I think not. I’ve just returned from a meeting of malaria researchers in Basel, Switzerland. The meetings were excellent. It is rare to have such a wide showing of malaria experts in one place, talking about nothing but malaria.
The meeting was notable for what was included, namely excellent presentations on vaccine development, subsidies to increase access to medications, malaria elimination programs in less than talked about parts of the globe (Bhutan, Turkmenistan, PNG), and the paucity of research on Plasmodium vivax.
The meeting was also notable for what it did not include, namely global economic determinants of malaria.
To me, malaria is 100% a disease of poverty. Where poverty is low, malaria is low. This is true globally, as well as within still malarious countries. The graph to the right shows the relationship of country level GDP with the estimated number of malaria cases per 100,000 in 2006. Though accurate data on the true number of cases is difficult to obtain for developing countries for a host of reasons, the trend should be clear. More money equals less malaria.
Is this because on better funding for malaria programs? After all, wealthier countries are able to put more resources into prevention, mosquito control, and treatment. Sure, I think this is partially the case. It has to be said, however, that malaria was eliminated from the United States without modern medicines and insecticide treated bednets, cornerstones of current malaria control strategies. Though DDT was instrumental in helping to control malaria transmitting mosquitoes in the US, the truth is, the bugs are still here.
Malaria deaths around the world are down. It is also the case that worldwide development is up. The economies of developing countries are improving, record numbers of people are moving out of entrenched poverty and, while within country inequality is increasing, global inequality is decreasing. Personally, I think the relationship between development and malaria is no accident at all.
What strikes me, is that this topic was hardly mentioned last week. I brought it up a couple of times, but, unfortunately, scientists are hesitant to move out of their comfort zone, and wish to give it little thought. Talk of politics or economics produces blank looks in scientists trained in microbiology or entomology. I’m sure its the same on the other end. Certainly, the current research is important, helpful, relevant and should be continued. However, I don’t think that we, as scientists, should stick our heads in the sand and willfully ignore the bigger picture.
Malaria will be eliminated not through fancy pharmaceuticals and ever improved bednets, but through the increase in access to employment, market economies and remunerative opportunities. Malaria will be eliminated through the elimination of entrenched poverty, the expansion of free education, reductions in gender inequities and improved nutrition. In my opinion, these were the true factors which led to the elimination of malaria from the US, Europe, Japan. Granted, there are climatic differences between those countries and sub-Saharan Africa, but P. vivax, a cold weather malaria, was also fully eliminated.
People I spoke with sort of waved their hands and acted as if there is nothing we can do about these global and economic problems. I disagree, of course. Policy makers look to scientists for answers (though they make ignore what they don’t like). Endless bednet trials that only marginally expand on previous research do not do much to ameliorate the structural factors which keep people in poverty. Research which explores those big picture factors, however, could have vast benefits.
My good friend Kathleen recently picked up a job at the World Bank. She used to work at National Geographic. Getting jobs at really interesting and amazing places is a symptom of having a great personality and living in Washington D.C.
Recently, she sent me a note telling me how great the food at the Bank is. This is the week of the World Bank/IMF spring meetings (please get me tickets) so, to celebrate, I asked her to write a short piece about it. Next time I go to D.C., lunch will be at the Bank, preferably with Kathleen and Jim Young Kim, listening to the beautiful sounds of an employed piano player two floors up.
Anyway, here’s her mouth-watering piece on eating at the World Bank:
Many office buildings house a small store where you can buy soda, gum, and chips. At the World Bank, that store has espresso, refrigerator magnets, and wine. The last thing I bought there was a cucumber, mint, feta cheese tabouleh wrap. And a bag of chips. Well, no, no chips.
The cafeteria at the Bank is famous. Google has an autocomplete for it. It has a Yelp page. You use real plates and cutlery. So grab a tray and come with me! The first station is called whole+sum. You pick a protein and two veggies. Today’s are
—Green Chile Chicken Stew with Potatoes & Peanuts
—*Spicy Black Bean Chili with Lime Crema
—Fresh Tilapia in Rich Mole
—*Poblano Brown Rice & Beans
—*Farro Salad with Orange Cumin Dressing
—*Cilantro Jicama Slaw
—*Grilled Pineapple Wedge with Honey & Lime
—*Romaine Lettuce, Mango, Red Onions, Radishes & Buttermilk Avocado Salad Dressing
The asterisks above and the cards by the food indicate what is veggie and what has pork. Today’s general theme is Cuba. The “Global” station is serving “ropa vieja, pollo a la babacoa, moros y cristianos, yuca frita with mojo sauce, jicama salad with avocado, and ensalada rusa.” For the rest of the week we will be seeing jicama. They will work leftovers into the salad bar and sandwiches. (The World Bank building itself is built from buildings they’ve used since the 1940s. Use leftovers.)
The soup station has four kinds. Because this is the World Bank (did she just say “Je prends un bento box,” working three languages?), the stations are named South Asian & African, Pacific Rim, Quiche, Noodle Bowl, Good (“A new station that is good for you, your neighbor, the community, and the planet” that today features lemon herbed chicken, sockeye salmon with herbs de Provence, gingered ahi tuna, beef with cracked pepper and garlic, sage citrus pork [contains pork]), Mediterranean Flatbreads, Pizza, Deli, Everything Vegetarian, Sushi/Sashimi/Bento Box, Salad Bar. The desserts are what you would see at a Paris bakery. There is a frozen yogurt station. At the cashier station, there are cookies, apples, and wine. (I figure this is a French thing. It’s the second most-heard language in the hallways. France is a country that “graduated” quickly from being a recipient of funds to being a donor.)
Each station expands with ever-changing flavors. My Czech teammate, who is studying Chinese, often gets ramen at the Noodle Bowl. You get two or three noodles to choose from, two or three broths (today it’s red coconut curry or tom yum), chopped tofu and green onions, and all that stuff. Three kinds of flatbread at that station. Ever-rotating African street/comfort food.
The building takes up an entire city block. The dining hall nearly does. Because the selections are so many and the dining room so vast, there is a waiting area just past the cashiers. I don’t know how the cashiers do their job, but the food is simply and very reasonably priced (often by whether or not there is meat) and the cashiers are reliably cheerful.
They have eliminated single-serving condiment packets; the waiting area is where you get Sriracha for your noodles, vinegar for your pommes frites. The takeout containers and cutlery are biodegradable.
The walls of the main dining room feature doors of the world. They are beautiful, painted, carved, mostly wood. Many must be surprised to find themselves in a D.C. basement after so many years on a farm in Kazakhstan or a temple in Malaysia. If you don’t want to eat in the main dining hall, you can eat on a bridge over a pool or on a mezzanine. From the mezzanine you can enjoy the sounds of a player piano two stories up.
The diversity continues: There are children. The Bank has daycare and many kids get to have lunch with their parent. Got a picky eater? Take him to the World Bank cafeteria.
Dr. Jim Young Kim, former President of Dartmouth, has formally been named as the next head of the World Bank. It marks the first time that a Michael Jackson impersonator has been chosen to lead an international development organization.
The naming of Kim is somewhat anticlimactic. Jeff Sachs made a very visible appeal to the position, travelling around the world and obtaining the endorsement of high ranking figures in countries suchs as Kenya and Costa Rica. When the short list of candidates came out, which included Larry Summers, it was obvious that the Obama admin hadn’t even considered Sachs at all.
Kim was quickly named following the rejection of Summers by European members of the World Bank’s administration. Former and current executives at the Bank called to offer the position to either Ngozi Okonjo-Iweala, Nigerian Finance Minister or former Colombian Minister of Finance Jose Antonio Ocampo, both appropriate candidates.
Kim’s appointment is important as it represents the first time that developing countries had any say in who would lead the Bank. The influence of the BRICS is rising, and clearly with good results. The United States will likely be a dominant world power for decades to come, but it’s waning influence should be a welcome change.
Despite so much discussion world wide, it was disappointing that Kim would be offered the job to such little fanfare though this too, could be indicative of America’s more seemingly humble facade on the world stage. I believe that Kim will likely be the last American appointee for a while, though applaud his appointment.
Kim will make a fine leader for the Bank. Let’s hope that he leads it well.
I received the following from an unnamed source.
Statement from Jim Yong Kim
Date: April 16, 2012
Dr. Jim Yong Kim today released a statement in response to his selection by the World Bank’s Executive Directors as 12th President of the World Bank:
“I am honored to accept the Executive Directors’ decision to select me as the next President of the World Bank Group. I am delighted to succeed Robert Zoellick, who has served with excellence and distinction during the last five years, and I am grateful to the Bank’s member countries for the broad support I have received.
I have spoken with Minister Okonjo-Iweala and Professor Ocampo. They have both made important contributions to economic development, and I look forward to drawing on their expertise in the years to come.
It is befitting that I conclude my global listening tour in Peru. It was here in the shantytowns of Lima that I learned how injustice and indignity may conspire to destroy the lives and hopes of the poor. It was here that I saw how communities struggle to prosper because of a lack of infrastructure and basic services. It was here that I learned that we must raise our sights to match the aspirations of those most excluded. And it was here that I learned that we can triumph over adversity by empowering the poor and focusing on results.
As President, I will seek a new alignment of the World Bank Group with a rapidly changing world. Together, with partners old and new, we will foster an institution that responds effectively to the needs of its diverse clients and donors; delivers more powerful results to support sustained growth; prioritizes evidence-based solutions over ideology; amplifies the voices of developing countries; and draws on the expertise and experience of the people we serve.
My discussions with the Board and member countries point to a global consensus around the importance of inclusive growth. We are closer than ever to achieving the mission inscribed at the entrance of the World Bank – “Our Dream is a World Free of Poverty.” The power of this mission is matched by the talent of the World Bank Group staff. May this shared mission embolden our efforts to end the disparities which too often diminish our shared humanity. Let us work together to provide every woman and man with the opportunity to determine their own future.”
Last week (or whenever) I wrote the praises of Dr. Kim, now head of Dartmouth, who is slated to be Barack Obama’s nominee to lead the World Bank after Robert Zoellick steps down in June. While it’s a given that the Americans will have their way, this has not stopped the rest of the world from proposing its own candidates.
The Economist, for those living in a box, is a (European) right leaning weekly news magazine. Inexplicably, I have been given a free online subscription. Despite occasionally receiving emails from its editors that this subscription has been given to me in error, I continue to have full access to the magazine (and its audio component) every week. I don’t complain.
This week’s included an article on Ngozi Okonjo-Iweala, present Nigerian finance minister, and former Managing Director of the Bank (one of many), appointed by Zoellick himself. Graduating magna cum laude from Harvard and later pursuing her PhD in regional development at MIT, she seems suited to the task.
The Economist (and now also the Financial Times) believes Kim to be a substandard nominee, noting his lack of experience in development economics and economics in general. They also note his lack of experience at the Bank and not so subtly malign his work at Partners in Health as “charity work.” Interestingly, they overlook his experience on the HIV/AIDS commission at the WHO, an organization that is hardly charitable.
Worse yet, they dig in to Dr. Kim’s past, noting that he quoted radical academic Noam Chomsky in a University address and his praise of Cuba’s health care system, painting him as some sort of communist lefty, as if to say that providing cheap and effective health care is a bad thing. Certainly, the United States could stand to learn a lot from Cuba’s system.
It’s almost as if the Economist stole from the playbook of the Republican Party during the 2008 presidential election. I would think that his having given former Pres. George H.W. Bush an honorary degree at Dartmouth would erase such suspicions.
Ngozi Okonjo-Iweala is not a bad candidate. Her experience at the Bank and her status as one of a few respected members of the horribly corrupt Nigerian government make her suited to the role. It is also not surprising that colleagues at the Bank have come to call for her appointment. However, it could be that Dr. Okonjo-Iweala’s connections to the Zoellick/Wolfowitz Bank may be that which makes her a less than desirable candidate. Dr. Okonjo-Iweala could be an entrenched contintuation of a heavy handed Bank aligned with US financial interests, rather than an advocate of truly human development.
Certainly, the Americans will win, as they always do in matters pertaining to the Bank. However, we could have done much worse than Kim. My personal opinion, though a person who has limited experience with or at the Bank (read: none) is that the head of the Bank is a diplomatic and managerial position. The head of the Bank may bring vision and choose those who may develop strategy, but does not develop strategy. Dr. I assume that Kim, who clearly has laudable intentions will choose a staff which will address seemingly ingnorable problems such as world wide poverty and inacceible health care. Though I would like to see the Bank leadership go to a non-American candidate, my vote, at this time, is for Mr. Kim.
Go, cosmic rapper.
It was announced to day that Barack Obama will appoint Dartmouth President and physician Jim Yong Kim to be the next head of the World Bank. This breaks a string of appointments of right wing demagogues including Paul Wolfowitz and Robert Zoellick, both part of the group which orchestrated the invasion of Iraq and the heavy handed response to 9/11 by the Bush admin. I saw Zoellick speak recently and felt kind of gross after it was over.
Jim Yong Kim has an impressive list of publications on global health, notably collaborating with Partners In Health founder and human advocate, Paul Farmer. In fact, Kim was also part of the group that founded PIH and is known for his work on “Social Medicine” (a broad signifier for social determinants of health with a focus on clinical delivery).
Kim is co-founder of The Global Health Delivery Project, a group at Harvard that seeks to improve the health and welfare of population in developing countries by focusing on issues of health care delivery.
Problems of delivery of health care in developing countries has been perhaps my number one interest as of late. In fact, I am even writing a paper on it. As researchers, we can develop effective and radical new clinical techniques and medicines, but they do no good if the systems aren’t in place to deliver them effectively. Issues of delivery will be the primary impediment to controlling and eventually eliminating devastating diseases such as malaria. It is encouraging that Kim has been selected to fill this position.
It is unsurprising that Columbia University development economist Jeff Sachs was not chosen (he has withdrawn his nomination), despite appealing to the world community to pressure the Obama admin to select him. However, it is a relief that the first choice, Larry Summers, has to forego stepping in to a leadership position at the WB. I can think of no WORSE choice. The entire world appeared to agree and it marked the first time that the international community has had a say in who heads the Bank, a welcome departure from past appointments.
Sachs himself even came out in support, likely aware of his role in having Kim picked: “Dr Jim Kim is a superb nominee for the World Bank presidency,” Sachs said in a statement. “I support his nomination 100 percent. I congratulate the administration for nominating a world-class development leader for this position.”
I am interested to learn more about Kim. He may certainly have some ideological skeletons in his closet, though his association with Farmer leads me to think not. Congratulations to the Obama admin for taking the high road on this one.
UPDATE: OK, so it appears that Kim will be the first WB President to ever be caught on film rapping and dancing at a Michael Jackson tribute:
A new World Bank report on the state of poverty in the world suggests that the number of people living on $1.25 a day have declined over the past decade. Even raisig the bar to $2.00 a day indicates great gains in the world fight against poverty.
Much of the improvement in world poverty numbers come from Asia, specifically China, which can boast that nearly 662 million people now no longer live on less than $1.25 a day compared to 1981. In 1981, nearly 77% of people in East Asia lived in poverty. Now, only 14% do.
Though this is cause to celebrate, the world is not out of the woods yet. Africa, though slowly recovering from the disastrous structural adjustment era, which erased previous gains in poverty reduction, still provides home to large numbers of ultra poor households, particularly in rural areas. Nearly 45% of Africans live in poverty at present.
One should praise the great successes of economically emergent Sub-Saharan African countries. One should not forget to ask why Asia has been a success story and why Africa has not. Most relevant, the World Bank should at least make mention of their complicity in creating conditions of entrenched poverty in Sub-Saharan Africa.
When I saw Robert Zoellick of the World Bank last year, he only made passing mention of the programs which erased Africa’s past economic gains, dismissing the matter as a fringe concern of political freaks and over-reactionaries. The simple truth is that it is impossible to dismiss policies which have favored narrow US interests and reflected a narrow view of economics only appropriate for the most developed of countries, policies which have been implemented at the expense of the very poor.
Jeff Sachs, world famous development economist and savior of developing countries the world over has offered to take the job. (Check out a hilarious set of videos of Jeff Sachs gallavanting around the world with Angelina Jolie, here, here and here).
We could do worse. Larry Summers, Secretary of the Treasury under Clinton, advisor to Presidents Bush and Obama, former head of Harvard University and vocal adherent to the idea that men are inherently smarter than women (which he lost his job for).
Larry Summers was complicite in the final negotiations of the 1993 WTO Uruguay Round of trade talks, (the largest international trade agreement since GATT), and which ceded many international trading powers regarding develeoping countries to large (and US/British controlled) financial institutions like the WTO. African countries were largely unaware what they were signing when they signed on. During the Uruguay round, African countries largely ceded their ability to participate in trade resolutions and put control on international markets in the hand of big guns such as the United States. Larry Summers was on hand to threaten to take away foreign aid if they didn’t sign on.
It would be a disaster for the developing world if Larry Summers were to head the World Bank.
Hillary Clinton has long been pegged to be next in line for the chair of the World Bank, though she herself has been cagey on the issue.
I doubt Sachs will get the job, given the track record of the US in selecting World Bank heads in the past. The United States has reserved the right to name the head of the The World Bank since its inception, despite being an international institution. That Sachs is American might help, but his lack of shady Washington connections count him out. His alleged brief track record of neo-liberalism, particularly his controversial role in East European economic “shock therapy”, might help his case.
I respect the man’s work. There aren’t many out there that have been willing to be so vocally critical of US policy toward developing countries and its impact on human health. He makes his case in a manner that is understandable by even those not familiar with global health and world economics, and the video with Jolie clearly shows that he’s more than willing to take his case to the American public.
Uniquely, Sachs has been more than willing to take the Obama administration to task for it’s policy of doing absolutely nothing for global health. I had the pleasure of seeing Sachs speak at the last meeting of the American Society of Tropical Medicine and Hygiene and spoke with him briefly afterward where I proceeded to ask him for a job. He laughed and kindly told me to email him.
Robert Zoellick, present head of the World Bank, came and spoke at the UM Business School today. I went into the talk with a number of personal prejudices, though I attempted to keep an open mind. It’s difficult, though, after having read so much about the World Bank and its deep history of pushing US economic policy on to the world and make life unbearable for developing economies.
Zoellick himself has a complex history. In addition to being appointed head of the World Bank in 2007 under GW Bush, Zoellick has served and the Deputy Secretary of State and the US Trade Representative under Bush and, worse yet, was the managing directed of Goldman Sachs. Zoellick served as Executive Vice President of Fannie Mae, and as Deputy Chief of Staff under George Bush, Sr.
Zoellick signed the famous Jan 26, 1998 letter to President Clinton from the Project for the New American Century (PNAC), along with Richard Armitage, Robert Kagan and Donald Rumsfeld, that advocated for war against Iraq. PNAC were a neo-conservative think tank who were instrumental in the development of the worst policies of the Bush years, including the failed strategy in Afghanistan and the disastrous invasion of Iraq.
Although the group is now defunct, and some of its members, such as Stanford professor Francis Fukuyama, have publicly disavowed their links to the group (and its importance), PNAC’s philosophy is summed up in its by-line:
“The Project for the New American Century is a non-profit educational organization dedicated to a few fundamental propositions: that American leadership is good both for America and for the world; and that such leadership requires military strength, diplomatic energy and commitment to moral principle.”
Zoellick was part of the dubious foreign policy advisory group during GW Bush’s 2000 campaign, the Vulcans, which included later World Bank head Paul Wolfowitz, later Sec. of State Condoleeza Rice, Richard Armitage and others. This group would help form the disastrous Bush Doctrine which would appear after the 9/11 attacks.
Zoellick’s laundry list of neo-conservative credentials should give one pause to consider how he would become the leader of a financial institution whose stated goal is “poverty reduction.”
Zoellick’s presentation was essentially a reading of the World Bank PR sheet, listing the five points that Zoellick stated that he hoped to achieve when he became leader of the Bank in 2008. Zoellick was only challenged directly by two groups of individuals. First, was a staged walk-out of people wearing dollar bills over their mouths, intended to distract the audience from Zoellick’s introduction. Second, was a question by Alan Haber, the first President of the Students for a Democratic Society. While he drew sneers and laughs from the audience, he was the only person to mention the World Banks dubious past, specifically, the structural adjustment policies of the 80′s and 90′s, which led to vast declines of health and economy in African countries.
Zoellick was noticeably agitated by Haber’s question and rather bullish in his response. He claimed that the Bank hasn’t endorsed structural adjustment policies for 15 years. The content of his presentation, however, conflicted with this claim.
Zoellick repeatedly called for the liberalizing of markets by developing countries, specifically calling for deeper access of American businesses to developing economies, a view which is essential to neo-liberal thinking. He blatantly referred to the Bank as a means of pursuing United States economic interests though the encouragement of market liberalization in the developing world. Odd, given that the Bank is supposedly an international body. I have long found that conservatives only rail for free markets as much as it benefits themselves. Zoellick proved that he views the liberalization of markets as necessary only in such that it benefits US economic interests.
At numerous times, he called for the privatization of government services, using an example from China to illustrate his point. China recently took the Bank’s advice (and their money) to privatize toll roads in one province of China, emanating Indiana, of all places. Zoellick called government allocation of resources “inefficient,” ironic considering that the World Bank itself is a government body. Zoellick referred to the Bank’s (arguably paternalistic) role in helping to root out political corruption and inefficiency in developing country economies.
Most telling, however, was Zoellick’s attitude of US exceptionalism. He claimed several times, that the United States has an important role to play in insuring world political and economic stability. He called for the United States to remain focused on foreign policy and not to sidetrack itself with its domestic concerns, as it has done since the 2007 economic crisis, but the aims of that foreign policy appear to mostly economically sef-serving. Still, this is clearly a philosophical point of United States hegemony, oft repeated by US right wingers. Zoellick stated flatly, “if the US sidelines itself, it’s going to become a much nastier world.” While this is a point that’s free to be debated, it can be argued that the world has become a nastier place simply because the US refused to sideline itself on certain issues, an historical fact that Zoellick, like other heavy handed right wingers, chooses to overlook. How Zoellick and his conservative bretheren, some of whom are fighting for the next Presidential nomination, presume to maintain US “exceptionalism” in a world of rising economic powers is completely up to speculation.
I sincerely tried to listen to the presentation while being skeptical of the World Bank’s critics[1-3]. However, Zoellick essentially solidified my position that the World Bank is a body that acts solely in the economic interest of the United States. While individuals at the Bank may sincerely wish to better the world and alleviate poverty, it is apparent that the leadership works under narrow, self-interested goals, antiquated economic assumptions, and in a sequestered environment which prevents them from truly seeing the larger economic picture of the world. In addition, the condescending tone that Zoellick takes when referring to developing nations (specifically in SSA) make the entire prospect is rather frightening.
1. Stein H: Beyond the World Bank agenda: an institutional approach to development. Chicago: University of Chicago Press; 2008.
2. Stiglitz JE: Globalization and its discontents. New York: W. W. Norton & Co.; 2002.
3. Cooper F: Africa since 1940: the past of the present. Cambridge, U.K. ; New York: Cambridge University Press; 2002.
3. Howard S: Economic development and the anatomy of crisis in Africa : from colonialism through structural adjustment. 2000.