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The plight of Malawi has been rightly described by Carol Bellamy, head of UNICEF, as the perfect storm of human deprivation, one that brings together climatic disaster, impoverishment, the AIDS pandemic and the long-standing burdens of malaria, schistosomiasis and other diseases. In the face of this horrific maelstrom, the world community has so far displayed a fair bit of hand-wringing and even some high-minded rhetoric, but precious little action. It is no good to lecture the dying that they should have done better with their lot in life. Rather it is our task to help them onto the ladder of development, to give them at least a foothold on the bottom rung, from which they can then proceed to climb on their own.
This is a story about ending poverty in our time. It is not a forecast. I am not predicting what will happen, only explaining what can happen. Currently, more than 8 million people around the world die each year because they are too poor to stay alive. Every morning our newspapers could report, "More than 20,000 people perished yesterday of extreme poverty." How? The poor die in hospital wards that lack drugs, in villages that lack antimalarial bed nets, in houses that lack safe drinking water. They die namelessly, without public comment. Sadly, such stories rarely get written.
Since Sept. 11, 2001, the U.S. has launched a war on terrorism, but it has neglected the deeper causes of global instability. The nearly $500 billion that the U.S. will spend this year on the military will never buy lasting peace if the U.S. continues to spend only one-thirtieth of that, around $16 billion, to address the plight of the poorest of the poor, whose societies are destabilized by extreme poverty. The $16 billion represents 0.15% of U.S. income, just 15¢ on every $100 of our national income. The share devoted to helping the poor has declined for decades and is a tiny fraction of what the U.S. has repeatedly promised, and failed, to give.
Yet our generation, in the U.S. and abroad, can choose to end extreme poverty by the year 2025. To do it, we need to adopt a new method, which I call "clinical economics," to underscore the similarities between good development economics and good clinical medicine. In the past quarter-century, the development economics imposed by rich countries on the poorest countries has been too much like medicine in the 18th century, when doctors used leeches to draw blood from their patients, often killing them in the process. Development economics needs an overhaul in order to be much more like modern medicine, a profession of rigor, insight and practicality. The sources of poverty are multidimensional. So are the solutions. In my view, clean water, productive soils and a functioning health-care system are just as relevant to development as foreign exchange rates. The task of ending extreme poverty is a collective one--for you as well as for me. The end of poverty will require a global network of cooperation among people who have never met and who do not necessarily trust one another.