One year ago, in the wake of the Haiti earthquake, Bill Clinton wrote in TIME that "given the right organization and support, Haiti could become a self-sustaining and successful country." That hasn't happened. Despite the best intentions of many around the world, including the former President himself, Haiti is still a basket case. Only 5% of the 675 million cu. ft. (19 million cu m) of rubble in Port-au-Prince has been removed from the streets. At least 1 million Haitians still live in tents. A preventable cholera epidemic has claimed more than 2,500 lives. In a recent report in Slate, Maura R. O'Connor concluded that never in Haitian history has "there been so much unemployment and destitution and dependence on outsiders."
What went wrong? How did such a huge outpouring of foreign assistance donor countries have pledged some $11 billion manage to accomplish so little? Observers affixing blame for Haiti's failures tend to fall into one of two camps: those who point fingers at the armies of foreign NGOs working in Haiti; and those who fault the Haitians themselves. In that respect, the Haitian tragedy reflects a broader debate in foreign policy circles about the relationship between aid and development. But perhaps even more important is what it says about how Americans should think about their responsibilities to the rest of the world.
For the anti-NGO camp, Haiti is a case study in the hypocrisy of the global relief bandwagon that descends on poor countries victimized by wars, famine and natural disasters. A growing chorus of critics accuses humanitarian-aid groups of using misery to validate their existence, spending funds inefficiently and creating a culture of dependence among the people they are supposed to help.
All of those problems have played out in Haiti. Only around 10% of the funds committed to Haiti's recovery have actually been spent there. Aid contracts intended to provide work for Haitians have benefited foreign companies instead. A review by the Associated Press found that out of 1,500 U.S. contracts given out in the last year, only 20 went to Haitian-owned companies. Even before the quake, Haiti was home to more foreign aid workers than any other country on earth and yet the presence of 12,000 NGOs failed to prevent a cholera epidemic that medical experts believe should never have broken out. One adviser to Haitian Prime Minister Jean-Max Bellerive told the Wall Street Journal that the NGO community has "infantilized" the country and usurped responsibilities better left to the Haitian government.
To which one might ask, What Haitian government? If you belong to the "blame Haiti" camp, you're less likely to ascribe the postearthquake mess to outsiders than to the country's defective political culture. In recent years, development economists have sought to explain why some countries lift themselves out of poverty while others chronically underachieve. Stable, transparent institutions like police, courts and banks are critical to the success of poor nations. But Haiti's long history of disarray has left it with few institutions worthy of trust. For those who emphasize such internal factors, Haiti wouldn't be saved even if every dollar of aid money were spent and every NGO disappeared tomorrow. Until the country's political class proves it can govern, Haiti's people will continue to suffer.
So who lost Haiti? The rapacious foreign aid workers or the feckless local politicians? The answer, of course, is both. But that doesn't mean Haiti is doomed. The hopeful story of the past two decades is that of the astonishing rise of incomes and living standards across the developing world. The fact that these gains have come in places both where NGOs have a large presence (like Rwanda) and where they don't (like China) shows that foreign aid organizations can play a vital role, though they do so best by stimulating private investment rather than providing social services. Ultimately, development does require the kind of responsible local leadership that doesn't appear anywhere on the Haitian horizon. And yet numerous formerly poor, underperforming countries from Indonesia to Mozambique to Brazil have achieved a degree of stability and prosperity that would have been unthinkable a few years ago.
All of which means it's too early to give up on Haiti. But it's also an argument for a more pragmatic American approach to helping societies in need. Since the Marshall Plan, U.S. policymakers have viewed foreign aid as a tool for advancing the country's security interests. The public, on the other hand, sees it in moralistic terms; thus our tendency to steer attention and money toward those places, like postearthquake Haiti, where suffering is most extreme. And yet American largesse is a finite asset. Trying in vain to alleviate the most desperate situations will inevitably mean shortchanging individuals, societies and governments that are better positioned to succeed. Our moral obligation isn't to solve the world's most intractable problems. It's to act where we can do the most good.
Ratnesar, a TIME contributing editor-at-large, is a Bernard L. Schwartz Fellow at the New America Foundation and the author of Tear Down This Wall: A City, a President, and the Speech That Ended the Cold War. His column on global affairs appears every Monday on TIME.com.