If I asked most people about the major health problem in sub-Saharan Africa, how likely would I be to hear about soaring HIV rates in places like Malawi, Zaire, Botswana, or even--recently--South Africa?
How long has it been since some rock-star celebrity with an American flag sewn inside his jacket convinced Dubya to pony up more American dollars for HIV in Africa?
In 2006 the international community spent approximately $350 Billion on HIV/Aids, the overwhelming bulk of which was spent in the developing world (think Africa and Asia) where roughly 380,000 children under the age of 15 died from the disease.
But according to the British medical journal The Lancet, this has been a fairly substantive policy error, because what we should be spending money on is combating malnutrition during pregnancy and the first two years of a baby's life.
According to researcher Bruce Cogill, malnutrition was responsible for 2.2 million deaths of children under 5 in 2005, and in 2006 the TOTAL global spending on nutrition aid was $250 million--just 0.7% of the funds expended to combat HIV/Aids.
"If you eliminated malnutrition, you would prevent 35 per cent of child deaths globally," Cogill said, noting that 11% of the entire global disease burden results directly from early childhood malnutrition.
The Lancet's editor, Dr Robert Horton, argues that this early intervention is critical:
Moreover, additional studies in the journal showed that 80% of the world's malnourished children live in just 20 countries (which contain 67 million affected children), rendering it possible to develop a carefully targeted intervention program.
It's all so logical that I'm betting (as much as I don't want to) that it won't happen. Why?
1) HIV/Aids is "sexy" in a media sense; it sells, and there is sufficient impact of the disease in industrialized nations to help keep up the drumbeat to "find a cure" or "develop a vaccine."
2) Malnutrition, except when it's tied to genocide (like Darfur), is old news. We've all seen Sallie Struthers waddle through villages for some child-saving charity on late-night cable to become numb to it. We tend to believe that global hunger or malnutrition is a problem that could not be so easily solved.
3) Neither the UN nor the various NGOs that justify their existence by intervening in such problems have a great stake in actually seeing them ended, and they are so administratively cumbersome and corrupt that they probably couldn't complete the job if they tried.
Here's what The Lancet said about the current system of nutrition relief:
There seem to be two ways to approach this issue: statist and libertarian.
The statist solution would (obviously) be to empower one massive bureaucracy, demand huge contributions from the industrialized world, and then waste much of the money delivering a fraction of the goods through the corrupt and inefficient governments of the affected nations. You know, employ the same strategy that has so effectively wiped out HIV/Aids with that $350 Billion per annum....
What about a libertarian solution?
Just thinking out loud here, but let's start with the reasonable assumption that better nutrition, less childhood stunting, and far lower childhood mortality rates would lead to a generally healthier and more economically productive population in whatever country we're talking about....
Those healthier people constitute potential future customers (assuming global warming doesn't kill them all over the next forty years and make the point moot) for a wide variety of products marketed by (you guessed it) the industrialized world.
So what would happen if an entrepreneur came along who convinced, say, Kraft General Foods, Nestle, General Mills, and a few others in the global food business to pay him or her to develop brand consciousness among 67 million Third World children (and their parents) by delivering food and blatant product advertising into starved areas at the same time?
[Well, the first thing that would happen is that the crass entrepreneur would be pilloried by the mainstream media, but I'm conducting a fantasy here, so let me be.]
Last year, Kraft General Foods took in some $8.5 Billion world-wide, and even with a write-off of some $300-400 million to marketing and R&D, made a $702 million profit (down 30% from the previous year's $1 Billion). In that year, Kraft spend $1 Billion on media buys--or roughly four times the global expenditure on fighting childhood malnutrition.
Want to bet that Kraft could be enticed into dropping $50-75 million into a malnutrition program if it was allowed to include commercial branding materials like Kraft bibs, T-shirts, etc. etc.
General Mills in 2007 took in somewhere in the vicinity of $12 Billion, roughly one-sixth of which came from international sales. Again, want to bet against GM being unwilling to make a speculative investment of $75-100 million to develop a marketing presence in those 20 countries?
Nestle, the world's largest food company, reported that its profits, not revenue but profits, grew last year to $3.39 Billion.
Now Nestle is a controversial company--involved in controversies in the late 1970s over its baby milk formula marketing in Africa, its pet food in Latin America, its bottle water problems, and allegations that the company uses forced labor in producing chocolate.
But a controversial company is one that is in the most need of building brand loyalty, and the sort of program I'm suggesting would allow Nestle to donate, say, $150 million (plus marketing materials) to my hypothetical third-party entrepreneur, who would be able to sell the giant company as rehabilitating its image.
Here's the point: a profit motive could be used to develop a resource base very quickly that would be able to expend far more than the insignificant $250 million that the UN and all the NGOs now piffle away on childhood malnutrition.
But again, it won't happen, because the outcry would be that these mercenary companies were victimizing these babies by brainwashing them to buy their products. Worse, the idea that my hypothetical entrepreneur might actually get rich off this business (call it "Feed the World's Children, Inc.") would cause diplomats and world leaders to step in with indignation (and hands out).
Oh well. For a moment it all seemed possible.
The reality is that governments, international organizations, and non-governmental organizations simply are not set up to mobilize and deliver a program to end childhood malnutrition because that might mean overtly employing the profit motive.
They'd rather line the pockets of Kofi Annan's son, as with the Oil for Food program in Iraq.
How long has it been since some rock-star celebrity with an American flag sewn inside his jacket convinced Dubya to pony up more American dollars for HIV in Africa?
In 2006 the international community spent approximately $350 Billion on HIV/Aids, the overwhelming bulk of which was spent in the developing world (think Africa and Asia) where roughly 380,000 children under the age of 15 died from the disease.
But according to the British medical journal The Lancet, this has been a fairly substantive policy error, because what we should be spending money on is combating malnutrition during pregnancy and the first two years of a baby's life.
According to researcher Bruce Cogill, malnutrition was responsible for 2.2 million deaths of children under 5 in 2005, and in 2006 the TOTAL global spending on nutrition aid was $250 million--just 0.7% of the funds expended to combat HIV/Aids.
"If you eliminated malnutrition, you would prevent 35 per cent of child deaths globally," Cogill said, noting that 11% of the entire global disease burden results directly from early childhood malnutrition.
The Lancet's editor, Dr Robert Horton, argues that this early intervention is critical:
"Undernutrition is the largely preventable cause of over a third - 3.5 million - of all child deaths. Stunting, severe waste wasting and intrauterine growth restriction are among the most important problems. There is a golden interval for intervention: from pregnancy to 2 years of age. After age 2 years, undernutrition will have caused irreversible damage for future development towards adulthood."
Moreover, additional studies in the journal showed that 80% of the world's malnourished children live in just 20 countries (which contain 67 million affected children), rendering it possible to develop a carefully targeted intervention program.
It's all so logical that I'm betting (as much as I don't want to) that it won't happen. Why?
1) HIV/Aids is "sexy" in a media sense; it sells, and there is sufficient impact of the disease in industrialized nations to help keep up the drumbeat to "find a cure" or "develop a vaccine."
2) Malnutrition, except when it's tied to genocide (like Darfur), is old news. We've all seen Sallie Struthers waddle through villages for some child-saving charity on late-night cable to become numb to it. We tend to believe that global hunger or malnutrition is a problem that could not be so easily solved.
3) Neither the UN nor the various NGOs that justify their existence by intervening in such problems have a great stake in actually seeing them ended, and they are so administratively cumbersome and corrupt that they probably couldn't complete the job if they tried.
Here's what The Lancet said about the current system of nutrition relief:
The final paper in the series states that the international nutrition system - made up of international and donor organisations, academia, civil society, and the private sector - is fragmented and dysfunctional, and needs reform, say authors of the fifth and final paper in the series. They say: "Financial, intellectual, and personal linkages bind these organisations loosely together as components of an international nutrition system... we argue that such a system should deliver in four functional areas: stewardship, mobilisation of financial resources, direct provision of nutrition services at times of natural disaster or conflict, and human and institutional resource strengthening." Their analysis of evidence to date finds that currently, there are substantial shortcomings in each of the areas above. Fragmentation, lack of evidence for prioritised action, institutional inertia, and failure to join up with promising developments in parallel sectors are recurrent themes. Many problems are systemic within organisations in the field.
There seem to be two ways to approach this issue: statist and libertarian.
The statist solution would (obviously) be to empower one massive bureaucracy, demand huge contributions from the industrialized world, and then waste much of the money delivering a fraction of the goods through the corrupt and inefficient governments of the affected nations. You know, employ the same strategy that has so effectively wiped out HIV/Aids with that $350 Billion per annum....
What about a libertarian solution?
Just thinking out loud here, but let's start with the reasonable assumption that better nutrition, less childhood stunting, and far lower childhood mortality rates would lead to a generally healthier and more economically productive population in whatever country we're talking about....
Those healthier people constitute potential future customers (assuming global warming doesn't kill them all over the next forty years and make the point moot) for a wide variety of products marketed by (you guessed it) the industrialized world.
So what would happen if an entrepreneur came along who convinced, say, Kraft General Foods, Nestle, General Mills, and a few others in the global food business to pay him or her to develop brand consciousness among 67 million Third World children (and their parents) by delivering food and blatant product advertising into starved areas at the same time?
[Well, the first thing that would happen is that the crass entrepreneur would be pilloried by the mainstream media, but I'm conducting a fantasy here, so let me be.]
Last year, Kraft General Foods took in some $8.5 Billion world-wide, and even with a write-off of some $300-400 million to marketing and R&D, made a $702 million profit (down 30% from the previous year's $1 Billion). In that year, Kraft spend $1 Billion on media buys--or roughly four times the global expenditure on fighting childhood malnutrition.
Want to bet that Kraft could be enticed into dropping $50-75 million into a malnutrition program if it was allowed to include commercial branding materials like Kraft bibs, T-shirts, etc. etc.
General Mills in 2007 took in somewhere in the vicinity of $12 Billion, roughly one-sixth of which came from international sales. Again, want to bet against GM being unwilling to make a speculative investment of $75-100 million to develop a marketing presence in those 20 countries?
Nestle, the world's largest food company, reported that its profits, not revenue but profits, grew last year to $3.39 Billion.
Now Nestle is a controversial company--involved in controversies in the late 1970s over its baby milk formula marketing in Africa, its pet food in Latin America, its bottle water problems, and allegations that the company uses forced labor in producing chocolate.
But a controversial company is one that is in the most need of building brand loyalty, and the sort of program I'm suggesting would allow Nestle to donate, say, $150 million (plus marketing materials) to my hypothetical third-party entrepreneur, who would be able to sell the giant company as rehabilitating its image.
Here's the point: a profit motive could be used to develop a resource base very quickly that would be able to expend far more than the insignificant $250 million that the UN and all the NGOs now piffle away on childhood malnutrition.
But again, it won't happen, because the outcry would be that these mercenary companies were victimizing these babies by brainwashing them to buy their products. Worse, the idea that my hypothetical entrepreneur might actually get rich off this business (call it "Feed the World's Children, Inc.") would cause diplomats and world leaders to step in with indignation (and hands out).
Oh well. For a moment it all seemed possible.
The reality is that governments, international organizations, and non-governmental organizations simply are not set up to mobilize and deliver a program to end childhood malnutrition because that might mean overtly employing the profit motive.
They'd rather line the pockets of Kofi Annan's son, as with the Oil for Food program in Iraq.
Comments
There's one working model.
Project(Red).. there's two.
Seems to be all the rage, I don't see why it can't be done.
(it's raspberry too, a scent I love, but the wife doesn't necessarily like)