The powerlessness at the bottom of the pyramid-seem familiar?
■"Where a Cuddle With Your Baby Requires a Bribe," by Celia W. Dugger, New York Times, 30 August 2005, p. A1.■"Joint effort to fight AIDS virus in China," by Michelle Healy, USA Today, 30 August 2005, p. 5D.
Really depressing story of how poor people are systematically ripped off in service situations by provider systems that demand they pay extra in fees or bribes for the same things that the better-off get for free:
The bribes vary from place to place and in the services afforded, but stretch from cradle to grave, according to surveys and anticorruption investigators. People pay to give birth, and to collect their loved ones' bodies from mortuaries, and for everything in between: garbage collection, clean water, medicines, admission to public schools. Even policemen double as shakedown artists.
Sound bad enough? Well, "increasingly, it is being recognized as a major obstacle to economic development, robbing the impoverished of already measly incomes and corroding the public services they desperately need." In short, in far too many instances, such high barriers to service means many poor inside the Gap are discouraged from seeking medical care in the first place.
Think more official developmental aid is going to solve that all by itself?
This is why the promotion of good government in the Gap isn't some idealistic Wilsonian nonsense, but a moral cause that involves saving millions upon millions from premature deaths. Plussing up aid won't do it, nor will pretending we're all in this together. For some bad regimes, the "one campaign" that will work will be a military one.
But in many more situations, especially among the New Core states like China or India, where governments are incentivized by their growing and economically successful connectivity to the global economy to raise their public-sector capacity to deal with such problems, lest they prove a turn-off to foreign direct investment that prefers a safer or more stable environment, more aid can make a difference, so long as it's largely focused on growing local response capacity and not just treating and streeting the current patient pool.
In the end, if you want to curb the bribery and corruption, you need to give the country in question the economic opportunity to achieve a better state of affairs via the private sector. As with most Gap problems, the quickest solution route is to grow your way out of the problem. Absent the growth, expect far too much of the economic power to remain with the government, and expect that power to corrupt on a wide scale.