+09 Net ODA received by India
(Current US $)
1E+09
Net ODA received by China
500000000 (Current US $)
0
Net ODA received by South
-5E+08 Africa (Current US $)
-1E+09
-1.5E+09
Year

According to OECD, Official Development Assistance (ODA) is defined as Govt. aid designed
to promote the economic development and welfare of developing countries. From the above
chart, it is clearly visible that China has become the only net donor of ODA among the BRICS
nation. India is the highest recipient of ODA among the BRICS nation. Net ODA received (% of
GNI) in Brazil was 0.06 as of 2015. Its highest value over the past 55 years whereas net ODA
received (% of central government expense) in Brazil was 0.151 as of 2015. Net ODA received
by South Africa has been increasing over the course of time.

Conclusion
It has been observed that the impact of ODA is huge in India. While most of the aid comes from
domestic sources, yet with the rise in the incidence of HIV, incidence of TB and the growing
concern over maternal mortality ratio in South Africa, the country is seen to receive an
increasing amount of ODA over the years. South Africa needs to work on the better
implementation of policies and make proper utilization of the aid received. On the other hand,
China has well implemented the policies towards better health of the citizens of the nation; the
country has well achieved the target set by the MDGs and is the only BRICS member to be a
donor of ODA to other nation. Brazil has also been doing well in implementation of various
health policies. Though the nation have been receiving positive net ODA to improve on their
health parameters further in the future.

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