Wednesday, 29 May 2013

There are better things for Bill Gates to spend his money and time on

Joseph Lyons (pic) was Australia's prime minister in 1938, the year, as it happens, of the Anschluss - when Hitler declared unification of Austria with Nazi Germany. Lyons is the only Aussie PM to hail from Tasmania. The king at the time was George VI (the 2010 movie The King's Speech is about him) who had come to the throne because his brother, Edward, had decided to run off and marry an American, Wallis Simpson. 1938 was also the year when the last case of smallpox was recorded in Australia. Smallpox appeared for the last time in 1977, in Somalia.

What's this all got to do with Bill Gates? Well, Gates has been in the news here since his visit to meet with the prime minister, Julia Gillard, in Canberra yesterday. Gates is using his foundation to work to eradicate polio, and he spoke about how Australia can spend more on overseas aid.
''Australia has the lowest debt, or close to the lowest, of any rich country," [Gates said,] "and the lowest deficit of any country I can think of. This country has more connections through trade with developing countries than any other country on the planet. The idea that you can take 0.5 per cent [of gross national income] for the world's poorest seems quite reasonable.''
There is a lot of support online for Bill Gates because of his philanthropy but I think that he is wasting his time and money. That's not to say that the eradication of polio - which is largely confined to three countries: Nigeria, Pakistan and Afghanistan - should not be a priority. It should be; there is no point in tolerating the suffering of people from preventable disease in any country. But as the case of Australia illustrates with regard to smallpox, there is no reason why those countries cannot do the job themselves, given the right circumstances. Which gets me to my point.

What Bill Gates should be doing with his money is working to strengthen governance in countries in the world where diseases such as polio continue to exist. Polio is not the problem but rather is merely a symptom of other, larger, problems. Polio is spread not only through human-to-human contact but also through contact with the faeces of an infected person, meaning that it is likely to spread where sanitation is poor. Poor sanitation is a problem of government, because such services are usually publicly-funded. But in many countries the quality of government means that construction of sanitation does not keep up with population growth, especially in cities where large numbers of poor people congregate, living in substandard conditions. While polio can be tamed by immunising children it is more important to ensure that all residents in affected countries are provided with good sanitation as this will help to remove other health threats at the same time, and contribute substantially to quality-of-life.

Poor sanitation is in most cases also a symptom: of the larger problem of poor governance. The most deleterious disease in developing countries like Pakistan and Nigeria is official corruption. Not only does it prevent good sanitation facilities from being constructed because money is stolen for personal gain, it also accelerates the spread of radical ideas that form the basis for civil conflict, exacerbating the problem of provision of essential services such as good sanitation. When a government is spending all its time and money fighting religious radicals it is less able to spend do what it is supposed to do.

In 1938 when smallpox last appeared in Australia the country had been a sovereign nation for 37 years, and was notably free of corruption. It had a strong civil society, solid institutions, and an educated electorate that was served by a free and public education system. Under such conditions it was possible to eradicate smallpox, a terrible disease. Polio continued to appear in epidemics even through the 1950s until the polio vaccine invented by the American researcher Jonas Salk appeared in the middle of that decade. And the case of Salk is also relevant because he grew up also in a country with strong civil society, largely free of corruption, and benefited from a competent education system.

If Bill Gates wants to really make an impact on countries where diseases like polio are still prevalent he should be trying to strengthen governance, improve public education (especially of girls), eradicate corruption, support a free and independent media, and buttress civil institutions there. These are the real building blocks of disease-free cities, and in addition to working against common and preventable diseases they can also work to promote many other benefits, such as respect for human rights (especially of women), tolerance of difference, and the loss of the appeal of radical ideas. If Bill Gates wants Pakistan or Nigeria to become like Australia, these are the things he should be trying to fix because they are at the root of the symptoms he is currently spending his time, money and energy to remove.


Keren Lavelle said...

An interesting argument, Matt. But one person's system of governance may be another person's alien, imposed, not terribly functional system. Whereas to wipe out a disease is a distinct possibility, as in the case of smallpox.

Matthew da Silva said...

My approach includes the belief (yes! I believe in it!) in various inalienable and universal human rights. I know this is old-school and slightly cheese-eating but there you go. The fact is that people are wealthier, happier and healthier in countries that have a secular, liberal government. If some people find that prospect revolting, they're going to have to put up with all the downsides the alternatives always offer.