Many of us have given money to projects in the developing world that are seeking to help in different ways. These often focus on particular things, like schools or orphanages or small-scale employment projects or health.

But say you were given £10 million to invest in improving our world, how would you spend it? How would you even work out how to spend it? What do those who actually have this kind of money do?

The UN has developed a huge programme to solve the world’s problems: the 2015-2030 ‘Strategic Development Goals’ (SDGs). There are 17 goals and 169 targets! While these are mostly admirable in theory, given the UN’s track record, and that of most central-planning attempts, they are flashy, costly, reward the wrong people and typically don’t work very well, with both pragmatic and political pitfalls impacting their effectiveness. The UN defends itself by saying it just needs more money... yet it has a very significant budget. One of the criticisms is simply that it has too many targets – and is spreading its efforts too thinly.

Aiming for greatest impact

Is there, however, a better way? Organisations like Bjorn Lomborg’s Copenhagen Consensus Centre have already laid out practical plans that would achieve real change at a fraction of the UN’s cost – and without the political authoritarianism. Dr Bjorn Lomborg is an economist, a Visiting Fellow at Stanford University’s Hoover Institution and writes for the Wall Street Journal, and the NY Post. The Economist listed his recent book Best Things First as one of the best books of 2023.

Costs and benefits are judged from a hard economic perspective. These economic benefits, however, are borne out of lives saved, improved health and nutrition, and better educated populations who live in more secure environments.

He, working together with many others, has identified twelve areas of development that provide the best cost-benefit calculation – that is, for every pound spent on them, the returns provide multiple pounds in benefits, focused on the world’s poorest people. We tend to think of the good being done in emotional terms, and that’s valid, but it’s the sustained strengthening of the economy that will underpin long-term stability and well-being, so costs and benefits are judged from a hard economic perspective. These economic benefits, however, are borne out of lives saved, improved health and nutrition, and better educated populations who live in more secure environments.

Twelve priorities to focus on

1. Tuberculosis
   This used to be a killer disease in the West – in the UK special isolation wings were added to hospitals to treat it. It has been essentially eradicated here for 50 years, but is still common in developing countries. This is partly because it’s hard to diagnose and needs consistent treatment, so focused education and local clinics are important. The financial costs are relatively easy to calculate, and the benefits can be determined from work-days, child-care, education and skills etc. not lost. Each pound invested in treating and preventing this disease returns £46 of societal benefit – not to mention the reduction in human suffering!
   
2. Education
   Primary education is more widespread, but analysis shows that many still lack basic literacy and numeracy, in part because of large class sizes, where teachers have limited skills. The most cost-effective solutions proposed by Lomborg and co. include a hybrid curriculum of tablet-based self-paced learning, together with other joint work. This fits the teaching to each pupil’s speed of learning while maintaining the social age-based cohesion of the class. Education and know-how drive value in all areas of community life. The cost-benefit ratio for this intervention is calculated at 1:65.
   
3. Maternal and newborn health
   “Newborn babies are at ten times greater risk of dying in low-income countries than in rich countries”, claims Lomborg. As well as the human suffering, this costs up to 6% of GDP in lost potential. Basic Emergency Obstetric and Newborn Care service packages have been developed that could improve this statistic significantly. If applied, they calculate the cost-benefit ratio to be 1:87.
   
4. Agricultural R&D
   Food poverty has decreased over recent decades from affecting a third of the world’s population to only a tenth. But obviously this is still too high; malnutrition kills over 2 million annually. A brilliant 6-fold improvement in crop production over the last 100 years due to improved fossil-fuel powered fertilisers, mechanisation, better crop yields and storage techniques has also reduced prices. But there’s much more to do. One obstacle is smallholders, who cannot produce crops to the same scale as large farms, so our warm support for small-scale development may not necessarily be the right thing, nor subsidies that can distort results. More local research and development is needed to ensure production is maximised for local conditions. The cost-benefit ratio for a greater focus on this is calculated between 1:33 and 1:250.
   
5. Malaria
   Malaria was once well known throughout the world yet has been largely eradicated in developed countries. This is due to insecticides, draining swampy land, physical barriers and quinine treatment. It is now mainly restricted to the African continent, but with increased resistance to drugs and insecticides, deaths are rising. Physical protection (nets) is a key cost-effective factor in prevention, providing £48 pounds in economic benefits for every pound spent.
   
6. E-procurement
   E-procurement is a low-cost intervention with potential far-reaching impact. This is, quite simply, about reducing corruption, which costs the intended beneficiaries of projects over £1 trillion each year through collusion, bribes, sub-standard products, etc. Corruption benefits the already powerful and weakens both the community’s trust in officials and the belief that anything could change. An online system can create transparency, reduce costs through better competition and speed up the whole process. Cost-benefit ratio: 1:38 – 309!
   
7. Nutrition
   The first 1,000 days of a child’s life from conception is crucial for cognitive and physical development, and a quarter of the world’s youngest are not getting the right nutrition to develop properly. Mothers often need supplements when pregnant or breastfeeding to pass to their babies. Cost-benefit ratio 1:14-18.
   
8. Chronic diseases
   Chronic diseases affect all parts of the world, but the greatest impact is on the poorest. Infectious diseases are decreasing while non-communicable diseases predominate. Across the world the main causes of death in 2019 were: heart 33%, cancer 18%, infection 14%, injury/war 8%, respiratory 7%. As we know, some of these are down to lifestyle and focusing on these in various ways from medicine to taxation would bring a cost-benefit ratio of 1:23.
   
9. Childhood immunisation
   Vaccination in the Covid era has acquired a bad name with many, but, historically, ethically administered programmes have been very successful, reducing childhood disease in the West to about 2% of what it was a century ago. The developing world has not yet caught up, so more application is needed. The cost-benefit ratio for this is a whopping 1:286.
   
10. More trade
    Middle-income Americans gained a 29% increase in purchasing power through foreign trade, as imports were cheaper than locally produced items – which was great if it wasn’t your job that was lost to cheaper foreign competition! However, in general, trade helps everyone, through competition, economies of scale and innovation. Reducing trade barriers (tariffs, quotas) seems to benefit all in the long run – but especially those in developing countries. Cost-benefit ratio: 1:7 for richer nations; and 1:95 for poorer nations.
    However, there is an issue with this: other barriers can occur from war and politics, leading to a reassertion of self-sufficiency e.g. in energy, food or manufacturing. From a Western perspective, the growing wealth of Asia or the Middle East from our imports has often not made them friendlier but more aggressive, as they realise our dependence on them – with China being a particular concern.
    
11. Skilled migration
    Some of the solutions promoted could cause greater concern – in particular, free migration. Imagining the world as one nation, allowing free movement, will help the poorest significantly, as many would move to where they can get a better life (skilled or unskilled). Even though global inequality has dramatically fallen by a third in the last 20 years, an estimated 2 billion people (a quarter of the world) plus dependents, would move. We can see that such is the pull to migrate, that the danger is little deterrent – nor is the risk of being an illegal immigrant. But the effects of 20% wage reduction, and failing social and governing institutions, make this very unpopular for receiving nations. Even if longer-term benefits appeared, many would feel it was no longer ‘their’ country. However, this change would bring a cost-benefit ratio of 1:45.
    
12. Land tenure security
    The World Bank estimates that 70% of people don’t have access to formal land registration. This affects domestic and commercial security. Owning land or property leads to investing in it, such as through irrigation or planting fruit trees, thus reducing poverty. However, there is resistance to this from the very top. For example, “In Zambia, the president outright owns all the land”, claims Lomborg. Creating tenure disempowers existing elites. It can be done – Rwanda was the first in Africa to regularise land – but it is a huge undertaking marking and agreeing every piece of land. Cost-benefit ratio: 1:18 (rural); 1:30 (urban).
    

Then UN's glaring omission

The UN’s goals have a glaring omission: better governance. This is probably the biggest single factor in the flourishing of communities (and was foundational for the West’s prosperity). As an economist, Dr Lomborg’s work is invaluable as a well-researched cost/benefit study. It will benefit right-minded governments and also make us think about real-world priorities, and as such, is an important contribution to how we could approach development.

The UN’s goals have a glaring omission: better governance. This is probably the biggest single factor in the flourishing of communities.

Lomborg is very diplomatic as he works with national leaders, but the suggestions of E-procurement and Land tenure – both simple in concept – point to resistance from the governing elite in various countries to carry out reforms. As the majority of nations in the UN have low scores for democratic accountability, it’s maybe not surprising the UN doesn’t emphasise it.

The Bible is highly critical of this behaviour:

“Your rulers are rebels, partners with thieves;
they all love bribes and chase after gifts.
They do not defend the cause of the fatherless;
the widow’s case does not come before them.” (Isa 1:23)

Africa is often a focus for development. Despite its huge mineral wealth, there is widespread poverty. Many there recognise governance failures and push for change. In 2006, a lucrative prize was set up by the Mo Ibrahim Foundation to improve governance, and that work continues. Wanjiru Njoya, a prolific Kenyan commentator, especially on anti-white racism, violence and misgovernment stated; “It is our conviction that governance and leadership lie at the heart of any tangible and shared improvement in the quality of life of African citizens.”

Money matters

There is also the question of who pays for these Best Things. Most funding will come from Western taxation, but the World Bank has been heavily criticised for diverting funds from these priorities to ‘climate issues’. The developing world needs cheap energy, rather than being hamstrung by UN preoccupations. Roughly 600 million people in Africa still lack access to electricity.

Some charities have spent more time lecturing the West on real or imagined historical issues than addressing the more serious current ones hampering poverty reduction.

We need to push our Christian and other charities to agitate more for good governance rather than a ‘don’t rock the boat’ policy – which plays into the hands of political abusers. Some charities have spent more time lecturing the West on real or imagined historical issues than addressing the more serious current ones hampering poverty reduction.

Through all this grand planning, support for small-scale work is always welcome, as it adds to whatever else gets done, and in the many countries where Christians are persecuted, it provides vital aid and encouragement that would come from nowhere else.