A $50 billion question

In his latest book, Bjørn Lomborg asks how we can best spend aid money.

While reading Danish political scientist Bjørn Lomborg’s latest book, How to Spend $50 Billion to Make the World a Better Place, one phrase kept running through my head: better left pdf.

This short edition — just over 170 pages — is simply an abridged version of a previous book edited by Lomborg called Global Crises, Global Solutions, which chronicled the ideas that came out of the Copenhagen Consensus of 2004. And it comes off that way – as a rehash. Not that its content isn’t important, but most of the data is a few years old now.  

What is new in this version is that Lomborg asks the $50 billion question: How do we prioritize where we spend aid money in fighting global challenges? The problems he lists are extensive: climate change, disease, civil war and arms proliferation, access to education, financial instability, governance and corruption, malnutrition and hunger, migration, sanitation and clean water access, subsidies and trade barriers. What should we do first? Lomborg and a pantheon of economists discuss 10 of the most pressing problems and then rank them according to “solvability.” They counsel: Fight HIV/AIDS, control malaria, liberalize global trade, and provide micronutrients to the undernourished — in that order.

While Lomborg’s instinct to create order of the chaos makes sense, the act of ranking comes off as a rather whack-a-mole approach to deep, systemic problems. And if you’re looking for substance beyond the surface, it just isn’t there. Can you seriously discuss climate change in 18 pages? Or communicable diseases in 19 pages? Given that short shrift, it’s a wonder the economists were even able to rank these issues. Overall, the result is simplistic, abrupt, and – paradoxically – unfocused for such a short book, which leaves the reader wondering if a white paper or article might have been a more appropriate vehicle for these ideas.

Another problem with the book is the almost total absence of experts and analysts from the developing world. Of the two dozen or so chapter authors and counter-argument presenters, all were attached to universities or institutions in the West, with the exception of only one or two. How much more valuable — and real — might this ranking system be if Lomborg had gone to the developing world and asked economists from those countries to identify the world’s most pressing problems and how they thought aid might be used more effectively? At the very least, this would have diversified and nuanced the rankings. At the very most, it would have been a substantially better book.

However, even these Western experts generally disagree on how aid money should be spent — highlighted in the opponent’s views sections, which follow each of the chapters. In a counter argument, Jacques van der Gaag thought the AIDS/HIV chapter fell short of addressing the needs of those who already suffer from the disease, and that basic health care services in places where AIDS is most rampant remain in such an abysmal state that simply throwing money at prevention is a stop-gap measure. David Evans, in another counter argument, doubted the figures presented and argued that there is an imperfect assessment of the burden the disease actually places on households.

Lomborg also neglects to distinguish which problems seem regional, or geographically specific, and those that are truly global in scope. For example, the control of HIV/AIDS, which is often managed regionally, tops the list as one with a “very good” chance to be adequately addressed, while global climate change initiatives are relegated to the “bad” category. And the solutions to combat each of these are overwhelmingly top-heavy and bureaucratic, rather than entrepreneurial. There is nothing in the book about bottom-of-the-pyramid approaches, private-public hybrids, or how global and local philanthropy can partner with governments and business sectors to tackle these issues.

Take the climate change initiatives, for example. The economists agree that potential solutions, such as the Kyoto Protocol, are unworkable and unrealistic, but eschew the fact that there must eventually be a new global standard for governments to enforce. They also ignore the possible impact of climate change on a whole range of issues: migration, for example, as some regions become less habitable, and the attenuating conflict, disease, or poverty that might result from this upheaval. There are, indeed, major holes in Kyoto, but by relegating it to last place in “solvability,” there is a risk that what is perhaps the largest and most damaging issue will remain ignored because of its complexity.

But let’s not get stuck on Kyoto, since it is a minor focus of this book. If Lomborg’s treatise has a redeeming quality, it is the idea that some of these global crises are not as daunting as they first appear — when painted in numbers. (What’s $50 billion when the cost of the war in Iraq could reach $1 to $2 trillion by the time all is said and done?) A mere $27 billion dollars could prevent about 28 million cases of HIV/AIDS by 2010, say the economists. Another $12 billion could address the problem of micronutrient deficiency in a majority of the developing world. The economists don’t offer an overall number for trade liberalization, but estimate its benefits could be up to $2.4 billion per year. Lastly, just $10 billion would be needed to dramatically reduce the number of cases of malaria in developing countries. Clearly, Lomborg and his cohorts should get in touch with Bill and Melinda Gates.