This post was written by Helen Epstein, author of The Invisible Cure: Why We Are Losing the Fight Against AIDS. I was heartened to see that Shanta Devarajan, the World Bank’s Chief Economist for Africa, blogged about my article Cruel Ethiopia in the New York Review of Books.

The article—and Dr. Devarajan’s blog—deal with the extremely delicate and complex relationship between economic and social development and human rights. He and I agree that there is no simple formula to explain this relationship. However, in order to help the poorest people realize their basic right to development, and to ensure our aid dollars are spent as effectively as possible, we need to try to understand it. That’s why I was troubled by this section of Dr. Devarajan’s blog.

Ethiopia has done well in reducing poverty and child mortality, and increasing primary completion rates because their system of delivering basic services has various elements of this accountability built in. Local districts receive resources based on clear, data-driven formulae that can be independently verified (by third-party civil society groups). The allocation of these resources within the district is decided in community meetings, with the final budget posted on a central bulletin board for the community to see.

If only this were true.

Dr. Devarajan is describing the “social accountability” component of a World Bank-Ethiopia program to support health, education and other social services. In general, social accountability programs train community groups or NGOs to carry out surveys of local government budgets, monitor the quality of services such as clinics and schools, and publicize problems such as corruption or absenteeism among teachers and health workers. In an ideal world, these groups then work constructively and openly with local government officials to find feasible solutions to these problems.

Social accountability programs can be an extremely powerful mechanism for holding local authorities to account, building local democratic mechanisms, improving education and access to safe water, and even saving lives. A World Bank-sponsored evaluation of two such programs in Uganda found that one increased the amount of public education funding that actually reached schools nearly four-fold, and another increased the survival of children under five by one third, with no additional direct funding for health services.

When I first visited Ethiopia in late 2008, I was eager to see how the social accountability program that Dr. Devarajan refers to was working. But during the four visits I made to the country over the next 12 months, World Bank and other officials repeatedly told me the program had been only a small scale pilot program, that it had ended in 2008, and that an expanded program was planned, but would not start until after the elections in May 2010. So I am not sure what program Dr. Devarajan visited. Even in the pilot projects, the monitoring was not, by and large, done by “third party civil society” groups. Nearly all the NGOs were ruling party affiliates.

There is no automatic relationship between development and human rights. But it’s worth asking whether development can ever occur in a society where a government is deaf to its people. It seems to me that development takes root in societies that listen, either because the people truly have power, as in a democracy, or because the government is afraid of what would happen if they demanded it.