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This CGD Note by C. Peter Timmer explores the alliance between US farmers, processors and shippers that forms the political foundation of the US food aid program. The Note outlines the current winners and losers of US food aid, and argues that surprisingly, the recipients are most often the losers. Procuring supplies from thousands of miles away risks missing the narrow window of opportunity during disasters to reach those in need, and risks doing serious harm to the local economy. Timmer suggests that the ready availability of food aid can also undermine the incentive for local governments to invest in rural infrastructure, agricultural research and domestic price supports. He argues that progress in making food aid more efficient and more effective is possible within the current political realities. However, we cannot do well by simply doing good. To move forward, the author urges Congress to convert a substantial share of the physical delivery of food aid to cash support over five years, and to make that support available to local NGOs.