When You’re Rich They Think You Really Know

Daidle deedle daidle, daidle daidle deedle daidle dum. Am I to be continually disappointed? It certainly seems so. The Wall Street Journal has re-published an annual letter from Bill Gates and given it the title “My Plan to Fix The World’s Biggest Problems”. I expected a plan to fix the world’s biggest problems. What I got was the prevailing wisdom of MBAs everywhere—the importance of measurement and a lengthy list of Mr. Gates’s foundation’s accomplishments:

In the past year, I have been struck by how important measurement is to improving the human condition. You can achieve incredible progress if you set a clear goal and find a measure that will drive progress toward that goal—in a feedback loop similar to the one Mr. Rosen describes.

This may seem basic, but it is amazing how often it is not done and how hard it is to get right. Historically, foreign aid has been measured in terms of the total amount of money invested—and during the Cold War, by whether a country stayed on our side—but not by how well it performed in actually helping people. Closer to home, despite innovation in measuring teacher performance world-wide, more than 90% of educators in the U.S. still get zero feedback on how to improve.

Let’s consider the program to eradicate polio, the subject on which Mr. Gates elaborates in the letter. After a multibillion dollar eradication program, polio remains endemic in just three countries: Afghanistan, Pakistan, and Nigeria. In recent years the project has actually lost ground in those countries:

Some Islamic clerics have even issued fatwas saying that any person who became paralyzed or died from polio would be given the status of a “martyr” for refusing to be duped by a western conspiracy.

Insurgents also claim polio vaccinators are spies.

In Pakistan, such beliefs gained particular credence after it emerged that the CIA used a fake vaccination team headed by a Pakistani doctor, Shakil Afridi, to collect information about Osama bin Laden.

In Pakistan’s North Waziristan tribal area, local Taliban leaders have also issued a fatwa banning polio vaccinations until the United States ceases drone strikes in the area.

In enforcing these bans, militants have killed scores of foreign and local humanitarian aid workers. In the past week, gunmen in Pakistan killed eight polio vaccination workers. In Afghanistan on December 1, gunmen killed a 20-year-old Afghan woman who distributed polio vaccinations in the eastern Kapisa Province.

This spate of violence has coincided with growing cases of polio in Afghanistan and Nigeria — and threatens to stifle recent progress toward defeating the disease in Pakistan.

In Afghanistan, an polio-prevention campaign involving thousands of volunteers and a number of international agencies almost wiped out the deadly disease in 2010.

The Afghan government registered only 25 polio cases that year, but that figure tripled to 76 last year. Afghan President Hamid Karzai blamed the Taliban, demanding that they allow teams of vaccinators to administer antipolio drops to children in areas under their control.

Meanwhile, the cancellation of the immunization programs in Pakistan on December 19 due to the recent violence threatens to reverse recent gains toward eradicating polio in that country. Some 56 polio paralysis cases where reported in Pakistan this year, down from 190 cases in 2011.

In Nigeria, attempts by Islamic extremists to ban a United Nations immunization campaign have resulted in the infection returning to eight previously polio-free countries in Africa, according to the UN. Last year, Nigeria recorded 43 cases of polio, compared to just 25 cases the year before.

As Jonathan Swift wrote, “reasoning will never make a man correct an ill opinion, which by reasoning he never acquired” and I doubt that better measurements will convince Pakistani clerics who are opposed to vaccination as a Western plot otherwise.

Throughout his career as CEO of Microsoft, Mr. Gates made a practice of solving 90% of a problem and then proclaiming it 100% solved. I sincerely hope he’s not applying the same standard to the “world’s biggest problems”.

As to education in the United States, please reflect on this question. Is our problem that we don’t have enough measurements or that the measurements don’t reflect well on those whose job it is to solve the problem and, consequently, go unheeded?

8 comments… add one
  • Icepick Link

    In Pakistan, such beliefs gained particular credence after it emerged that the CIA used a fake vaccination team headed by a Pakistani doctor, Shakil Afridi, to collect information about Osama bin Laden.

    Gotta say, this is an incredibly stupid-assed thing for the CIA to do. There’s a hell of a lot of common good for the world in seeing that vaccinations get done. Jeopardizing that for some idiot cloak-and-dagger stuff is just dumber than rocks. About as dumb as the average anti-vaccine Hollywood celebrity, in fact.

    Which reminds me of a joke I heard Lemmy from Motorhead tell once:

    “How do you know the CIA wasn’t involved in the plan to kill [J. F.] Kennedy? Well, he’s dead, isn’t he?”

  • Excellent piece, thank you.

    Great men with great plans reap mostly unintended consequences.

  • Drew Link

    “Measurement” is just a vanishingly tiny sliver of the business lexicon/orthodoxy: what gets measured gets managed. It happens to be true. But its the management that matters; measuring is just setting the table. It also happens to be the essence of science.

    ice

    I saw the movie Zero Dark 30 this weekend and the polio incident was referenced in the context of trying to get insight into the compound in Islamobad (sp?) after they had identified the site but did not know if bin Laden was really there. If true – and who knows how much “artistic license” they took – that wouldn’t be so stupid. BTW – I’d recommend the movie. Its not that its some great Hollywood accomplishment, but just for historical reasons. Its really a ten year story of the efforts to find UBL leading up to the raid. The raid is actually a heart pounding period in the movie. This is no Bruce Willis movie crappola; given all the footage I’ve seen of real combat on the Military Channel its probably a pretty faithful portrayal. I can never think about an old friend – a Navy Seal – the same way. Ginormous brass balls and disciplined execution anyone would admire.

    Also, I was embarrassed I couldn’t easily identify all the characters. The one of central interest is of course “Maya” who is a woman and CIA operative who tracks UBL for 10 years and puts herself out as the primary advocate of the raid, convinced he is in the compound. The question: no doubt if this person actually existed there is a bounty on his or her head and is in basically a witness protection program- was it even a woman? Or is that part of the protection?

  • Icepick Link

    Drew, pretty much anything that undermines the credibility of vaccine programs is stupid. Undermining the credibility of that program will probably cost a lot of lives and create a fair number of crippled survivors. And that’s just for the polio outbreak. Consider all the other possible outbreaks of more contagious diseases. This is just simply stupid policy, period, selling long-term positives for short-term goals.

  • Drew, pretty much anything that undermines the credibility of vaccine programs is stupid.

    Have to agree. Osama is a bad dude. Ultimately responsible for thousands of deaths. Real bad.

    However, diseases that can be thwarted by vaccines and similar programs kill millions…they are far worse.

  • Drew Link

    And the loss of credibility for vaccine programs is the fault of the US, not crazed and malintentioned Islamist fundamentalists.

    Got it.

  • Icepick Link

    Drew, if the CIA is using vaccination programs as a front for spying, or running fake vaccination programs for same, then yes, that is on us.

  • Drew, if the CIA is using vaccination programs as a front for spying, or running fake vaccination programs for same, then yes, that is on us.

    Again, I have to agree. If we used the program as cover for a spy operation, then yes we did something to cast doubt on it. The conspiracy theorists and paranoiacs have something legitimate to point too. As the saying goes, just because you are paranoid doesn’t mean they aren’t out to get you.

Leave a Comment