The End of Poverty Part 1

THE END OF POVERTY

HOW WE CAN MAKE IT HAPPEN IN OUR LIFE TIME

JEFFREY SACHS

PENGUIN BOOKS              2005

PART I

The Goal

For the first time in history, our generation has the opportunity to end extreme poverty in the world’s most desperate nations. Jeffrey Sachs lays out how poverty has been beaten in the past, how – in realistic, attainable steps – we can make a real difference for the one-fifth of humanity who still live in extreme poverty, how they can find partnerships with their wealthy counterparts to escape the poverty trap, how little it will actually cost, and how everyone can help. We can end poverty by 2025 and change the world for ever.

The author

Jeffrey Sachs is Director of The Earth Institute at Columbia University, Quetelet Professor of Sustainable Development, and Professor of Health Policy and Management at Columbia University as well as Special Advisor to the United Nations  Secretary General Kofi Annan. He is internationally renowned for his work as economic advisor to governments in Latin America, Eastern Europe, the former Soviet Union, Asia and Africa. He served the WHO under Gro Harlem Brundtland and directed the work of the UN Millennium Project. Bono has opened the eyes of millions of fans and citizens to the shared struggle for global equality and justice and through his gifted leadership has connected worlds that would otherwise have remained separate. Together with his close associates he pushes the agenda for global development to the forefront of often indifferent and unaware global leaders.

The plan

The plan laid out is not only a critical path to accomplish the 2015 Millennium Development Goal of cutting poverty by half, but a handbook on how we could be the first generation to unknot the tangle of bad trade, bad debt, and bad luck; to end the corrupt relationship between the powerful and the weak; to help the 15,000 people daily dying needlessly from AIDS, TB, and malaria; to help the 8 million people who die each year because they are too poor to stay alive; to address the plight of the world’s poorest of the poor, whose societies are destabilized by extreme poverty and thereby become havens of unrest, violence, and even global terrorism; to close the yawning gap between what the rich world claims to be doing to help the poor and what it is actually doing; to use our wealth wisely; to heal a divided planet; to end suffering of those still trapped by poverty; and to forge a common bond of humanity, security, and shared purpose across cultures and religions.

Peace and prosperity

This book is about making choices – choices that can lead to a much safer world based on a true reverence and respect for human life and will help to show the way toward the path of peace and prosperity, based on a detailed understanding of how the world economy has gotten to where it is today and how our generation can mobilize our capacities to eliminate extreme poverty.

 

Foreword by Bono 2004

• Let me introduce myself. My name is Bono and I am the rock star student. Let me tell you how Jeff Sachs and I started this journey.
• It started when my great friend Bobby Shriver had advised me to meet Jeff before I went up to Capitol Hill to lobby on behalf of Jubilee 2000 for the cancellation of the LDC’s (least developed countries’) debt to the rich countries of the OECD (Organization for Economic Cooperation and Development) as part of the millennium celebrations.
• Hunger, disease, the waste of lives that is extreme poverty are an affront to all of us. To Jeff it’s a difficult but solvable equation. An equation that crosses human with financial capital, the strategic goals of the rich world with a new kind of planning in the poor world.
• The end of poverty is a challenge that’s hard to ignore. Jeff is hard to ignore. He’s not just animated; he’s angry. Because he knows that a lot of the crisis in the developing world can be avoided.
• Staring at people queuing up to die and knowing that this doesn’t have to be so is too much for most of us. Jeff is creative. I am crushed.
• Jeff is an economist  who can bring to life statistics that were, after all, lives in the first place. He helps us make sense of what senseless really means: fifteen thousand Africans dying each day of preventable, treatable diseases – AIDS, malaria, TB – for lack of drugs that we take for granted.
• This statistic alone makes a fool of the idea many of us hold on to very tightly: the idea of equality. What is happening in Africa mocks our pieties, doubts our concern, and questions our commitment to that whole concept.
• If we are honest, there’s no way we could conclude that such mass death day after day would ever be allowed to happen anywhere else. Deep down, if we really accept that their lives – African lives – are equal to ours, we would all be doing more to put the fire out. It’s an uncomfortable truth.
• This book is about the alternative – taking the next step in the journey of equality. If we’re serious we have to be prepared to pay the price. Some people will say we can’t afford to do it. I disagree.
• I think we can’t afford not to do it. In a world where distance no longer determines who your neighbor is, paying the price for equality is not just heart, it’s smart.
• The destinies of the “haves” are intrinsically linked to the fates of the “have-nothing-at-alls.”
• If we didn’t know this already, it became too clear on September 11, 2001. The perpetrators of 9/11 might have been wealthy Saudis, but it was in the collapsed, poverty-stricken state of Afghanistan that they found succor and sanctuary. Africa is not the front line in the war against terror, but it soon could be.
• “The war against terror is bound up in the war against poverty.” Who said that? Secretary of State Colin Powell. When a military man starts talking like that perhaps we should listen.
• In tense, nervous times isn’t it cheaper – and smarter – to make friends out of potential enemies than to defend yourself against them?
• The plan Jeff lays out is not only his idea of a critical path to accomplish the 2015 Millennium Development Goal of cutting poverty by half – a goal signed up to by all the world’s governments. It’s a handbook on how we could finish the job.
• We could be the first generation to outlaw the kind of extreme, stupid poverty that sees a child die of hunger in a world of plenty, or of a disease preventable by a 20-cent inoculation. 
• We are the first generation that can afford it. The first generation that can unknot the whole tangle of bad trade, bad debt, and bad luck. The first generation that can end a corrupt relationship between the powerful and the weaker parts of the world which has been so wrong for so long.
• In Jeff’s hands, the millstone of opportunity around our necks becomes an adventure, something doable and achievable. His argument is clear. We converge from our different starting points … he from markets, I from placards. Luckily we agree you need both.
• Will we in the West realize our potential or will we sleep in the comfort of our affluence with apathy and indifference murmuring softly in our ears? Fifteen thousand people dying needlessly every day from AIDS, TB, and malaria. Mothers, fathers, teachers, farmers, nurses, mechanics, children.
• This is Africa’s crisis. That it’s not on the nightly news, that we do not treat this as an emergency – that’s our crisis.

Future generations flipping through these pages will know whether we answered the key question. The evidence will be the world around them. History will be our judge, but what’s written is up to us. Who we are, who we’ve been, what we want to be remembered for. We can’t say our generation didn’t know how to do it. We can’t say our generation couldn’t afford to do it. And we can’t say our generation didn’t have reason to do it. It’s up to us. We can choose to shift responsibility, or, as the professor proposes here, we can choose to shift the paradigm.

 

Introduction

• This book is about ending poverty in our time. The $450 billion that the United States will spend this year on the military will never buy peace if it continues to spend around 1/30^th of that, just $15 billion, to address the plight of the world’s poorest of the poor, whose societies are destabilized by extreme poverty and thereby become havens of unrest, violence, and even global terrorism.
• The share of U.S. GNP devoted to helping the poor has declined for decades, and is a tiny fraction of what the United States has repeatedly promised, and failed, to give.
• All parts of the world have the chance to join an age of unprecedented prosperity building on global science, technology, and markets. But certain parts of the world are caught in a downward spiral of impoverishment, hunger, and disease. Our task is to help them onto the ladder of development, from which they can then proceed to climb on their own.
• Safety and prosperity depend on collective decisions to fight disease, promote good science and widespread education, provide critical infrastructure, and act in unison to help the poorest of the poor.
• The wealth of the rich world, the power of today’s vast storehouses of knowledge, and the declining fraction of the world that needs help to escape from poverty all make the end of poverty a realistic possibility by the year 2025.

 

Chapter One: A Global Family Portrait

Malawi: The Perfect storm

• As we arrive in the village, we see no able-bodied young men at all. In fact, older women and dozens of children greet us, but there is not a young man or woman of working age in sight. Where, we ask, are the workers? Out in the fields?
• The aid worker who has led us to the village shakes his head sadly and says no. They are nearly all dead. The village has been devastated by AIDS, which has ravaged this part of Malawi for several years now.
• There are just five men between 20 and 40 years of age left in the village. They are not there this morning because they are all attending the funeral of a fellow villager who died of AIDS the day before.
• The margin of survival is extraordinarily narrow; sometimes it closes entirely. One woman we meet in front of her mud hut has 15 orphaned grandchildren.
• She points to the withered crops that have died in the fields next to her hut. Her small plot, perhaps a half hectare (a little more than an acre) in all, would be too small to feed her family even if the rains had been plentiful.
• The problem of small farm size and drought are compounded by yet another problem: the soil nutrients have been depleted so significantly in this part of Malawi that crop yields reach only about one ton of maize per hectare with good rains, compared with three tons per hectare that would be typical of healthy soils.
• She reaches into her apron and pulls out a handful of semirotten, bug-infested millet, which will be the basis for the gruel she will prepare for the meal that evening. It will be the one meal the children have that day.
• I ask her about the health of her children. She points to a child of about four and says that the small girl contracted malaria the week before. When they got to the hospital, there was no quinine, the antimalarial medicine, available that day. With the child in high fever, the grandmother and grandchild were sent home and told to return the next day.
• In a small miracle, when they returned the next day after another 10-kilometer trek, the quinine had come in, and the child responded to treatment and survived.
• More than one million African children, and perhaps as many as three million, succumb to malaria each year.
• This horrific catastrophe occurs despite the fact that the disease is partly preventable – through the use of bed nets and other environmental controls that do not reach the impoverished villages of Malawi and most of the rest of the continent – and completely treatable.
• There is simply no conceivable excuse for this disease to be taking millions of lives each year.
• Our guide to Nthandire is a Christian aid worker, a dedicated and compassionate Malawian working for a local nongovernmental organization (NGO). He and his colleagues work against all odds to help villages such as this one. The NGO has almost no financing available and survives from meager contributions.
• There are only poor in this village. No clinic nearby. No safe water source. No crops in the fields. And notably, no aid.
• Attending school is now a hit-and-miss affair. Children are in and out of school with illness. Their attendance depends on how urgently they are needed at home to fetch water and firewood, or to care for siblings or cousins; on whether they can afford to buy supplies, a uniform, and pay local fees; and on the safety of walking several kilometers to the school itself.
• We fly to the second city of the country, Blantyre, where we visit the main hospital of Malawi and experience our second shock of the day.
• This hospital is the place where the government of Malawi is keen to begin a treatment program for the roughly 900,000 Malawians infected with the HIV virus and currently dying of AIDS because of lack of treatment.
• The hospital has set up a walk-in clinic for people who can afford to pay the dollar a day cost of the antiretroviral combination therapy, based on Malawi’s arrangements with the Indian generic drug producer Cipla, which has pioneered the provision of low cost antiretroviral drugs to poor countries.
• At the time of our visit, this treatment site is providing anti-AIDS drugs on a daily basis to about 400 people who can afford it – 400 people in a country where 900,000 are infected. For the rest, there is essentially no access to anti-AIDS medicine.
• Democracy is bound to be fragile in an impoverished country where incomes are around 50 cents per person per day, or around $180 per person per year, and where the stresses of mass disease, famine, and climate shock are pervasive.
• Amazingly, the Malawians have done it, while the international community has largely stood by through all of this suffering.
• Malawi put together one of the earliest and best conceived strategies for bringing treatment to its dying population, and gave an enormously thoughtful response to the challenges of managing a new system of drug delivery, patient counseling and education, community outreach, and the financial flows that would accompany the process of training doctors.
• Yet the international processes are cruel. The donor governments – including the United States and Europeans – told Malawi to scale back its proposal sharply because the first proposal was “too ambitious and too costly.”
• After a long struggle, Malawi received funding to save just 25,000 at the end of five years – a death warrant from the international community for the people of this country.

Carol Bellamy of UNICEF has rightly described Malawi’s plight as the perfect storm, a storm that brings together climatic disaster, impoverishment, the AIDS pandemic, and the long-standing burdens of malaria, schistosomiasis, and other diseases. In the face of this horrific maelstrom, the world community has so far displayed a fair bit of hand-wringing and even some high-minded rhetoric, but precious little action.

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