Citizens v. Extreme Poverty
Jeffrey Sachs, Project Syndicate/Candide's Notebooks, July 9, 2006
Twenty years ago, a grass-roots movement led by Rotary International, a voluntary organization with around 1.2 million members in more than 200 countries, decided to attack. As of the mid-1980’s, there were more than 300,000 cases of polio per year worldwide, despite the disease’s virtual elimination in the richest countries, where vaccination was routine. Rotary took on the challenge of getting vaccines to the poor, in regions with weak or non-existent public health systems. Rotarians dreamed not only of reducing the number of polio cases, but of eradicating the disease entirely. This goal is now within reach.
Rather than wait for politicians to take up the fight against polio, Rotarians led the way. A few years later, the World Health Organization, and then other international agencies and donor countries, joined the cause, creating a coalition of official and private organizations that now support Rotary’s vision. By 2006, the number of polio cases had been cut dramatically, to well under 3,000 cases per year.
Complete eradication is in reach, but is still proving elusive, as small outbreaks have plagued one country or another in recent years. In some cases, such as Northern Nigeria, social resistance to the vaccine has blocked adequate coverage of the population. Pockets of polio transmission also persist in India, Pakistan, and Afghanistan. In a few other countries, the disease has been sporadically reintroduced by travelers from regions where polio has not yet been eliminated. And, in rare cases, the vaccine itself has failed and led to infection.
Still, despite the difficulties of rooting out the very last cases, the progress made against polio has been historic. More importantly, Rotary’s leadership on polio offers a more general lesson in the fight against extreme poverty, hunger, and disease. Even when politicians don’t lead, it is still possible for committed individuals and voluntary organizations to change the world. The key is to link a bold idea with a practical and powerful technology, and then to push the idea and technology forward through mass citizen action.
These same lessons can be applied to the Millennium Development Goals (MDG’s), the targets for fighting poverty, disease, and hunger that the world’s governments adopted in 2000. The MDG’s are bold but achievable. For example, they call for reducing by 2015 the proportion of the world’s population that was chronically under-nourished in 1990, and for cutting the child mortality rate by three quarters. The MDG’s also address the scourges of maternal death in childbirth, lack of access to safe drinking water, and killer diseases such as malaria, tuberculosis, and AIDS.
Just as with polio, the fight against hunger, disease, and lack of access to safe water and sanitation can be carried forward with practical and powerful technologies. Indeed, these technologies are so powerful that they can enable families currently trapped in poverty to escape it once and for all.
Consider hunger in Africa. Most of Africa’s farmers, working tiny plots, do not produce enough food to feed their families, much less to earn an income. The root of the problem is that Africa’s farmers are too poor to obtain the basic modern inputs—including high-yield seed varieties, fertilizers, and small-scale water management systems—that could enable them to double or triple their output of food and cash crops.
The solution is therefore not much more complicated than a polio vaccine. If organizations like Rotary International can help African farmers to get a 50 kilogram bag of appropriate fertilizer and a 10 kilogram tin of improved seeds, the rise in farm output could be enough to relieve extreme hunger and help farm households begin to earn some income.
Such practical approaches can solve many of the key problems of extreme poverty. Consider, similarly, the death and illness caused by malaria, which can be reduced very sharply through the use of mosquito nets for beds and anti-malaria medicines. An anti-malaria bed net costs just $5, lasts five years, and can accommodate two children. Thus, for just $0.50 per year, each child can be protected by a bed net. And a $1 medical treatment can cure malaria if the child gets infected despite the bed net. Yet bed nets and anti-malaria medicines do not reach the people who need them, because the people who need them are too poor.
Fortunately, the American Red Cross and other organizations have been following the Rotary model, using private donations and private volunteers to fill the gap left by our political leaders. Red Cross chapters across Africa, in partnership with other organizations, are now distributing bed nets free of charge to impoverished families, in the same way that Rotary has been distributing polio vaccines.
The time has arrived for a massive effort by voluntary organizations to take up the MDG’s through private action. We need not wait for the politicians. In a short period of time, the world’s citizens can make deep inroads in the fight against disease, hunger, and poverty. Then the politicians will follow.
The key is practicality, boldness, and, most importantly, a commitment by those who are better off to volunteer their time and money to bring practical help–in the form of high-yield seeds, fertilizers, medicines, bed nets, drinking wells, and materials to build school rooms and clinics—to the world’s poorest people.