Economist Jeffrey Sachs insists that poverty is a solvable problem – and no one on the planet works harder to get governments off their butts to find (and fund) solutions

JEFFREY SACHS DOESN'T think small. In 1985, Sachs was a newly minted economics professor at Harvard – tenured at the impossibly young age of 28 – when the government of Bolivia invited him to save their country, which was headed over a cliff. Annual inflation was 25,000 percent. Sachs devised a Hail Mary plan to stave off economic collapse, a blitz of spending cuts and free-market reforms that came to be known as “shock therapy.” It worked. Bolivia was saved. And Sachs became known as the economist to go to for big, radical ideas, a troubleshooter for the world’s most insoluble problems. In the heady days after the Soviet Union’s collapse, Sachs advised the government of Poland on its transition from a planned economy to a free market: another success. Then he brought shock therapy to Russia. There, he experienced his first, and perhaps only, failure. The common wisdom is that he emerged from his Russian experience chastened, perhaps even humbled. Not so, says Sachs. Russia was just too chaotic, too opaque for his idea to take hold.

In 1995, Sachs traveled to sub-Saharan Africa for the first time. He found a continent in crisis, beset with pandemic diseases like AIDS and malaria, and struggling to achieve even modest economic growth. Sachs took it as a challenge. Extreme poverty, he believes, can be solved. In two books, The End of Poverty and Common Wealth, he described how to do so. Part policy prescription, part passionate cri de coeur, his books describe shock therapy for the crippling problem besetting Africa, a massive infusion of smartly targeted foreign aid – perhaps as little as $200 billion – that would, once and for all, wipe out dire poverty.

Many of Sachs’ colleagues scoffed at his naïvette. After all, they’d spent careers fruitlessly pursuing the same solution. They’d seen billions in foreign aid siphoned off by kleptocrats or simply wasted. Aid doesn’t work, they said. Africa is too corrupt, its social infrastructure too fragile to absorb so much aid from the rich world.

No, said Sachs. The problem is not Africa’s governance; it is ours. The only thing lacking is the political courage to commit to solving the problem. Since then, Sachs has worked tirelessly to rally the world to his view. He was instrumental in devising the Millennium Development Goals, United Nations benchmarks designed to measure progress toward a goal of ending extreme poverty by 2015. Through his Millennium Project, he monitors villages throughout Africa to measure the impact of simple things like delivering anti-malaria sleeping nets and helping farmers increase their yield through better fertilizer.

And Sachs travels the world constantly – occasionally in the company of U2 lead singer and activist Bono, who has called Sachs his hero. When he spoke to power, Sachs had just returned from a whirlwind trip to Tanzania, Mozambique, Egypt and Jordan. With the global economic crisis threatening fragile progress across the developing world, he was feeling a new sense of urgency. The need for big ideas has never been greater.

You’ve been very critical of the bank bailout plan in the US. Say you were in [Treasury Secretary] Tim Geithner’s shoes. What would you prefer to see happen?
I would prefer to have the banks pushed to clean up their balance sheets at fair market value. And if they need recapitalization after that, have the government intervene by providing capital. That would still clean up the banks not by subsidizing the current shareholders, but by having the current shareholders take whatever lumps are implicit in the decisions that have been made, and then move on from that point. In extreme cases, it would mean intervening in the banks. I don’t think the idea of buying these bad assets at inflated prices is a very attractive or effective way to proceed.

In The End of Poverty, you write about the 1920s. You’re talking about the overhang of debt and shrunken trade, and overstretched budgets of countries in Europe. To someone who is reading the newspapers today, that sounds pretty familiar. Are we in for that kind of wrenching instability?
I think that we do need active policies to find our way out of the current morass. My expectation is that Asia, led by China and by India, can lead the region to continued economic growth, and can lead the way toward a world recovery. I think Europe and the United States will recover afterward. I also support the idea of a government investment-led recovery, especially in the US and Europe, where private demand is likely to be seriously subdued for quite a while. So the idea of stimulus through public investment and public services strikes me as an appropriate response. Also, the difference between the 1920s and now is that we don’t have a gold standard to constrain us from taking the kind of monetary policies needed to save the banking system, preserve liquidity and allow for cross-currency exchange-rate adjustments.

So if we combine public investment and currency flexibility and sufficient, but not panicked, monetary expansion, I think we’ll find our way out of this. I agree with virtually everyone on this: I don’t think it’s going to be a V-shaped recovery, except possibly in China. In Europe and the United States, it’s going to be a much more gradual recovery because the loss of wealth that’s been experienced is very significant and is going to persist.

Speaking of loss of wealth, a lot of people are assuming that one of unfortunate side effects of this global crash is that it’s going to be hard to maintain current levels of foreign aid. During his campaign, Barack Obama was talking about doubling the amount of foreign aid the US gives. If that’s scaled back significantly, what does that mean for the fight against global poverty?
I think the tragedy is the amount we’re giving to banks and to our stimulus packages dwarfs what’s needed for development aid. To claim that there isn’t money for development purposes is not correct – though it’s a point that is clearly being made and heard in many parts of the donor world. Aid is being squeezed, but it’s ironic because trillions of dollars are going for domestic stimulus. And then the billions of dollars needed for keeping impoverished people alive somehow can’t be found afterward? I think it continues to be an optical illusion, a lack of political will and a real tragedy. The money does exist.

If we thought about it more accurately, we’d understand that proper development assistance – for example, to build power plants, water projects, irrigation and so forth – is itself a stimulus programs, because a tremendous amount of the capital goods and construction would actually come from the economies that are financing the aid. It’s yet another form of stimulus. In this sense, it would make perfect sense from every point of view – humanitarian, geopolitical, national security and stimulus – to integrate development assistance into the overall plan. This has not been done yet.

You make the point in The End of Poverty that that kind of mindset depends on us seeing development as a positive-sum equation. But in times of scarcity, people tend to see things on a zero-sum basis. How do you change that?
I think individual businesses that could be providing the power plants and the sewerage plants and the construction projects in poor countries understand very well why this would be attractive. These companies ought to let their national governments understand that as well. Here we have this irony of an excess of global savings, and yet we have these urgent investment needs in certain parts of the world. And part of what we ought to be doing is channeling that excess savings into those investment projects.
Companies themselves know full well that they have the kinds of technology, machinery and so forth that are exactly the urgent needs of the poor countries. And so I’d like, in that sense, to see aid re-tied a bit. In other words, the countries that are giving aid are linking it to the export of capital goods from their countries. This was seen as improper. But by cutting off the links between aid and domestic business, we’ve also cut off the legs of political support for development aid. That’s quite a bad mistake.

Second, I think that President Obama and other world leaders better understand how unstable the poor countries are right now, how deeply threatened they are by this global crisis. Remittances are down, foreign direct investment has collapsed, banks are under threat, mining projects have closed down, foreign exchange earnings are down. I’ve just been recently through a number of countries in Africa and the situation is extremely serious. This is a matter of straight national security and geopolitics. Of course, everything gets handled in stovepipes in our world. So the Treasury officials don’t necessarily understand this. And the foreign policy officials don’t necessarily have their hands on economic levers. But if they talked to each other, we’d do a better job of coming up with a practical approach.

Let’s talk about China’s role in Africa. It’s a country that’s investing a lot in, for example, infrastructure projects in Angola. But China gets criticized a lot, too, because they supply Zimbabwe and the Sudan with military materiel. What do you think about China’s role in Africa?
I think on the whole, China’s relations in Africa are highly productive for Africa and the African leaders that are engaged in this new bilateral relationship are very excited by it. After all, China is actually delivering investments, whereas Europe and the United States are making promises that don’t get fulfilled. So there is a great deal of excitement about China’s practicality, the fact that projects get promised and actually get delivered. On the whole, I very much support that pragmatism. I’ve seen with my own eyes the difference power plants and roads can make. You can’t help but see them everywhere, because China is engaged in that kind of infrastructure investment probably about as much as Europe and the US combined. It’s quite remarkable and quite pervasive.

Of course, China has its national interests and is operating reflecting those, whether it’s securing natural resource concessions or commercial projects or geopolitical influence. It’s definitely doing all of those. But so do our governments. Yet our governments are a little bit lazy in their foreign policy because they think they can push Africa around or induce behavior one way or another without the investments that go along with the influence. I think that’s a process that’s coming to an end. There have been so many words, so many promises. There’s so much cynicism about the traditional donors. Politicians ought to understand that they have to change the nature of the relationship.

I wonder about countries in Africa that are maybe on that first rung of the economic-development ladder. A lot of their progress would seem to depend on developing export-driven economies. But how do they compete with China and India at this point? How do we give them space to develop the kind of economies that are going to help them rise?
I think a lot of what Africa needs right now, first of all, is basic infrastructure. So that’s why I always put so much stress on aid or long-term finance. Because we’re still at the stage of building basic roads, the power network, water and sanitation, clinics and schools. These are fundamental building blocks of an economy. They’re not by themselves the parts that make an economy rich. Those are the parts upon which exports and service industries and primary production depend. And Africa is still largely bereft of a lot of that vital infrastructure.

Now when Africa improves its basic productivity, by and large it’s going to start as either a primary commodity exporter or as a processor of its primary commodities. And in this sense, I think there will be a lot of complementarities with Asia because the East Asian and South Asian economies are tremendously, tremendously land-scarce. And Africa has both the mineral and the agricultural potential to be really complementary to the Chinese and Indian economies.

The Millennium Development Goals were formulated around 2000. And 2015 is an important target date. So we’re roughly halfway there. How are we doing?
I think what’s been remarkable about the goals is, nine years after they were enunciated, they have a tremendous operational hold on governments,
especially in the poor countries. I’ve just been to Tanzania, Mozambique, Egypt, Jordan and heard a tremendous amount from the leadership of every government about the Millennium Development Goals. That’s quite remarkable. It’s not just for show. These became core organizing principles for development practice within these economies. By itself, that’s already changed the game. There’s a tremendous increase of focus on issues of child mortality, maternal mortality, basic disease control, universal primary school completion – and now, very recently and extremely importantly, on agriculture, especially around the hunger crisis. So this is a great result to date.

In terms of the actual progress, it’s quite mixed. And, of course, that’s extremely worrisome in the poorest parts of the world. Certain countries have made phenomenal progress. Egypt has had fantastic success in reducing child and maternal mortality. China obviously has over-performed on the reduction of poverty and many of the other goals. But in sub-Saharan Africa, almost every country lags significantly in achievement. One of the main reasons for that is that the rich countries didn’t come close to honoring the obligations they made on the Millennium Development Goals. So we’re still working every single day to try to get rich countries to honor the rather modest commitments that they took but did not fulfill. So they picture is very mixed.

There’s been real progress in some places, and a lot of potential progress, even in Africa, in the next few years in many aspects of disease control and reduced child and maternal mortality. But we’re not going to achieve the goals most likely in some of the – in fact, in many – of the poor countries. I think we’re going to need to think about how to harness this tremendous, unique global force that has come into action to address these dire conditions. The question is how do we keep that going until the goals are met? And of course, every day, how do we accelerate progress toward the goals, especially by getting the rich countries to live up to the things they promised they would do, but clearly have not done yet.

What’s the most important thing you’ve learned from the Millennium villages?
The results show unequivocally that it’s possible to make tremendous progress in crucial areas in a short period of time with directed investment. Food production can be increased from one year to the next by at least a factor of two, and perhaps by a factor of three or more. Malaria can be controlled very, very rapidly. Children can be encouraged to go to school and to increase their performance through interventions as simple as a midday meal for the kids.

These are examples of the “quick wins” of the Millennium Villages. It’s shocking to me every time I visit these villages, as I did last week in Tanzania, that these remarkable achievements that we’ve seen across Africa aren’t being picked up and replicated everywhere. The reason is, while these interventions are very inexpensive and highly cost-effective, they’re not free. And to scale up requires that donors learn from this experience and follow through.

We’re also finding some hard aspects that don’t come as quickly or that are serious challenges over the longer term. Probably the most traumatic of these is water. Water for agriculture is not something that is easily invented in places facing climate change and growing water scarcity. We see that when the rains fail and the crops fail, you get crisis. We’re seeing more and more of these crises across Africa.

So I would urge – and do urge all the time – that policymakers understand that the water crisis, and especially the crisis of the drylands, which are the regions in the Sahel of Africa and the Middle East and Central Asia in particular, are the most challenging development crises in the whole world. Not coincidentally, they’re also the source of the greatest geopolitical instability in the world. And the violence we see in places like Somalia or Afghanistan or Pakistan, to a very significant extent, are crises of water and hunger, even though they’re not typically counted that way. We’re learning a lot about what can be done. But even greater difficulties are coming. We’re definitely seeing the climate change crisis develop before our eyes. On the whole, though, what we’re seeing is that practical, targeted investments that really reaches people on the ground can work, and can work very effectively and very rapidly and very dramatically to improve life conditions and to improve the security of those communities.

I wanted to ask you about your first trip to sub-Saharan Africa in 1995. Was there something that happened on that trip that changed your thinking?
I suppose it’s inevitable in life, but each time I’ve arrived in a region, I’ve become fascinated by the challenges. And I’ve spent time trying to address those problems. For me, my active advising career started in South America in the second half of the 1980s and then several years in Eastern Europe and the former Soviet Union, then two or three trips every year to India and China. It was in 1995 that I started to travel to Africa. As was the case with every one of these regions as I’ve come to experience them personally, certain things grabbed me as being overwhelming. In Eastern Europe, of course, it was the end of communism and the political reunification of Europe. In China, it was the breakthrough of late-stage rapid development, watching that before one’s eyes and trying to understand the mechanics of it and the underlying logic of it.

But in Africa it was the massive amount of disease, which absolutely shook me. It was so shocking that it caused me to ask lots of questions that I had not asked before about both the nature of poverty in Africa and its distinctiveness, which I attribute at least in part to its disease burden, the distinctive ecology and all of the problems that arise from that. But I also began to understand much more clearly these big challenges of mobilizing international efforts to fight pandemic disease. That’s been something I’ve been working on pretty much day in, day out for the past decade.

There’s this unfortunate view out there that Africa is somehow a lost cause, that giving aid to Africa is throwing good money after bad. It’s an idea that gets recycled from time to time. What’s your best counter-argument?
First of all, I find the idea that one would claim that a region of 800 million people is a lost cause completely untenable from every point of view. I can’t even begin to think in those terms. What would that mean practically? That on our planet we would decide, well, those people are going to suffer and die? There’s nothing we can do about it? It’s a kind of mindset that I find kind of impossible to even get my head around, quite frankly.

In other words, if it were claimed that this is a lost cause in the sense that what we’re doing isn’t working, the only logic I would see is, well, then we have to double what we’re doing, because we’re talking real people, we’re talking about hundreds of millions of them and I basically can’t myself operate under the assumption that we give up on hundreds of millions of people. Period. So I’m starting from a different proposition: that we have to do everything we can to try and solve the problem of mass suffering and instability.

Now, there are some who say, well, just let the market do it. That’s a different kind of answer. “Why do you care about aid? Aid doesn’t work.” The problem is governance and so forth. I’ve spent enough time on the ground all over the world to have profound doubts about that approach, for reasons that I’ve tried to explain at length. That kind of argument, at least I can understand. It’s people saying, well, here’s a different way to success. But what I can’t believe –
 or actually, it’s just visceral – I can’t take an argument that says there’s nothing to be done. Because that is too shocking in its implication. Once you stop seeing Africa as numbers in a chart or awful pictures in a magazine, you start thinking about the situation as practical challenges of a major region of the world that is part of our world and whose problems become our problems and whose successes can become part of
our own successes.

Now the other thing that obviously moves me is a very strong belief that the kinds of challenges we’re facing are challenges essentially of poverty. They’re not, I don’t believe, challenges that are so mystical or so profoundly rooted in some metaphysical sense that they’re unsolvable. So everything that I’m doing is based on my understanding of the practical steps that can be taken to address very specific practical problems that I see and that I believe can be dissected, approached in a very concrete and specific way, and solved. There are innumerable examples of successes of that approach, whether it’s eradication of smallpox or near-elimination of polio or control of malaria in recent years in many part of Africa, or increased food production in places that have for whatever reason been enabled to implement proper agricultural policy in recent years.

The proposition that I’m making is that we take a specific, science-based approach to the specific challenges; that we demystify this; that we don’t look at this as one un-addressable morass, but rather as a set of specific, albeit deep-seated, challenges, that can be analyzed and then can be approached practically.
I see that kind of approach confirmed all the time, whether it’s in the villages or in these health successes or agriculture successes or successes in children getting to school or the spread of mobile phones in Africa in recent years and the conquering of isolation – that’s come, incidentally, very much on a market basis in that case. When I’m engaged in these problems, I have anything but a sense of hopelessness. It’s more a sense of frustration: it’s the feeling that it’s just not all that hard if we put a modicum of effort into it to actually see these problems to their solutions.

Have you read Paul Collier’s recent book, The Bottom Billion? What did you think of it?
I agree with some of it. Some of it is based on my own writings. Some of it I can’t quite agree with. I can’t quite understand the point that he’s making. But basically he identifies some of the structural features of African poverty, whether it’s land-lockedness or some other structural features, whether it’s the resource curse and so on. I share, and have in some cases actually been the pioneer, of some of that analysis.

But in my view, he’s focused a lot on specific issues of conflict, which certainly play a role, but he is not sufficiently attuned to the possibilities right now in conflict-free places that just need a bit of practical help to get off the ground. Those are the kinds of countries that I’m emphasizing in my own work. Countries like Mozambique or Tanzania or Ghana or Senegal or Mali that are sufficiently well governed, sufficiently development-oriented, peaceful, and yet extremely poor, which with targeted investments could make a major improvement in their condition.

One of the things that really jumped out at me about that book was that Collier advocates military intervention to prevent coups and stabilize countries that are really on the brink. Especially after Iraq, is this approach something that’s still tenable?
I basically disagree with that – probably not 100 percent, since I think everything depends on the circumstances. But a lot of the reasons we find ourselves faced with seemingly unpalatable choices is that we’ve neglected the easier paths of actually trying to prevent collapse in the first place.

So I tend to see challenges like Darfur, for example, as development challenges more than military challenges. And I believe that if we spent more time on helping countries to avoid collapse and helping them to find their way to economic development, we’d have a lot fewer of these miserable circumstances. Now there are cases like Zimbabwe where the problem is an internal political disaster more than anything else. You know, Mugabe clinging to power for decades. In those circumstances, I certainly have profound sympathy for the Zimbabwean people, but I am very much against external intervention by force because I think it can just lead to mayhem. I think the Zimbabweans are going to largely have to solve their own problems. We should just not give comfort to the Mugabe regime. I think if South Africa were more consistent in telling Mugabe that his time has really come to an end, we could accelerate a peaceful transformation. So each place needs its own solution. I’m profoundly skeptical, as you asked, about the ability to use force in most circumstances. But I wouldn’t rule it out entirely – for example, in the midst of a Rwanda-type situation, where a close and detailed analysis shows that it would be possible to save a vast number of lives from bloodshed through a UN-led intervention, one shouldn’t argue with that.

What about in terms of providing aid to a country like Zimbabwe or even North Korea, where there’s obviously a real food-security problem? I mean, how should we approach giving aid to those countries?
I don’t think there’s a tremendous amount that can be done. These are tragic circumstances, but they are largely political circumstances. And we cannot really run those countries from the outside, and I don’t think we should try to do so. If we were doing everything we could in peaceful countries so that all the other problems in the world had been solved and we were left with the problems of a place like Zimbabwe, I’d probably have a better answer. But the fact is that even when places are peaceful, ready for development assistance, begging for it, have organized plans and good governance, they still don’t get the help they need.

So in that sense, I’m always a little bit wary of going to the toughest cases, because we don’t even help to solve what should be the relatively straightforward and easier cases.

You’ve advocated developing a new Green Revolution like the one in the 1960s. Where is that going to come from? How do you jumpstart it?
Jumpstarting it is straightforward because basically the limiting factors in most years in Africa are soil nutrients and the good seed to go along with them. So basically, a package of seed and fertilizer could by itself probably make Africa self-sufficient in food on average. That will not solve the problem of drought, which is very serious and increasingly frequent. For that, one needs several kinds of things. At the top of the list are irrigation and water storage. Second is better crop diversification.

Third is better crop varieties that are most drought-resistant. And then would come probably genetically modified crops with the drought-resistant traits. So there’s a tremendous amount that can be done now. Every agronomist knows it. It’s a mystery only to our donor agencies, and a mystery only because of our profound neglect. Africa could be perhaps even doubling its average food production with a proper system to subsidize impoverished farmers to get the seed and fertilizer that they need. This kind of subsidy system would be temporary – maybe 10 years – because it would allow farmers to build up assets to improve their farms and to institute credit systems that would take over from the direct subsidization. It will take a while, but that’s the kind of build up we need. At the same time, though, it’s quite clear that with all the wonderful things that can be done, we’re going to need even more than that, especially for adaptation to climate change. As I’ve been saying, the water challenge, at least from what I can see, is the greatest of the unsolved problems.

You focus on climate change in Common Wealth. Do you think we need to be focusing on that at the same time we focus on the problem of entrenched poverty? It seems like there’s just going to be greater pressure on water supplies and food supplies.
Long-term, I think population control is really vital. Because we’re seeing an explosion in populations in some of the most environmentally stressed parts of the world. This is one of the worst vicious circles on the planet. The fact that impoverished rural areas are the very places where population growth is the fastest. And that’s because poor people have many circumstances that lead them to have very large families, exactly under conditions in which they can’t support those large families. Children are social security. Children are working on the farms. The mothers are disempowered in male-dominated societies. Family planning and contraception isn’t available. The girls are not able to stay in school. All these are factors conducive to very high population growth rates. This is taking place in circumstances that absolutely cannot sustain the populations, especially the populations that are coming, but arguably the populations they have right now, certainly not under the scarcity of capital conditions they find themselves in.

So really the first thing that is needed, locally, nationally and globally, is to aim for a stabilized population by mid-century. You can’t really do it much faster than that because of population momentum. But we certainly could aim for stabilizing the global population at perhaps 8 billion or a little bit over 8 billion by mid-century. The second thing is that many of the things that are needed to support economic development are really the kinds of things that also support resiliency to climate change: better management of water, as I’ve been talking about; landscape management for better hydrology; more efficient irrigation and so on. Those are development strategies; they’re also sustainability strategies.

A lot of the energy resources that are being developed – by far the most important being solar power – would both tremendously boost African development, but at the same time put it on a path to environmental sustainability as well. This is a long-winded way to say that I think we need to keep multiple objectives in mind, not just ending poverty, or not just fighting environmental degradation, but actually seeing it truly as this package deal of sustainable development. And when you view it in that focus, there are many, many things that can be done that are mutually supportive rather than contradictory. They cost money. That’s my endless quest: to try to raise the investment funding we need to take on these challenges in a serious way.

You mentioned you’ve been in Africa the last couple of weeks. You travel pretty tirelessly. What’s an average week like for you?
I’m typically on the plane a couple times during the week. I’m either seeing project sites or working with governments, mainly in the developing world. Or being part of international meetings, academic conferences, or trying to convince governments in the US, Europe, or Japan to step up right now. It’s a pretty varied, pretty active. These are very hectic and active days because the crises just keep piling on one after the other.

You’ve become a sort of celebrity. I guess you are a celebrity, hanging around with Bono and all. How does it feel to be so personally associated with this cause?
This is so much the core of what I’m doing right now, and the days are filled with a combination of excitement at the positive and sometimes exhilarating things and a tremendous amount of frustration – especially at this time, when we have a global crisis on top of all these long-term problems and the poverty crisis and the climate crisis. This is a very stressful period, no question about it.

Speaking of other stressful periods, what did you learn from your work in the former Soviet Union about taking on huge problems?
This is what I’ve been doing for a long time, and a lot of the times I’ve seen success, usually with long lags. Sometimes I’ve just hit walls that I’ve not been able to overcome – of which Russia was, for me, by far the most traumatic. I decided a long time ago I would try my best to work on big problems. And when you do that, you learn a lot, you see a lot of frustration, and you also have a chance to glimpse at some big breakthroughs as well.

Why did you decide that, and when did you decide that you were going to work on these huge issues?
I think it’s a privilege to have a chance to do it. Of course, I didn’t exactly plan the kinds of things that I’m doing. But life threw up very interesting possibilities for me, and I was lucky to be able to get involved with the kind of work I’ve been doing now for a quarter century. I found it from the first moment thrilling and fulfilling and with enough success to keep me believing that these big problems can be cracked one after another. You know, it’s possibly being spoiled by some of these successes that I keep being very optimistic about that.

In The End of Poverty, it seems what you’re describing is almost like shock therapy. Do you see that as something you took from your experience in Eastern Europe and Russia?
I think it’s more that when you see things that can be done, and you believe for hopefully sound reasons that they are likely to be highly effective, the case for gradualism becomes a little bit less convincing to you. I use a kind of test for when I’m in a village, for example: how would I feel about my daughters being villagers or even staying overnight in some of these disease-burdened places. And that helps me to engage the sense of urgency that I think is required by these circumstances. So it’s not a philosophical … I wouldn’t say it’s an emotional or philosophical point. It’s really a practical point. Certain things take time. You don’t change a country’s infrastructure overnight. You can’t change a country’s education profile from one year to the next.

These are generation-long challenges. But you can get bed nets out in a few months to people who would otherwise die of malaria. When you can take those steps, then the case for leaving people suffering or leaving people in hunger in my mind doesn’t exist. These are circumstances that cry out for action at the scale that is feasible.

What’s your relationship like with the Obama administration? How do you gauge its attitude toward this issue as compared to the previous administration?
I have a large number of friends and associates and colleagues in the government. I’m counting on them to come through right now. So far, the administration has been mainly enmeshed in this domestic crisis. That worries me, because I don’t believe that US can get out of its own internal crisis if the world is falling to pieces. And so I think it’s not a matter of choice or temperament, but a matter of necessity, that we treat this current crisis as a global crisis.
I expect a lot from this administration. I think the president is extremely gifted and can certainly become a great president. To do so in our age means to become a president who helps find solutions to global-scale problems.

This is why I wrote Common Wealth, to emphasize that we need a foreign policy that doesn’t view this in the slot of humanitarian actions or “winning hearts and minds,” but understands that these problems are front and center to the well-being and security of every country in the world, including the United States.

The public health advocate Dr Paul Farmer, who I think you’ve probably worked with many times …
Yeah, yeah.

… Once said that the only time he ever really despaired about what he was doing wasn’t when he was confronting problems in clinics in poor countries. It was when he realized that people weren’t listening, just weren’t paying attention. Do you ever despair over people’s ability to ignore extreme poverty?
Our world operates in part by compartmentalizing these problems with the view that the poor are either ignored or they can be somehow walled off, even literally walled off from the rest of the world.

So while there are, on the one hand, countless numbers of people all over the world that are vitally committed, interested and engaged in these challenges, there’s also a significant part of the world that’s barely aware of them, or really doesn’t care, or believes in the gut that these are not our problems and that the best and most effective thing to do is to just try and keep away from them, because why get involved in problems that are not ours? It’s too expensive, too hard. So there is a huge range of attitudes toward these issues. But I find that the more people have seen, have traveled, have been involved on the ground in one way or another, the more convergence there is. I view the problems of public understanding mostly as problems of information and awareness rather than problems of values or fundamental conflict. I’m optimistic, as I’ve said many times. I still believe in the Enlightenment values, that with goodwill and enough shared understanding of these problems, we can actually also find shared responses to them. But in terms of frustration? There’s no shortage of it.