There remain dramatic disparities between the development and less developed world. And contrary to what the politically correct would suggest, these disparities don’t often stem from colonialism, racism, or indifference. Far from it.
Trillions are spent bilaterally and multilaterally in order to improve the quality of life for those not lucky enough to live in the OECD. Indeed, the United Nations Sustainable Development Goals have 169 targets to achieve before 2030. They include ending poverty and hunger, “gender equality,” clean energy… and, well, you get the picture. Not everyone gets a pony, but that’s about the only thing the UN, in its infinite wisdom, left off the list.
Unsurprisingly to everyone who doesn’t work at the United Nations, that esteemed institution and its even more esteemed members are on track to miss ALL of these goals but ONE. What’s more, Bjorn did the calculations, and the UN goals are so cost-ineffective (about 11 cents to the dollar) that we would be better off just giving the dollar away, and doing 89 cents more worth of good.
This stands in stark contrast to the 2000 Millennium Development Goals, which were more modest, more achievable, and with the expenditure of billions, actually achieved in some part. Why isn’t “achievable” always the standard? You sillies. Doesn’t “ending hunger" sound better than “mitigating hunger?” Of course it does.
In response, our good friend Bjorn Lomborg gathered a list of 12 “Best Things” to alleviate some of the world’s most persistent problems. In his book, Best Things First, he lays them out, including the requirement for substantial returns on a dollar invested and achievability. Things like child and maternal survival in childbirth; education; malaria… We talk about them in the pod. See for yourself, and ask yourself why it is that everything is not run with the standards Lomborg suggests. If only.
HIGHLIGHTS
We’ve talked to you before about what the world shouldn’t do. This is different?
BL: Actually, this is what I do for most of my work, is actually try to focus on where can we spend money and do a lot of good for the world. But in most of the rich world, unfortunately, most of the focus is on the stuff we shouldn't be spending money on where we spend tons of money and don't get very much bang for our buck. But if you look around the world, there are plenty of problems. People are still dying needlessly from a lot of infectious diseases like tuberculosis, malaria, there's terrible education. There's still a lot of women and children that die around childbirth and on and on, and all of these, it turns out we can do a lot about for very little money.
Give us an example?
BL: So this book is really about where can we spend money and do an incredible amount of good. One of the things that we've found is an education. Right now, the world has for the world's poor half, so the 4.1 billion people who live in low and low-middle income countries, they have almost half a million kids in primary school. Unfortunately, most of these kids are just not learning. They're in the school, but they're not learning. And so the question is, is there a way to make them learn more? And the simple answer is yes, there is. There's actually a couple ways, but let me just share one of them with you. If you take these kids... So we put, just like in rich countries, all 12 year olds in the same grade, all 13 year olds in the same grade. But these kids are actually wildly different in their abilities. Some of these kids are far ahead of the teacher and bored and some of these kids have no clue what's going on. But ideally, the teacher should be teaching each one of these kids at his or her own level.
But of course you can't do that in a class of 50. But what you can do is to take these kids one hour a day, put them in front of a tablet that has educational software. This educational software will very quickly figure out where exactly this guy or this girl is and start teaching at that exact level. It turns out that this cost about $21 per kid per year, but it delivers three years of schooling
What prompted you to write this?
BL: For the longest time, the UN has set all kinds of goals and we've never really achieved much. But in 2000, they set what you call the Millennium Development Goals, which was really a very, very short list of, let's get people out of poverty, let's get people out of hunger, let's give them clean drinking water and sanitation, stop moms from dying, stop kids from dying and get everybody in school. There was a little more than that, but that was pretty much what that was. And it garnered a lot of attention and got a lot of people going. We spent more money on it and we actually achieved a lot of this. Just to give you one example, in 1990, about 12 million kids died each year under five. So 12 million kids died. And we promised to reduce that by two thirds. We didn't quite succeed, but we actually succeeded to see only 6 million kids dying each year in 2015.
Now, again, I'm putting scare quotes around only because obviously that's still way too many kids, but we actually have a situation where 6 million kids survive each and every year because we were smart. And then the UN obviously wanted to set new targets, and one of the things they were bothered about... And I get that, these Millennium Development Goals were really just set in a backroom in the UN by about six guys, and these were literally all guys. And that doesn't quite feel right for global goals. So it feels like more people should be involved and we should hear more voices and all that stuff. The UN opened it up and said, "What do you think we should listen to?" When you do that, not surprisingly, you end up with a lot of suggestions. At one point there were more than 1400 targets in play.
They ended up with 169 targets, which are just incredibly long…
So fundamentally, in the current set of goals, which the US government and every other government on the planet have signed up to, would basically promise to do all good things for everyone all the time everywhere. We promised that we are going to fix poverty, we're going to fix hunger, we're going to fix education. We're also going to fix corruption, war and climate change, and we're going to do all of these things and lots and lots of other things along with making sure that everybody get organic apples and community gardens. It really is just one of those things where we promised everything to everyone, and look, they're all carried with good intentions, but at the end of the day, of course, it's not good intentions that actually pull people out of poverty or make sure that that kids learn or that they don't die from easily curable infectious diseases, that is that we focus on the right things
Depressingly, we're achieving almost nothing. The UN secretary is suggesting that we may actually fail on pretty much everything we promised,
What’s your answer?
BL: We looked at more than a hundred different priorities. We didn't look at everything, but we really tried to look across pretty much everything that has been promised and say, "What does the literature tell us? Is this going to be a phenomenal investment, a so-so investment, or not a good investment?"
And then we took the really phenomenal ones and then we selected them on saying, "You have to be able to get at least $15 back for every dollar you spend." We were simply going to look for the very, very most effective ones. Look, this is not a magical number, it's one that we've been using for a long time, but what it really just means is these 12 are going to be amazing, and that's why we picked those 12. We believe that there's not other big ones that are left out there that would also have been amazing, so we probably have scoured the whole space. But of course there are a lot of other ones that are pretty damn good, and we should probably also do them, but I think we should do the really amazing ones first.
Tell us about the amazing ones.
BL: So we have a situation where about half a million people die each year almost exclusively in Africa. And what we need to do is spraying and mosquito nets. It turns out that spraying is really, really difficult to do, and that's one of the reasons why we're not advocating this because you have to do it really well, and much of this will be somewhat corrupt, and then it doesn't really work. But if you do it with mosquito nets, this is something that we've proven. We know that we can get more people sleeping under mosquito nets. They'll be insecticide treated mosquito nets. They cost somewhere between $1 and $4 a piece. So it's not really all that much. If you get people sleeping on them and you get most people doing that, it actually dramatically reduces infection rates. And so for what is it, we find the total cost, if we look across the rest of the decade, it'll cost about $1.1 billion a year additional, but it'll save in the order of 200,000 people each and every year.
What about education?
BL: So, one of the good examples is Indonesia, back in the early 2000s, Indonesia decided they were going to double their spending on education, which is of course very laudable. They put it into their constitution, and they doubled the amount of public spending on education. They have hired many more teachers. They have hired more than a million more teachers. They have doubled the pay for each individual teacher. Indonesia has one of the lowest class ratios in the world. Unfortunately, it's not helped at all.
This very famous paper is called Double for Nothing. So what they found was that you spent twice as much money, but you got absolutely no impact on learning. Now the teachers are much, much more happy,. So there is that. If you pay them twice as much, not surprisingly, they're very happy, but you didn't actually improve the indicator that you aimed to do. And this tells us a very important thing, and that goes exactly to your point of saying it's not enough to just identify and say, "Oh, we want to do something about education." Well, there's a lot of ways that you can actually spend more money on education and do very little or no good. So reducing class sizes is a typical argument. It does do a little bit, but typically very little at very high cost.
Likewise, building more schools, typically, it turns out to be nice actually because it reduces your travel time for the kids, but it doesn't actually have any effect on learning. There are lots of these studies that show this has no or very little impact, but what we identified is these two amazing things. So one is, as I mentioned, basically teaching each kid at the right level that is getting the kid to learn more. The other one is to make the teacher better. So remember, most teachers, especially in poor countries, are just marginally better than the kids that they're teaching. They don't get paid very much. Honestly, when you go do their classes, studies show that about 40% of the classes seem entirely unplanned. They're just sort of rambling on as you might remember, some of your bad teachers from primary school.
So if you make these plans, this is what you should teach this class. This is what you should teach this week. This is how you get through... These are the questions you can ask, and teach the teachers to teach better. And Kenya is now doing this. It turns out that this is very, very cheap. It costs about $8 per kid per year, but it'll make the teachers teach much better. And actually the kids will learn about two years of learning for every one year they go to school. So again, amazing outcome. This is the kind of thing that we should do.
You also talk about childbirth…?
BL: We could do something about that very, very easily. It's just simply making sure that you have better care before and especially during the delivery. So get women into institutional birth and make sure that those institutions actually have some really basic emergency and obstetric care. This could be one thing. And again, I didn't know this — more than 700,000 kids die each year because they never breathe or they stop breathing in the first hour of their life. And this happens even in rich countries. We know that about 5% of all kids that are born need to have positive air pressure. You need to put a mask and give them some air into their lungs to get them breathing.
We do that in the rich world. You need this very, very simple little bag, basically a plastic mask and a low bag that you pump. Then you pump air into the kid and you give that kid a much better chance of surviving. This costs perhaps $65, and you can save in the order of 25 kids over the three years it'll last. So again, if you do all of these things, and again, this is a systemic thing, I'm not trying to say we should have a GoFundMe for just this plastic mask. It's a lot of different things. We want to get into the hospitals, very simple things. We could save in the order of 166,000 moms and about 1.2 million kids each and every year. So 5 billion you could save in the order of 1.4 million people each and every year. This is just one of the best things we could do.
But isn’t corruption one of the most corrosive problems?
BL: Again, we know corruption is a huge issue. … Clearly it'd be lovely to try to find a way to get rid of a lot of corruption. Now, there's a lot of ways that we don't know how to do that, but there is one way as you point out. And again, we're simply picking up on the really, really low hanging fruit. This is called e-procurement. And again, as you say, it sounds incredibly boring, but the reality is the biggest purchaser of goods and services in most economies is the government. And this is especially true in poor countries. So anything from post-it notes to roads, but obviously roads is the major public works as the major part of this, and it's hugely corrupt.
If you put this online, so if you actually put this a little bit like eBay, you have the whole country asking for all of its procurement over the internet. It makes it easier for more companies to bid. More companies will know about this, and it's harder, not impossible, but harder to be corrupt on this. It's harder to put up your goons. And so what happens, and we know this empirically, it reduces the price that the government has to pay for its goods and services. And that means you have more money left over.
if you focus on skilled migration, so take doctors, engineers, some of the really highly educated STEM workers, the benefit of moving someone from low pay countries to high pay countries is potentially enormous. It's also good for the receiving country, so typically for the rich country because we have too few kids and too many retirees in the long run. And this could mitigate some of that.
How do we stop developed countries from investing in bad ideas?
BL: I think fundamentally the reason why democracies spend a lot of money is because it gets politicians reelected. It's the kind of thing that has great PR is the kind of thing that has lots of crying babies or cute puppies or whatever, the things that make the news. And so it's not surprising that we're spending a lot of resources on things that only do fairly little good. I actually tend to think that most of the things we do are not totally lost but there's a lot of things that we do that are only so so. I think what this book really does is it helps us identify here are some amazing things. It makes it easier for people who are arguing for, we should be spending more on malaria or tuberculosis or maternal and newborn health, that this is actually one of the world's 12 best things to do.
We’ve always talked to you about climate, and this book isn’t about climate change. But it seems as if a development project *isn’t* about climate, it won’t go anywhere…
BL: It is an important issue because again, as I point out, we spend what, about $1.1 trillion in climate each and every year. We spend about $2 trillion on military, and we spend $5 trillion in education globally. So clearly the money's out there. We spend about what, $110 billion on cosmetics, as Dany mentioned very early on. So we can certainly afford these $35 billion. But it is true that a very large part of the conversation is about climate change. And so I do actually mention it. I go through why it's not on the top list, and that's because all the major studies show, even if you do... Climate is a real problem and it certainly is something we should address. But even if you do really, really well, you can't make it do $15 back on the dollar, sort of a global coordinated carbon tax will give you $2 back on the dollar, which is a good thing.
We would certainly take that if we were companies, if you could get $2 back on every dollar, you would certainly do that. But it requires a lot more specificity and you have to be very careful that you do it well so that it doesn't fall down below $1 back on the dollar. And certainly a lot of the things that we're doing in climate right now are more sort of feel good measures that have fairly little benefit costs. So one estimate for the Paris Agreement for instance, is that it delivers 11 cents back on the dollar, which of course is not very good. You could have given the dollar away and done what, 89 cents more good. But the fundamental point here is not to say that in a perfect world we should do all great things. That's not what I'm arguing here.
So there are definitely things we should be doing and be considering doing, but if you want to do a lot of good, this is not the first place you want to start. That is those 12 amazing things that just everyone in the world really ought to be able to come together on doing. And I think that's one of the crucial bits if we can leave that conversation with saying, "Not only is this amazing to do, but I also think in some way it has this amazing opportunity to bring us all together in this hyperpolarized world." We can all sort of agree, spending a little money on doing amazing good is probably a good thing to do. If you want to put it very bluntly, the left wing likes to spend money and the right likes to spend it, maybe not spend very much, but spend it really well, hey, if we spend a little money incredibly effectively, that's hard not to say yes to.
Full transcript here.
SHOWNOTES
Best summer books of 2023: Economics (Martin Wolf, Financial Times)
Go to 2030 because that is end of SDG era. Costs rise from ~$30bn to ~$50bn for average cost of $41bn per year.
All the papers here.
- Climate-related disasters killed ever fewer in 2022, but the media only delivers climate-doom
- Even countries perceived as the “losers” of free trade will gain $7 for every dollar of costs.
- So, e-cars only good if driven far, but they won’t reach that mileage.
- Stop the panic: World is burning less, not more.
- Media loooves talking about heat deaths. But ignores much larger problem of cold deaths.
We’re not reaching the Global Goals. What now? (Bill Gates and Bjorn Lomborg, GatesNotes, June 1 2023)
The time for an honest and open dialogue on climate is right now (Anantha Nageswaran and Bjorn Lomborg, Live Mint, June 19 2023)
Trade Should Be Trending (Bibek Debroy, Bjorn Lomborg, and Aditya Sinha, Economic Times, June 15 2023)
Bjorn Lomborg: To reduce global inequality, let skilled people move where they want (National Post, May 7 2023)