The New York Times reviews Charles Kenny's book, Getting Better:
In the not too distant past — 1980 — one of every six babies born in the West African nation of Liberia died in infancy. Overall life expectancy was a mere 48 years. The great majority of Liberians couldn’t read in 1980. Most girls had never attended school. Over the last 30 years, infant mortality has fallen sharply, and life expectancy has jumped to 58 years. Most Liberians today can read. More than 80 percent of girls attend school. Politically, the country is much freer than it was in 1980, the year of a deadly coup.Economically, however, Liberia has been the world’s single worst performer over the last 30 years. Per capita income has fallen an astounding 80 percent, according to official World Bank statistics, which makes the country an extreme example of Africa’s long-running economic troubles. While people may debate the causes of those troubles — corrupt and autocratic governments, feckless foreign aid, postcolonial hangover — everyone seems to agree that Africa is a story of failure.But is it?In a new book called “Getting Better,” Charles Kenny — a British development economist based in Washington — argues that the answer is absolutely not. Life in much of Africa and in most of the impoverished world has improved at an unprecedented clip in recent decades, even if economic growth hasn’t.“The biggest success of development,” he writes, “has not been making people richer but, rather, has been making the things that really matter — things like health and education — cheaper and more widely available.”...One caveat to Mr. Kenny’s argument is that progress in Africa has slowed over the last decade or so, largely because of the scourge of H.I.V. And by any definition, the quality of health and education in sub-Saharan Africa remains horribly low.Several countries there still have a life expectancy of only about 45 years. By comparison, life expectancy in the Stone Age was about 34 years, notes Gregory Clark, the University of California, Davis economist who wrote “A Farewell to Alms,” an economic history of the world.“Despite the creation 60 or more years ago of cheap medical interventions that can dramatically reduce infant mortality and despite considerable medical aid and assistance from the rich countries,” Mr. Clark told me, “the poorest countries in Africa have advanced life expectancy 10 years from conditions in 200,000 B.C.”...Mr. Kenny responds that H.I.V. is akin to a modern plague. The fact that sub-Saharan Africa has made even modest progress while battling the plague is remarkable. Much of the rest of the world, meanwhile, continues to make great progress on health, education, infrastructure and even human rights.He is certainly right that people often overlook this progress and instead believe that global misery is intractable. “The strongest argument against a moral imperative to act,” as Mr. Kenny says, “is that we are powerless to make things better.” Clearly, we aren’t powerless. The real question is not whether foreign aid and local government programs can work — it’s which programs work and which do not.The most hopeful part of Mr. Kenny’s hopeful message is that progress in health, education and human rights may ultimately bring economic progress as well. He is cautious on this point, noting that economists have failed time and time again to come up with consistent explanations for economic growth.But African growth has accelerated over the last decade, and the acceleration followed improvements in education and other basics. It’s true that Africa’s growth is unimpressive compared with the Asian miracle, but the growth is still the most rapid in Africa’s recorded history. Perhaps those investments in Africa’s people needed time to produce returns.As I read “Getting Better,” I couldn’t help but think of some parallels with life in the United States. Our own economic growth has been disappointing for much of the last four decades. Over that same period, though, other aspects of American life have improved enormously. A large majority of Americans experience far less discrimination today — be it discrimination based on sex, race, religion or sexual orientation — than they would have 40 years ago. For most people, life was not better in the fondly remembered 1950s and 1960s.
Kenny's book says that even though people in many countries have not seen incomes increase, they are much better off anyhow because the drivers of the better life are innovation, ideas, and institutions:
Global improvements in quality of life have been fostered by the spread of technology and ideas. Very cheap health technologies that can dramatically reduce mortality have spread rapidly across the world. The proportion of the world’s infants vaccinated against diphtheria, pertussis and tetanus –the DPT shot—climbed from one fifth to nearly four fifths between 1970 and 2006. And ideas that save lives –wash your hands, don’t defecate in the fields you eat from—are increasingly accepted.
People around the world are also more ‘informed consumers’ than they used to be. They demand not only soap to wash their hands, they want schools to educate their girls, and they want governments which respect their rights. The increasing demand for education in particular is an important part of the story behind climbing primary enrollments –less than half of primary-age kids worldwide were enrolled in school in 1950, by the end of the century the figure was closer to nine out of ten. Valuing ABCs and getting DPTs –these are the forces behind global improvements in quality of life.
The spread of technologies and ideas explain a strong global pattern to quality of life improvements with countries rich and poor, tropical and temperate, seeing similar rates of progress over time. The shocks of AIDS and state collapse explain most of the (limited) variation from that global pattern in the case of health. And a similar story applies to measures of education –if less so to human rights.
At the same time, a country’s relative standing in terms of quality of life appears to be connected to the same historical factors that explain present-day relative income performance. Even if global inequality in quality of life has fallen, countries that started earlier in the provision of health and education services, or began with a greater respect for human rights, remain ahead to this day.
