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As the income gap between developed and developing nations grows, so grows the cacophony of voices claiming that the quest to find a simple recipe for economic growth has failed. Getting Better, in sharp contrast, reports the good news about global progress. Economist Charles Kenny argues against development naysayers by pointing to the evidence of widespread improvements in health, education, peace, liberty — and even happiness.

Kenny shows how the spread of cheap technologies, such as vaccines and bed nets, and ideas, such as political rights, has transformed the world. He also shows that by understanding this transformation, we can make the world an even better place to live.

That’s not to say that life is grand for everyone, or that we don’t have a long way to go. But improvements have spread far, and, according to Kenny, they can spread even further.

To Alex and Julia

PROLOGUE

An infant wakes up in an African village and whimpers for the breast. His mother reaches through the mosquito netting and lifts him onto her chest. He is slightly feverish from the injections he had the day before—still, better that than a case of measles. His elder sister runs in after a visit to the pit latrine, singing her ABCs as she washes her hands. She gobbles down some corn meal porridge while her mother pours water from the disinfectant jug. The little girl, already dressed in her school uniform, puts on her shoes, grabs her pen and exercise book, and trips off down the gravel road to school, leaving mother and baby with only the sounds of static and a radio announcer reading the news.

This is a wholly undramatic story—yet startling and beautiful in its own right. Similar tales of drama-free mornings are repeated countless times across the region every day. Nobody gets sick, nobody gets shot, and nobody dies. Kids go off to school, and parents to work. They return to food on the table and a peaceful night. Its beauty is in its banality, a sign of the considerable progress that African countries have made in extending a basic quality of life to ever more people. This book is about that progress in Africa and around the world, what has caused it, and how we can keep it going.

Despite counterclaims and hand wringing, things are getting better, everywhere. Rich countries may be getting richer faster than poor countries, and we may be unsure how to improve that situation, but poor countries and poor people aren't stuck in the nightmare of an ever-growing and unsupportable population, living on bare subsistence. Instead, those countries with the lowest quality of life are making the fastest progress in improving it—across a range of measures including health, education, and civil and political liberties. The progress is the result of the global spread of technologies and ideas—technologies like vaccinations, and ideas like "you should send your daughter to school." And Third World governments, alongside aid agencies and nonprofits, have played a vital role in extending the reach of these technologies and ideas.

All of this is not to deny continued deprivation and suffering worldwide, alongside considerable waste, incompetence, and corruption in government and assistance programs alike. But all of the progress that we have seen is a sign that things can get better, and that we have some considerable capacity to make them better. This, surely, is the best motivation to try even harder to overcome the deprivation and suffering that remains.

ONE

ABANDONING HOPE

In 2009, the leaders of the world's largest economies congregated in London for their summit on the recent fiscal crisis. Following well-established precedent (international summits discussing global economic coordination and financial sector reform are more hackneyed than a Miss World pageant), the participants issued a declaration that included language on the need to sustain the progress of global development even in these tough economic times. "We start from the belief that prosperity is indivisible; that growth, to be sustained, has to be shared; and that our global plan for recovery must have at its heart the needs and jobs of hard-working families, not just in developed countries but in emerging markets and the poorest countries of the world too," suggested their final communiqué, which had largely been written before the world's leaders arrived in London. Much the same could have been said decades before, familiar to the attendees of the first "Global Economic Summit" of what would become the G-8, when it was held south of Paris in 1975 to discuss exchange rates and economic coordination in the midst of an oil crisis and, once again, global recession. Or, indeed, to the attendees of London's 1933 World Economic Conference, which greeted new US President Roosevelt in high hopes that he would reverse the regulatory trends of his predecessor in the midst of that global recession.

Outside the headquarters of the 2009 summit, 35,000 protesters also followed a familiar script, chanting in support of a kaleidoscope of causes—nuclear disarmament and an end to the Iraq war, action on climate change and banking reform. And many marched to protest the inability or unwillingness of their leaders to foster global development for the world's poorest inhabitants, as they had promised. These protesters saw the latest financial crisis as further evidence of the failure of economic development. In so doing, they, too, joined a historied chorus.

A host of others, from public intellectuals to the heads of international aid organizations to commentators and politicians on both the left and the right, shared the concerns of world leaders and protesters alike. In a widely accepted version of the recent history of global development, there are two things left to argue over—who is to blame, and what to do about it. But all agree about the current state of the planet: Much of the world is a cesspool of economic stagnation, overpopulation, malnutrition, ignorance, violence, and disease.

The Right would abandon "Third World rat-holes," as US Senator Jesse Helms once called them, to their inevitable fate. The Left looks at the same failure and blames continuing Western dominance—colonialism still rampant, but carried on in a different form as the neo-imperialism of the International Monetary Fund and the World Bank. Others argue that the problem lies with poor countries' geography and natural endowments, and blame the inadequacy of donor efforts to help overcome these barriers to progress. But in all interpretations, these "causes" are the root of the same blight—an abject failure to develop across much of the Third World, a crisis of global proportions.

"Crisis" might even be a generous way to refer to the performance of African countries over the forty or so years since independence, at least according to numerous commentators. Robert Kaplan, in The Ends of the Earth, argues that Africa suffers from "new age primitivism." Oxford University's Paul Collier argues in his book The Bottom Billion that many African societies face a "fourteenth-century" reality of "civil war, plague, ignorance." Similarly, Harvard historian Niall Ferguson suggests that "[e]mpires have their faults, no doubt. But independent African governments have often been more exploitative and worse for economic growth." Ferguson goes on to argue: "Africa's problem is not a problem that aid can solve. On the contrary: aid may simply make the problem worse."¹

African economic stagnation is the big reason that Dambisa Moyo (in her best seller Dead Aid) and Bill Easterly (in his, The White Man's Burden) are skeptical about the role of aid, as well. Gregory Clark, a professor of economics at the University of California at Davis, suggests of Africa: "[T]he whole technological cornucopia of the last two hundred years [has] succeeded in producing among the lowest material living standards ever experienced. These African societies have remained trapped in the Malthusian era." His resulting view of the efficacy of aid is suggested by the title of the book from which this quote is drawn: A Farewell to Alms.²

Others, though, draw on exactly the same narrative of African failure to call for a redoubling of aid efforts. Take Jeffrey Sachs, Columbia University economist, special adviser to the United Nations secretary general, and one of the most widely cited development economists of the twenty-first century. He directs a program designed to show the feasibility of meeting the United Nation's Millennium Development Goals—an ambitious set of targets for global progress in poverty reduction, improved health and education, gender equality, and environmental sustainability—by the target date of 2015. Sachs sees more aid to Africa as central to such an effort.

But the litany of failure—and in particular, African failure—suggests that the success of development has been limited indeed. And this, surely, is a significant indictment of the government leaders, international agencies, nongovernment organizations, and businesses that should have been fostering development. In particular, it might suggest that those who despair of aid's impact have a point. The last forty-two years have seen aid transfers to developing countries worth approximately $2 trillion. That's enough to bail out American International Group ten times or so. If crisis is the only outcome, perhaps it's time to pack up the aid missions and go home.

Luckily for the developing world—and for the leaders, organizations, and businesses involved—the reality of global progress is something entirely different. While Africa and many other parts of the planet have lagged in terms of income growth, they have also seen historically unprecedented improvement in health and education, gender equality, security, and human rights. And much-maligned governments and aid agencies have played an important role in that progress. Too narrow a focus on one indicator of success—income—has blinded many to these broader advances, and that is a potential tragedy. Indeed, recognizing this broader progress is an important first step in efforts to sustain it.

Before looking at that broader progress—and how we can make the world even better—it's worth discussing what the "crisis of development" is, and at what, in particular, Africa has failed. A broad justification for a sense of failure regarding development is based on evidence regarding income growth, which many economists and those who follow their analyses take as the ne plus ultra of how to measure economic progress. In truth, evidence on income growth is not encouraging. It suggests considerable long-term divergence in incomes between rich and poor countries worldwide, and a forty-year stagnation in African incomes that has left the average sub-Saharan country little richer than it was at independence. To take but one example, Senegal had an income per capita of $1,776 at independence in 1960 and of $1,407 in 2004. The United States, in contrast, had a GDP per capita a little more than seven times larger than Senegal in 1960. By 2004, the United States was around twenty-six times richer.

This divergence in incomes over the past fifty years, reflecting slower growth in poorer countries than in wealthy ones, spreads far beyond the Sahara. It is a worldwide phenomenon, brooking only limited exceptions, which are mostly concentrated in Asia. Consider Brazil, one of the bright spots in the South American economic scene. In 1975, Brazil's income per capita was 30 percent of the United States'. By 2003, this had dropped to just above 20 percent.³

Evidence of a growing gap in global incomes—what Harvard economist Lant Pritchett calls "Divergence, Big Time"—fosters a broader sense of doom regarding development because income per capita has become the most common gauge for the overall quality of life in a country. We care about income because, worldwide, the answer to the question "Would you rather be richer or poorer" is pretty much always the same. As a character puts it in David Mamet's movie Heist, "Everybody needs money—that's why they call it money."⁴

Economists and noneconomists alike care about money because of overwhelming evidence that poorer people die younger, their children die more frequently, they lack access to education, they face higher rates of crime and violence. And while Western environmentalists may complain that more economic growth is unsustainable, and Western sociologists and psychologists may insist that there is little evidence it creates greater contentment, even these Cassandras are usually quiet on the subject of the importance of higher incomes in poor countries. Given all of that, rapid income growth is surely the holy grail of development.

From there, it is a simple step to the conclusion that, if income is diverging, so is the broad quality of life of citizens in different nations. And, in turn, that regions or countries on the wrong side of income divergence are failing at development. Based on income growth, much of the developing world's situation really does appear dire.

What is worse, we appear to have very little idea about which methods speed economic growth in poor countries. Take the East Asian Miracle of the last fifty years, for example. East Asia is the one region that has consistently upheld the promise of global convergence in income. A number of countries in that region grew significantly faster than the average for the club of rich countries that make up the Organization for Economic Cooperation and Development (OECD). GDP per capita growth rates averaged 6 percent in East Asia between 1975 and 2000, by far the best performance of any region in the world. These growth rates pulled hundreds of millions out of poverty and propelled a number of countries into high income status. South Korea, only as rich as Ghana in 1960, is now itself a member of the OECD, and Singapore is richer than Italy. This suggests the potential for rapid economic catch-up if only we could replicate the miracle.

If only.

As a result, the East Asian Miracle is a topic in numerous academic papers—over six thousand by one rough measure—and a subject of lively debate as to causes and policy pointers. The bad news is that no consensus has emerged. Those who believe that investment is fundamental to economic growth struggle against technologists over the role of capital versus ideas in East Asia's performance. Dirigistes battle free marketeers over the lessons regarding the role of the state in development. Jesus Felipe of the Asian Development Bank concluded his survey of the East Asian growth literature by arguing that "this work has become a war of figures. From the crudest calculations to the most detailed studies ... [i]t seems that re-working the data one can show almost anything." We don't have a strong conclusion about the "right" policies that promoted growth in the region or, indeed, whether policies were central to the process at all.⁵

Just as confusingly, there is little agreement about the reasons behind the "failure" of Africa. In June 1996, The Economist magazine published a piece based on results from a global statistical study concluding that had African countries only followed better policies, the region would have grown 4.6 percent per annum faster than its historical growth rate—indeed, faster than many East Asian countries. A year later, The Economist published another piece based on results from a global statistical study that concluded: "For much of the world, bad climates, poor soils and physical isolation are likely to hinder growth whatever happens to policy." This study suggested that, even if Africa had followed better policies, it would have grown 2.3 percent slower per year than the countries of South and Southeast Asia. These two articles, with their markedly different conclusions, provide an illustration of the problems facing even the best development economists—in fact, both articles were written by the aforementioned Jeffrey Sachs. In East Asia and Africa alike, we know the plot, but in East Asia, no one can agree on the hero, and in Africa we're unclear on who's the villain.⁶

This is not to indict The Economist or even Jeff Sachs—or rather, it is not to indict only them. Thousands of papers and articles attempting to divine the causes of long-term economic growth around the world, testing hundreds of possible determinants, have produced results that are just as contradictory and inconclusive.

Nonetheless, recent analyses of country wealth have increasingly emphasized the role of long-term factors. Scholars now link present-day income with influences such as the mortality rate of colonial settlers in the eighteenth and nineteenth centuries, climate, natural resource abundance, and the extent of human losses to the slave trade. A growing mound of research papers and articles reinforces the conclusion that we know much more about the histories that rich countries or poor countries share than we do about the policies that will make poor countries rich.

In short, rich countries have a higher quality of life than poor countries. Poor countries are growing slower than rich countries. Many countries—especially in Africa—are hardly growing at all. And we don't appear to know terribly much about how to speed growth in those very same countries.

How, then, could one argue against the idea that development (whatever one's definition) has failed and Africa, in particular, is a region mired in a nightmare? How, then, could one argue for the central claim of this book?

One can do so by looking beyond income and pointing to evidence of widespread success in broader elements of development. Recent food-price rises notwithstanding, the evidence for any country being stuck in a technological dark age of population explosion and miserable subsistence without hope of exit is threadbare. Indeed, technologies of increased production have spread worldwide, and looking at almost any measure of quality of life except income suggests ubiquitous improvement. The general picture is of rapid, historically unprecedented progress in quality of life—progress that has been faster in the developing world than in the developed. This is true for measures covering health, education, civil and political rights, access to infrastructure, and even beer production. Since 1960, global average infant mortality (to examine something more serious than beer production) has more than halved, for example. In 2006, nine million children who would have died before then if mortality rates had remained at their 1960 level, celebrated their first birthday. And the vast majority of those children lived in developing countries.⁷

This broad progress might lie behind one other indicator that seems to be going up across much of the developing world—happiness. The proportion of populations in surveyed countries who say they are happy has been rising over time in economies that have seen rapid growth as well as in economies that haven't. Smile, and more of the world than ever before will smile with you.⁸

Evidence of widespread progress in quality of life applies also to Africa. This is not to downplay the region's challenges. Only in the last few years have we seen the horror of starvation and mass murder in Southern Sudan. Rwanda failed to prevent genocide, and Congo-Zaire, Sierra Leone, and Somalia long failed to create the conditions for normal life to continue. At times Ethiopia has failed to adequately feed large parts of its population. Zimbabwe has teetered on the brink of starvation, and cholera has reemerged in the country to kill thousands. These tragedies deserve global attention and a strong response.

At the same time, the proportion of the population of sub-Saharan Africa affected by famine between 1990 and 2005 averaged less than three-tenths of a percent. The proportion who were refugees in 2005 was five-tenths of a percent. The number who died in wars between 1965 and 2001 averaged one onehundredth of a percent. These figures add up to stories of despair for many millions in Africa—but they remain stories of the small minority. For the rest, progress has been considerable. The percentage of sub-Saharan Africans who could read and write, just to offer one example, doubled between 1970 and 1999, from less than one-third to two-thirds of the adult population.⁹

There are other hints that income is not the end-all of development goals. The comparative experience of East Asia and the Middle East regarding life expectancy is a case in point. While we have seen over six thousand academic papers related to the subject of the East Asian Miracle, the "Middle East Miracle" is a topic in perhaps one academic article, where the phrase is used to describe a hoped-for future. Perhaps that's because the region turned in a particularly grim economic performance. Per capita economic growth rates averaged only about 0.5 percent between 1975 and 2000.¹⁰

But in fact the Middle East has experienced a miracle, just not one of income growth. Like most miracles—which typically deal with curing leprosy, healing the lame, raising the dead—this one involves health. When it comes to the miracle of life rather than the miracle of riches, the Middle East and North Africa lead the global pack, noticeably ahead of East Asia. Between 1962 and 2002, life expectancy in the Middle East and North Africa increased from around forty-eight years to sixty-nine.¹¹

How can we reconcile the evidence of income stagnation in many of the world's poorest countries with evidence of dramatic advances in quality of life even for people stuck in those stagnant economies? And what accounts for the comparatively weak link between growth in GDP per capita and rates of improvement in quality of life? The short answer is that the biggest success of development has not been making people richer but, rather, has been making the things that really matter—things like health and education—cheaper and more widely available. It is the invention and spread of technology and ideas that have, literally, reduced the cost of living. A considerable majority of people worldwide have benefited more in terms of quality of life from technological change and the spread of ideas than they have from income growth. Even people today who remain as poor as their parents, grandparents, and ancestors back through time have seen quality-of-life improvements that would astound their grandparents and, in many cases, would have been beyond the reach of their ancestors, however rich they might have been.

For example, probably no country in the world saw much more than 90 percent of children survive their first year of life in 1900. It did not matter how rich the parents; the state of health technology placed a significant upper limit on an infant's chance of survival. The United States saw an infant mortality rate of nearly 15 percent, despite an average income that was one of the highest in the world at the time—a little above $4,000 measured in today's dollars. In this first decade of the twenty-first century, the country with the highest recorded infant mortality in the world is Sierra Leone, whose mortality rate is only 2 percent higher than the rate in the United States a century earlier—17 percent. Yet income per person in Sierra Leone has dipped as low as $404 in the recent past, or one-tenth the level of the United States a century ago. Countries as poor and wretched as Haiti, Burma, and the Congo have infant mortality rates today that are lower than those that any country in the world achieved in 1900.

Behind progress in the quality of life even in stagnant economies lie two factors: supply and demand. First, individuals can access innovations that allow for improved goods and services at low cost—more calories or better drugs for the dollar. Take growing access to vaccines. The percentage of the world's infants vaccinated against diphtheria, pertussis (whooping cough), and tetanus—with the DPT shot—climbed from one-fifth to nearly four-fifths between 1970 and 2006.¹²

The second factor behind improved outcomes is a growing demand for these technologies and related services. People around the world are better-informed consumers than they used to be. They demand soap to wash their hands, they want schools to educate their girls, they want governments that respect their rights. Consumers have learned both the value and the practicality of such service provision. We'll see that the demand for education is a particularly important part of the story behind climbing primary enrollments. Less than half of primary-age kids were enrolled in school in 1950, but by the end of the century the figure was closer to nine out of ten. Valuing ABCs and getting shots for DPT: These are the forces behind global improvements in quality of life.

But a final element of the story behind the spread of technology and ideas is the fact that governments are doing a better job at delivering services. Worldwide, countries are far more concerned about improving the quality of life of their citizens than they were a hundred years ago. The most corrupt and inefficient of countries in Africa are still providing services of a quality and extent far in advance of any country in the world prior to the Industrial Revolution. Even though teachers are educating perhaps only half of the kids in class, and more are absent, schools are getting built and staffed. Even though health care systems are laden with half-trained staff struggling to work with looted dispensaries, people are getting vaccinated and antibiotics are widely available.

On the supply side, advances in technology have made the provision of services more straightforward. On the demand side, the advance of knowledge has made such service delivery expected. A sense of crisis in development ignores these considerable successes in extending the reach of health services, education, and other basics of quality of life to rich and poor alike. That's the focus of this book.

These advances are no cause for complacency. Infant mortality may have fallen from 12.6 percent to 7.5 percent in Ghana between 1965 and today, but it is still at levels four and a half times that achieved in Vietnam. The rate at which children finish primary school in Tanzania may have climbed from 46 percent to 56 percent between 1990 and 2005, but 44 percent of children don't have a full primary education. We can do better.

Nonetheless, the success of development in the past is all the more reason to believe that we can improve outcomes in the future. Africa is not an insoluble mess, a thousand-piece Jackson Pollock jigsaw with the edge pieces missing. It has chalked up some dramatic gains. And if it has done so before, it can do so again. Recognizing the success that the world has already experienced gives us some grounds for believing that future development programs won't go to waste.

And a leading role for technology and ideas is not to declare the irrelevance of income growth. No one should argue that countries where a considerable percentage of the population live on less than a dollar or two a day don't need economic growth. At the same time, an excess focus on income obscures the fact that for people living in the poorest countries today, the forces that have driven significant improvements in quality of life are technological change and the progress of ideas, not income. This is especially good news because, as we'll see in greater detail in later chapters, we don't really seem to know how to increase the speed of income growth. In contrast, we appear considerably better at improving the broader quality of life for everyone, at whatever income. A greater focus on proven approaches to more rapid improvement in health and education may have a significantly greater impact on the quality of life of poor people in poor countries than yet another quest for the grail of income growth.

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On Sale: Dec 4, 2012
Page Count: 272 pages
Publisher: Basic Books
ISBN-13: 9780465031030

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Charles Kenny

About the Author

Charles Kenny, previously a senior economist at the World Bank, is now a senior fellow at the Center for Global Development and a columnist for Bloomberg Businessweek and Foreign Policy magazines. He lives in Washington, DC.

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Charles Kenny

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