Bjorn Lomborg Keynote Lecture

Summary:

On 30 November 2023, the Rafael del Pino Foundation organised the keynote lecture "The 12 most efficient solutions to the main global problems. What works", given by Bjorn Lomborg, Danish academic, writer and environmental activist and president of the Copenhagen Consensus Center, on the occasion of the publication of his book of the same title.

How do we think about a world where there are many things we want to do, but we don't have enough money? How do we do good? Well, we have the famous SDGs. Every government in the world has committed to them until 2030. What they promise. They promise everything, to everyone, everywhere, all the time. Of course, there are many goals, 169. Many hundreds of promises: to end poverty, to create social protection systems, to end hunger and get organic apples, to end communicable diseases and to stop drug and alcohol abuse. Some of the promises are great and can be achieved, but others, like alcohol abuse, we don't know how to do it. Then we are also going to solve all the war, inequality, jobs for all, sustainable tourism, living in harmony with nature, having more urban parks for the disabled and many more goals.

These are all good intentions, but we are not achieving them. Jeffrey Sachs has done an admirable thing which is to try to determine how many of the targets we are achieving. In 2000 we were at 50%. Over the years we have reached 67 and, at this rate, we will reach 72% by 2030. But we had promised that we would be at 100% by that date. We are doing things in such a way that we are not going to be happy because we are not going to get there. If we kept going at the current rate, we wouldn't get there until 2080. We are half a century behind schedule. This cannot be if you promise everything to everybody, there are no priorities, you are not committing yourself in a sensible way. What you are doing is spreading scarce resources like butter on a huge slice of bread.

We can do so much more, but it requires us to prioritise. Why don't we prioritise? We have a lot of good causes, so most government and investor donors are going to put their money into things that have these causes: cute animals, crying babies, NGOs. But we don't. We need to prioritise better. In the Copenhagen Consensus we are working on how to prioritise, where to spend the last dollar. What we have done is to look at all the targets to locate those places in the world where we can do the most good. That is, for every euro spent, to get fifteen euros of good, fifteen times or more the benefits. We are looking at how to do things well. Some don't require a lot of money, but most do. There is also a non-financial cost. If you tell a mother to take her baby to be vaccinated, maybe she needs half a day to do it, maybe they have to take a bus and it costs them, and they have to take time off work. That is a cost, but it is not a cost that we have to cover.

All these promises are going to cost $41 billion, but $6 billion is not financial, so we need $35 billion every year. It's tremendous, but it's not much in the international system, but the important thing is that we are going to save 4.2 million lives a year. Also, the poorest part of the world is going to be richer by a trillion dollars. If we do it right, we are going to get a fantastic result.

This is not difficult. If there is a lack of money, how are we going to achieve it? There are things that achieve a lot of results with little money, others that consume a lot of money for few results, and others that we don't know how to correct, how to fix. That is why we have to prioritise.

There are three ideas that help us. They are three issues: education, maternal and child health and tuberculosis. Everyone agrees that education is extremely important everywhere in the world. The world's children are in school, but they don't learn much. The world's poorest countries have doubled investment in education in recent years, but there has been virtually no impact on learning. We are spending a lot of money, but we don't see it making a difference. Children don't understand what they are reading. The UN does a report and asks children to read a sentence and 80% of children in the poorest part of the world don't respond because they can't read the sentence, they can't get the words to make sense in sentence form and, if you don't get it, you're not going to be productive when you're an adult. We're talking about 370 million children who are functionally illiterate. It's a horrendous result.

We know a lot about what doesn't work. If we ask people how to fix learning, some will say that we need better teachers, that we need to pay them more, that class sizes need to be smaller, ... These are many arguments and we hear them many times when we talk to people, but that's not the way things are. Fewer students per classroom works somewhat, but it is very expensive. Indonesia is a fantastic example of what doesn't work. The country wanted to improve education and included in the constitution a doubling of investment in education. Teacher salaries skyrocketed, they hired a million more teachers, they have one of the smallest average class sizes. They did it in different regions at different times, which allowed for random checking, but it had no impact on learning. They spent a lot more, they had much smaller class sizes, teachers were happier, but that was not the objective. So you have to recognise that there are a lot of things that don't work, or work badly.

But there are many things that do work. What is the most pressing problem in education? We're talking about New Delhi, we're talking about mathematics, and we're talking about children at the end of secondary school. The researchers went and asked the children what grade they were in, and they were in different grades. If you are a teacher, how are you going to train these children? You're a teacher, there are fifty kids. These kids are going to be bored out of their minds and some of them are not going to understand what's going on. So most of the children don't understand anything. If all the twelve-year-olds are together in a classroom, but they are very different, you are not reaching the level of each one of them. You have to teach kids at their level. The problem would be the same if you had 50% of boys and girls. That's why reducing class size doesn't work. Fortunately, there is another way to teach each child at his or her level. Put him or her in front of a tablet, with a pedagogical training software for one hour a day. This software will quickly determine the level of each student and will teach them immediately at their level. This system is much better and, as it is a guarantee, you can share the tablet among many children, so it is less expensive. And if you give them the tablet they will share the drawings. What we do is make sure that it is a pedagogical tool, so we are going to get a fantastic result. If you do it for each pupil for one hour a day, the pupil is going to learn a lot. If you do it for a full school year, it will cost $31 per student per full year for one year. At the end of the year, he will have learned three times what he would have learned otherwise. This will mean that each child will be smarter and therefore more productive as an adult and will be able to earn the equivalent of an additional $2,000 in income. In short, learn according to level and give children a tablet one hour a day with pedagogical software.

It can be done in a cheaper way, which is without technology. They simply test the children once a year and the worst ones are moved to one class, the intermediate ones to another and so on. It is much cheaper and the most advantaged are together, dividing the classes by levels.

Another formula is structured pedagogy. We know that in poorer countries the teachers are little more educated than the children and many of them have no idea about pedagogy. These teachers say that lessons are often unplanned. We know that today, when we teach mathematics in one way, but 40% of teachers don't even introduce the concepts. There should be workshops to learn how to teach, for example, fractions. This helps teachers to be better. Malawi has come up with tablets for primary school pupils. So has Kenya. It's all based on randomised trials and we know they work. Of course tablets will be stolen, children will lose them or have them stolen, there will be power cuts. But we have already taken that into account because we are seeing the results of what has been achieved through these large-scale experiments. The costs are more limited and the benefits are the discounted future earnings. We anticipate that these guys will make ten thousand dollars more.

If we look at it for the 90% of children in the poorest part of the world, this would cost about $8 billion, but that well done is going to be more like $559 billion. So this part of the world will get better results. The good thing about this is that once people have worked on this study, we can say that every euro spent is going to bring sixty-five euros of social benefit. That's a great investment. That's what we should be doing as a civilisation. That's the advantage of this approach.

Regarding maternal and newborn health. Giving birth is very dangerous for most people in the poorest part of the world. Every year, 295,000 women die in childbirth and 2.3 million babies die in their first month of life. In some rich countries around 1800, 1% of women died in childbirth. It was like gambling with your life every time you were going to have a child. That has been greatly reduced since then. With the help of antibiotics it has been reduced to zero in rich countries. In Sri Lanka we also see that it has gone down a lot. But there are still many countries that have not yet reached those good statistics, even though the situation is improving. On infant mortality, one in five children used to die in the first month. Now, that figure has come down a lot, but we have not yet delivered on the promises we made.

This is a big problem, but it can be solved very easily. We are working with the WHO and we have identified the most effective policies, the ones that are going to give us the best cost/benefit ratio, and these are basic emergency care, obstetric and neonatal care. And also family planning. This basic care includes many things, for example, women being in a clinic, having disinfectants. 20% of medical facilities around the world don't have disinfectants, which leads to more infections. Birth asphyxia is a very serious issue. More than 700,000 children a year die from it. One in five babies at birth is not breathing, so they have to be given oxygen so they can breathe. In rich countries we have very expensive and good instruments for this, but it can be done with a hand pump. It's as simple as that. But if we don't have this device, which only costs 65 dollars, the child can die. If it is used 25 times a year and you add the work of the health workers, it would cost five dollars to save a life. All institutions need to be better funded, have more workers, more disinfectant and more of these devices so that when women go to give birth, the babies can survive. Providing hospitals and clinics with everything they need would cost an extra $2.5 billion a year. Staff time is 2.1 billion and incentives are 200 million. This is the cost, not too much. The total annual cost would be five billion dollars, but the benefits would be to save 166,000 mothers, which is a value of 32 billion. It would also save 1.2 million children, which is worth $482 billion and there would be a demographic dividend of $41 billion, which means the economy grows faster. The total benefits would be $559 billion and the cost/benefit ratio would be 114. In other words, every euro spent would give us 114 euros of social benefit.

This is not complicated. We could save many lives and make children more productive. So their societies would be richer in the future if we do these simple, basic things. The same conclusion applies to tuberculosis. For very little money, $6.2 billion, we can do a lot of good by eradicating TB - 46 times the return on investment.

We have twelve fantastic policies with evidence that, if we spend money on them, we can do great good. For $35 billion, these twelve things - TB, maternal and newborn health, malaria, nutrition, chronic diseases, childhood immunisation, education, agricultural R&D, e-procurement, security of tenure, trade and skilled migration - can prevent a huge number of deaths and a lot can be achieved in social benefits. With that, we can save 4.2 million lives every year. Whatever we do, this has to be done first.

The Rafael del Pino Foundation is not responsible for the comments, opinions or statements made by the people who participate in its activities and which are expressed as a result of their inalienable right to freedom of expression and under their sole responsibility. The contents included in the summary of this conference, written for the Rafael del Pino Foundation by Professor Emilio González, are the result of the debates held at the meeting held for this purpose at the Foundation and are the responsibility of the authors.

The Rafael del Pino Foundation is not responsible for any comments, opinions or statements made by third parties. In this respect, the FRP is not obliged to monitor the views expressed by such third parties who participate in its activities and which are expressed as a result of their inalienable right to freedom of expression and under their own responsibility. The contents included in the summary of this conference, written for the Rafael del Pino Foundation by Professor Emilio J. González, are the result of the discussions that took place during the conference organised for this purpose at the Foundation and are the sole responsibility of its authors.

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