Foreign Aid Ledger Shows Priorities : Diplomacy: Congress expected to change direction of American spending overseas.

Foreign aid, facing stiff scrutiny this year from the new Republican-controlled Congress, has been a mainstay of United States foreign policy for the past half-century.

Now being refocused, American spending overseas has been a fact of international life since the end of World War II, when the aid program began as an instrument in the Cold War against communism.

Foreign aid, military and economic combined, has totaled more than $450 billion since the beginning of U.S. foreign assistance programs.

“Among the largest recipients of the past were Korea and Taiwan, which have ceased needing support and are now donors themselves,” said economist Anne O. Krueger of Stanford University.

To stabilize the Middle East, Israel and Egypt have traditionally been the biggest beneficiaries. Together, they are getting more than $5 billion in security and economic help from the current $13.7-billion aid package.

Russia receives $400 million, and another $400 million is split among former Soviet republics such as Ukraine, Georgia, Moldova and Azerbaijan. To help secure its strategic position, Turkey gets half a billion. Greece gets about $300 million.

Since the end of the Cold War, aid to Central America and the Caribbean has dropped, said international economist Ernest H. Preeg of the Center for Strategic and International Studies in Washington, D.C.

A sweeping congressional overhaul of foreign aid, proposed by Sen. Mitch McConnell (R-Ky.), chairman of the Senate Foreign Operations Subcommittee, would set priorities tied tightly to American security and economic interests.

Despite decades of foreign aid, McConnell contends, most poor countries are still poor. Aid subsidizing failures should not continue, he says. Africa could be most affected.

Of the $1.6 billion now designated for Africa, about half is earmarked for emergency food and humanitarian relief for countries that include Eritrea, Rwanda and Burundi.

The United States is the world’s largest food donor, providing more nutrition to the needy than all other donors combined.

“We’ll see that the money that has been going to the poorest countries in the Third World, is going to move away from them to the formerly Communist countries,” said Charles Doran, international relations professor at the Johns Hopkins University School of Advanced International Studies.

Some form of aid is still spread among more than 100 countries, but full-scale programs are now operating in only 50 countries, said Jay Byrne, spokesman for the U.S. Agency for International Development (USAID), which dispenses about half of the $13.7 billion. The rest is dispensed by the Defense Department and other federal agencies.

In the past 50 years, death rates among infants and children in the developing world have been cut in half. USAID immunization programs are credited with saving more than 3 million lives a year. An estimated 80% of the world’s children are now immunized. Smallpox has been eradicated worldwide.

The simple process of oral rehydration therapy, developed through aid programs in Bangladesh, has helped keep millions of children alive.

Life expectancy in the developing world has risen by about one-third. Infant mortality rates have declined 10% globally in the past decade.

Countries such as India and Bangladesh have become virtually able to feed themselves.

In the past two decades, the number of chronically undernourished people has dropped by 50% worldwide.

Investments in better seeds and agricultural techniques have enabled a billion people to be fed.

Most of the top 50 countries that consume American agricultural products, were once foreign aid recipients, according to USAID.

In the 28 countries with the largest USAID-sponsored family-planning programs, the average number of children in each family has dropped from 6.1 in the mid-1960s to 4.2 today.

USAID has provided the majority of funding for private voluntary organizations such as CARE, Feed the Children and the American Red Cross.

In the past two years, the agency has begun to pull out of 23 countries, including places where giving aid amounted to throwing dollars down foreign drains, Byrne said. He singled out Zaire and Togo.

Congress and the American people, the experts agree, are going to demand greater accountability and a better balance sheet than they did during foreign aid’s first half-century.