Jeff Sachs has ideas about how to solve the "crisis in the drylands," but first this is Dani Rodrik noting that Sachs' views on distributing insecticide treated bed nets for free to populations threatened by malaria appear to have been vindicated:
Jeff Sachs vindicated: On insecticide-treated bed nets (ITNs), at least. There has been an ongoing battle between Sachs and segments of the global public health community on ... whether ITNs should be distributed free (the Sachs position) or at a positive, albeit subsidized price. Those who favor the latter argue, in part, that charging a fee makes the program more sustainable and that it reduces wastage from giving away the nets to those who do not need or will not use it. See the arguments here (gated, unfortunately).
A new randomized experiment carried out by Jessica Cohen and Pascaline Dupas reaches striking and unambiguous results:
Taken together, our results suggest that cost-sharing ITN programs may have difficulty reaching a large fraction of the populations most vulnerable to malaria. ...[W]e find that ... free distribution is more cost-effective than partial-but-still-highly subsidized distribution... We also find that ... the number of infant lives saved is highest when ITNs are distributed free.
Finally, we do not find that free distribution generates higher leakage of ITNs to non-intended beneficiaries. To the contrary, we observed more leakage and theft (by clinic staff) when ITNs were sold at a higher price. We also did not observe any second-hand market develop in areas with free distribution. .
This is randomized experiments at its best: it addresses an important policy question and significantly changes (or should change) our priors on it.
Here's more from Jeffrey Sachs, but on a different topic, solving the ongoing crisis in the drylands:
Crisis in the Drylands, by Jeffrey Sachs, Scientific American: The vast region of deserts, grasslands and sparse wood lands that stretches across the Sahel, the Horn of Africa, the Middle East and Central Asia is by far the most crisis-ridden part of the planet. With the exception of a few highly affluent states in the Persian Gulf, these dryland countries face severe and intensifying challenges, including frequent and deadly droughts, encroaching deserts, burgeoning populations and extreme poverty. The region scores at the very bottom of the United Nations’ Index of Human Development...
As a result of these desperate conditions, the dryland countries are host to a disproportionate number of the world’s violent conflicts. Look closely at the violence in Afghanistan, Chad, Ethiopia, Iraq, Pakistan, Somalia and Sudan—one finds tribal and often pastoralist communities struggling to survive deepening ecological crises. Water scarcity, in particular, has been a source of territorial conflict...
Washington looks at many of these clashes and erroneously sees Islamist ideology at the core. Our political leaders fail to realize that other Islamic populations are far more stable economically, politically and socially—and that the root of the crisis in the dryland countries is not Islam but extreme poverty and environmental stress.
The Washington mind-set also prefers military approaches to developmental ones. The U.S. has supported the Ethiopian army in a military incursion into Somalia. It has pushed for military forces to stop the violence in Darfur. It has armed the clans in the deserts of western Iraq and now proposes to arm pastoralist clans in Pakistan along the Afghan border. The trouble with the military approach is that it is extremely expensive and yet addresses none of the underlying problems. ...
Fortunately, much better solutions exist once the focus is put squarely on nurturing sustainable development. Today many proven techniques for “rainwater harvesting” can collect and store rain for later use by people, livestock and crops. In some areas, boreholes that tap underground aquifers can augment water availability; in others, rivers and seasonal surface runoff can be used for irrigation.
Such solutions may cost hundreds of dollars per household, ... far too much for the impoverished households to afford but far less than the costs to societies of conflicts and military interventions. The same is true for other low-cost interventions to fight diseases, provide schooling for children and ensure basic nutrition.
To end the poverty trap, pastoralists can increase the productivity of livestock through improved breeds, veterinary care and scientific management of fodder. ... The wealthy states of the Middle East are a potentially lucrative nearby market for the livestock industries of Africa and Central Asia.
To build this export market, pastoralist economies will need help with all-weather roads, storage facilities, cell phone coverage, power, veterinary care and technical advice, to mention just a few of the key investments. With crucial support and active engagement of the private sector, however, impoverished dryland communities will be able to take advantage of transformative ... technologies...
Today’s dryland crises in Africa and Central Asia affect the entire world. The U.S. should rethink its overemphasis on military approaches, and Europe should honor its unmet commitments of aid to this region, but other nations—including the wealthy countries of the Middle East and new donors such as India and China—can also help turn the tide. The only reliable way to peace in the vast and troubled drylands will be through sustainable development.