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Helping the bottom billion
Kevin, a soon-to-be loyal MR reader, asks:
What single intervention would do the most to improve the health of people living on less than $1 a day?
Experts answer here. The first guy asked says give them cash. One woman, whom I believe is a practitioner of living on a dollar a day, responds: "Improve the house, which is small and untidy."
What I found noteworthy is how many plausible but quite distinct answers there were. While I disagree with Jeff Sachs on many issues, I think he is right to stress just how many different problems have to be overcome for sustainable development to occur.
Your thoughts?
Posted by Tyler Cowen on October 25, 2007 at 07:42 AM in Economics, Medicine | Permalink
Comments
Free and important medicines for a limited period and upto a certain age for children. Also, free vaccines. I will avoid complicated bone marrow type treatments for free. On a aggregate basis , they turn out to have a poor cost-benefit ratio.
Posted by: sa at Oct 25, 2007 7:53:22 AM
This one is the winner:
Davidson Gwatkin, Consultant on Health and Poverty, Washington, D. C., United States of AmericaThe health of the world's poor would be best served by a series of revolutions that bring into power national leaderships that are centrally concerned about the well-being of disadvantaged groups within their borders.
Personally, I'd go for the global elimination of agricultural subsidies.
Posted by: Gary at Oct 25, 2007 8:15:24 AM
One would think the easiest answer would be to give them another dollar a day, and let them figure it out individually since top-down one-size-fits-all solutions may not be as efficient. But I don't know if this would backfire due to the Friedman-Savage utility function (http://en.wikipedia.org/wiki/Friedman-Savage_utility_function).
Posted by: Will at Oct 25, 2007 8:51:07 AM
Bill Clinton needs to champion the message in the World Bank's annual report 'Doing Business' - namely, that obstacles to new business development by small entrepreneurs is (aside from health care issues) the single largest problem holding back poor countries. One quick example: how is anyone supposed to run a legitimate business in Dem. Rep. of Congo when their combined corporate tax rate is 235%?
That, and nominate Hernando de Soto for the Noble Prize in economics for his work on private property rights and the informal sector.
Posted by: Alex Ambroz at Oct 25, 2007 8:51:32 AM
Bjorn Lomborg of Copenhagen Consensus asked 8 economists to say how best to use an additional US$50 billion in donor assistance. Investing in health via prevention of infectious and communicable diseases ranked highest, with special emphasis on HIV/AIDS. Later, other development specialists and international policymakers agreed. Global Fund, PEPFAR, DFID, and Nordic donors are putting their money in some degree in accordance with thos recommendations. Cutler of Harvard, Deaton of Princeton, and Nordhaus of Yale have written of the positive benefit-cost ratios of investing in better health in the USA and rest of the world. Good investmnet opportunities in global public health goods.
Posted by: W McGreevey at Oct 25, 2007 9:23:59 AM
I think part of Kumariah Balasubramaniam's answer is the key:
"legal protection of domestic agriculture,"
Unless property rights are established and enforced, how can the impoverished permanently escape the numerous conditions that threaten their lives?
Posted by: John Dewey at Oct 25, 2007 9:33:10 AM
I support a University of Florida medical mission to a rural area of the Dominican Republic. They like to bring vitamins, vaccinations. So I hope that these help.
I also think that providing DDT might help.
Would bleach to put in water help?
Posted by: Floccina at Oct 25, 2007 9:37:39 AM
Easy access to clean water. It's not even close, in my opinion.
Posted by: pawnking at Oct 25, 2007 9:44:43 AM
One woman, whom I believe is a practitioner of living on a dollar a day.
"Whom" should be "who".
Posted by: gc at Oct 25, 2007 10:17:05 AM
Wow -- grammar nazis on MR...
There IS NOT one best solution: As Will says, people have different priorities. That said, the rich world can STOP getting in the way (ag subsidies, arms trade), and the poor world can concentrate on letting people choose their actions (if allowed, see Gwatkin). The provision of public, scale and spillover goods *does* require some political coordination, but that can occur at the community -- not national -- level (see Ostrom, passim).
Posted by: David Zetland at Oct 25, 2007 10:29:04 AM
The editorial board at 60 Minutes might say, Plumpynut: http://www.cbsnews.com/stories/2007/10/19/60minutes/main3386661.shtml.
Posted by: C at Oct 25, 2007 10:36:25 AM
I am going to list only the top 2 in my opinion.
First and foremost Access to clean Fresh water, contaminated water breeds so many diseases it is scarry. Fresh water also allows affective hygene.
Second is small sustainable agriculture or ranching. Each family needs to own a cow or chickens or goats. These provide food, can reproduce and create more. The family can sell or eat the off spring and create wealth not only for them but the village
Posted by: Roland Johnson at Oct 25, 2007 10:47:27 AM
Access to easy and cheap capital. People can often live (relatively) comfortably on a dollar a day on a day to day basis. Economic shocks or a requirement for capital to build a house, for example, can upset this equilibrium, leaving people exposed to money lenders etc. etc.
Posted by: tom at Oct 25, 2007 10:54:10 AM
British colonization.
Posted by: 8 at Oct 25, 2007 11:21:23 AM
Colonize them.
Posted by: JoshK at Oct 25, 2007 11:23:58 AM
I think the answers that call for clean water and sufficient food are the best (at least short term), though they don't specify a way out of the eventual Malthusian trap. Better education is obviously a good long-term solution.
But my personal favorites were probably the calls for revolution and increased breastfeeding.
Worst answer was the one that called for 'A highly respected, politically independent, empowered, courageous, motivated, transparent, technologically competent, and properly supported World Health Organization.'
Why yes!... but as long as you're taking this tack I think you might as well ask for a band of Seraphim to descend from the heavens bringing food, water, and magical candy to anyone that wants it...
Posted by: bbartlog at Oct 25, 2007 11:51:53 AM
I notice two things. One is that many of the responders don't actually answer the question. Instead, they answer a similarly themed, but very different question. The other is that many of these suggestions don't actually lead to an immediate benefit to the poor. Instead, they immediately benefit some bureaucracy with the implication this will somehow benefit the poor. These two are not unrelated.
And that explains why so much foreign aid does not actually help.
Posted by: Chris Durnell at Oct 25, 2007 11:59:26 AM
Along with the Copenhagen Consensus: Micronutrients. Get those IQs up.
Posted by: Jason Malloy at Oct 25, 2007 12:17:35 PM
A better battery. This would permit cheap micro-power installations. Lack of infrastructure keeps them separated from the world economy. No power, no telecoms, no internet, no investment. It makes everything more expensive for the local populations. With a better battery (something you could fill and empty with current as easily as putting gas in a tank), all sorts of otherwise silly Green power systems actually become practical.
Posted by: Michael at Oct 25, 2007 12:17:53 PM
I would give them freedom. We live and die by our decisions. Allow them the freedom to make a different decision about their life, like look for a job or start a business. Most starving people live in socialist societies with no freedom or property rights. Without property rights, people cannot accumulate wealth. Without wealth, there is no economic growth. Without growth, there is no alternative to starvation. Freedom is the first pre-condition to improvement.
Posted by: jorod at Oct 25, 2007 12:31:02 PM
Allow them to immigrate to the "Western" world. It may or may not improve our standards of living or our health, but when they no longer make only $1 a day, they can start spending more on healthcare or whatever else they value.
Posted by: Stan at Oct 25, 2007 12:55:22 PM
A bicycle.
Really, this is a proxy for
access to markets to sell stuff (and buy stuff more cheaply),
access to medical care that may be too far to walk but easy cycling distance,
access to a school, a public library that may exist but be too far (or take so long to get to that other vital tasks can't be done).
Sure, a car or small motorcycle works as well, but a sturdy new bike (like those in the World Bicycle Relief program) is $109, even with their NGO infrastructure. And bicycles don't create the drain on foreign exchange that oil imports would, and can be kept in repair for years/decades without particularly exotic parts.
Posted by: ZBicyclist at Oct 25, 2007 1:54:54 PM
Litteracy.
literate people usually have less children.
literate people can read about contraceptives.
literate people read newspapers and form better opinions.
literate people don't have to be told about agricultural techniques, they can go an search for them by themselves.
literate people know how to use google.
literate people know how to read a manual that explains how to keep water clean, and manuals are cheaper than experts doing the explainning.
literate people can kick your ass.
(bicycles shouldn't be given, as locals do know how to build them)
(freedom is hard to give. i mean how do you do it ?)
(colonization is like communism, if it didnt work once, why do you expect it to work again ?)
(vaccines could be useful but people need to want them, otherwise you're waisting your time)
Posted by: nu at Oct 25, 2007 2:13:04 PM
More open borders. The combination of allowing people to sell their labour further afield and the remittance investment flow that would result would have the greatest effect in aiding the world's most poor.
Posted by: Simon at Oct 25, 2007 2:27:20 PM
If more technology that allows people to circumvent their Governments came along it might help.
Posted by: Floccina at Oct 25, 2007 2:57:41 PM
