HIV-AIDS should be the top priority
http://www.smh.com.au/articles/2005/07/04/1120329381846.html

July 5, 2005

It's more urgent to fight malnutrition and malaria than to tackle climate change, writes Bjorn Lomborg.

IN THE run-up to the G8 meeting in Scotland, the British Prime Minister, Tony Blair, has called on the international community to set the right global priorities, which he has unequivocally stated should be Africa and global warming. Blair is right in challenging us to set priorities. But his choice is probably wrong. While we should accept his challenge, we should also get our priorities right.

Political leaders rarely espouse clear priorities, preferring to seem capable of giving everything to everybody. They must work with bureaucracies, which are naturally disinclined to have their efforts prioritised, lest they end up as anything less than No. 1. Whenever we prioritise, we not only say where we should do more (which is good) but also where we should not increase our efforts (which is regarded as cynical).

But not talking about priorities does not make the need to prioritise go away. Instead, the choices only become less clear, less democratic, and less efficient. Refusing to prioritise, dealing mainly with the most publicised problems, is wrong. Imagine doctors at a perpetually overrun hospital refusing to perform triage on casualties, merely attending patients as they arrived and fast-tracking those whose families made the most fuss. Refusing to prioritise is unjust, wastes resources and costs lives.

So what should be our top global priorities? This question was addressed in a groundbreaking project involving a long list of the world's top economists at the Copenhagen Consensus last year. A dream team of eight economists, including three Nobel Laureates, confronted the basic question: if the world had an extra $US50 billion ($66 billion) to do good, where could that money best be spent?

The top priority turned out to be HIV-AIDS prevention. A comprehensive program would cost $US27 billion, but the potential social benefits would be immense: avoidance of more than 28 million new cases by 2010. This makes it the best investment the world could make, reaping social benefits that outweigh the costs by 40 to 1.

Similarly, providing micronutrients missing from more than half the world's diet would reduce diseases caused by deficiencies of iron, zinc, iodine and vitamin A with an exceptionally high ratio of benefits to cost. If we could only find the political will, establishing free trade could be achieved at a very low cost, with benefits of up to $US2.4 trillion a year. Fighting malaria pays off at least five times the costs. Mosquito nets and effective medication could halve the incidence of malaria and would cost $US13 billion.

The list goes on to focus on agricultural technologies to tackle food production and hunger, as well as technologies to boost the supply of clean drinking water and improve sanitation. Given these problems are most acute in Africa, Blair's priorities have some merit.

But the Copenhagen Consensus showed us not only what we should be doing, but also what should not be done - at least not right now. The experts rated responses to climate change extremely low on the to-do list. In fact, the panel called these ventures - including the Kyoto Protocol - bad projects because they cost more than the good they do.

This does not mean that we should ignore climate change. Global warming is real. But the Kyoto rules will make an almost imperceptible difference (postponing temperature increases from 2100 to 2106) at a substantial cost (about $US150 billion a year). Given scarce resources, we must ask ourselves: do we want to do a lot of good now, or a little good much later?

Far from suggesting a policy of laissez faire, this question addresses the pressing problem of prioritisation head on. Why did thousands die in Haiti during the recent hurricanes and not in Florida? Because Haitians are poor. They cannot take preventive measures. Breaking the cycle of poverty by addressing the most pressing issues of disease, hunger, and polluted water will not only do obvious good, but also make people less vulnerable.

The G8 meeting has put global prioritisation on the agenda. Now is the time to get our priorities right. The urgent problem of the poor majority of this world is not climate change. Their problems are more basic: not dying from easily preventable diseases; not being malnourished from lack of simple micronutrients; not being prevented from exploiting opportunities in the global economy by lack of free trade.

We can prevent HIV by handing out condoms and improving health education. We can prevent millions from dying from malnutrition simply by distributing vitamin supplements. These are not space-age technologies, but staple goods that the world needs.

Doing the best things first would be a great investment in the planet's future. If we are serious about solving the world's most serious challenges, we owe it to ourselves to set the right priorities.

Bjorn Lomborg is the organiser of Copenhagen Consensus, editor of the book Global Crises, Global Solutions and author of The Skeptical Environmentalist.