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A Practical Plan to End Poverty

By Jeffrey D. Sachs
Monday, January 17, 2005; Page A17

Americans know a good deal when they see it. Today a group of leading scientists and practitioners from several fields -- agriculture, medicine, economics, education, engineering -- is making a proposal to the world. If rich and poor countries will follow through on the promises they have made over the past five years to fight extreme poverty and disease -- and rely on the best science and technology in doing so -- the world can save millions of lives and extricate hundreds of millions of its poorest people from the trap of extreme poverty. The cost is a mere 50 cents out of every $100 of rich-world income in the coming decade.

The point is simple. Consider malaria, a silent tsunami whose devastation washes over Africa at a proportion that dwarfs the recent Indian Ocean tsunami. Each month more than 150,000 African children die of malaria; that's about the death toll of the Asian disaster. Yet those deaths do not sear the public's mind. Off camera, they are largely unknown. On top of the tragedy and vast economic cost, they contribute to the continent's population explosion, as impoverished Africans have large families to counter the ever-present threat.

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The shocker is that malaria, unlike an Indian Ocean earthquake, is largely preventable and utterly treatable. There is no excuse for the millions of malaria deaths that will occur this year. A $5 dollar mosquito bed net specially treated with insecticide, used widely throughout rural Africa, could dramatically lower the rate of malaria illness and death. Effective medicines, at roughly $1 per dose, could treat the cases that slip by the bed nets. Yet Africa's poverty is so extreme that rural farm families know about the bed nets and the medicines -- and long for them -- but can't afford the few dollars they would cost.

Today's report of the Millennium Project, an independent advisory group to the United Nations, shows that just $2 to $3 per American and other citizens of the rich world would be needed each year to mount an effective fight against malaria. The rich world's actual spending to fight malaria is closer to 20 cents per person per year.

The report, "Investing in Development," doesn't stop at malaria, though controlling it might be the greatest bargain on the planet. The project's scientists show how special "fertilizer trees" could replenish Africa's soil nutrients and lead to a doubling or tripling of food crop yields in just a few years, enabling farmers to grow more food more reliably and break free of famine. Using these and other cost-effective modern tools, Africa could have its own "green revolution," as Asia did some decades ago. As in Asia, food security in Africa would be a prelude to sustained economic growth.

The study documents how emergency obstetrical care could be provided at local clinics even in impoverished settings, saving hundreds of thousands of mothers who will die in childbirth this year because of obstructed labor and other complications. The project similarly documents how the introduction of low-cost, nutritionally balanced school meals, using locally produced foods, could improve the health, nutrition, school attendance and performance of more than 100 million children in the world's poorest countries.

Taken together, these and similar steps would change the face of extreme poverty -- indeed, put the world on a path to eliminate it in this generation. Yet these steps are not taken. The United States and most other donor countries don't give even 50 cents out of every hundred dollars of income to these causes, in public or in private contributions. The actual amounts are closer to 20 cents per hundred dollars, and they are not well targeted on the basic investments to end poverty.

Why don't we invest more? The reason is not stinginess but the lack of recognition of what we could accomplish if we really put our minds to it. Americans think that we give much more than we do. They also believe, erroneously, that corruption in poor countries blocks effective use of aid, even though dozens of impoverished countries are rather well governed yet still starved of help.

The outpouring of grief and generosity after Asia's disaster shows that Americans are ready -- even yearning -- to contribute to save lives and livelihoods. Here are three steps for an American response to today's report:

First, the president, with Republican and Democratic leaders of Congress, should call upon all of us to act to combat the silent tsunamis such as malaria, hunger, maternal mortality and extreme poverty that grip Africa and other impoverished regions, including parts of our own hemisphere. They should endorse the report's "practical plan" to combat these horrendous but ultimately solvable scourges.

Second, just as the White House and Congress finally did with Africa's AIDS pandemic, our leaders should do the arithmetic properly. Instead of symbolic and underfunded programs to fight extreme poverty in Africa and elsewhere, they should calculate and put before the American people the amounts that are truly needed. Today's study precisely shows that the financial conclusions are not frightening: just one-half percent of our annual income. At around $60 billion total from the United States, this is a tiny fraction of, say, our annual military spending, now around $450 billion, and a vital investment in our national security.

Third, the president should call on Americans to get involved, as he did with AIDS in 2003 and with the tsunami last month. The upcoming State of the Union address is the place to start. The president should lead our great nation to use our wealth and technology to help conquer the scourges of malaria and hunger that grip hundreds of millions of our impoverished brethren around the world. We all know that unaddressed suffering adds greatly to instability and insecurity throughout the world. Americans yearn to act.

The writer leads the U.N. Millennium Project and is director of the Earth Institute at Columbia University.

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