We'd raise our standards on what we measure and manage. Donors, aid agencies, and NGOs would run controlled project trials wherever feasible, and careful statistical analysis where not – funding what works, reworking what doesn't, and amply rewarding people for working across organizations to deliver country-based results.
We'd get over the "scandal" that a quarter of aid is technical assistance, decried because recipient countries don't get cash. Such skills are painfully absent among the last billion, whose educated tend to emigrate. In fact, we'd fund more and better technical assistance – especially in agriculture, property rights, banking, and governance.
The leadership and citizens of African countries, particularly those adjoining landlocked and desperately poor nations, would take bolder steps to diversify their economies, create new markets across borders, cut "protective" tariffs and red tape, clamp down on spurious "fees" that enrich bureaucrats, and implement reforms of their own to avert having terms dictated by wealthy donor nations.
We'd push harder on labor standards by giving the International Labor Organization some real authority to ensure that wealth from business and resource development does more than enrich local elites. A national minimum wage was made law in the US to preempt bottom-fishing in the poorest regions. Given the global nature of markets now, it's time to negotiate an international minimum wage, pegged to purchasing power parity for a basic basket of subsistence goods.