Topic Notes: Infectious Diseases, Environmental Issues, and Foreign Aid

Stoa’s three policy resolutions offered for 2018-19 are on the StoaUSA website: reforming international policy toward infectious diseases, international conventions on environmental issues, and reforming federal government foreign aid.

The resolutions are interconnected as both environmental and infectious disease issues are a part of current foreign aid programs. Much foreign aid involves agricultural policies–a recent Stoa topic–with the goal of maintaining prices by exporting crop surpluses (though food aid exports can bankrupt farmers in developing countries). International environmental policies that reduced or banned DDT contributed to the return of malaria and infectious diseases (though DDT use is still controversial and debated, more on this below).

The economics of all three resolutions involve economic freedom as a way to connect people in poor countries to the global economy. Hernando de Soto’s PBS documentaries, such as Globalization at the Crossroads streams are online here. U.S. foreign aid policies tend to be blind to the institutional reforms DeSoto and other development economists argue are essential for economic development.

Each year Economic Thinking workshops and online resources present history and economic principles relevant to chosen debate topics. Economic principles serve as tools to help students and policymakers better understand public policies and current events. Debaters who invest the time to learn relevant economic principles will gain an advantage in case preparation and competition.

Economics principles, particularly Public Choice economics, provide key insights into how the political and policy worlds actually work. Public policies and government programs are influenced and often controlled by concentrated interests who directly benefit from regulations and subsidies.

For example, the federal government funds light rail, ethanol, and electric cars not because such subsidies are good policy or advance national interests, but because concentrated interests benefit from these policies while the costs to the public, though higher in total, are smaller and distributed. (Plus light rail, ethanol, and electric cars are romantic and appeal to journalists, academics, and young people.)

With that preface, here are initial thoughts on the three Stoa resolutions.

Public Health and Infectious Diseases in the Developing World
Resolved: The United States federal government should substantially
reform its international policies towards infectious diseases.
In 2007 public schools debated reforming U.S. public health policy toward Africa. I spent much of the year researching the history and economics of public health and infectious disease policies. An Economic Thinking study guide on the topic is here (pdf).

Infectious disease policy is narrower than overall public health, but politics and ideology often overwhelm research on solutions. Consider a 2016 article: “Politics, Power, Poverty and Global Health: Systems and Frames,”   in the International Journal on Health Policy and Management, part of the government’s National Center for Biotechnology Information (NCBI). The article comes up when searching for “international infectious disease policy distorted by politics.”

The author, Solomon Benatar, first takes aim at World Bank statistics documenting the hundreds of millions worldwide that have been lifted out of “extreme poverty” (defined by World Bank as income below $2 a day):

However, such ‘economic advancement’ cannot be credibly labeled as ‘lifting out of poverty,’ other than in terms of the ludicrously low levels of income considered as poverty by the World Bank. While there have also been improvements in some lower common denominator measures of health, such as death rates, these improvements are not remotely sufficient to support optimism about ‘global convergence’ in wealth and health outcomes.

It is true that death one of “some lower common denominator measures of health” and true too that we would like to see much more prosperity for people beyond just not dying. Still, fewer people, especially children, dying is a very good thing. Let’s start there and discover ways to support human flourishing.

According to the International Journal on Health Policy and Management article, key problems:

include the ideology that promotes neoliberal economic policies, and their progressive legal entrenchment in trade rules and other exploitative processes that (i) sustain pervasive poverty, (ii) prevent the development of healthcare systems capable of limiting emerging new infectious diseases and epidemics,12 and (iii) contribute to internecine conflict with massive displacement of people and large numbers of refugees.

Maybe the “trade rules” the author is referring to are protectionist barriers that prevent people in the developing world to join the world economy and earning higher wages by providing goods and services to world markets… But no, that’s not the world nor the reforms the author has in mind. Many think of markets as exploitation and global trade as damaging and chaotic.

The author next lists other global “crises”:

These, and other complex 21st-century global crises such as climate change, environmental degradation, the global economic crisis and crises in food, water and energy security will shape the future of all globally.1,13,14 It is arguable that new definitions of poverty are required to drive more intensive alleviation processes that have greater potential for ‘eradicating poverty in all its forms’ and improving global health.

The “intensive alleviation processes” the author refers to involve, of course, increased foreign aid. That is, wealth transfers from taxpayers in developed world to governments and aid agencies in poor countries. (Reforming foreign aid policy, another proposed Stoa policy resolution, is discussed below. For a preview see the webpage and trailer for the documentary Poverty, Inc.).

Consider though how the the author weaves global health policies with ideology and colonialism:

The historical antecedents of ‘global health’ activities began with colonial medicine in the 18th and 19th centuries, when international travel made conquest possible and enabled the foreign expansion of industry and extractive processes to increase the wealth and power of colonising nations. Tropical disease medicine then followed in the early 20th century when advances in medicine and the development of the disciplines of bacteriology, parasitology, helminthology and drugs to treat these infestations/infections enhanced the security of foreign powers through improved control of infectious diseases. International health activities expanded and changed in the mid 20th century when infectious diseases were largely controlled in wealthy countries. A range of co-operative endeavours were then implemented to promote and improve health in low- and middle-income countries.

If the infectious disease topic is chosen, debaters will have an opportunity to examine this history as well as the scientific and medical issues involved. But notice the claim  of “foreign expansion of industry and extractive processes to increase the wealth and power of colonising nations.” International trade helped millions in both poor and wealthy countries prosper. A first consequence of expanded international trade and prosperity was rapid population growth in Africa, India, China, and Latin America.

As cocoa exports and other international trade in West Africa expanded from 1900 to 1960, population quadrupled and average income quadruped as well. Trading companies in Britain and France prospered, but so did cocoa farmers, traders, and land developers in West African countries. Economic anthropologist Polly Hill’s research on migrant cocoa farmers in Ghana outlines this trade and entrepreneurship success story. Interestingly British colonial officials, often sipping tea and gin at their clubs in coastal cities, had no idea of the dynamic and thriving cocoa economy thriving in the interior.

Tropical diseases and poverty are connected. As people have more income they can and do take steps to protect themselves from malaria, yellow fever, and other infectious diseases. Students will have an opportunity to read the history of various infectious diseases, including more recent outbreaks. But still the topic turns on economic development, with poverty  being the reason local families, medical workers, and public health officials struggle to contain disease outbreaks.

The infectious disease topic will draw debaters into the longstanding DDT debate. DDT spraying reduced disease across the world and especially in Africa and India. When DDT use was stopped in the U.S. and reduced later in Africa and India, malaria returned with a vengeance and millions perished. Those against DDT use claimed it was losing it effectiveness against mosquitos and malaria, and that it was devastating to the environment, building up in the food chain. Rachel Carson’s book Silent Spring mobilized environmentalists, public health officials, and international agencies.

This 2015 Yale Environment 360 article, Rachel Carson’s Critics Keep On, But She Told Truth About DDT defends the mainstream view. Its subtitle reads:

More than half a century after scientist Rachel Carson warned of the dangers of overusing the pesticide DDT, conservative groups continue to vilify her and blame her for a resurgence of malaria. But DDT is still used in many countries where malaria now rages.

On the other side is a 2012 anthology Silent Spring at 50: The False Crises of Rachel Carson (link to Cato Institute book forum with video or podcast). A 2012 Cato Institute Policy Report, The True Legacy of Rachel Carson’s Silent Spring. See also the American Enterprise Institute posts: Silent spring? Not so much  and The Excellent Powder about the 2010 book, The Excellent Powder: DDT’s Political and Scientific History

The Roger Bate Excellent Powder post begins:

Winston Churchill was the first national leader to applaud the insecticide DDT. Sixty-six years ago, when prime minister of Britain, he praised the “excellent powder,” which was preventing thousands of allied troops, refugees, and other victims of war from dying of typhus, yellow fever, and malaria. For the next 20 years, DDT became seen as the world’s most successful public health insecticide, saving millions of lives from insect‐borne diseases. It helped eradicate lethal diseases from dozens of countries, including the United States and, by the 1970s, all of Europe.

But one book, Silent Spring by Rachel Carson, changed DDT from global savior to global pariah…

And debaters don’t have to look to Africa or Latin American for dangerous infectious diseases. Consider this April 17, 2018 New York Times article: New York Mice Are Crawling With Dangerous Bacteria and Viruses:

Mice that live in the basements of New York City apartment buildings — even at the most exclusive addresses — carry disease-causing bacteria, antibiotic-resistant bugs and viruses that have never been seen before, a new study from Columbia University finds.

International conventions on environmental issues
Resolved: One or more international conventions on environmental issues should be substantially reformed.
Wikipedia has a list of international environmental agreements. The difference between conventions and agreements is explained on Cornell law site:

International conventions are treaties or agreements between states (the primary actors in international law). … International convention is used interchangeably with terms like international treaty, international agreement, compact, or contract between states.

A 2011 history of international environmental conventions is online here, and is organized around major conventions (Pre-Stockholm, From Stockholm to Rio, and then by topics like nature, natural resources, marine environment). The essay begins:

The publicity surrounding the UN Conference on Environment and Development (UNCED), which took place in Rio de Janeiro in June 1992, confirmed the central place that global environmental concerns over issues such as global warming and loss of biological diversity have on the world political agenda.

[Update]: A note on environmental “treaty congestion” from The Guardian:

According to the UN Environment Programme we now have “treaty congestion”. World leaders have signed up to an impressive 500 internationally recognised agreements in the past 50 years, including 61 atmosphere-related; 155 biodiversity-related; 179 related to chemicals, hazardous substances and waste; 46 land conventions; and 196 conventions that are broadly related to issues dealing with water. After trade, environment is now the most common area of global rule-making. 

Of course this resolution will drop debaters in the middle of intensely controversial issues that separate many conservative and libertarian researchers and pundits from those more mainstream or progressive. International environmental issues will also draw debaters into the strange and terrible history of eugenics and population control. For example, many conservative environmentalists object to immigration because it increases U.S. population growth which they believe negatively impacts the environment. Environmentalists have pushed for foreign aid and international agreements enforcing population control measures overseas as well. This essay, In appreciation of Julian Simon, provides some background, including this from 1984:

The United Nations Population Fund, which receives tens of millions of U.S. taxpayer dollars each year, has been involved in the one-child policy from the beginning. They should withdraw from China or face a funding cut-off.

The author, Steven Mosher meets economist Julian Simon for lunch to discuss the draconian Chinese one-child policies he has best testifying to Congress about, but the conversation turns to economic fallacies that misguided population control (and environmental policies) were based on:

The Chinese government may need to reduce the birth rate as a precursor to economic development, I concluded, but in doing so they have run roughshod over the rights of the Chinese people.

In mentioning the economic rationale for population control, I thought I was merely stating the obvious. After all, I had been taught at Stanford University that there are powerful reasons for limiting the numbers of people in developing countries, economic development and environmental protection among them.

To my surprise, Julian took exception. The Chinese government is mistaken, he said. Population growth does not have a statistically negative effect on economic growth. We know that from many years of careful quantitative scientific studies. Because human knowledge allows us to produce more finished products out of fewer raw materials, natural resources are becoming more available, not scarcer. Human beings are the greatest resource. You need more, not fewer, of them for economic development.

Continuing economic analysis of biodiversity and other environmental issues is Danish statistician Bjorn Lomborg. Lomborg, an strong environmentalist and supporter of Greenpeace, was in the Los Angeles airport when he saw a 1997 WIRED magazine cover story THE DOOMSLAYER featuring Julian Simon (with little devil’s horns on his head). Lomborg read the story in disbelief, since he believed in most of the environmental calamities Simon claimed were untrue. Lomborg returned his university and with his statistics graduate students set out to prove Simon was wrong. But it turned out that Simon, also a statistician, wasn’t wrong.

A few years late (2001) Lomborg’s The Skeptical Environmentalist: Measuring the Real State of the World was published by Cambridge University Press (Julian Simon’s The Ultimate Resource was published by Princeton University Press). See also Lomborg’s website and his book Cool It and other writings.

Again though, the economics of all this are much the same as with recent and current Stoa policy debate topics on agricultural policy and transportation policy. Concentrated interests benefit from current and expanded foreign aid programs and subsidies while costs are spread out among tens of millions of taxpayers. People in the developing world are hurt by many U.S. foreign aid and international environmental policies, but they don’t vote or have a voice in the U.S.

Many Problems and Some Benefits from U.S. Foreign Aid
Resolved: The United States federal government should substantially reform its foreign aid.

No easy answers for reforming foreign aid programs. Students can learn much from New York University development economist William Easterly’s books, journal articles (and Facebook posts). Easterly’s website is here. His book The Tyranny of Experts is discussed here.

Also important on the key role of institutions in economic development is  Daron Acemoglu and James Robinson’s Why Nations Fail: The Origins of Power, Prosperity, and Poverty. Easterly’s review in Wall Street Journal here.

See also How To Fix Poverty: Why Not Just Give People Money? (NPR, August 7, 2017):

The payouts are part of a grand and unprecedented experiment that is motivated by an equally sweeping question: What if our entire approach to helping the world’s poorest people is fundamentally flawed?

Cell phones and mobile money are having a huge impact in the developing world as this 2016 MIT News article reports Study: Mobile-money services lift Kenyans out of poverty

And another popular approach (and past debate case) calls for expanding microlending and microfinance, long associated with economist and Nobel Peace Prize winner Muhammad Yunus. Here is a recent Quartz article: The inventor of microfinance has an idea for fixing capitalism.

For more on microlending see former homeschool debater Samuel Wahlen’s 2017 book Microfinance: An Economic Analysis of Banking to the Poor   

Also, many past Economic Thinking posts discuss foreign aid.