Delanceyplace.com 11/12/08-Helping the Poor

In today's excerpt--over the last several decades, programs to aid the global poor that have been conceived at high levels within foreign aid organizations have routinely fallen short. Those conceived in the field have the better record of effectiveness:

"At the World Economic Forum in Davos in 2005, celebrities from Gordon Brown to Bill Clinton to Bono liked the idea of bed nets as a major cure for poverty. Sharon Stone jumped up and raised a million dollars on the spot (from an audience made up largely of middle aged males) for more bed nets in Tanzania. Insecticide-treated bed nets can protect people from being bitten by malarial mosquitoes while they sleep, which significantly lowers malaria infections and deaths. But if bed nets are such an effective cure, why hadn't planners already gotten them to the poor? Unfortunately, neither celebrities nor aid administrators have many ideas for how to get bed nets to the poor. Such net are often diverted to the black market, become out of stock in health clinics, or wind up being used as fishing nets or wedding veils. ...

"[Field workers at] Population Services International (PSI), headquartered in Washington, D.C., ... stumbled across a way to get insecticide-treated bed nets to the poor in Malawi, with initial funding and logistical support from official aid agencies. PSI sells bed nets for fifty cents to mothers through antenatal clinics in the countryside, which means it gets the nets to those who both value them and need them. (Pregnant women and children under five are the principal risk groups for malaria.) The nurse who distributes the nets gets nine cents per net to keep for herself, so the nets are always in stock. PSI also sells nets to richer urban Malawians through private-sector channels for five dollars a net. The profits from this are used to pay for the subsidized nets sold at the clinics, so the program pays for itself. PSI's bed net program increased the nationwide average of children under five sleeping under nets from 8 percent in 2000 to 55 percent in 2004, with a similar increase for pregnant women.

"A follow-up survey found almost universal use of the nets by those people who paid for them. By contrast, a study of a program to hand out free nets in Zambia to people, whether they wanted them or not (the favored approach of the centralized planners), found that 70 percent of the recipients didn't use the nets. The 'Malawi model' is now spreading to other African countries."

William Easterly, The White Man's Burden, Penguin, Copyright 2006 by William Easterly, pp. 13-14