DEALING with all the world鈥檚 woes should be simple. We should win the war against hunger, end conflicts, stop communicable diseases, provide clean drinking water, step up education and halt climate change. But we don鈥檛. Over 30 years ago, the UN called on the developed nations to double the percentage of money they were spending on overseas development aid, but the sad fact is that the developed world now spends a smaller percentage of its wealth on overseas aid than it did in 1970.
Some seem to believe that this merely shows that we should redouble our efforts to get the international community to increase its funding. I applaud this effort, and think it is necessary to keep up the political pressure. But I also think we need to be realistic and admit that we will not be getting close to doing all the right things anytime soon.
If this is true, we have got to start asking the hard question: if we don鈥檛 do it all, what should we do first? We live in a world with limited resources. That means we have a moral obligation to spend each dollar doing the most good that we possibly can. We need to start talking about prioritisation.
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Surprisingly, such an explicit economic prioritisation has not been done before. Why? Prioritisation is seen as bad, because whenever we prioritise we not only say where we should do more (which is good) but also where we should not at first increase our efforts (which is seen to be cynical). This view puzzles me; not talking about priorities does not make problems go away, they only become less clear, less democratic, and less efficient. Refusing to prioritise, and dealing instead mainly with the problems with the most buzz is wrong. Imagine doctors at a perpetually overstretched hospital refusing to perform triage on casualties, merely attending patients as they arrived, fast-tracking those whose families made the most fuss. Not prioritising is unjust, wastes resources and costs lives.
I often get asked what my own list of priorities looks like. My answer is not a list but a procedure. Get the top economists on each global challenge to identify the very best solutions, write overviews of all the economic models of their costs and benefits, and have a stellar team of general economists use the cost-benefit analyses to prioritise the different solutions. This is what happened in the Copenhagen Consensus earlier this year, where 30 specialist economists joined forces with eight of the world鈥檚 top economists 鈥� including three Nobel laureates 鈥� to make a global priority list of how best to spend $50 billion.
The top priority is to prevent HIV infection. A comprehensive programme would cost $27 billion. Yet, the social benefits would be immense: such a programme would avoid more than 28 million new cases of HIV infection by 2010. This makes it the best investment the world could possibly make, reaping benefits that outweigh the costs by 40 to 1. Similarly, providing the micronutrients missing from more than half the world鈥檚 diet would reduce diseases caused by deficiencies of iron, zinc, iodine and vitamin A with an exceptionally high ratio of benefits to cost. If we could only find the political will, establishing free trade could be achieved at a very low cost, with benefits of up to $2400 billion a year, about half of which would accrue to developing countries. Mosquito nets and effective medication for malaria could halve the incidence of the disease. It would cost $13 billion but create benefits at least five times that. Next on the list are agricultural technologies to tackle hunger and water technologies to handle food production and the lack of clean drinking water and sanitation.
鈥淭he urgent problem of the poor majority of this world is not climate change鈥�
If the Copenhagen Consensus showed us what we should be doing, it also showed what we shouldn鈥檛 be dealing with right now. The experts rated responses to climate change extremely low on the 鈥渢o do鈥� list. In fact, the panel called these ventures 鈥� including the Kyoto protocol 鈥� 鈥渂ad projects鈥� simply because they cost more than the good they would do. Again, this does not mean that we should ignore climate change. We should, for example, be looking at the right mix of incentives and regulations to encourage investment in promising new renewable energy technologies. But when we have scarce resources we have to ask ourselves: do we want to do a lot of good now, or little good much later? We need to ask if we can do more for the developing world by investing differently.
The urgent problem of the poor majority of this world is not climate change. Their problems are truly very basic. We can prevent HIV by handing out condoms and improving health education. We can prevent millions dying from malnutrition by giving them simple vitamin supplements. These are not space-age technologies, but simple necessities. The message from the Copenhagen Consensus is that it is possible to solve some of the most serious challenges the world faces. To do so is not only morally urgent; it is also a very good investment.