Nearly anyone who’s lived in or visited a large city has had the experience of being confronted by a panhandler, frequently a homeless person, looking for a handout. And nearly all of us have exactly the same reaction: avert our eyes, walk away as quickly as we can, perhaps toss the poor guy a buck or two if that makes us feel any better. Noone is under the illusion that the buck or two we might give will make the guy less homeless or put him on the road to recovery or, indeed, solve any of his problems. That would take more time and attention and caring than we’re willing to give. Maybe more than we have.
In a recent post, Should Jeffrey Sachs get $150 billion per year?, Dan Drezner draws attention to Time magazine’s cover article in which economist Jeffrey Sachs pleads with the rich countries of the world that $150 billion per year would relieve the plight of the poorest people in the world. Here are the problems Sachs identifies for solving:
- Boosting agriculture
- Improving basic health
- Investing in education
- Bringing power
- Providing clean water and sanitation
Here are the steps he lays out towards the goal:
- Commit to the goal
- Adopt a plan of action
- Raise the voice of the poor
- Redeem the U. S. role in the world
- Rescue the IMF and the World Bank
- Strengthen the U. N.
- Harness global science
- Promote sustainable development
- Make a personal commitment
To see how he fleshes out these problems and goals you’re going to have to read the article and (presumably) his book.
Frankly, I’m deeply skeptical about the utility of government development funding. I tend to agree with those who characterize it as “poor people in rich countries giving money to rich people in poor countries”. I’m also tired of the canard that the U. S. doesn’t give enough foreign aid. That is a lie. When all sources of foreign aid including public, private, and corporate (especially individual-to-individual) are included the United States is among the most generous of nations.
The solutions that I think are effective tend to be more organic in nature: set up the conditions for success, remove the conditions that create failure. Teach a man to fish sorts of solutions.
So, let me make some suggestions for the kinds of policies and programs from the wealthy nations that I think would really solve the problems of the poorest people in the world. My solutions don’t involve strengthening international institutions, large development programs, or grand solutions of any kind so they won’t be too popular with the world government types. Not too many lobster dinners here. They also won’t be pain-free: they require changes to some of the most cherished (and expensive) programs of Western governments. But I think they’d actually have lasting effect which is more than you can say for most grand solutions.
Promote democracy
I notice that in the catalog of ills in the article short shrift is given to two of the traditional scourges of humanity: war and famine. War and famine are principle causes of many of the evils discussed in the article and we know what causes them: not enough democracy. Democracies tend not to go to war with neighboring democracies. Famine is not that people don’t grow enough food. Famine is people starving other people. And people in democracies don’t starve their own people. If you want to read more on the subject from someone who really knows what he is talking about go to scholar R. J. Rummel’s blog Democratic Peace and prowl around.
We can’t take no, maybe, or eventually for an answer any more. We’ve got to use every means at our disposal to promote democracy everywhere. And, yes, we’re going to have to learn to walk and chew gum at the same time. And, yes, sometimes that’s going to mean boots on the ground. And, yes, that won’t make the French happy. But if you want to eliminate poverty you’ve got to promote democracy. Vive la revolution!
End agricultural subsidies and tariffs
Want to end world hunger? Other than by promoting democracy as I mentioned above, I mean. End agricultural subsidies and tariffs. Here’s what the Bread for the World Institute has to say:
It [ed. a report from their organization] says most subsidies are delivered through mechanisms that distort production and trade while producing little net income for small farmers. It urges the United States and other industrialized nations to promote free trade by eliminating subsidies and tariffs.
“The estimated gains to all countries from the elimination of subsidies and tariffs in developed countries would be $100 billion,” it says.
If the U.S. and other countries eliminated subsidies, developing nations “would see their net agricultural trade triple, from $20 billion to $60 billion,” it says, and more than $25 billion in additional income would go to farmers and agricultural workers in the developing world.
According to the report, industrialized nations spend $310 billion a year in subsidies to protect farmers–six times as much as they provide in development assistance to poor nations. It says the United States spent more than $95 billion on domestic agricultural subsidies in 2001, but the subsidies did not help smaller U.S. farmers or reduce hunger and poverty in rural America.
Here’s what the World Bank has to say on the subject.
By the way, there’s a blog devoted exclusively to the need to eliminate agricultural subsidies. Want to know more? Read it there.
Stop importing health care professionals from poor countries
There’s another of the Four Horsemen discussed in the article: pestilence. Sending money won’t be enough to improve health care in the poorest countries. Sending pharmaceuticals (or subsidizing their prices) won’t help either: misused or abused pharmaceuticals can be as bad (or worse) than none at all. It’s a great way to encourage the development of drug-resistant disease organisms. There must be health care professionals to actually minister to sick people and ensure that the drugs are used properly. There are only two ways to get health care professionals into these countries: either we can send them or they can train their own. Can anyone doubt that it’s much, much cheaper for them to train their own?
23% of all doctors in the United States are foreign-educated. The situation is even worse in the United Kingdom where 30% of all physicians are foreign-trained. The health care brain-drain from sub-Saharan alone is simply horrifying. Take a look at this (IMG = “International Medical Graduate”):
Country of medical school of sub-Saharan African international medical graduates (IMG’s) in the United States and Canada
Country of training Number of African-trained IMG’s in USA1 Number of African-trained IMG’s in USA2 Number of physicians remaining in home country3 Percent Nigeria 2,158 123 22,894 9% South Africa 1,943 1,845 23,844 14% Ghana 478 37 1,210 30% Ethiopia 257 9 1,564 15% Uganda 133 42 722 20% Kenya 93 19 4,001 3% Zimbabwe 75 26 1,694 6% Zambia 67 7 676 10% Liberia 47 8 72 43% Other 83 35 12,912 1% Total/Average 5,334 2,151 69,589 10%
1American Medical Association: Physicians’ professional record (AMA-PPD). 2002
2Buske, Lynda. Associate director of research, Canadian Medical Association. Personal communication. February 3, 2003.
3Number of physicians from the World Health Organization.
The overwhelming preponderance of sub-Saharan doctors emigrate to just five countries: the United States, United Kingdom, Canada, Australia, and Germany. IMO, we should be exporting doctors to sub-Saharan Africa, not importing them.
The situation with other health care professionals including nurses and dentists in sub-Saharan Africa is similar. There are really only a small number of practical alternatives available to stop this brain drain: we can pay foreign-trained health care professionals to remain in their home countries, we can prohibit immigration of health care professionals into the country, we can reduce the “pull” factors by reducing health care professional salaries here, or we can export health care professionals. Or we can train a lot more health care professionals everywhere.
For more on this subject see The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain (from which much of the material in this section was drawn) and International migration of health workers: labour and social issues.
There’s also a great blog written by someone who’s really on the front lines on the subject of health care in poor countries: Finestkind Clinic and Fish Market (fans of M*A*S*H Goes to Maine will understand the name). She’s a retired Oklahoma doctor living and working in the Phillipines.
Other steps
This post is beginning to get much too long but there are many other steps, mostly baby steps, that should be taken. In the article they mention energy but the two energy approaches they mention are “power transmission” and diesel-powered generators. The power-transmission they’re talking about is most likely either hydro-electric or power generation through burning fossil fuels. Hydro-electric is no solution to energy problems. The methane produced by hydro-electric dams (particularly in the tropics where it’s warm) may be a more significant—and more easily eliminated—source of global warming than carbon dioxide in the temperate zone (which is the main target of the Kyoto agreement). See here for more. As to diesel-powered generators do we really believe that increased dependence on fossil fuel consumption is a good energy solution for poor people around the world?
There’s a great blog devoted to energy solutions (many of them micro-solutions): World Changing.
Much of the energy needs (not to mention a major cause of air pollution and deforestation) in very poor countries is provided by the use of wood as fuel for cooking. For a much more creative and environmentally sound solution to this problem take a look at this approach from Sun Oven. Install a solar oven in a village and reduce deforestation, free the time spent gathering firewood (an increasingly dangerous practice in many parts of the world), and put the village into business. But these are small solutions better managed on a small scale (unlike a hydro-electric dam). Not the stuff of grand governmental solutions.
In the paragraphs above I’ve suggested several measures that the richest countries can take to reduce the poverty among the poorest of the poor. And many of my suggestions not only involve no additional tax dollars—they actually cause a reduction in the need for tax dollars due to reductions in subsidies. Will we adopt some of these measures? Or will we toss a few dollars to the poor, hurry away, and avert our eyes?
The single quickest thing the wealthy countries could do to reduce suffering in impoverished countries is to decriminalise DDT.
Another good suggestion, triticale. Wish I’d thought of it.
I agree with most of your prescription except for the establishment of Democracy. We have enough evidence that the market dominant minorities suffer grevious harm, and even death, when free markets and democracy are introduced hand in hand, to the degree I might add, that is even freer than what the US experiences.
How do you think the Hutus will react to the market dominant Tutsi if unchecked markets are introduced and the Hutus get political power via their sheer dominance of population? How will the Lebanese fare in Kenya, the Hausa-Fulani in Nigeria, whites in South Africa, Chinese in the Burma, etc. All we need do is look at what happened to the Chinese in Indonesia & Phillipines, Jews in Russia, etc.
Democracy and free markets are a powder keg for much of the world.
Thanks for visiting, TangoMan. First of all when I write “democracy” it’s short-hand for liberal democracy and the rule of law. That that kind of democracy eliminates famine and war is so well-documented it should be considered as beyond doubt at this point. Go to the link I gave and read.
Dave,
A well regulated democracy, like we have in the US, is a far cry from what the IMF and the World Bank have been advocating. You bet that the rule of law can bring stability and end famine, but it also brings about a huge disparity of wealth, and time and time again, the disparity cleaves along ethnic/racial lines. The successful are usually a minority group and as we’ve seen in Indonesia, misery follows the democratic legislation that trys to redistribute the wealth from the plutocrat minority to the impoverished majority.
Giving a free vote to everyone isn’t a panacea. Observing the rule of law, when the law actually works against the majority of people isn’t a great way to instill respect for the law.
Much of my cynicism has been formed by reading Amy Chou’s World on Fire.
As I wrote earlier, I pretty much agree with your prescriptions, but think that the democracy solution needs a whole lot more refinement so as to allow the troubles that Chou documents, from her experiences with the IMF, to have a pressure release of sorts.