Something's hot in the state of Denmark

A veritable bean-counter Olympics just took place in
Copenhagen. Can the policy wonks save the third world?

By Peter Woodford

When wealthy westerners take pause and look to the woes of the world's poorest countries, expected reactions would run the gamut from sorrow, guilt, compunction, to even outrage. But how about regret � that an economic opportunity has gone begging? This last sentiment inspired a team of eggheads to harness some of the greatest economic minds in academia to launch the lofty Copenhagen Consensus.

The whole thing started when a group of economists at Denmark's Environmental Assessment Institute, frustrated with the doomed Kyoto accord, decided to take an economic approach to solving the world's problems. Why stop at the environment, they asked themselves. They set about prioritizing and putting price tags on the solutions to some of the most pressing issues. That's when the Copenhagen Consensus was born. Health, particularly in less-developed countries, figures prominently in their plans because unhealthy people are notoriously unproductive.

The Copenhagen Consensus' organizers take a dim view of many previous attempts at global problem solving, like Kyoto, dismissing them as economically unsound and thus unlikely to be put into action. They decided to set the more emotive sentiments aside and focus on cost/benefit analysis. The group invited international experts in a number of economic fields to write challenge papers with their prescribed remedies to a pressing global problem and an estimated cost of implementation. They took on tricky tasks like estimating the economic benefit of dealing with the high incidence of low birth weight in sub-Saharan Africa, hunger and malnutrition, and communicable diseases. The papers were presented at the week-long summit held from May 24 to May 28 in Copenhagen.

SUMMIT'S UP
Boiled down to its essence, much of the summit aimed to provide the best ways for richer nations to buoy the poorest ones, which they hope will cause markets to grow and money to circulate more rapidly. The areas of global health tackled by the Copenhagen Consensus experts were communicable diseases, malnutrition, access to basic healthcare services, and hygiene. Middle-income, developing countries have been doing quite well at reducing infant mortality, controlling diseases like malaria, and raising their citizens' life expectancy, so the lion's share of the Consensus' attention was focused on less-developed, particularly sub-Saharan African, countries.

The summit structure is quite novel; the original challenge papers were disseminated and then critiques or 'opponents' views were drafted by dissenting experts. In one paper, Health Economists Ann Mills and Sam Shillcutt of the London School of Hygiene and Tropical Medicine, tackled communicable diseases. The authors found that a relatively modest investment in insecticide-treated nets for protecting children in sub-Saharan Africa would yield a very high cost/benefit ratio of 10 (in money terms, an investment of $1.7 billion US would yield a benefit of about $18 billion US) and greatly assist in the battle against malaria.

While the humanitarian benefits of protecting these kids against the ravages of malaria are pretty straightforward, the Consensus are more interested in the real, albeit complex, connection between the disease and economic loss affecting even those who don't get sick. For example, malaria has been shown to affect cognitive development, leaving some sufferers less fit to take care of themselves in the long-term. The result is that someone (ie, a parent) who may have otherwise been a productive worker might be compelled to act as caregiver to the affected person.

Professor Mills is quick to point out that one mustn't dehumanize the world's sick and poor and think of them only as "producers." "I think the Copenhagen Consensus is a very interesting opportunity to look at the economic costs and benefits of these problems," she says, "but with a big caveat � other sorts of information are also important when deciding which problem to tackle."

The opponent notes written to critique her paper by Jacques van der Gaag, Dean of the School of Economics at the University of Amsterdam, questions some of the dollar figures and argues that money given to under-developed states often benefits their more affluent residents. Professor Mills agrees that unequal access is a nagging problem in the Third World. "The better-off receiving disproportionate benefits from public health services in very poor countries can be partly explained by the simple fact that they have better access to urban centres where those services are concentrated," she says, adding, "I would definitely favour actions that would increase universality of healthcare coverage."

All challenge papers and opposition notes from the Copenhagen Consensus are available at www.copenhagenconsensus.com.