Mr. Sachs loses AIDS debate to Mr. Budget Constraint
The World Bank hosted a debate (click on the above screen shot to get to the link for the whole webcast) on the proposition:
Continued AIDS investments by donors and governments is a sound investment, even in a resource-constrained environment.
Jeffrey Sachs and Michel Sidibé (head of UNAIDS) argued in favor, and Mead Over and Roger England argued against. There was a show of hands of the audience pro and con before and after. As Mead Over reports, nobody was surprised that a vast majority was pro before the debate; the surprise was that a substantial minority changed their minds to con after the debate.
Mead Over has written a post summarizing the debate, paraphrasing in his words each participant’s argument (see the video linked above if you want the exact words of each). Here is Mr. Sachs:
Jeff Sachs: This debate is a sham, because resources are not really scarce. With financial transactions taxes and higher taxes on the rich we would have more than enough money to address all the health problems of the world.
Mead Over and Roger England argued that, in the real world, alas, there really is a budget constraint on health and on everything else.
The cost of pretending this budget constraint does not exist, they argued, is that the lives saved by increasing AIDS spending cause many more lives to be lost when AIDS crowds out more cost-effective health interventions.
…Sounds like Mr. Budget Constraint did win the debate.
Sure, there are trade-offs in the World of aid. But Sachs is clearly also right, as a proportion of GNI developed country aid budgets are puny. We could give a lot more. And by doing this ease those trade-offs a little.
Why don’t we give more aid?
There are lots of reasons, but one of them is surely the small armada of professional aid sceptics like Dambisa Moyo and William Easterly (at least in polemic mode) who argue the case against aid. Sure, there are also times when Easterly, including in this blog post, points out that some aid can work, but the overarching tone in his polemic work at least is that: donors are venal, aid doesn’t work, and that markets are enough.
These are comforting words to readers of the Wall Street journal, and to organisations funding the Development Research Institute like the Earhart Foundation, the Thomas W, Smith Foundation, the Searle Freedom Trust, the John Templeton Foundation. But they are also words that help the cause of those who prefer for ideological reasons that we give less aid rather than more. And because of this, they are words which play a role in constraining possible future aid increases.
And this is, in turn, helps perpetuate the ugly world of aid trade-offs, where we have to decide whether to try and save the life of someone with aids, or someone with Malaria.
To be clear I’m not saying Professor Easterly is a Bad Person, I agree with some of what he writes (a great example of Easterly supporting a good cause is here), and find his academic work useful. I also think the world of aid needs critique.
But this critique needs to be good faith rather than bad faith, and thoughtful rather than polemic. Otherwise, you just end up with less aid rather than better aid.
When Mr Budget Constraint wins he kills people, and if I were Professor Easterly I would not chuckle about this.