As the Cold War began, an institutional framework to respond to humanitarian emergencies came into existence. The United States played a primary role in the development of the major institutions of the international relief and rehabilitation network—including the United Nations International Children's Emergency Fund (UNICEF), the Food and Agriculture Organization (FAO), and the World Health Organization (WHO)—and contributed significantly to the funding of such organizations. Although the United States could not completely control the directions of these institutions, the State Department carefully oversaw U.S. relations with these intergovernmental organizations, and their growth did not displace unilateral efforts. Voluntary organizations, increasingly institutionalized, frequently served the larger purposes of American foreign policy as well as their own relief goals.
The functions and priorities of U.S. government agencies, intergovernmental organizations, and nongovernmental organizations shifted from emergency relief to economic and social development. Rising aspirations for political and economic independence in European colonies sparked greater U.S. attention to these underdeveloped areas, later known as the Third World. Fear of Soviet communist expansion into those areas generated efforts to promote economic development in order to undercut communist appeal. Increasingly, foreign aid became a permanent practice. The academic community produced development studies that emphasized the need to link political, economic, and social development and which suggested that the United States could assist nations to develop. Organizations involved in foreign assistance proliferated and moved from a focus on emergency relief as a response to disaster to attempts to solve underlying conditions of poverty that often led to crises. During the immediate postwar era, much relief was sent to Europe; afterward it went increasingly to the Third World. While some voluntary agencies resented government efforts to use them in the service of American foreign policy, others reveled in the role. As the government expanded its involvement in foreign relief, federal grants became easy money in comparison to the tremendous effort required to raise private funds.
An organization that reflects many of these trends is the Cooperative for Assistance and Relief Everywhere (CARE). In 1945, twenty-two American organizations collaborated to found what was originally called the Cooperative for American Remittances in Europe. At first a parcel service, the organization shipped "CARE packages" of Army surplus food to friends or relatives of Americans in Europe. Soon, specially prepared packages of purchased items were being sent to strangers in Europe, and then to Asia and the developing world. CARE packages captured the imagination of the American public, and celebrities like Ingrid Bergman helped spread the organization's appeal. CARE eventually stopped sending the famous packages and, like other such organizations, expanded from relief during emergencies into other areas including health care and development advice and assistance. CARE relied heavily on government grants as well as private donations.
During the Cold War, much CARE activity was focused on areas of strategic significance to the United States, such as the Phillippines in 1949, Korea in 1951, and Vietnam in 1966. In the early 1950s, relief assistance was targeted to areas of political concern including Korea (through UN auspices, during the Korean War), Yugoslavia (to encourage its break with the Soviet Union), and India (which was offered food loans, not grants). In 1954 Congress passed the Agricultural Trade Development and Assistance Act (Public Law 480), later known as Food for Peace. Under Title I of this legislation food surpluses, owned by the U.S. government, were sold at reduced rates to foreign nations and could be sold in the open market. This use of the market was intended to deter charges that the United States was dumping its surplus and to alleviate concerns about fostering dependence on relief assistance. Title II provided for U.S. food surplus to be used as grants for humanitarian assistance. Most of this food surplus was distributed through the auspices of the nongovernmental groups, especially CARE and Catholic Relief Services. In practice, both Title I and Title II food aid usually went to allies or friendly governments.
In the early 1960s the Kennedy administration reconsidered food assistance, hoping that the rationalizing of food needs and distribution would combat world hunger and malnutrition. Food assistance remained political, although the new emphasis on economic development meant that food aid went to development programs as well as for emergency assistance. The United Nations, increasingly conscious of the significance of food, created the World Food Programme (WFP) in 1963. Reflecting the new emphasis on development, only 25 percent of WFP funds were targeted for emergency relief. U.S. organizations like CARE continued to work with the American government through the Agency for International Development (AID), which was charged with coordinating both relief and economic development assistance, with the priority on development. The world's reliance on U.S. food to handle world crises led President Lyndon B. Johnson to call for greater multilateral cooperation to handle famines like those faced by India in the mid-1960s. Indeed, world agriculture was changing, with nations like Canada also being well-endowed with agricultural surpluses. However, in the early 1970s a world food crisis emerged as the U.S. agricultural surplus dwindled and bad harvests in the Soviet Union and elsewhere taxed world food supplies. The wealthier food-importing nations purchased at higher prices, leaving the poorer nations unable to afford what remained. Food assistance reflected U.S. strategic priorities. Food shipments to Southeast Asia made up half the commodities under the Agricultural Trade Development and Assistance Act in 1974, leaving less available for the Sahel region in western Africa, wracked by famine caused by an extended drought.
Increasingly, a network of organizations responded quickly to humanitarian crises. Although relief organizations extended their functions to focus on development, most retained their capacity for responding to disasters. Despite the more permanent character of a large number of institutions like CARE, Save the Children, American Near East Refugee Aid, Catholic Relief Services, World Vision, and Lutheran World Relief, ad hoc responses to natural disasters sometimes led to the creation of short-term organizations or committees to handle a crisis, often but not always by coordinating through other, more permanent, relief agencies like the American Red Cross. Such emergencies as flooding in Bangladesh, an earthquake in India, a hurricane in Central America, and famine in Ethiopia led to outpourings of voluntary private assistance as well as government aid. Refugees from civil conflicts, such as the thousands of Southeast Asians who fled Vietnam and Cambodia in the 1970s and 1980s, generated similar outpourings of assistance, with the added complication that relief organizations had to work with suspicious governments. In such cases, while intergovernmental organizations sought to help, the nongovernmental organizations were often able to maneuver more successfully to provide relief. While critics complained of overlapping and duplication of effort, inefficient fund-raising, inadequate or unfair distribution of food, cultural insensitivity and racism, excessive emphasis on institutional self-preservation, impersonal and unfeeling treatment of the suffering, corruption and mismanagement, poor analysis by media and relief organizations, inattention to underlying causes of crises, and a host of other flaws in the network, international relief was largely effective in reducing immediate suffering and resolving emergencies.
The phrase "repeat disasters" came into use as certain areas faced recurring crises. For example, in the early 1970s famine in western Africa resulted in hundreds of thousands of deaths. Some of the same regions faced an even worse crisis in the 1980s. Such events heightened calls for means to prevent or mitigate disasters. In the 1960s and 1970s foreign aid came under increasing criticism, and some of those criticisms were applied to relief assistance. Food aid often undermined self-reliance, injuring indigenous agriculture by reducing incentives to produce and tempting governments to rely on free or inexpensive foreign food to the detriment of their own farmers. Critics pointed out that food relief, not just food aid, could have this effect, citing as an example the response to a 1976 Guatemalan earthquake. An abundant Guatemalan harvest spoiled as people stood in line for free food. Short-term relief of disaster rarely faced such criticisms, but short-term relief efforts continued to face charges that they failed to address underlying political, social, and economic conditions that lead to continued distress. Efforts to reduce the effects of dependence and to foster dignity resulted in renewed emphasis on developing indigenous organizations for relief, particularly in areas subject to recurring crises. International assistance increasingly operated in cooperation with such local organizations, some private, many governmental.
Much of the criticism of foreign aid was linked to the political uses to which it was sometimes put. Clearly, all disasters did not receive the same response. When Nicaragua suffered a devastating earthquake in 1972, President Richard M. Nixon provided aid to the dictatorial pro-U.S. regime. When Hurricane Fifi devastated Honduras in 1974, the regime of General Oswaldo López was out of U.S. favor because he supported labor and land reforms and had nationalized the timber industry. Fifi left 8,000 dead and as many as 300,000 Hondurans homeless, yet U.S. assistance was not forthcoming. López slowed the pace of reform and eventually resigned.