Are the extreme poor hungry?

An obvious question maybe. The WFP reports that there are 842 million undernourished people in the world today. Policymakers, too, seem to think so: at Davos last month global leaders committed to the zero hunger challenge. MDG 1 refers to 'eradicating extreme poverty and hunger'. Ayuda en Acción also have a cool campaign on hunger right now which reminds me of Where the Wild Things Are. So the extreme poor are hungry, right?

But are the extreme poor hungry?

This question is the the central problem posed by Banerjee & Duflo (B&D) in Chapter 2 of Poor Economics, and of the second week of the 'The Challenges of Global Poverty' MOOC of theirs I'm currently taking. So, inspired by Development Intern's weekly report on Sachs' rival course on Sustainable Development, I'm going to do something similar, hopefully mashing up course material with ideas from their book and other sources sufficiently to sidestep anticipated legal issues (it's a free course available to anyone so not sure 'revealing course content' has any meaning but whatever I'm a coward).

Getting back to the question, B&D suggest that we could be looking at a food-based 'poverty trap'. I.e. poor people don't have enough food to be productive, meaning they earn less and have less money to buy food, and so the cycle continues. Meanwhile someone with more money can buy more food, be more productive, and thus escape from poverty. In the class B&D use concepts like the S-shape graph and capacity curves and elasticity so you feel like a real economist: it's fun.

But if we actually look at the actual behaviour of the poor in developing countries, we get a story different to the WFP and poverty trap narrative. B&D find that in Udaipur, the poor could spend up to 30% more on food than they actually do by cutting expense on festivals, alcohol and tobacco. Another study cited by B&D found that a 1% increase in income only translates into a 0.67% increase in food expenditure. Significance: there's room for the poor to be buying more food. A further study in China even found that when the price of rice declined, people ate less rice (that is to say, fuck you conventional economics). In general, Deaton and Dreze find that poor Indians have been eating less and less over the last few decades while the percentage of people complaining that they do not have enough food dropped from 17% in 1983 to 2% in 2004. Not what you would expect from hungry people stuck in a food-based poverty trap. So maybe poor people in general have enough food. As B&D put it, “most adults, even the very poor, are outside of the nutrition poverty trap zone”. We can offer some explanations - technological change means that people aren't doing as much physical labour and so require less food; people are healthier so lose fewer calories to hungry parasites or to fighting illness.

But the Freakonomics-style journey doesn't end there, because it's not just that the WFP is totally wrong and everyone is fine food-wise. Roughly half the children under five in India are stunted, a horrific stat which suggests something is going seriously wrong with their nutrition. So, skipping a few steps, we arrive at our 'solution': it's quality not quantity. When 40% of pregnant women are anaemic according to the WHO, it doesn't matter how much rice you give them, they need iron. And this is particularly bad in India because many people are vegetarian and the staple is rice (which actually inhibits iron absorption) creating a perfect, iron-free, storm. The results of addressing nutrient deficiencies are huge - B&D cite a study which found that deworming children for two years (equivalent of giving them the nutrients and calories taken by the worms - and yes it does work like that) led to a yearly increase in income of 20% and a lifetime gain of $3269, compared to a cost of $1.36 per deworming treatment. Bam.

Sweet potatoes: yummy and nutritious

So we need to get kids dewormed (already happening in Kenya), nutrients to pregnant women and to young children, because that's where the real 'hidden hunger' is, say B&D. Another nail in the coffin of USAID's food aid policy based on getting US-produced staples to supposedly needy countries (not that it needed another one). And bad news too for the Campaign for Boring Development with its focus on increasing incomes: money isn't the issue here, so having more of it won't make a big difference. Fortified fish-sauce is already cheap and within reach of the poor in Indonesia (relative to its benefits and average income). Instead we need to directly target mothers-to-be during pregnancy with fortified foods, perhaps sprinkle children's food at school with micronutrient-rich salts, and more sustainably, develop nutritious foods that people actually want to eat (see DFID bloggers' on exactly this topic.
Orange fleshed sweet potatoes and iron-rich beans are where we're heading apparently).

The most interesting part of this I've left until last. If the benefits are so great and the costs so small, why aren't poor people doing this anyway? And this is where B&D are at their best, taking us away from high-level, often introspective debates driven by Western academics (whatever its merits, I still find the fact that Nina Munks just wrote a book on Jeff Sachs kind of surreal) and towards the realities of the poor. As they drily put it, “the natural place to start to unravel the mystery is to assume that the poor must know what they are doing”. Unpacking all the reasons why the poor might not take to foreign experts' advice would, and probably will, take another blog post (think mistrust of the state and NGOs, difficulty of verifying supposed benefits, human psychology). But one aspect of the explanation becomes obvious when you think of the extreme poor as normal people. Because people aren't machines made to maximise their productivity or long-term income - I'm sure I'd be better off productivity-wise giving up coffee, sugar and alcohol but I'm not going to. Now imagine you work a lot harder than I do, and on top of that don't have the internet, books, podcasts and a load of leisure time to spend with friends, you might be justifiably tempted to spend your money buying tastier but less nutritious food, or even saving up for a TV, instead of investing in things that might, in the long-term, be objectively 'beneficial'. B&D quote George Orwell's The Road to Wigan Pier:

“When you are unemployed, you don’t want to eat dull wholesome food. You want to eat something a little tasty”.

So a couple of conclusions from this week's class: 1) quality not quantity. And 2) the extreme poor in developing countries know what they're doing more than we give them credit.

Thursday resolutions

Two sobering things have occurred to me this morning, both of which will hopefully improve this blog.

1. I am not Duncan Green. Perhaps obvious but important anyway. So given that I'm not an experienced Oxfam strategic advisor, author of the influential development book From Poverty to Power, I can stop trying to match him and other bloggers I follow for originality and analytical insight. I can be happy continuing to stab blindly in the dark at assorted issues vaguely relevant to development. More honesty and less coherence.

2. If I were to read my own writing but written by someone else, it would sometimes piss me off. There's nothing worse than a young person spewing out self-involved verbal diarrhoea. Just read a few articles on Thought Catalog and you'll get the point. So despite my best instincts (I love words) I'm going to try to unlearn the verbose rhetorical tendencies (witness the previous phrase) drilled into me at school.

Now that's over with, hopefully an actual post will appear sometime soon on food and the poor, the crappiness of (some) NGOs or why we need to rethink how we do education, depending on which semi-started draft I choose to finish.

I'm not sure, and that's okay.

More of a reflective, slightly nebulous piece - apologies in advance. So I had the pleasure of listening to Mark O’Connell speak on ambivalence on a Four Thought podcast (the perfect accompaniment to a tipsy walk home in the early hours), and his strikes me as a valuable message for all, even in policy debates about development (yeah I can shoehorn anything into ‘being relevant to development’).

So in a nutshell, ambivalence is simultaneously holding two incompatible beliefs, the uncertainty of having mixed feelings about an issue. Ours is not the age of ambivalence, O’Connell points out: we inhabit a world of 'omniscient' politicians, of Ted Talks with a single take-home message, and of eight clear MDGs.

Academically I’ve had some experience of this. I’m currently doing some research into managerialism in NGOs. This is the theory and practice of managers in development, an ideology which relies on assumptions of development as a linear, mechanistic process of change in a technical, scientific sense. In its most exaggerated forms, local context is abstracted away to produce a replicable ‘recipe for action’ which can fit neatly into a logical framework analysis. The managerialist logic is what motivates you to write up that nice report of your development project in which you iron out all the inconsistencies and present a clear problem-solution-implementation-success narrative, recounted by a coherent, objective self. Managerialism in this context is the antithesis of ambivalence.

But while certainty’s clearly useful when attempting to make and justify decisions, it can also be extremely problematic for thinking about development. Suppressing ambivalence and constructing a single narrative (of a project for instance) can reduce reality to a single set of ‘truths,’ preventing political engagement and contestation, and favouring the opinions of some as more legitimate than others. But not only is this approach dangerous in its implications, it is misguided in itself, as it fundamentally misrepresents human experience, of which ambivalence is a inherent feature, as O’Connell points out. In fact one thing I am certain of is that people are hopeless psychological bundles of mutually contradictory and illogical thoughts and opinions. This misrepresentation in turn means that the given development project is unlikely to produce successful outcomes, addressing as it does only part of reality.

And in my own personal case, too, I’ve felt the conflict between ambivalence and certainty quite strongly. Up to the last couple of years, I have unintentionally but systematically avoided firm opinions on issues short of the most obvious, especially in domestic politics. My strategy, which my friends/siblings/ex-girlfriends may recognise, has been either to say ‘I don’t know’ when pushed on something, or, if I know something about it, argue fervently against whatever my interlocutor is proposing. Often I’ve literally produced a counter-argument and immediately realised that I don’t actually believe what I’m saying. Some of the time I even have the good humour to admit it. Anyway more recently I’ve decided that facetiously sitting on the fence is not all that productive politics-wise so I’ve been doing things like reading and thinking and writing a blog to try to trace some lines in the sand. But I do get the sense sometimes I’m just arming myself with facts and arguments to shield myself with dogma (even progressive, internationalist, statistics-based dogma) and hide my own ambivalence.

So fittingly I’m not going to come to a conclusion, even one simply arguing for ambivalence. Perhaps proposing ambivalence as a guide when thinking about politics is just a dressed-up defence of ignorance and lack of reflection. But certainly in the narrow context of development policymakers and particularly NGOs constantly searching for results, legitimacy and funding, to recognise the inevitable plurality of potential opinions on even the apparently most certain of facts, will allow them to be more flexible in their offering and to de-centre themselves in the development process.

As O’Connell neatly ends his talk, “Have the courage of your own ambivalence”.

The Great Escape

Read book. Took notes on book. Listened to Development Drums podcast. Read review. Went on holiday to Bologna. Got flu. Now finally ready to pass on a few thoughts about Angus Deaton’s The Great Escape.

First thing, just to highlight, is the amazing, bird’s eye view you get of progress in a) global health and b) income/economic growth over the last couple of hundred years. One general message is that, on a world scale, things have been getting better at an incredible rate over the last couple of hundred years and that a big part of the inequality we see is a result

of the some parts of the world becoming rich (which is undeniably positive as a fact in and of itself). And Deaton provides loads of lovely statistical snippets to show it. For example in the health ‘section’, for the last 160 years, for every four years of calendar time, the world’s highest life expectancy increased by a year.  Meanwhile, between 1820 and 1992, the average income of all the inhabitants of the world increased between seven and eight times and the fraction of the world’s population in extreme poverty fell from 84 to 24% (at the same time as the world population increased by billions). Deaton is clearly a master of the data and a giant in his field and it shows.

Then of course we get some broad ideas of the ‘why’ without there being an overarching grand theory, which is quite refreshing and probably bang on given the scope and scale of the changes we are talking about. Deaton also focuses on some other pertinent issues like the hazards of measurement and indicators, economic growth as an overwhelmingly positive force (or not) and the (topical) issue of income inequality within the USA and worldwide (I have a word doc to which I add links to contributions on the inequality debate: currently on about 15 articles/reports in the last month).

But the most polemical, and (for me) interesting stuff is found in the final section on aid and why it’s bad, which got me writing angry comments in the margins. To cut straight to the chase, the central argument is that “foreign aid makes governments less responsive to the needs of the poor, and thus does them harm”. Essentially if we accept that poverty (broadly defined) is a consequence of poor institutions, and that aid to governments undermines institutions and democracy, weakening the social contract, aid is bad. Which isn’t revolutionary stuff, very broad-brush, reminding me a bit of Easterly with the idea that aid mucks with incentives, combined with sort-of Duncan Green/Oxfam change coming from combination of active citizens and progressive states working together. Deaton therefore also criticises what he characterises as the ‘hydraulic approach’ to aid whereby monetary inputs are automatically assumed to lead to positive outputs, with development conceived as a technical issue – definitely agree here, as does pretty much everyone up to date with current development thinking. And regarding the main argument about aid and institutions, the theory sounds eminently plausible...

However. The first problem is, as Owen Barder points out, this is an empirical not a theoretical question, and there isn’t hard evidence supporting Deaton’s view that all to-government aid ends up wrecking the given country’s political institutions and gets siphoned off by corrupt governments rather than being used to help the country’s people. Anecdotally, Barder mentions Ethiopia’s human development progress (see Development Drums podcast for this and further references) and Rwanda struck me as an example after listening to a Guardian podcast listing the positively stunning gains made in health there. This reported that in the last ten years alone: deaths from AIDS and TB were down 78%. Maternal mortality down 60%. Under five mortality down 70%. Paul Farmer called these developments ‘the steepest declines in mortality ever recorded, at any time, and in any place’. In this light, and even despite serious concerns about political freedoms in Rwanda, Deaton’s caricatured claims about corrupt African governments just don’t square with reality. It might be possible, in fact, for aid to strengthen democracy and the social contract when its use is made accountable to the people through traditional institutions. Rwanda’s imihigo system, whereby if the local ‘mayor’ fails to deliver on developmental promises he is made a social pariah, is one example. Chris Blattman in his review makes this point even more strongly:

 “And, frankly, I personally find it hard to believe that levels of democracy in Africa would be as high as they are without aid. I think the most important forces driving democracy are probably internal to Africa, and the example and economic success of advanced democracies comes second. But aid and foreign meddling comes a close third”

On the general point, Owen Barder, with characteristic succinctness, crystallises the underlying criticism when he accuses Deaton from arguing from extremes. And I’d agree that the sentence “the director of one aid agency gave me a bloodcurdling account of how aid funds had gone to gangs of murderers” isn’t the most nuanced or helpful reflection on aid I have read recently.  Basically there is definitely something lazy if not worse about taking a homogenised image of the African other (based on Mobutu or Mugabe for example) as a key premise of an argument about aid.

And second, even conceding Deaton’s argument about aid’s effects on political institutions, to claim, in the absence of hard evidence, that this overrides the (widely accepted) results from worldwide health initiatives (just one example) is a little strong for me. When first reading the chapter I’d scribbled down a note to Owen Barder’s ‘pocket defence’ of aid based on the smallpox case as potential rebuttal, and I’ve got to admit I did a fist-pump when he unleashed it in the podcast. And after Deaton took this road, it was a bit of a slippery slope, where he seemed to edge towards the view that political rights and freedoms trumped everything. The USA should consider stopping trade with Saudi Arabia (Deaton agrees to), okay, but then should the rest of the world stop trading with the USA because of Guantanamo? Deaton’s refrain that dealing with countries like Ethiopia under repressive dictatorships was “like having blood on our hands” seemed unconvincing.  Surely not supplying healthcare when people will die without it is also ‘having blood on our hands’? The world isn't that black and white.

And this is where my angry notes in the margin come in. Because it seemed to me that Deaton was, in general, pretty sloppy in the final chapter. My quibbles include: his use of hyperbole (see ‘gangs of murderers’ example above); his reliance on anecdotes, for example about 'WaBenzi'/corruption in Kenya; his random pot-shots about loosely connected issues ranging from RCTs (which he doesn’t like) to aid apparently being used as a way for rich country governments to boost their popularity (erm not sure I buy this given recent findings from ODI “the public may be becoming less supportive of maintaining, let alone increasing, current levels of UK spending on aid”). But worst of all (what Owen Barder with wonderful tact referred to as the chapter being “less well-evidenced”) his disingenuousness with statistics – his bread-and-butter! So he pulls up graphs showing that there is no positive correlation between aid and growth, or between aid and democracy, and then leaves these facts 'floating' in his argument, flirting perilously with the causation-correlation fallacy that jumped out even at me as a non-economist/statistician.  For a social scientist renowned in his field, to toy with these arguments seemed pretty petty.

Basically ‘Deaton-on-aid’ got a bit rant-y (though I do appreciate the sentiment of frustration with the aid sector, as Owen Barder put it, “a cry of exasperation”) and obscured the more important take-home ideas that most people agree on now and which did also come out partly in the final chapter:

1. Aid isn’t the solution – we can do far more through migration, climate change, trade policies, 'aid for development' in promoting global public goods like scientific knowledge etc;
2.  Aid and development is political - I think we can all agree that the technical, depoliticised, 'problem-solving' conception of aid and development can be put to bed;

But alongside these two conclusions drawn by Deaton, Chris Blattman's fundamental objection to Deaton is worth keeping in mind: that 'The answer to “Does aid work?” is the same answer to every question in social science: “It depends” ’(from his own review). So Deaton is coming up with (probably) the wrong answer to (definitely) the wrong question. The Great Escape is a triumph in terms of tracing broad global trends in health and income with rigorous statistical evidence, but the final chapter is best taken with a large dose of salt. Time to move on from Sachs-vs-Easterly methinks.

Dorian Gray, NGO critic

Apologies in advance for a straight-up self-indulgent and frivolous post. So I'm currently reading The Picture of Dorian Gray by Oscar Wilde (nice counterpoint to following international development blogs and source of endless fantastically enigmatic quotes for hypothetical dinner parties). And it turns out, despite his self-professed superficiality (the guy basically trades his soul away to keep his incredible Greek-god level beauty - one lover of his: “The world is changed because you are made of ivory and gold. The curves of your lips rewrite history.”), he is an astute commentator on the contradictions of the international NGO apparatus. Who knew? Granted if my source of cutting, up-to-date analysis of development issues is a novel written in 1890 it is not worth your time reading it. But the irony of a guy who rejects anything moral or 'deep' serving up a classic commentary on the paradox of big-D Development was too much for me to resist just this once. So here you go (no spoilers by the way):

Dorian Gray to Basil Hallward, his friend and creator of the painting of Dorian which gets old and disgusting as he morally decays in order that he can keep his wonderful youth:

"You remind me of a story Harry told me about a certain philanthropist who spent twenty years of his life in trying to get some grievance redressed, or some unjust law altered -- I forget exactly what it was. Finally he succeeded, and nothing could exceed his disappointment. He had absolutely nothing to do, almost died of ennui, and became a confirmed misanthrope"

What Dorian actually means here: In a nutshell, many development NGOs are set up to run projects in a developing country and achieve some outcome like improvements in education or enabling people to escape poverty. But a by-product of success (or the realisation that it actually makes more sense to just employ someone local who is infinitely better equipped to do the job than a well-meaning white, middle-class expat) is that there is no longer any reason for said NGO to exist (at least in the form of predominantly expat-staffed). But that means all of us lovely people in the global North who want to work in Development are out of a job (boo). So faced with this basic contradiction, instead of taking Gray's philanthropist's option of retiring bitterly, probably to become a bloodsucking banker (those are the only two options right?), many NGOs have reinvented themselves as intermediaries in the aid-chain to keep their relevance (classic justification being that they are more flexible, closer to the grass-roots and innovative than big bulky donors thus better vehicles for partnerships with Southern NGOs). Or others just carry on doing an implementation job which is less efficient than letting local people/organisations do the same thing. And others still carve out another niche, maybe bringing relevant actors together to facilitate change or highlighting the needs of the poor, Oxfam-style.

Basically what Dorian is trying to say here more generally is that there is often a fundamental disjuncture between the desire to help and the actual need for us development workers (aspirational in my case). Which is a common idea, highlighted by people like Angus Deaton most recently. Fortunately for me, I don't buy into this view, that there is little or no need for the activities of the development 'sector'; it just means that we have to make sure that we keep questioning the value of what we do and ensure that the results for the 'beneficiaries' of the work are always put first. Ed Carr offers one defence of why it is fundamentally good and useful to work in development (crucially, given the right skills and the right programme, see HowMatters on this). So we are not doomed to 'die of ennui' for a lack of development work, fortunately.

Next week, how to deliver structural economic transformation in Sub-Saharan Africa using quotes from Romeo and Juliet.