With U.S. funding, nongovernmental organizations have helped immunize millions of babies. Thanks to debt relief, most African children are in school, and in the last six years the number of people receiving HIV/AIDS medicines in developing countries has increased tenfold. Our country provides assistance through the Foreign Assistance Act of 1961. But the world has changed dramatically since then. It's time for the U.S. to get smarter about how it delivers foreign aid.