TRIGGERnometry - 5 Easy Ways to Save the World - Bjørn Lomborg

00:00:00.560 Here are 12 things you can focus on to actually make a big impact.

00:00:04.480 So let's talk about that.

00:00:05.600 The UN is actually trying to save the world for about 15 trillion dollars.

00:00:10.000 So a totally absurdly large amount.

00:00:13.680 You can do it for about two one-thousands of a bit of what the UN would actually like to spend.

00:00:19.680 But what we shouldn't be doing is to say my obsession with obesity or with climate change

00:00:26.160 or with plastic straws or with all these other things, take precedence over the fact that for

00:00:31.040 most people in this world, you know, it's really about the fact that their kids are dying from

00:00:35.840 easily curable infectious disease, get bad education, are losing out of productivity

00:00:40.720 because of corruption, all these other issues that we could fix really cheaply.

00:00:44.720 So get your priorities right when you care about the world.

00:00:48.400 And for 35 billion dollars, we can make the change.

00:00:56.160 Hello and welcome to Trigonometry. I'm Francis Foster.

00:01:04.480 I'm Constantine Kishen.

00:01:05.600 And this is a show for you if you want honest conversations with fascinating people.

00:01:10.560 Our brilliant and returning guest today is the author of a new book called The Best Things First,

00:01:16.000 Bjorn Lomborg. Welcome back to the show.

00:01:18.400 Thank you.

00:01:18.960 It's so good to have you. Last time we were talking about something more controversial,

00:01:22.560 but this, what you're talking about now, is how to save the world.

00:01:26.560 Exactly.

00:01:27.040 It's exciting.

00:01:28.160 And save the world fairly inexpensively.

00:01:31.360 Well, that is the exciting part, because anyone can save the world if you give them a trillion

00:01:35.040 dollars. You're talking about a much smaller amount here.

00:01:38.080 Yes. Actually, let me just, so, you know, the UN is actually trying to save the world for about

00:01:43.200 15 trillion dollars. So a totally absurdly large amount. So if you promise everything to everyone,

00:01:50.480 if you want to, you know, fix disease and hunger and poverty and, you know, get everybody organic

00:01:56.960 apples and community gardens and, you know, fix war and corruption and climate change and everything

00:02:02.160 else, the cost is about 15 to 20 trillion dollars and we're spending about five right now. So we're

00:02:08.640 missing about 15 trillion dollars. Just to give you a sense of proportion, I mean, that's, you know,

00:02:12.960 it's 15 percent of global GDP, but it's also more than all the governments in the world collect in

00:02:20.160 taxes. So that's just not going to happen. We're just not going to be able to have that amount of

00:02:24.960 money. And so what we're trying to say is, wouldn't it be fun if we could do a lot of it? We can't do

00:02:30.320 it all, but if we could do a lot of it, the most effective stuff for very, very little money. And we

00:02:36.080 actually come out with saying you can do it for about two one thousands of a bit of what the UN

00:02:42.160 would actually like to spend. So about 35 billion dollars. I did that calculation in my head on you.

00:02:47.920 Yes, yes, yes. And it's roughly right. So fundamentally, for what is essentially couch

00:02:55.520 change in the international community, we could do an immense amount of good. We could save 4.2

00:03:02.000 million lives each and every year. That's, you know, that's about 14 percent of all that die

00:03:06.720 in the poorer half of the world. And we could make each one of these people almost a dollar richer

00:03:12.800 each and every day. So that's 4 billion people. So that's about 1.1 trillion dollars. This is just

00:03:18.480 fantastic stuff. How do you, how do you get from 30, like they get, the dollars get multiplied

00:03:25.600 massively? Absolutely. How does that happen? So, so for instance, one of the things that we know

00:03:30.160 is that education sucks in most of the developed, were a developing world. So. And the developed

00:03:36.080 world as well. That, that is true. And, and people love to complain about it and we could probably

00:03:41.360 make education much, much better. But still remember, uh, the average student in sub-Saharan

00:03:47.040 Africa is below and far below the 99th percentile in the UK and the US. So despite the fact that you 0.96

00:03:55.520 think your kids are not learning very much, they're still learning immensely much more than what

00:04:00.720 happens in, in most of the low and low middle income countries. We call them, uh, the poor half 1.00

00:04:05.520 of the world. So the 4.1 billion people who live in low and low middle income countries. So these are

00:04:10.880 the people who live for, you know, less than $13 a day. Often, you know, the average is probably,

00:04:15.360 what, $6 a day or something. Very, very little. We could help that. The, the main reason why education

00:04:22.320 sucks is that you have, you know, we do this universally. You put all the 12 year olds in the 1.00

00:04:28.240 same grade. You put all the 13 year olds in the same grade. But remember, these 12 year olds are

00:04:34.000 vastly different. Some of them are really, really smart and knows what's going on. And some of them,

00:04:38.560 no clue. How are you going to teach a class of 50 when they're so widely, uh, you know, spread out?

00:04:44.480 You're not. You're essentially, you're going to try to aim for the middle and you're going to miss,

00:04:48.720 you know, all the smart kids and all the kids who don't really know what's going on.

00:04:52.400 And that's a terrible waste. What we know works is to make sure that you teach each one of these kids

00:05:00.320 at his or her own level. Now you can't do that with 50 kids and one, one teacher, but what you can

00:05:06.240 do, and I'm just giving one part of the example, you can put them in front of a tablet with educational

00:05:11.760 software. You do that one hour a day. So they're basically, you know, in front of this tablet,

00:05:16.800 uh, it'll very quickly find out just exactly how, uh, you know, how well are you on, on this topic?

00:05:22.000 Do you know a lot or do you know very little? And then start teaching him or her right at that level.

00:05:28.160 If you do that one hour a day for a whole school year, so the rest of the, you know,

00:05:31.760 seven odd hours or eight odd hours, uh, it's still going to be the same boring class where you

00:05:37.200 learn very, very little. Uh, and of course all the other kids also going to be using the same

00:05:41.280 tablet and that's the way we keep the cost down. If you do that for one year,

00:05:46.160 each of these students will on average have learned as much as they normally would in three years.

00:05:51.200 Wow. So for very, very little money, this costs about $30 per student per year for this, you know,

00:05:57.120 you need, uh, solar panels to recharge them. You need to buy the tablet. You need to teach people how

00:06:02.160 to use it. You need a storage so they don't get stolen, all this kind of stuff. But if you do all of

00:06:06.640 that, it'll cost $30 and it'll deliver three years of learning. And that's how you make people rich.

00:06:12.320 Because what happens if you learn more, you become more productive when you're an adult

00:06:17.120 and you'll have that all the way through your adult life. We can simply find a way. So there's

00:06:21.360 about half a billion kids in primary school right now in the lower half of the world.

00:06:26.080 If we make them smarter, they will make their nations better off. Not only will they make their

00:06:31.680 own families better off, but they'll make their nations richer. And so the whole benefit of that

00:06:36.560 will be in the order of $600 billion. So spend $10 billion on these tablets and some other things

00:06:43.600 we could also talk about. And then you make them $600 billion better off in the long run.

00:06:48.480 Remember, this is actually discounted back. So much of this will happen far in the future.

00:06:53.760 And we're, we're heavily saying that's worth less. It's actually in the order of $6 trillion,

00:06:58.960 but because you're comparing it to now, we're saying it's about $600 billion. That's a phenomenal

00:07:05.360 investment. You spend $1, you do $65 of good. You spend one pound, you do £65 of good. That's how

00:07:11.920 you multiply the world. And again, that's how you find really smart, simple things that have amazing

00:07:18.800 impacts. Bjorn, before we go into, and we delve into this more deeply, when I was reading your book,

00:07:24.960 my question was like, was as I was reading it going, why hadn't people done this before?

00:07:30.400 So the truth is, this is not rocket science. So most people know some of this stuff. So they,

00:07:39.680 you know, it's well known that, for instance, one of the very, very effective things in education

00:07:44.720 is teaching at the right level. And you can do that with a tablet. But if you ask most politicians,

00:07:51.120 what do you want to do? You know, a tablet doesn't really look like anything. You want to

00:07:54.880 build schools and go and cut the cord. Or you want to increase teachers pay, which obviously

00:08:02.000 make all the teachers want to vote for you. Or you want to reduce class sizes, because a lot of

00:08:07.360 parents are arguing for that. And look, all of these things probably have slight impacts, but very slight

00:08:14.480 compared to the enormous amounts of spending. So for instance, Indonesia, back in the early 2000s,

00:08:20.880 they actually made a constitutional change. So they decided they were going to double spending

00:08:25.600 on education. So they hired about a million more teachers. They have one of the lowest class

00:08:30.720 sizes in the whole world. They doubled spending on each teacher. So they basically doubled their pay.

00:08:38.320 And then they put it out all over the country, which you would think, that's great, right? I mean,

00:08:43.760 they really care about education. Unfortunately, some people studied this. And they looked at...

00:08:51.680 So, you know, because they implement it in different regions at different times,

00:08:54.720 you can actually do a pseudo-randomized control trial and see how much did it change the

00:09:01.360 learning of all these kids. It turned out that it had absolutely no impact. The famous paper is called...

00:09:08.000 No impact. No impact. The famous paper is called Double for Nothing. So, you know,

00:09:13.520 it sort of tells you the whole story there. It's a very widely quoted paper. It also

00:09:20.240 looked at how happy are the teachers. And not surprisingly, when you double their pay,

00:09:23.760 they're actually much happier, which also you would imagine in the long run probably mean that

00:09:28.880 they will be slightly better teachers. So we're not saying that we know everything. It seems reasonable

00:09:33.920 that there will be some sort of impact. But you couldn't measure it at all. So fundamentally,

00:09:38.640 there's a lot of wrong ways to spend enormous amounts of money. And so the answer to your

00:09:43.040 question is simply, it's not that we don't know that there are some things that work effectively,

00:09:47.920 and there are some things that are less effective. But it's just, we're also trying to do a lot of

00:09:52.160 other things. Politicians are trying to be popular. Most people are trying to do stuff that sounds good,

00:09:57.520 and, you know, looks good on TV. And you have the feeling that, you know,

00:10:01.440 I want my kids to have a lower class size because then he or she is going to become really smart. 0.95

00:10:07.840 But unfortunately, the answer is no, you should have her or him in front of a tablet for an hour a

00:10:12.960 day. Wow. So there's a lot of parents there who are going to be very upset because the kid's going

00:10:17.360 to be like, you see, the tablet is the way to go. Or I'm very happy, right? Because I mean,

00:10:22.240 fundamentally, you want your kid to do a lot better. Yeah, you do. You do. Is it partly as well,

00:10:27.040 Bjorn? Is that we're not being honest about these conversations? People aren't being honest

00:10:31.920 when we're discussing these topics? Yes, I think so. I mean, you know, fundamentally,

00:10:36.240 so the whole thing sort of stems from the UN's so-called sustainable development goals. They

00:10:42.640 run from 2016 to 2030. This is the global promises that all governments, the UK, everybody else have

00:10:49.920 promised the entire world. And they basically, as we started out with, they promised everything to

00:10:55.920 everyone. So of course, we're not being honest when we say, we're going to promise you everything.

00:10:59.920 No, you're not. Well, you're going to promise it, but you're not actually going to deliver.

00:11:03.600 We're failing on pretty much all of these promises. We've promised to deliver all these amazing things

00:11:08.800 by 2030. We'll probably be half a century late on this. And there seems to be no interest in

00:11:16.400 actually spending a lot of money. So what happens is, if you only have a little money,

00:11:20.960 and you spend it on the popular stuff, it obviously means that you'll end up not having

00:11:25.520 any money for the smart stuff. And so in that sense, yes, the book is really about saying,

00:11:30.960 look, why don't we do first the really smart stuff? And then, you know, please feel free to

00:11:36.000 spend extra money on all the other stuff. But $35 billion, that's really, you know, a couch change.

00:11:42.320 Let's just spend that and then, you know, do all the other stuff that you want.

00:11:45.680 Well, that makes sense. Bjorn, before we get into the specifics,

00:11:48.160 just remind everybody the sustainable development goals very quickly. What were they?

00:11:53.200 And how far or close are we on that? So fundamentally, I can't tell them. I've worked on these

00:11:58.480 for seven years. Nobody can tell you all of them. There's 169 promises.

00:12:03.520 We've got a lot of time. Okay, good. So I'm just going to start reading. No, look,

00:12:08.480 it literally, it says, you know, it says amazing things like, you know, end poverty,

00:12:13.920 which is great. I'm not sure anyone really knows how we should end poverty. We can reduce poverty.

00:12:19.280 But then it also goes on to talk about how we need to make sure that everybody get a fair wage. And

00:12:24.160 we also make sure that that happens for not just for men, but for women, which is great. And for

00:12:29.760 handicapped people and for elderly people and young people without an education, on and on.

00:12:35.280 And then, you know, it just goes into the weeds about everything we should be doing about this.

00:12:39.360 It does sound a little milk and honey.

00:12:40.480 Oh, it's totally, it really is everything. And then, of course, it goes on to disease

00:12:45.440 and say, we should get rid of disease. I think that's a great idea. I'm not sure how we would do

00:12:50.320 that. Again, you know, we can get rid of infectious disease or pretty much. But, you know, you need to

00:12:58.400 have your conversation about which ones should we do first and how much should we do. Some of it is

00:13:03.120 realistic, some of it is not. But then, you know, non-communicable diseases, so the stuff that you,

00:13:09.040 you know, chronic disease, we're not going to be able to get rid of that. And they promise to,

00:13:13.840 so they have more moderate, they're promising we should cut it by one third. We're no way

00:13:20.400 on the path of that. Right now, we're just not achieving it at all. And again, it's just unrealistic.

00:13:26.480 And then they go through all these other things. So it's a lot of wonderful thoughts, but nothing is

00:13:32.720 actually happening. And that's why if you try to estimate the total thing, and believe me, that's

00:13:38.560 very, very hard to do. But Jeffrey Sachs and some of these people in New York have actually tried,

00:13:44.240 what they find is that we are getting better. But that's fundamentally because the world is getting

00:13:49.680 better. So, you know, not surprisingly, the SDGs actually sort of indicate something that's nice.

00:13:54.320 So it is getting better. But it's getting better very slowly. There was no pickup after 2016 when we

00:14:00.640 started doing the SDGs. So there's been no sort of, yay, we all want to do it. It's just the same

00:14:06.800 path as it was before. And if you follow that path, remember, COVID totally broke that. But if you

00:14:12.400 imagine we sort of follow that path for the rest of this decade, we'll be far, far away. We'll probably

00:14:19.040 only get to what we promised half a century late. Makes sense. So the story is that you're saying is

00:14:25.600 basically we're throwing a hell of a lot of money at a wide range of things because we want to deliver

00:14:31.200 all things to all men. And here are 35 billion, 12 things you can focus on to actually make a big

00:14:37.200 impact. So let's talk about that. What are the biggest things that we actually should be looking

00:14:40.880 at, Bjorn? So we should be looking at education, as I talked about, and then we should look at some

00:14:45.440 of these other things. So let me give you one other example. I'm not going to do all 12. But one obvious

00:14:51.600 thing is maternal and newborn health. So the thing, again, I learned a lot when I was writing this book

00:14:59.680 because I work with some of the smartest economists. And they, again, work with all these people who

00:15:04.080 actually do the stuff. I'm not an expert on this. They are. And I've just learned a lot from them.

00:15:09.360 So one of the things that surprised me was so many moms are still dying from childbirth. So about 300,000

00:15:16.240 moms die each and every year in this world. And they needn't do that in childbirth. 2.3 million 1.00

00:15:22.960 kids die each and every year in the first 28 days in their life on earth. That's just terrible. And

00:15:29.040 again, totally, totally unnecessary. So much of this is because there's complications during birth,

00:15:35.600 and there's no materials to handle that. So the mom has preeclampsia or eclampsia, basically high 1.00

00:15:42.320 blood pressure, and she bleeds out. We know how to fix that. We fix that routinely in the rich world. 1.00

00:15:48.480 We should make sure moms get into institutional birth, give birth in institutions instead of just 1.00

00:15:54.720 doing it at home, so that there is an opportunity to treat her if things go wrong. Likewise, you know,

00:16:01.200 and again, I didn't know this at all. So most kids that come out of mom just start breathing right

00:16:07.360 away, about 80%. So 15% need a slap in the back to get going, and then they start breathing,

00:16:14.160 and that's fine. But even in rich countries, about 5% of all kids just don't breathe.

00:16:19.200 Wow.

00:16:19.680 So you need to start giving, you need to push in air into their lungs, and then they go,

00:16:25.600 and then they survive. And of course, we just do that in rich countries in rocket science.

00:16:30.960 You just need a simple hand pump. I mean, in rich countries, we have something more fancy because

00:16:36.320 we can't have such easy things, right? But in the poor part of the world, you just often don't

00:16:43.600 have this hand pump. It costs $65 for each of these hand pumps. It works for probably three years,

00:16:49.840 and in that time, you could probably save about 25 kids. $65, 25 kids life saved.

00:16:56.240 That doesn't seem like a lot.

00:16:57.120 Why are we not doing that? And again, the point here is not that, you know, I don't want everybody

00:17:02.160 to rush out and do a GoFund just for this hand pump. It's about getting all of these things. So,

00:17:06.720 you know, for instance, disinfectants. Yeah, you'd imagine that's a good idea to have disinfectants

00:17:13.120 on the surfaces in your hospital wing. But again, we don't. And so, a lot of places do, but you know,

00:17:19.440 about a fifth don't. We should make sure that that has it there. And so, the point with this argument is

00:17:25.360 really just to tell people, if we focus more on maternal and newborn health, that's by making sure

00:17:32.240 that the women come in to institutional birth. So, about two-thirds are doing it now. We want almost 1.00

00:17:38.240 all in institutional birth. And that these institutions actually have midwives, that they

00:17:43.040 have disinfectants, that they have this hand pump. These very, very simple things. World Health

00:17:47.280 Organization has a whole list of this. If you did all of that, it would cost about $5 billion a year. So,

00:17:53.040 not nothing. But then you could save 166,000 moms each and every year. And you could save 1.2 million

00:18:01.680 kids each and every year. Wow. It just blows your mind that we're not doing this. And the simple

00:18:08.320 reason why we're not doing it is because it has very little sort of public awareness. I don't know,

00:18:14.240 have you guys ever seen the, this is the Monty Python skit with the machine that says Pling?

00:18:20.160 No. No. No. You have, it's a, uh, uh, uh, uh, the meaning of life. You, oh God, you've got to say

00:18:26.880 that. Anyway, so, uh, they're, they're, they're, these doctors, uh, uh, in, in an operating room or

00:18:32.240 something, uh, and they have all these machines and they're all totally excited about the machines

00:18:36.240 and the, uh, and the manager of the hospital comes in and he's, then they, oh, let's show him the

00:18:40.880 machine that says Pling, which is apparently the most expensive machine in the hospital. So,

00:18:44.800 everybody's very excited about it. And then at one point John Cleese goes, uh, still something

00:18:51.280 missing there. Hmm? Hmm.

00:18:58.640 Patient. Yes. Where's the patient?

00:19:01.440 Patient. They're so excited about these expensive machines that they forget that this is about the

00:19:07.600 woman. And, you know, she, it's funny and she gets just neglected all the time and they want 1.00

00:19:12.560 to emphasize the machine that says Pling, right? I mean, and, and, you know, obviously it's a

00:19:16.800 caricature and, and, you know, I'm not saying that all doctors are like that, but doctors probably

00:19:21.120 rather would have an MRI scanner than they would one of those hand pumps, right? Because, you know,

00:19:26.560 it's fun to go to a conference and say, yes, we have this, you know, this new MRI scanner,

00:19:31.200 2000 or whatever it's called, but you know, this hand pump, uh, you know, old, old stuff,

00:19:35.920 but it's actually this hand pump that'll help save, uh, 25 kids.

00:19:39.760 Because in some ways, you know, when you've got people in sitting around a room in the UN

00:19:44.800 and they're all very intelligent, they almost desire complex solutions because it's more grandiose,

00:19:53.360 isn't it? Than something as simple and as prosaic as a hand pump.

00:19:57.360 Yes. But, but it's not that they haven't promised also to fix this, right? Because they promise

00:20:02.640 everything. But, but the point is that when you're promising everything, you have no direction. If

00:20:07.920 you have 169 priorities, you have no priorities. And if you promise everything, you inevitably leave

00:20:14.480 it to people to say, hmm, would I rather have a cheap hand pump that nobody cares about? Oh,

00:20:19.440 would I like a lot of expensive stuff and a new hospital wing and, you know, all these other things.

00:20:24.080 Uh, so, you know, uh, the, the, the truth is we almost inevitably end up doing stuff

00:20:29.440 that's less effective, not because people are bad, but because they have lots of other

00:20:33.280 incentives apart from, you know, doing the best things first. And so that's why I think by making

00:20:38.880 this book and by forcing everyone to sort of confront the fact that there are some incredibly

00:20:44.080 effective things we can do, it becomes a little harder to not do that first.

00:20:48.320 You know, the thing that you talked about in your book, which really resonated with me and

00:20:54.480 everyone can drink now, my mother's Venezuelan. So Venezuela is the fifth biggest oil producer in

00:20:58.880 the world. It should be actually with the largest oil reserves in the world. It should be arguably one

00:21:04.320 of the richest countries in the world. It should be on the same level as Saudi Arabia, but because of

00:21:08.480 chronic mismanagement and to put it more accurately, corruption, it has never reached those heights and

00:21:15.280 most likely, tragically never will. And when you see in the third world, that is the real problem 1.00

00:21:22.560 for me. That is a cancer, which means that we talk about education, health, all of these things,

00:21:28.720 but a lot of the time it's because these funds are being leeched by people in higher positions.

00:21:34.240 So how do we solve corruption, Bjorn?

00:21:35.920 Because that is one of your points.

00:21:37.440 It is, it is.

00:21:38.320 Which I will say, just to add to France's point, being from Russia, I was like, I like everything

00:21:44.240 else beyond saying this seems a little bit unrealistic. How do you fix corruption in the

00:21:49.440 developing world?

00:21:50.080 I will answer the corruption question just before I've said that all of these approaches actually

00:21:56.320 assume that there will be corruption and that people will be incompetent and that people will,

00:22:01.120 you know, steal some of the tablets. So this is all based on reasonably large-scale experiments

00:22:06.640 where you've gone out to do this for a region, for instance, for the tablets. So we know that

00:22:11.680 some of them are going to get stolen. We know that some of the teachers just don't care,

00:22:15.200 and we know that all these things. So if you assume sort of basic incompetency as much of the

00:22:20.000 world has, then it's $65 back. So we're not assuming sort of, oh, if everything was wonderful,

00:22:26.960 then we can get $65. No, if everything was wonderful, it would probably be much, much higher.

00:22:31.360 So we include that people are less than ideal, right? But back to the corruption point.

00:22:37.600 So corruption costs a lot of money. We don't quite know. For obvious reasons, it's hard to survey.

00:22:45.680 So a popular estimate that also seems reasonably well-sourced is that it costs about a trillion

00:22:50.480 dollars in the world. So we're basically losing about one percent of global GDP to corruption.

00:22:55.680 So absolutely, there's a lot of ways that corruption is just terrible. And of course,

00:22:59.680 for Venezuela, it's been much, much worse. I don't know about Russia, but I wouldn't be surprised. 0.93

00:23:04.160 That's pretty bad. Yes. So how do you fix it? Well, there's a lot of ways that you don't know

00:23:09.920 how to fix it. But we've actually found one, and again, this is not us. This is evidence that we know

00:23:17.520 out in the literature that the biggest consumer of, so the biggest demand for most products in the

00:23:26.560 world actually come from governments when they procure stuff. So anywhere from Post-it notes to roads,

00:23:32.880 but obviously roads and that kind of stuff are much, much more expensive. So it really is when

00:23:37.120 you ask for roads or other infrastructure projects, these are typically hugely corrupt. So we did work

00:23:43.120 in Bangladesh, and the sort of standard understanding is that they have British laws, and so you hand in

00:23:50.960 and seal envelope with your bid in a government office. But the problem is it's only advertised in

00:23:56.800 a really, really small and obscure journal, so only a few people see it. And then, you know,

00:24:03.040 the local elite already has decided, you're going to have that bid, right? And so they put up goons 0.98

00:24:08.880 outside that office, so you can't physically come in with the bid. And so they get the bid at an

00:24:15.040 outrageous rate, right? If you did e-procurement, so basically put this online, a little bit like eBay,

00:24:21.680 there's a lot more to it, right? But fundamentally, it's just simply, if the government said,

00:24:25.520 we'd like a road, who wants to bid on it online? You can still be corrupt, and you can still make

00:24:31.520 some sort of impacts, but it's much harder. Everyone will hear about it. A lot more people

00:24:36.960 are going to bid for it, so that bids down the price. Typically, you also get higher quality.

00:24:41.040 But crucially, it's much easier to flag if people are sifting off a lot of money. They'll probably

00:24:46.640 still be sifting off some money, but less. And so what we find is, on average, this simply,

00:24:52.160 this approach simply makes governments about 6.75% more effective. They simply get, you know,

00:24:59.120 more for their money. We told this to the Bangladeshi finance minister, you know,

00:25:04.880 our calculations basically show that if you do e-procurement, you can get $700 million more

00:25:11.760 stuff every year. How's that not cool for a finance minister? Now, the problem is, of course,

00:25:16.400 he knows that the people just below him, or a couple of layers down below, they're actually

00:25:20.320 making a lot of money off of being corrupt. So you have to have the political will to do,

00:25:24.800 and that may be what you were sort of, hmm, is that going to work? But we know it works in a lot

00:25:29.120 of countries. But there's still 70 countries, low and low-middle-income countries, that haven't

00:25:33.440 completed the e-procurement journey. It costs trivially little. So we're talking about, you know,

00:25:40.320 5, 10 million dollars per country. And there's some, you know, add-on effects. We estimate about

00:25:47.760 72 million dollars. This is just nothing. And it would generate about 10 billion dollars

00:25:55.520 in more purchase opportunity. Remember, it's mostly smaller countries that are still not

00:26:00.960 implemented this. And we're simply saying, that's an easy win. It's not going to work for everyone.

00:26:05.600 Not everybody is going to have the political will to do it. And there'll still be corruption,

00:26:09.600 but less. So this is just an incredibly easy win. And again, we don't fix all corruption,

00:26:14.960 but we fix some of it. And that's, you know, the point here is, again, we need to get out of this,

00:26:20.800 oh, we got to fix the whole problem. You know, we got to fix all of health or all of education

00:26:25.520 or something. No, we need to do better than we did before.

00:26:28.820 This is kind of one of the things that's happened, isn't it? We've somehow got ourselves locked into

00:26:34.640 this maximalist mindset where it's like all or nothing. Either you do it. And we have this

00:26:41.440 conversation in this country about all sorts of the NHS. You know, we must fix the NHS. It's if

00:26:47.900 the Labour are in power, they broke it. If the Tories are in power, they broke it. And sort of people,

00:26:53.660 a phrase that I heard in the last couple of days that I really like is trade-off denialism.

00:26:58.240 Yeah. We seem to be there on a lot of these issues.

00:27:01.480 Oh, God. Look, fundamentally, the world is about trade-offs. And we all know that in our personal

00:27:06.020 lives, right? I mean, if we're going to replace the roof so it doesn't drip in, you can't afford

00:27:10.600 your summer holiday. And we know this. And well, you know, some people will max out their credit

00:27:14.840 cards, but eventually they'll find out that there is a trade-off, right? And you have to make these

00:27:19.800 trade-offs. But of course, politicians are elected on the promise of being able to promise more than the

00:27:25.540 other guy. And that inevitably leads to everyone promising everything to everyone. And then we all

00:27:31.200 get disappointed, which is a bad setup. So at least what we're trying to say is, look, why don't we do

00:27:37.560 the smarter stuff first? And then we can do all the other stuff you're talking about. But, you know,

00:27:43.260 let's just set aside $35 billion. And again, the point in some ways, and it's important also to say

00:27:49.320 when we say we, I'm not saying, you know, I don't have $35 billion in the couch or anything.

00:27:54.540 I don't think you guys do either, right? So this is about government. So this could be the UK

00:28:00.140 government spending its development aid. It could be a lot of developing country government. So India

00:28:06.620 could decide, all right, we're going to, you know, get more tablets out to our constituents.

00:28:11.880 It could be, you know, rich billionaires like Bill Gates or Elon Musk that we're going to say,

00:28:16.340 I am going to, you know, spend my money. They couldn't do all of them, but, you know,

00:28:19.620 they could do one or two. So it's about getting everyone to think a little smarter about this.

00:28:24.600 Well, that's the exciting thing about what you're saying is you almost don't need any new money.

00:28:28.920 You just need to take some of the money that you're spending on other things and put it into

00:28:33.600 this stuff that makes more impact. So we've got education. We've got the corruption. We've got the

00:28:40.440 health, the maternity stuff we talked about. What about disease? Because there are some

00:28:45.940 diseases that are absolutely eliminable, if that is a word. Malaria, for example, right?

00:28:52.220 Yes. Tell us about some of that stuff.

00:28:54.420 So malaria is one of those things, you know, you think, and certainly the way we've conceptualized

00:29:00.020 malaria is that it's a tropical disease. And that's because almost all of it is now in Africa.

00:29:06.080 But that's not true.

00:29:07.020 No, it's not.

00:29:07.900 William, Oliver Cromwell died of malaria in this country. It's called ague in those times.

00:29:14.100 I didn't even know that. That's a good fact.

00:29:16.280 Yeah, because there was marshlands in Cambridge.

00:29:19.120 There you go. Malaria is not all bad. 1.00

00:29:20.560 Yeah, exactly. The Irish love malaria. 1.00

00:29:24.720 But actually, yes, exactly. You know, Russia had lots and lots of malaria in Archangel and

00:29:31.380 in Moscow, in Finland. It was endemic in 36 states of the US in the early part of last century.

00:29:39.780 So malaria has been a problem everywhere in the world. We fixed it because we got richer

00:29:46.780 and because we got more resilient and because when you're sufficiently rich, you also buy

00:29:52.520 canine back then, you know, drugs, so you get rid of it. And then you basically don't have malaria

00:29:57.500 again. You know, if someone flies in with malaria in England, it's not like, oh my God, then everybody

00:30:01.880 gets malaria again. We just make sure that he or she gets treated and then that's the end. We didn't

00:30:07.960 get rid of the mosquitoes. We just got rid of the parasite that's inside the mosquitoes that's

00:30:12.360 actually causing malaria. The problem with Africa is that they have especially bad mosquito that,

00:30:21.360 so a lot of other mosquitoes like to bite animals as well. And that means you dilute the problem a 0.91

00:30:27.480 lot. If you get a lot of livestock, basically they'll just, you know, what do you say? They'll

00:30:32.380 sting the livestock instead and they won't transmit the malaria. But unfortunately, the malaria that's

00:30:38.240 the malaria mosquito in Africa almost exclusively bite humans. So that's much, much harder. And then

00:30:44.860 they also have a parasite. The malaria parasite, that specific one, is much more deadly. So that's

00:30:50.520 sort of a double combo that means this, we've been able to do it in the rest of the world, but not in

00:30:55.400 in Africa. Now, by far the best way to deal with that is to get long-lasting insecticide treated bed 1.00

00:31:02.980 nets. Mosquitoes typically bite at night. If you put up a bed net and sleep under it, you both make

00:31:09.520 sure that the mosquito can't get to you. And because when it sits on the bed set, because it'd like to

00:31:14.220 get to you, it actually gets the pesticide and then it dies. So we know this is the way to do it. Now,

00:31:20.420 if you hand out bed nets, not all of them are going to be used well. Some of them are going to be used

00:31:25.100 for fishing and other stuff. There's all these stories about how you do different things with

00:31:31.720 them. But if you distribute more, you're going to get more people to sleep on them. And that means

00:31:36.560 not only these people will be saved, but also you make it much harder for the mosquito to keep 0.79

00:31:41.560 transmitting the malaria. Sorry, I'm now forgetting what it's called, but the malaria.

00:31:50.260 Parasite. Parasite. Thank you. That's the word I was looking for.

00:31:53.860 So that actually becomes much more rare. So this is the way we do it. So we looked at how much would

00:32:00.960 it cost to get all nations in Africa, all these 27 nations that have most of the malaria, up to 90%

00:32:07.420 coverage. They're about 70% right now. And that has a cost. It's about $1.7 billion a year. So not

00:32:14.920 trivial, but you could save about 200,000 people just doing that. And not only that, you would also

00:32:20.900 make these people much, much more productive because malaria is typically not deadly. So the

00:32:25.980 200,000 people that die, yep, that's terrible. And that's a real cost. But the vast number of people,

00:32:32.240 so we're talking about 500 million people get sick, many of them several times a year. That's a terrible

00:32:38.740 disease. And you have it for five to 15 days where you basically can't do anything. And so you lose out

00:32:45.760 on productivity. Many countries in Africa, you have to hire two people because you know one of

00:32:50.960 them is going to be sick with malaria. And that's, of course, incredibly unproductive. So not only do we

00:32:56.340 save 200,000 people, but we also make them much more productive. So again, these are simple solutions.

00:33:01.980 And again, it's not that we don't know this, but it's also just one of the many, many, many,

00:33:07.400 many things people are talking about. And so we're trying to say, well, let's talk about this first.

00:33:12.160 Yeah. And tuberculosis is also something you touch on.

00:33:15.480 Tuberculosis is, you know, that's just a phenomenal thing. So a fourth of everyone who died in the

00:33:22.640 1900s died from tuberculosis. Every fourth person in Europe that died back then died from tuberculosis.

00:33:29.380 It probably the biggest killer in the world. So over the last 200 years, it probably killed about

00:33:33.900 a billion people. You can't wrap your head around that. And we were incredibly worried about it in

00:33:40.840 Europe and elsewhere until we figured out, oh, we can cure it with, you know, with antibiotics.

00:33:47.100 And so it dropped off our radar. And we're like, okay, that's fixed. And nobody gets, you know,

00:33:51.900 nobody dies from tuberculosis today in rich countries. But that never happened in many

00:33:56.840 countries in the global South. So they still saw a decline. But, you know, India, just before its

00:34:04.280 independence in 1946, estimated about half a million people died from tuberculosis each and

00:34:11.040 every year. Last year, the World Health Organization estimated that half a million people died from

00:34:16.800 tuberculosis in India. Now, they brought it down fourfold, but the population has grown fourfold as

00:34:22.220 well. And that's why it's still the same number. We need to do something about that. And we know how to

00:34:27.120 fix it. So the simple point is you need to get more people to take their medication. That's actually

00:34:32.440 hard because you need to take it four to six months. But it's fairly cheap. And we know how

00:34:36.900 to do it. And you need to make sure that everyone do this. So, you know, you get sort of tuberculosis

00:34:42.260 anonymous where everybody gets together and say, yes, I took my pills all the way through the week

00:34:47.740 kind of thing. And you give them little prizes like juice boxes or something. And it feels a little

00:34:53.840 odd that we have to do that in order to get people to take the medication. But if you don't get

00:34:59.300 treated for tuberculosis, you on average will transmit it to 10 to 15 other people. So it's

00:35:04.880 a great investment. It's a little bit like when we distributed condoms for HIV AIDS. It's just a good 0.97

00:35:10.160 way to make sure that everybody else don't get it. And then the other part is we need to find. So we

00:35:15.800 estimate about 12 million people get TB every year, but we only diagnose about seven. So we still have

00:35:23.000 a lack of people that we're finding. And those are the ones that keep transmitting it to new ones.

00:35:28.280 And that's what's keeping the infection rate going. We know how to fix it. We just need, again,

00:35:33.700 about 5.5 billion dollars a year. And then we could save over this decade about 600,000. Over the

00:35:40.280 next three decades, about a million people each year. I'm sorry, how are you going to find the people that

00:35:44.360 we don't know that are transmitting it? Yes, yes, that's a very good question. So it's often very poor

00:35:50.980 people. It's people in slum areas. So BRAC, which is the world's biggest NGO in Bangladesh,

00:35:58.400 they had old, typically widowed women walking around. They would have like 15 families that 1.00

00:36:05.140 were their responsibility. So they'd go there every second and third day and say, so how are

00:36:09.800 people? Have anyone been coughing for a long time? And then, you know, if you've been coughing for three

00:36:15.580 weeks, then they say, shouldn't I take you to get tested? The problem here is tuberculosis is actually

00:36:21.540 a really stigmatizing disease. So, you know, for instance, if you get tuberculosis in Kenya,

00:36:30.180 about a fourth of everyone who gets it get divorced. Their partner just says bye, right?

00:36:36.500 Why? Because it feels, do I want my kids there when he's coughing and maybe not getting well?

00:36:44.320 I don't want to be the wife of the guy who has tuberculosis. Everybody else is going to shun me

00:36:49.700 at the market. Bjorn, I know you're trying to save the world, mate, but the problem is you're really

00:36:53.360 doing down the concept of marriage here. Everyone's watching this guy. No one takes their wedding

00:36:58.700 vows seriously anymore. I'm sorry. And you lose your job because people don't want to have a guy 0.92

00:37:05.340 with tuberculosis hanging around, right? And so, actually, a lot of people want to lie about,

00:37:11.580 do I have tuberculosis? You actually go to the doctor, especially if it's a private sector doctor,

00:37:16.760 he makes money off of you coming again. So, he will have an incentive to tell you, no,

00:37:21.540 it's not tuberculosis, right? And given that it's a little hard to diagnose, there's a good chance

00:37:26.480 he's going to say, and, you know, many of the symptoms are similar to a lot of other diseases.

00:37:31.080 He'll basically say, no, here's a Vic, right? Kind of thing. I'm not saying that

00:37:35.320 that's exactly what happens, but it has this tendency and everybody sort of wants to believe

00:37:39.720 that I didn't have tuberculosis because then my wife won't leave me and I won't lose my job and

00:37:44.740 all that stuff. So, we need to make sure that people actually go through this. So, you do that

00:37:49.600 by actually testing people. You test people in prisons and mining camps and slum camps and refugee 1.00

00:37:57.740 camps, that kind of thing. You possibly, and we have new gene tests that are very cheap and effective,

00:38:03.360 but you need to set up the system to do that. And, you know, it has real cost if you're going to

00:38:08.520 mass test a lot of people. But all of that is included in the $5.5 billion. So, again,

00:38:14.240 it's not that we don't know how to. It's even not that most of the world's governments haven't

00:38:18.740 already promised. I mean, yes, they've promised everything, but they've actually extra promised

00:38:23.000 this money, but still haven't delivered. So, you know, we're simply just saying, let's, again,

00:38:27.720 do the stuff that we have promised and that's incredibly effective. So, for every dollar

00:38:32.420 spent, you'll do about $46 worth of good. Bjorn, what is the connection between TB and AIDS? And

00:38:38.760 is that a part of the problem with the stigma element to it? Because we all know that when

00:38:42.920 the immune system collapses, it becomes very vulnerable, the body becomes very vulnerable

00:38:47.220 to certain diseases, and TB, unfortunately, finishes off a lot of AIDS patients.

00:38:51.920 Yes. So there is a connection in the typical setup and all the numbers I've given you are

00:38:57.300 actually without the HIV. And so for, you know, and there's a lot of different ways to think about

00:39:02.380 that. The health community has simply decided to say the people who die from TB, but because they

00:39:07.660 had HIV, died from HIV, which I think makes sense. So it's a, it's sort of a separate problem. The main

00:39:13.860 problem is not TB because they would probably have died from something else had they not gotten HIV

00:39:19.040 treatment. So it's a different conversation. It's one that we mostly have fixed. So again, remember,

00:39:25.440 HIV kills much, much less than, for instance, TB. It kills around 600,000, about the same number as

00:39:33.040 malaria. Whereas TB, the un-HIV TB kills about 1.4 million people. So again, TB is the world's

00:39:41.260 leading infectious disease killer. It wasn't in 2020 and 21 because of COVID, but it's been for the last

00:39:47.060 10 years besides COVID. I find that really surprising. So HIV AIDS only kills 600,000. I mean,

00:39:53.160 it only kills, I would have thought it'd be much, much bigger. Yes. But, and that's because you think

00:39:59.040 about back in the early 2000s where it was huge and it had the, the real opportunity to take over

00:40:05.460 the continent of, of, of Africa. And so it was incredibly good that we got a lot of drugs out

00:40:12.020 and actually managed to, to deal with HIV. But it's partly because we have managed to deal with HIV

00:40:18.340 and also because it got so much attention that now we should still remember that HIV is an important

00:40:24.620 disease, but it's much, much harder to find these really, really effective, cheap solutions going

00:40:30.700 forward. That's also why this is not one of our solutions. And it also shows you, you know, the,

00:40:35.000 the impact of, of, of prioritization. It does mean that we don't say we should do everything. Now,

00:40:40.700 I'm not saying we should cut back on HIV, but I'm simply saying this is not the first place where

00:40:45.320 we should spend more money because it turns out that you can probably only spend, you know, a pound

00:40:50.900 and do say five pounds worth of good, which is great, but it's not nearly as great as spending a

00:40:56.360 pound and doing 46 pounds of good. So we're simply pointing out, you know, the stuff that you should

00:41:00.880 do the very first. And obviously immunization is a massive part of this. Yes. So immunization is what

00:41:07.140 saved most of us. Uh, we have this whole conversation about COVID. I'm just going to

00:41:11.760 totally ignore it, but we, but we know that childhood immunization is an incredibly good

00:41:18.360 thing to do. So, you know, measles would probably kill two or three million kids each and every year

00:41:24.160 if we didn't vaccinate. We vaccinate most kids in the world. And that means we only see about 80,000

00:41:31.520 deaths each and every year. That's a fantastic outcome. Remember, uh, uh, no, well, you probably

00:41:37.180 don't, but smallpox, smallpox was, you know, one of the world's leading infectious disease killers.

00:41:43.120 It probably killed somewhere between 300 and 500 million people in the 20th century. We eradicated

00:41:49.060 that in 1978. That was an incredibly good investment. Uh, we actually go through the cost there. Uh,

00:41:55.880 one of the reasons why we could eradicate it is because it doesn't have a, uh, an animal reservoir.

00:42:00.780 So most diseases, if we get rid of them and humans, they'll still survive in animals and they'll come

00:42:07.300 back and perhaps literally bite us later on. And then we're back, but smallpox didn't. And so you

00:42:12.740 could actually eradicate it. We eradicated with a vaccine. Yeah. So this was the world's first vaccine.

00:42:18.900 Uh, it came from cowpox. So, uh, Jenner back in, in the 1700s, uh, realized, which a lot of other

00:42:25.160 people had also pointed out that the milkmaids didn't have, uh, didn't get smallpox, uh, because they

00:42:30.700 got cowpox first, uh, from the cows. And so he took their cowpox and put it into a, a young, uh, 0.56

00:42:38.920 guy and then infected him with, uh, with smallpox to see if he survived. This would not have passed

00:42:44.440 the ethics test today. I'm not sure you could do that today. No, I'm not sure he actually told

00:42:50.800 him the whole, the full scale of what he was doing. Anyway, he survived. And that's why science

00:42:54.220 doesn't work. We need that. This is, this is what we need to more. No, no. Too much red tape.

00:42:59.560 Yes. I'm not arguing for that, but I am arguing for that. We're, we're vaccinating a lot of people.

00:43:05.780 Uh, a lot of kids gets vaccinated, but we're not vaccinating as many as we could. So we could

00:43:11.480 still save more people from, uh, uh, measles from, uh, from, uh, uh, um, sorry, there's a lot of

00:43:18.400 things in there and I, now I'm forgetting most of them, but, uh, rotaviruses for instance,

00:43:22.280 which are one of the things that give, uh, most of the diarrheas, uh, that often lead to

00:43:27.620 about half a million kids dying. Tetanus as well. Yes. Uh, and yes. Polio I'm guessing too?

00:43:33.340 Polio is a different. Or is that done now? Well, it's a different, uh, uh, task. There's very,

00:43:38.320 very little polio left. And so the main challenge with polio is really that we can't get to the places

00:43:43.460 where people still have polio because we, you know, people there believe that they're

00:43:48.280 actually, you know, they're Bill Gates trying to put in, uh, uh, microchips or, or more worse

00:43:53.720 that they're, that they're, that we're trying to limit their population because we don't like 0.98

00:43:58.100 Muslims. There are a lot of, uh, you know, sort of, uh, uh, um, uh, uh, conspiracy theories about

00:44:03.160 that, but it's not mainly a monetary problem anymore. It's, it's more a political issue. Uh, so

00:44:09.220 these are, this is much more about getting people from, you know, most of these, uh, poor countries

00:44:13.780 from 80% to say 90 or 95%. Uh, and it's going to be costlier. It's going to be harder. But what we

00:44:20.320 find is it's going to save so many people that for every pound you spend, you'll do 101 pounds

00:44:27.100 worth of good. You know, it's just simply a fantastically good way to save about half a

00:44:31.560 million, uh, kids. Do you sometimes get frustrated beyond that you're in this field and you see the

00:44:36.460 way that people talk about vaccination and immunization and look, you know, let's forget

00:44:43.320 about COVID, but the, the fact that there's the, the sort of an anti-vax movement seems to be growing

00:44:48.780 to me, I find incredibly worrying. Yes. But, and yes, I do get frustrated, but remember, I,

00:44:56.420 I deal with so many other stupid, weird things that it's just one of the many things that you, 0.91

00:45:02.020 at some point you just have to let go and say, yes, this is annoying, but you know, 0.99

00:45:06.100 it's part of a world where people have too much time and, and they're quite frankly so well off

00:45:11.320 that they can afford, you know, you would never do that if your kids were regularly dying from

00:45:15.680 measles. And what we find is, you know, these people who think, oh, my kids shouldn't be

00:45:20.200 vaccinated against measles. Uh, when they discover that there's a death nearby or even their own kid,

00:45:27.300 they certainly want to vaccinate the next kid. So, you know, it sort of shakes people back into reality,

00:45:33.080 I think. Uh, and yes, that was an unnecessary death and I would wish that people didn't do it.

00:45:38.300 Uh, but yeah, most people get this. Uh, most people actually get that science and progress is

00:45:44.680 mostly a good thing. Uh, and that you want to do mostly what your doctors tell you just simply

00:45:50.620 because it's a good idea.

00:45:52.300 It is.

00:45:53.320 Uh, Bjorn, coming back to, to the bigger issue, can I ask a slightly sort of quest skeptical question,

00:45:58.580 which is, uh, um, I'm, you're, you and the people you're working with are a lot smarter than me.

00:46:04.180 So I'm assuming you've thought of this obviously, but a lot of the, the poorer countries in the world,

00:46:09.020 many of the things you're talking about, it's not that it's not only that they don't have the

00:46:13.720 particular gadget or whatever that they need, but it's an infrastructure issue. There aren't roads,

00:46:17.880 there aren't trains, there aren't whatever. Um, is that something that you guys have thought about

00:46:23.060 and included in these calculations?

00:46:25.340 Yes. So, you know, I, I'm saying yes. I think we've included almost all of it. So a lot of this

00:46:31.840 is based on what's called randomized control trials. So you actually, you know, you do this in some

00:46:36.400 villages and you don't do it in other villages and you see what happens. Uh, and so all of these

00:46:41.100 bad things, that was what we talked about before the corruption, the incompetence, and the fact that

00:46:45.880 there's no roads or there's poor roads is sort of baked into the result because we did it in real

00:46:50.960 world situations. So we're assuming that if the world can do what we did in these villages in this

00:46:56.260 region, then we've already baked in all the, all the bad, other bad things. So for instance, we,

00:47:02.380 we look at, uh, uh, uh, making more research and development for, uh, uh, for, uh, better agricultural

00:47:08.820 productivity. Remember what basically got us rich and what got us, you know, uh, the, the fact is most

00:47:15.140 people don't work in agriculture. That's, that's how we get rich, right? If everybody has to work

00:47:19.480 in agriculture, there's nothing else to do. So you want to get much higher productivity in

00:47:23.960 agriculture. We did that partially through the green revolution where you got better seeds for

00:47:29.320 rice and, uh, uh, and wheat and maize or corn, uh, so that you could grow a lot more for every hectare

00:47:36.140 acre you farm. Uh, but we didn't do that in the poor part of the world because they don't have

00:47:41.400 that much money. And that quite frankly, it wasn't our main concern. So cassava and sorghum and all

00:47:46.400 these other things that people grow in, in low income countries, we should make those work better,

00:47:52.720 but, and we know how to do it. And we, we suggest we should be spending about $5.5 billion, uh, on this

00:47:59.060 every year on average. And that would actually generate much higher yields, which would benefit

00:48:04.640 farmers and benefit consumers, farmers because they produce more consumers because each product will

00:48:10.320 cost less and then you'll have many fewer people starving. But your point is exactly, but what

00:48:16.520 about the roads? What about the infrastructure? What about, do they have irrigation? Do they have

00:48:20.620 mechanization? No, they still lack a lot of stuff. But the beauty of this is if you hand out a better

00:48:26.340 cassava, and I'm not really sure how exactly how big that is, uh, but it's not a seed, right?

00:48:30.820 I don't even know what that is to be honest with you. It's, it's, it's, it's sort of a potato kind of thing.

00:48:34.180 Yeah, they eat it in South America a lot.

00:48:35.820 Yes. So if you hand out that, you can grow this and make it grow more, make more cassava.

00:48:44.240 But even if you don't have the irrigation, even if you don't have the mechanization,

00:48:48.420 now had you had that, you would be doing even better, but you can do that without all of those

00:48:53.520 extra inputs. And that's, what's the beauty of much of this. So it works somewhat, but you know,

00:48:58.680 everything could be better, but that's, our goal is not to make the world fantastic. I mean,

00:49:02.600 that'd be wonderful, but that's not what we're trying to do. We're simply trying to make it

00:49:06.120 better. You're going for the super low hanging fruit that makes the biggest impact. And that's

00:49:10.440 why you're focusing on the poor half of the world. Yes. What I, what did occur to me as you were

00:49:14.860 talking though, is it's weird how the half the world is starving essentially, or is close to that

00:49:21.080 point. And in the West, the, one of the biggest causes of death is we have too much food and we

00:49:26.060 eat ourselves into an early grave. Yes. Is there a low hanging fruit there that we can do? Because it'd be quite

00:49:31.880 nice to do, to deal with that as well. Otherwise we're going to make the whole world fat and die 0.99

00:49:36.540 early as well. Yes. We haven't looked at that. So there, there's a, there's a moral part of this 0.99

00:49:43.800 and then there's the practical part. So very clearly the moral part is it's a much better situation

00:49:49.420 to end up eating too much food than too little, because you can sort of regulate that yourself.

00:49:54.340 Clearly we can't, but at least, but at least, you know, if I have to choose, I'd much rather have

00:49:59.620 the decision. A hundred percent. So, so we should just make sure that this is not a symmetrical

00:50:04.400 issue. No, no, no. But, but you're absolutely right. And I don't think there's a, there's an

00:50:08.760 obvious way to do this because, you know, we're involved as I, as I understand, we're involved

00:50:13.060 to say, you know, food could, you know, eat as much of it and, and preferably sweet and, and fat

00:50:18.940 because that then we'll put on a lot of weight for when winter comes. Finally, I guess that agrees

00:50:23.380 to have made wonderful. So, so, you know, we're, we're, we're basically fighting our

00:50:28.320 genes and I'm not sure exactly how you, how you get around that. Uh, now there's a lot

00:50:33.560 of other things that we can do. And your people will argue that we should have, uh, cities

00:50:37.580 that where you walk more, you know, if you look in New York and other cities where you

00:50:41.100 walk many, many cities in Europe, people are just not just less fat. And it's also, it's

00:50:46.920 good for your general health and all kinds of other things. It probably also makes for

00:50:50.080 better, uh, sort of culture and, uh, and social interaction. So maybe we should be focusing

00:50:55.440 on that. But the point again is this is not the kind of stuff where you spend a dollar

00:50:59.380 and get amazing returns. This is the kind of thing that rich countries can focus on.

00:51:03.920 And I love us focusing on it. And, and again, we're rich. We can actually do several things.

00:51:09.640 We can walk and chew gum at the same time. So we should be focusing on these issues as well.

00:51:14.320 But what we shouldn't be doing is to say my obsession with, you know, obesity or with climate

00:51:20.720 change or with plastic straws or with all these other things take precedence over the fact that

00:51:25.760 for most people in this world, you know, it's really about the fact that their kids are dying

00:51:30.640 from easily curable infectious disease, get bad education, are losing out of productivity

00:51:34.740 because of corruption, all these other issues that we could fix really cheaply.

00:51:38.580 And Bjorn, this is where we come to what I think you're, you're, you're up against with all

00:51:43.120 of this, which is education and awareness of the rest of the world in the West where we have the

00:51:50.420 money to be able to put into fixing these things easily. Because I grew up for a portion of my life

00:51:55.840 in Uzbekistan. I saw people with tuberculosis. I saw people, you know, I have some kind of thing with

00:52:01.760 TB where I was vaccinated against it, but I had some kind of reaction. Anyway, like that's a real thing. 0.93

00:52:07.440 I, I, I, and most people in the West haven't had that experience. They haven't been there.

00:52:12.440 And also we're not well educated on, on the trade-off conversation, which we had earlier,

00:52:17.720 which is like, you have a limited pool of resources. How do you best use it instead of going,

00:52:24.320 I want everything. Right. So it's also like a, there's something in the way that we think about

00:52:29.560 problems that seems off to me. Do you see what I'm saying? How do we fix that? Because if we can fix

00:52:34.580 that, then this becomes automatic. This becomes, you don't even need to write this book then.

00:52:38.900 Yeah. All right. So let me unwrite it. I don't want to take the book away from you.

00:52:42.080 No, you're right. Honestly, I don't think you can fix that because it's not surprising if you don't

00:52:48.980 have tuberculosis in your entire country. It's not a big thing in your mind. Yeah. Hume once wrote the

00:52:55.860 famous philosopher in the 1700s in Scotland that, you know, I can read about a big catastrophe in China 1.00

00:53:03.260 in the newspaper. And then I turn the page and it cuts my finger. And all I care about is my finger.

00:53:08.920 Right. I mean, you're just so like, this is how the world works. You know, honestly, we don't

00:53:13.940 care all that much about far off the world. So I, I, I, and I don't think that's necessarily bad.

00:53:19.900 You know, that's how we, we couldn't handle a world where we have to worry about everything all

00:53:23.840 the time. We'd be, you know, nervous wrecks. So it's much more about saying when you care about the

00:53:29.260 world, when you're not, don't just care, you know, God, I got to get the kids to soccer and I need all

00:53:34.560 this other stuff. But when you care about the world, then you start thinking about, okay, I want

00:53:39.820 to make sure I care rightly about the world. And we often end up carrying, you know, the, the, the

00:53:44.780 sort of plastic straw argument, which is nice. I don't want plastic in the ocean. Uh, there's a lot

00:53:50.680 of other conversations we can have about that, but you know, it's perhaps also good to get a sense

00:53:55.180 in proportion. Is this really the biggest problem in the world? No, it's not. You know, the biggest

00:54:00.060 problem is that a lot of kids die and a lot of kids don't get education and all these things that

00:54:04.760 we've talked about. So get your priorities right when you care about the world. And, and I think,

00:54:10.080 you know, if you look at what the world spends on the world, it's perhaps 1% of its GDP. And that's

00:54:17.320 nice. You know, that sort of suggests, yes, I care mostly about my finger, but every once in a while,

00:54:21.480 I care about people who are, uh, you know, suffering in China. When we then spend that 1%,

00:54:26.380 let's make sure we spend it well. And remember again, 1% is much, much more than what I'm, uh,

00:54:31.800 talking about here. So let's just get that right first. And look, that's what we're doing right

00:54:36.220 here. Yeah, completely. Now we talk about immigration a lot on the show and, you know,

00:54:42.980 the positives and negatives of it, but you've written a very positive, uh, chapter on immigration.

00:54:48.540 So let's get into that. Yes. So, so first of all, um, there's some economists out there who

00:54:54.340 points out, and I think that's a good point, uh, that the world is hugely misallocated in labor.

00:55:00.500 So if you have a person who works in McDonald's in Nigeria, that person makes about 15 times less

00:55:06.660 than the same person doing the same job in a McDonald's in the U S that seems to suggest

00:55:12.060 that you're just simply much more productive and a rich world setting. Uh, we certainly know that

00:55:16.860 we'd like to believe that the reason why we're making a reasonable, I don't know about you guys,

00:55:21.540 uh, but yeah, they don't send enough money, man. So yeah, we're actually making very little money.

00:55:26.360 Yeah. And you should spend more money on it. But, but, but yeah, in the rich world, we're making

00:55:30.840 pretty good money. We like to believe that that's because we're really smart. But the truth is most of

00:55:36.680 this is because we're among a lot of other smart people and we're incredibly productive in this part

00:55:42.300 of the world. So economists would argue that maybe we should move a large part of the world

00:55:48.120 to the West because that would make them much more productive. Remember, these are all the poor

00:55:52.840 people. We could make them much richer by moving to the West. Now that's a, you know, that's an

00:55:58.140 intriguing argument. And, and, you know, what they find is to some people, it's an intriguing, I'm not

00:56:04.080 saying it's a wonderful thing or anything. Uh, so they estimate we could double the world's GDP.

00:56:11.860 We could basically make the world twice as rich and that would solve a large part of the inequality

00:56:17.540 problem of the world. Now it would also make an insane amount of political problems. So that's not

00:56:23.980 what we're suggesting. Uh, what we're saying is it seems that most people are more willing to have

00:56:31.080 skilled migration than unskilled migration. You know, you, you, you're fine with some more doctors

00:56:36.480 coming in for the NHS because they're actually going to help, you know, save you or save your

00:56:40.840 kids or something. Uh, and that's sort of okay. It will be great for those doctors because they'll

00:56:46.200 come from, you know, very poor countries and they will be much more productive in a UK setting and that

00:56:53.060 will make them better off. And they were part of the developing world or the global South and now

00:56:58.900 they've become richer. That's what we want it to, uh, to happen. They've also become more productive.

00:57:04.080 They also help us with our birth. Uh, uh, you know, we have few kids and that's eventually going

00:57:08.500 to turn into a problem. It also helps the poor world. You know, you think, well, what about it's

00:57:14.720 brain drain? You were basically taking away a doctor, but we know that they're also going to send

00:57:19.480 a lot of remittances back home because that's how most people end up acting. And that will more than

00:57:26.180 outweigh the fact that they're lost in their original country. So overall we find that allowing

00:57:31.980 a little more skilled migration. So we're suggesting 10% more than what you normally have.

00:57:36.940 So Canada has a lot of immigrants. They would presumably be willing to take 10% more of a fairly 0.99

00:57:42.940 high number, whereas some other countries don't want any immigration, have very low immigration. So

00:57:47.320 they would take 10% more of a very low number. This is plausible, but again, I'm not arguing that this

00:57:53.000 is totally without political implications. Uh, but if you have skilled migration, 10% more,

00:57:58.640 it'll cost a couple of billion dollars, but it'll generate more than $20 billion in benefits for the

00:58:03.760 world. And it'll actually reduce, uh, inequality, uh, somewhat. Yeah, it's not a solution or anything,

00:58:08.900 but it's actually a pretty good deal. Uh, so, sorry, I, I said, it's, sorry, uh, 20, 20,

00:58:14.680 $2 billion and $40 billion. It's about 20, uh, back on the dollar.

00:58:18.560 And what would you say about the brain drain argument that what you're effectively doing

00:58:22.920 is taking a country's brightest and best, transplanting them into a country that is 0.99

00:58:27.080 already wealthy, which is going to generate more and more, more tax dollars for that country.

00:58:32.120 But actually those people, the doctors, the thinkers, the economists are really needed in

00:58:36.980 this country over here because they're the people who are going to help lift it out of poverty.

00:58:40.380 Yes, that is a correct argument. But as, as I also pointed out, the remittances and much of this

00:58:45.900 remittance will be used to teach the next generation. It is, it, it, uh, outweighs the

00:58:52.440 loss, uh, two to one. So it's actually probably a good idea even for the sending country, but it's

00:58:58.380 not nearly as good an idea as it is for the rich country that receives this person and for the

00:59:03.380 person, uh, him or herself. So there's, there's definitely political issues. And it's also one of

00:59:08.120 the, the chapters that are least obvious. So again, you know, we're economists. We try to simply say,

00:59:13.380 this is what the numbers tell us. Uh, we're well aware and that's, you know, we, we made that

00:59:19.000 abundantly clear. Some economists would say, open up the entire world, have, you know, 2.4 billion

00:59:24.480 people who move to the rich West. Uh, and you're like, really, really? Uh, but you know, that's not

00:59:31.740 what we're saying, but we are suggesting this would still be a good idea. Uh, whether you want to do it

00:59:36.880 at the end of the day is a political issue. Well, that's right. So you're giving the economic

00:59:40.800 assessment of the impact of that. And then there's political dimension to that. There's a

00:59:45.260 cultural dimension to that. And that is for the society to talk about and discuss in a political

00:59:49.540 way. Just to give you a sense of, of, of what we're really trying to do. We're, we want to put

00:59:53.840 prices and sizes on society's menu, right? We want to tell, tell you when you talk about, oh, we could

01:00:00.020 get rid of a cancer or we could get rid of a plastic stores or climate change or whatever. There's really

01:00:05.740 cost associated with that. You don't actually see, so how much is this going to cost you? But maybe

01:00:10.460 you'd want to know that. Just like if you go into a restaurant, you'd like to know, you

01:00:13.820 know, how much is this caviar going to cost me? Oh, 2000 pounds. Maybe I'm not going to

01:00:18.540 pick that. That, so we put prices and sizes on the society's menu and then you decide whether

01:00:23.880 you actually want to pay for it. Bjorn, it's been an absolutely fascinating conversation.

01:00:27.420 So good to have you back. Before we go to the local section where our audience have already

01:00:32.500 submitted questions for you that we'll ask you. And before we ask you our very last question,

01:00:35.880 the most obvious question to ask you is this. It's twofold. If I'm an ordinary person, I'm

01:00:42.100 a plumber, I'm a podcast host, I'm a YouTuber, I'm a comedian, I'm a writer, whatever, and

01:00:46.580 I'm listening to this, what can I do? And the second part of that is if I'm a policymaker

01:00:51.740 and I'm in a position of influence, I'm in government, I'm in the media, what can I do?

01:00:56.680 Right? Twofold, two-part question.

01:00:58.420 I would wish I could say here's a link to donate. Yes. Here you should donate this amount of money.

01:01:06.920 We have not done that partly because we're very wary of saying, you know, there's very few

01:01:11.540 organizations that sort of straight on do exactly what we talk about. So I think the right answer is

01:01:17.820 for us normal people, it's much more to say simply, you should keep talking about these are

01:01:24.420 the top priorities. So make sure that everybody else, don't talk about all this other stuff first,

01:01:29.580 but simply talk about let's fix tuberculosis, malaria, immunization of small kids, education,

01:01:37.220 agricultural research and development, e-procurement, and these are the things that I talk about in the

01:01:41.200 book. Let's make sure we focus on the really smart stuff. If you do that, that's going to be worth

01:01:46.200 much more than, you know, an extra five pounds because it helps change the political discourse

01:01:52.740 to being smarter. And that, of course, goes to your other part of the question. So what should

01:01:56.900 policymakers do? Fund these things, please. And it's important to say this is not just about,

01:02:03.820 you know, rich countries spending more money because at the end of the day, we also want

01:02:07.760 poor countries to do this. Remember, poor countries have actually doubled their spending per person

01:02:13.880 in schools over, sorry, per student over the last 25 years. So they're spending a lot more money

01:02:21.400 and there's virtually nothing to show for it. A little bit like what you were talking about in

01:02:25.280 the rich West. We're not seeing our education results increase and sometimes actually decrease.

01:02:32.140 So you should spend it smarter. So it's not just about overseas development aid. It's also about

01:02:37.820 making sure that politicians in these developing countries get with the message. We've actually,

01:02:43.220 I've been fortunate enough to write in 35 papers around the world. So Times of India, China Daily,

01:02:49.060 the Bangkok Post, you know, Philippine Daily Inquirer, a lot of other papers across Africa

01:02:55.400 and Latin America to write. So I've written 14 articles. So, you know, one about the general

01:03:01.540 priorities, 12 about these 12 individual ideas, and then sort of a summary. Again, this is not enough

01:03:08.040 to get everybody on board, but it certainly is the first push to get people to think smarter about this.

01:03:13.120 If we all think smarter, this is not just going to fix the $35 billion problem, but it's also going

01:03:19.540 to make us smarter about all the other challenges we face, right? Because, I mean, at the end of the day,

01:03:23.720 this is for rich people. It's just 1%. It'd be cool if we could get the other 99%, well, you know,

01:03:30.160 more, better prioritized. Absolutely. And Bjorn, the question that we always ask all our guests is,

01:03:36.180 what's the one thing we're not talking about that we really should be?

01:03:38.520 And you told me before we started, and I'm still a little blank, so I'm going to go, because there's

01:03:46.320 a lot of things we don't talk about. But I really think this book tells you about some of those stories

01:03:51.300 that we don't talk about, for obvious reasons we've talked about. We don't have tuberculosis,

01:03:55.920 but there's lots of tuberculosis in the world. We don't talk about immunization, but there's lots of kids

01:04:00.840 who still need immunization. We don't talk enough about education because we, you know, we're focused on

01:04:06.940 all these other things, like plastic straws. We should talk more about education. So really,

01:04:11.580 I'm just so excited that this podcast may actually have turned the tide and make us talk more about

01:04:17.160 the things that matter most, namely the things that kill an enormous amount of people and hold back

01:04:21.200 development. And for $35 billion, we can make the change.

01:04:25.520 Bjorn Lomborg, thank you for coming on. Best things first. Make sure you grab this and find out about it.

01:04:29.440 Can I just say you can actually see the conclusion on the cover?

01:04:32.560 Yes. The cost is down here. The benefit is massive.

01:04:35.920 Yes.

01:04:36.780 Indeed. Bjorn, thank you so much for coming back on the show. It's such a pleasure to have someone

01:04:41.300 with a positive vision and a realistic vision. It's not just like, oh, yeah, we should be. It's

01:04:47.160 actually, you're looking at how to fix the problems of the world. I think that's exactly the attitude

01:04:51.380 we need. So it's a real pleasure to have you back.

01:04:53.580 Thank you.

01:04:54.340 And head over to Locals, where we're going to ask Bjorn your questions. We'll see you there.

01:04:58.080 What do you think about AI? Oh, God.

TRIGGERnometry - July 02, 2023

5 Easy Ways to Save the World - Bjørn Lomborg

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