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Friday, June 16

Repeat after me: The US Department of State is not a triage desk, the US military is not the maid

REDMOND, Washington (June 15 - Reuters) - Microsoft Corp. Chairman Bill Gates said Thursday he will gradually give up his day-to-day duties at the company to concentrate on the charitable work of the Bill & Melinda Gates Foundation.
Pundita opened the comment section for On the Road to Perdition with Bill Gates, Dean Kamen and Jeffrey Sachs. I did so with the intention of saving myself time but it cost more time than my usual routine of answering/publishing emails in response to posts.

Now that I have registered my grumbles about the comment section, which I will continue to leave open for the time being, here are some reader observations that didn’t make it into the comment section and two that did but which I want to highlight in this post:

“Okay, I'll buy that disease-eradicating, profit-generating businesses won't eliminate poverty or reform government. But, won't they at least reduce disease and spur business investment, thus improving people's lives? And, if nothing else, if Gates fails spectacularly, won't he at least learn his lesson so that people realize wisdom, not money or technology, is what we really need?”
Dr. Ernie

Pundita replies:
A reminder: Pundita strays, but this is supposed to be a foreign policy blog; I look at development and foreign aid issues from that angle. But yes, Dean Kamen’s entrepreneurial approach, which I discussed in the March 29 post, will spur business investment. As to whether solutions posed by Gates, Kamen, and Sachs will “reduce” diseases such as malaria remains to be seen.

Yet this is a situation where success can be far worse than failure unless there is massive coordination between many international agencies and governments, massive infusions of aid money, and possibly military intervention. Here’s why:

Imagine Bill Gates gets his wish and a successful malaria vaccine is developed. Then Gates’ foundation teams with other transnational charities and WHO to launch a massive vaccination program across Africa. Success: malaria eradicated in wide swaths of Africa.

Here we come to a snag. Eradicating the disease means a spike in the inoculated population. Now overlay that situation on regions in Africa where there is water scarcity, food scarcity, and firewood (cooking fuel) scarcity.

Then project 3-5 years when the spike in population will place strains on health care and social systems already breaking or broken: sewage and water treatment facilities, hospitals, police forces, etc.

From the viewpoint of foreign policy (and US national security) the issue is one of accountability. As with George Soros, Bill Gates is carrying out foreign aid on a large scale. Yet he is a private citizen acting 'without portfolio' in areas that impact US foreign policy in many directions. When he screws up he can't be hauled before a military tribunal, a congressional inquiry, or an internal review at State.

Are Mr. Gates’ foundation and the United Nations able to deal with the situations that would arise from the scenario I’ve sketched? If not, First World governments would find themselves under pressure to avert calamity. Even if military action could be avoided you don’t want to think about the triage decisions that would have to be made. So it’s not for nothing that I titled the essay under discussion “On the road to perdition…”

Not surprisingly, Andrew Mwenda, the Ugandan journalist that Dave Schuler links to in his comment, also alludes to the hellish aspect of brainless foreign aid schemes applied to Africa. I have published Mwenda’s comments at the end of this post.(1)

And here is a link to a Wikipedia article about Mwenda; the Ugandan government’s attacks on him are a good introduction to his comments about foreign aid follies.

Now for Dymphna’s comments, which were also languishing in the comment section:

“Isn't it an interesting aspect of human nature that just because we do one thing extremely, fantastically well -- like, say, build a computer empire or perhaps act in films -- it somehow makes us a global expert?

Malarial countries need DDT and they've needed it for years. Now that we've eradicated *our* problem, we can safely ban it. Unless, of course, the Nile virus becomes endemic here. Then maybe everyone will once again be entitled to DDT.

How come these financial geniuses haven't studied success stories like Grameen? I'd love to see you explain Grameen...my favorite foreign charity. Actually, my only one.”

Pundita replies:
I haven’t studied Grameen’s charities. But for readers who are not familiar with the microinvesting concept pioneered by Grameen Bank, I mentioned it in the March 29 post (“Dean Kamen vs. the World Bank…”) and provided a link to the bank’s website:

Your comment about DDT is on target. There are sound approaches to fighting malaria-carrying mosquitoes that the vaccine approach ignores. Amazingly, one approach is a cell phone signal that repels mosquitos! – See the July 12 Pundita essay, Fire up the cell phone, gather round the radio: Not by any one way does democracy come to the rural developing world.

Yet as I noted in my reply to Dr. Ernie it’s actually success that is the greatest threat with disease eradication among impoverished populations. From this viewpoint the quality of the solution is not as important as the context in which it arises.

Whether good or bad, actions that impact millions of people within a short time have profound consequences. That’s a lesson the World Bank learned the hard way.

If Gates and his ‘New Giving’ circle think they can make a dent where the World Bank and USAID have failed, Pundita has no objection to honest efforts. Yet I strenuously object to plans that don’t deal with the starkest consequences of disease eradication in regions where critical resources are already strained to the breaking point.

Now for comments from Beth:

”I've often wished I had the brain and education to tackle "global" problems. I don't think that I do. But I also don't think these men do either.

"Disease leads to poverty, and poverty deepens disease. But the good news is that where health takes hold, women choose to have fewer children; and literacy, equality, the environment, and economic opportunity all improve. When health improves, life improves – by all measures." [1]

What's cause and effect in all of that mess? Does [Bill Gates] have any idea? Is he really saying that lowering birth rates will solve all the problems? If health and poverty and fewer children are all tied together – then isn't the simplest solution to start paying all those poor women to not have children just like we've paid all the farmers to not grow crops?
Beth Mauldin

Pundita replies:
Bill Gates applied a secularized, monogamous, First World behavior model to women in Third World African nations (Christian and Muslim) who are in a polygamous marriage. From that he somehow concluded such women would choose to have fewer children once infectious killer diseases are eradicated.

But in Africa the Christians and Muslim leaders are in a numbers battle and so both promote multiple births in families. Both have shown cowardice when it comes to standing up to demands by practitioners who want to take multiple wives. The leaders, if they can be called that, pander to males who are serial divorcers as the means to circumvent the four-wife limit in Islam and the call for monogamy in Christianity.

Let us hope Mr. Gates’ reasoning will improve once he turns more of his attention to his charitable enterprises. Correction: Let us pray.

1) "The road to hell is always paved with good intentions. The calls by Sachs, Bono and Geldof fall into that category. First, their calls for more aid assume -- and wrongly so – that the primary problem in Africa is lack of a resource base to generate revenue to invest in what the World Bank prefers to call 'poverty reducing expenditure areas' – free primary education, basic health care and infrastructure like roads. Of course these are good for the poor, but they are not poverty reducing. At best, they can be welfare improving. The primary problem for Africa is one of governance. The poor in Africa do not have basic social services because they are ruled by repressive, corrupt and incompetent governments. These governments spend millions of dollars annually on their corrupt and ineffective militaries, on ostentatious consumption by the political class, and on obese, profligate and highly incompetent bureaucracies. The institutions are very corrupt and incompetent that they stifle both domestic entrepreneurial initiative and frustrate foreign direct investment. These actions are not sustainable in the long term, of course, as these governments eat away the very economic foundation of their political survival. Foreign aid is the subsidy governments in Africa employ to avoid facing the consequences of their own folly. Without aid, many governments in Africa would stare regime collapse in the eye. Some would be stupid, retain the old ways and collapse. But many would be forced to reform their monetary and fiscal policies, to be frugal and prudent, to put in place public policies and political institutions that favor rapid economic growth and capital accumulation. They would have to listen more to their own people and foreign investors in policy making and policy orientation. In short, they would be forced to establish good, effective, accountable and democratic governments. Good and accountable government is not a product of altruism, but enlightened self-interest. Sachs, Bono, Geldof, Tony Blair – and all the many good but naive people of the West – need to learn that simple, commonsense logic."Andrew Mwenda, Ugandan libertarian radio and print journalist

2) Quote from Gates’ 2002 UN luncheon speech.
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