In a world of plenty, twenty thousand people died today because of extreme poverty. Tomorrow, twenty thousand more–many of them children–will succumb to the hunger and disease that prey on the poor of the developing world. Twenty thousand more will die the day after that, and so on.
Jeffrey Sachs’ message in his new book, The End of Poverty: Economic Possibilities for Our Time, is a simple one: It does not have to be this way. Sachs is called a “celebrity economist” by Time magazine–not because of his alliance with Bono, who wrote the forward to the book, but because Sachs is the director of both the Columbia University Earth Institute and the United Nations Millennium Project and has earned an international reputation for his work to reform failing economies in Latin American, Asia, Africa and Eastern Europe.
In an interview last week, Sachs talked about the book and his focus on achieving the Millennium Development Goals, the internationally agreed-upon plan to reduce extreme poverty, disease, and hunger by the year 2015. The Goals hinge on wealthy nations like the U.S. keeping a promise to devote 0.7 % of their national income to the world’s poor. (The U.S. currently devotes about 0.15% of gross national product to development assistance, the lowest percentage among the world’s donor countries.)
Q. In your book, you describe a rural family in Malawi led by a grandmother raising fifteen orphaned grandchildren. The family has been ravaged by AIDS, malaria and agricultural failures. How does foreign aid solve their problems?
SACHS: The theme of the book is that there are crises that are so severe that they are claiming millions of lives, but they’re not unsolvable. They are problems with practical, known solutions. Carol Bellamy of UNICEF has rightly described Malawi as a “perfect storm”: It is a place of chronic hunger, vulnerability to drought, endemic malaria and of course a massive AIDS crisis. Each of these is horrific in the scale of the suffering and tragedy it causes, but each also has practical solutions.
With farming, the problem in Africa is that farmers don’t have access right now to the basic inputs of modern farming: fertilizers, irrigation and improved seeds. Poverty is largely in farm households, and it is solvable directly through increasing the productivity of farmers and increasing rural productivity in general.
As for the disease burden, this is a case of mass death and even more mass suffering from diseases that are highly preventable and largely treatable. Malaria is a disease that has long inflicted havoc in Africa, yet malaria can be substantially reduced by the use of insecticide-treated bed nets, effective medication and community health workers to train households in how to use both the bed nets and the medication. This would be a very, very small investment for a very large return, yet none of the children shown in the book sleep under a bed net. None of those families can afford even a five-dollar bed net that lasts for five years.
With AIDS, the number of Africans infected with the virus who have access to anti-retroviral therapy, which now costs about 30 cents per day, is shockingly low. So each of the problems do lend themselves to practical approaches that would allow households trapped in extreme poverty to get in a position to start achieving economic improvement.
Q. In September 2000, the largest gathering of world leaders in history-147 heads of state and government-came to the UN and began the process of adopting the Millennium Development Goals you are pursuing, which include eradicating extreme poverty, achieving universal primary education and eliminating gender disparity. How did 9/11 affect the pursuit of those goals?
A. We opened the millennium with worries, but also with expectations that we could make a great amount of headway for the benefit of those who are suffering around the world. 9/11 threw off the process for a few years-there was the shock of the event itself, then the war in Afghanistan and the war in Iraq completely dominated global diplomacy. So the agenda of poverty reduction was put aside for a number of years. But there is a feeling now, although not as shared in the U.S. as it is in the rest of the world, that it is time to get back to that agenda of eliminating extreme poverty. Now, post-9/11, I actually sense an even stronger commitment throughout the world to address the problems of poverty, disease and hunger.
Q. The Millennium Development Goals are targeted to 2015 and then the elimination of extreme poverty by 2025, but people are dying every day right now. How much of this plan has to wait for another decade to pass?
SACHS: I can give you three examples of what we call “Quick Wins” that will save lives right away:
First, an absolutely simple step is to drop the user fees that are still pervasive in the poorer places in the world. We’ve found that when a government eliminates user fees on clinics and schools, the use of those services rises dramatically. So I propose in the book that we drop the user fees in those places, and compensate the government with just a little bit of aid from abroad in the form of debt cancellation or increased cash outlays to those governments.
A second kind of quick win is to allow farmers to get some of the most basic inputs, especially fertilizer, so that their crop yields can go up significantly, and then use part of that increased yield to provide food to local schools. I describe in the book how we are doing that in Kenya right now. With a little bit of logistics, we could have a massive increase in the next three years in the number of schools in poor areas that provide school meals, and we know from a lot of experience that this would make a huge change in the proportion of children that go to school.
A third way for quick progress is to control malaria. I believe it will be possible by the end of the year 2008 to get insecticide-treated bed nets and effective medication throughout Africa on a mass-distribution basis, and thereby make a tremendous advance in the control of the disease.
Q. Hopefully, we can assume that most Americans care about poverty-caused suffering and death. But most of us are not economists or elected officials, and most of us have no direct contact with anyone in the developing world. What can we do to stop this?
SACHS: Politicians in Washington think Americans don’t care. I don’t believe that. The Americans I know do care, but they need to tell their members of Congress that it is not a dangerous vote to support increased U.S. efforts to help the poorest of the poor in the world.
Just drop a one-sentence note to your Congressman and Senators: “This is not a dangerous vote. We want to help. It is going to make a safer world for us, and it is part of our moral and religious values. We want to be saving children if they can be saved.”
The political voice is crucial because our country needs to stand up and do more than we are doing right now. Our country is not really engaged in this effort with the intensity many Americans assume we are, and certainly not at the level we have promised to be and can afford to be. Public opinion polls show Americans believe we spend 25% of our federal budget on foreign aid, when it is really less than 1%. We’re providing very, very small amounts of help, much smaller than we said we would. (The U.S. promised at the Monterrey Financing for Development Conference in 2002 to spend billions more on aid than is currently being provided.)
This is where I think the President and Congress should be doing a great deal better than they are doing now. They can tell the American people, adult to adult: Here is what we are doing, here is what’s needed, here is what it would cost, and here is what we would accomplish. And then ask, “Are you for it, or you against it?” My feeling is that Americans would absolutely be for it. They are just assuming it is already happening.
Also, there are very rewarding ways to make individual contributions. Our UN Millennium Project allows a donation of six dollars to get a bed net right to a village in Africa. Communities can adopt and promote a counterpart community in a very poor region. Our calculations are that about $50 per person per year can make the difference between life and death. Some businesses and churches are helping that way, and the Millennium Project is trying to help any Americans who want to make that kind of contribution insure they are making direct impact. And, of course, there are many charitable organizations in the U.S. working in these countries as well.
Q. In your book, you cite the movements to abolish slavery in England during the 19th century, and the 20th century efforts to abolish colonialism in India and elsewhere, along with the civil rights movement in the U.S. What are the parallels between those efforts and the quest to end extreme global poverty?
SACHS: First of all, they were moral movements, often led in the churches, and they were based on values about the kind of world we want to live in and have the responsibility to create. The end of slavery in England didn’t happen because slavery became un-economic, it was because the Quakers and Methodists and others said, “Enough is enough, we have to behave with proper values.” And they changed history. The civil rights movement in our country and the end of colonialism were similar. These were mass movements for human dignity.
And that’s what we’re taking about now, but it’s even more than dignity, it is survival. When you see people dying because poverty prevents the proper medicines from being available–and I’ve seen too much of it–you realize that this is not just about dignity, and stability and fighting against the conditions that lead to violence in the world. It’s also life and death–nothing less than that.
The UN Millennium Project’s website is www.unmillenniumproject.org
FRAN QUIGLEY is an attorney and journalist in Indianapolis, Indiana. He can be reached at: firstname.lastname@example.org