2/22/13 - the white man's burden

In today's selection -- in the well-meaning effort to alleviate the suffering of the poor around the globe, the complex, sweeping, high-budget plans of Western nations often come to little and are trumped by low-budget, focused, practical plans:

"The West [has] spent $2.3 trillion on foreign aid over the last five decades and still had not managed to get twelve-cent medicines to children to prevent half of all malaria deaths. The West spent $2.3 trillion and still had not managed to get four-dollar bed nets to poor families. The West spent $2.3 trillion and still had not managed to get three dollars to each new mother to prevent five million child deaths. ... It's a tragedy that so much well-meaning compassion did not bring these results for needy people. ...

"Columbia University professor and director of the United Nations Mil­lennium Project Jeffrey Sachs ... offers a Big Plan to end world poverty, with solutions ranging from nitrogen-fixing leguminous trees to re­plenish soil fertility, to antiretroviral therapy for AIDS, to specially pro­grammed cell phones to provide real-time data to health planners, to rainwater harvesting, to battery-charging stations, to twelve-cent medicines for children with malaria -- for a total of 449 interventions. Professor Sachs has played an important role in calling upon the West to do more for the Rest, but the implementation strategy is less constructive. According to Pro­fessor Sachs and the Millennium Project, the UN secretary-general should run the plan, coordinating the actions of officials in six UN agencies, the UN country teams, the World Bank, the International Monetary Fund, and a couple of dozen rich-country aid agencies. This Plan is the latest in a long string of Western plans to end poverty. So for the twelve-cent medicines, the Planners are distracted by simulta­neously doing the other 448 interventions. ...

"Unfortu­nately, the West already has a bad track record of previous beautiful goals. A UN summit in 1990, for example, set as a goal for the year 2000 universal primary-school enrollment. (That is now planned for 2015.) A previous summit, in 1977, set 1990 as the deadline for realizing the goal of universal ac­cess to water and sanitation. (Under the Millennium Development Goals, that target is now 2015.) Nobody was held accountable for these missed goals. ...

"At the World Economic Forum in Davos in 2005, celebrities from Gordon Brown to Bill Clinton to Bono liked the idea of bed nets as a major cure for poverty. Sharon Stone jumped up and raised a million dollars on the spot (from an audience made up largely of middle-aged males) for more bed nets in Tanzania. Insecticide-treated bed nets can protect people from being bit­ten by malarial mosquitoes while they sleep, which significantly lowers malaria infections and deaths. But if bed nets are such an effective cure, why hadn't Planners already gotten them to the poor? Unfortunately, neither celebrities nor aid administrators have many ideas for how to get bed nets to the poor. Such nets are often diverted to the black market, become out of stock in health clinics, or wind up being used as fishing nets or wedding veils.

"The nonprofit organization Population Services International (PSI), headquartered in Washington, D.C., gets rewarded for doing things that work, which enables it to attract more funding. ... PSI stumbled across a way to get insecticide-treated bed nets to the poor in Malawi, with initial funding and logistical support from official aid agencies. PSI sells bed nets for fifty cents to mothers through antenatal clinics in the countryside, which means it gets the nets to those who both value them and need them. (Pregnant women and chil­dren under five are the principal risk group for malaria.) The nurse who dis­tributes the nets gets nine cents per net to keep for herself, so the nets are always in stock. PSI also sells nets to richer urban Malawians through private-sector channels for five dollars a net. The profits from this are used to pay for the subsidized nets sold at the clinics, so the program pays for itself. PSI's bed net program increased the nationwide average of children under five sleeping under nets from 8 percent in 2000 to 55 percent in 2004, with a similar in­crease for pregnant women. A follow-up survey found nearly universal use of the nets by those who paid for them. By contrast, a study of a program to hand out free nets in Zambia to people, whether they wanted them or not (the favored approach of Planners), found that 70 percent of the recipients didn't use the nets. The 'Malawi model' is now spreading to other African countries.

"The Washington headquarters of PSI, much less the Davos World Eco­nomic Forum, did not dictate this particular solution. The local PSI office in Malawi (which is staffed mostly by Malawians who have been with the program for years) was looking for a way to make progress on malaria. They decided that bed nets would do the job, then hit upon the antenatal clinic and the two-channel sales idea. This scheme is not a magical panacea to make aid work under all circumstances; it is just one creative response to a particular problem."



William Easterly


The White Man's Burden: Why the West's Efforts to Aid the Rest Have Done So Much Ill and So Little Good


Penguin Press


Copyright 2006 by William Easterly


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