The British Government's decision to end aid to South Africa reflects a misunderstanding of the current state of global poverty which threatens to undermine development efforts so far.
In the region of Tsumkwe, people in their 40s are near the end of their lives. Tuberculosis is widespread, malaria is endemic, and HIV is on the rise. Yet Namibia, the country Tsumkwe is situated in, is classed as 'middle-income' with a growth rate of 4.4% that is enviable for many European countries, and a per capita income of over US$5000. Sadly those national figures mask the huge disparities between the wealthy elite and communities like those in Tsumkwe.
Working for a development organisation that deliberately works with the poorest and most marginalised communities in their struggle for health, I increasingly find myself working in middle-income countries. In countries like Namibia, where communities have little support because donors like the UK have judged their country purely on its average national income, and not on a measure of inequality, and have deserted them.
The decision to end aid to South Africa, the world's most unequal country, or "the region's economic powerhouse" as Justine Greening calls it, is ostensibly based on the theory that an increase in average national income alone will pull all or most of a countries' citizens out of poverty. This is the same theory behind the ending of aid to India last year.
Perhaps ironically, it is South Africa and India that are the best examples of why this theory is flawed. Despite both experiencing high levels of growth in recent years, in South Africa, 39% of people live below the poverty line and the gap in income is widening. India is home to a third of the world's poorest people.
Clearly, these countries have not eradicated poverty. If wealthy countries are to contribute to development and the end of poverty, we must stop ignoring inequality.
One argument Greening and others may make is that if a country is performing well economically on average, it is up to the rich within those countries to take care of the poor. This argument seems to hold sway on the surface, but if the purpose of international development is to end poverty, has it fulfilled its aim if the number of poor people in a country is increasing? Has it really contributed to a better society if more people are dying needlessly? Is the type of 'development' it has contributed to, the right type of development? And can we abandon those people on the basis that their governments 'should' (but currently aren't) providing adequate assistance to them?
Continuing to base the distribution of aid on the theory that average national growth alone ends poverty undermines efforts towards eradicating poverty. It's time to re-think what 'aid' is for and where it should be spent.
Practically, what would this mean?
It would mean seriously considering the issue of inequality when deciding on priorities for funding poverty reduction, and addressing the structures within and between countries that sustain inequality.
It wouldn't mean deserting countries classified as 'middle income', but instead targeting funding within those countries to tackle the reasons high levels of poverty persist there.
For example, donors could invest more in governance and in strengthening civil society in developing countries, to promote more equitable, rights-based decision-making processes; they could support developing countries set up robust taxation systems so they can collect and redistribute more of the wealth being generated within their borders; and they could support more ethical, sustainable ways of doing business in developing countries, for example by tackling tax dodging and land grabbing by multinational corporations.
These should be the priorities shaping DFID's decisions about aid distribution, not simplistic national averages. More broadly these priorities should also inform the international community's efforts to create a new development framework that will take us beyond the soon-to-expire Millennium Development Goals in 2015.