Global Policy Forum

By Richard Horton

Global poverty is the most important foreign policy issue of our time--or, at any rate, it should be. And indeed there are signs that the sheer unrelenting grinding deprivation that keeps 1.1 billion people living on less than $1 a day is capturing the attention of many politicians for whom realpolitik has usually ruled out the interests of the poor.

Economists have long argued about how to advance development for the least advantaged. But in 2000, 147 heads of state translated their rhetoric into commitment, coming together under the leadership of UN Secretary General Kofi Annan to sign on to eight Millennium Development Goals (MDGs), from halving poverty to achieving universal primary education, all to be achieved by 2015. And poverty reduction was at the top of the agenda as finance ministers from the G-7 nations convened in London on Friday.

There is only a decade to go, but at the moment the MDGs look ludicrously optimistic. As Gordon Brown, Britain's chancellor of the exchequer and a passionate advocate for human development, declared last month at a meeting of African finance ministers in South Africa, the world is lagging as much as 100 years behind schedule. At present rates of progress poverty in Africa would not be halved until 2150, universal primary education would not be achieved until 2130, and avoidable infant deaths would not be eliminated until 2165.

Some see a chance for a turnaround. Last month Jeffrey Sachs, the Bono of development economics, presented the final report of his Millennium Project, which Annan had charged with mapping out a strategy to meet the MDGs. While many of his economist colleagues prefer to be gloomy about prospects for the poor, Sachs remains unassailably positive. Despite massive obstacles and perilous setbacks, he concludes, the MDGs remain achievable. The world knows what to do. It is simply a matter of political will--and more money.

Superficially, Sachs seems to be right. Lack of money is preventing antibiotics from reaching children with pneumonia, teachers from being trained, food from being grown and harvested, vaccines from being distributed, insecticide-treated bed nets from being used to protect against malaria, and drugs from being made available to treat tuberculosis and HIV-AIDS. While they gave generously after the recent tsunami struck, governments have been reluctant to honor their word to those living under conditions of chronic scarcity.

At the UN's development conference in Monterrey, Mexico, in 2002, donor countries pledged to give 0.7 percent of their total national income to overseas aid. But today the average aid to poor countries is still only 0.25 percent of national income. (In the United States, the figure is .14 percent.) The difference between promise and reality is $130 billion annually--easily enough, according to Sachs, to cut poverty by half.

There are also appalling differences in progress among developing countries, throwing the differences between rich and poor into even starker contrast. Sub-Saharan Africa in particular endures crippling levels of child and maternal mortality, infectious epidemics, and environmental destruction. Meanwhile, many African nations are trapped in an endless cycle--as poverty yields low or no taxes, lack of income prevents governments from investing in public health and other services, a sick workforce further disables the economy, and the cycle continues. Sachs sees many opportunities for ''quick wins.'' Training highly paid doctors and nurses will take too long. Instead, why not train village workers in the rudimentary principles of health? Do the same for farming and schools. Start distributing drugs now to treat tuberculosis, malaria, and AIDS rather than waiting for painfully negotiated agreements between government and industry. Stop the damaging disincentive of charging fees for health services. Make those services free and pay for them, at least partly, out of increased aid dollars.

The almost 300 economists, engineers, medical personnel, and other specialists who took part in the Millennium Project argue that if such policies are put in place, the lives of more than 2 million mothers and 20 million children will be saved by 2015--which would meet the goal embraced five years ago. These are staggering figures well within our reach. It is hard to disagree with Sachs when he says that a mixture of courage and compassion is all that we need to make this happen.