March 19, 2006
'The White Man's Burden,' by William Easterly
The Poverty Puzzle
MALARIA infects 300 million to 500 million people a year, causing severe pain and debilitation. A
million of those taken ill die, mostly infants and young children. Of the deaths, which amount to a
child every 30 seconds, more than 80 percent occur in the poor countries of Africa. Insecticide-treated
mosquito nets, which cost $5 or less, could prevent most infections. A mere $2.50 in medicine can
treat the deadliest form of the disease, the World Health Organization reports.
So why don't we just buy the nets and medicines? If we cared as much about the poor as Bono does,
couldn't the rich countries wipe out malaria and also eliminate the world's worst poverty?
It's not that simple, William Easterly argues in "The White Man's Burden." Take those mosquito nets.
When aid agencies hand them out in poor countries, he writes, "nets are often diverted to the black
market . . . or wind up being used as fishing nets or wedding veils." Free nets don't get to the people
who need them.
But in rural Malawi, clinics serving new mothers sell insecticide-treated bed nets for 50 cents each.
The nets come from a program developed by local Malawians working for Population Services
International, a Washington-based nonprofit organization. In Malawi's cities, the group sells nets for
$5 each, using the profits to subsidize sales in the countryside.
The program, Easterly reports, has "increased the nationwide average of children under 5 sleeping
under nets from 8 percent in 2000 to 55 percent in 2004. . . . A follow-up survey found nearly
universal use of the nets by those who paid for them." By contrast, when a Zambian program handed
out free nets, "70 percent of the recipients didn't use" them. Charging for nets may sound hardhearted,
but prices provide vital information about commitment.
The world's poor need more focused, trial-and-error programs like the Malawian net distribution and