Your Priorities for Fixing Hunger, Disease, and Sanitation

The 10 most effective ideas for improving the world.
May 3 2012 1:28 PM

Your Priorities for Fixing Hunger, Disease, and Sanitation

Slate readers choose their favorite solutions for the world’s biggest problems.

The idea behind Copenhagen Consensus 2012 is to prioritize some of the world’s most important spending, with the latest economic analysis providing us with an input. In a series of articles, I am drawing on new research papers that present the costs and benefits of the smartest ways to respond to global challenges. Each article has a poll, and Slate readers can vote on the investments that they believe should be the highest priorities, along with those that should not. You can read more about the rationale behind the project here.

Over the course of the series, we will see how readers rank responses to a range of challenges, and at the end we will identify the investments that Slate readers think should be the highest priority. We will be able to contrast these with the findings of a panel of Nobel laureate economists.

Yesterday we took a look at research by Frank Rijsberman and Alix Peterson Zwane of the Gates Foundation. They tackled the topic of water and sanitation.


I focused on their solutions to the challenge of sanitation, but I should point out that their paper also puts forward an investment in delivering clean drinking water to rural settings. Similar to the situation in sanitation, the technologies for bringing safe drinking water to people are well-known, so the challenge is largely one of sustainability. Their proposal targets the 770 million people in Africa and Asia that currently do not have access to safe water, and builds on research conducted in the last Copenhagen Consensus project, in 2008, by Dale Whittington and others.

Whittington’s team found that there were modest positive net benefits associated with rural water service from new borehole wells, with benefits that would be greatest in places where the burden of diarrhea is relatively high and existing water facilities are sparse. Of course, as they pointed out, such settings may also be those where capital costs are highest, which increases costs as well. Like Whittington, Zwane, and Rijsberman calculate that their proposed investment would have benefits worth three to four times higher than each dollar spent.

With sanitation added into the mix, this is what Slate reader priorities currently look like:

1 Tobacco Taxation Chronic Diseases
2 Bundled Micro-Nutrient Interventions Hunger and Malnutrition
3 Expanded Childhood Immunization Coverage Infectious Disease
4 The Reinvented Toilet Water and Sanitation
5 Subsidy for Malaria Combination Treatment Infectious Disease
6 Hepatitis B Immunization Chronic Diseases
7 Deworming of Children Infectious Disease
8 R&D to Increase Yield Enhancements Hunger and Malnutrition
9 Expanding Tuberculosis Treatment Infectious Disease
10 Community Led Total Sanitation Water and Sanitation
11 Acute Heart Attack Low-Cost Drugs Chronic Diseases
12 Generic Pill for Heart Attack Risk Reduction Chronic Diseases
13 Investing in Accelerated HIV Vaccine Development Infectious Disease
14 Sanitation as a Business Water and Sanitation
15 Increase Competition in the Fertilizer Market Hunger and Malnutrition
16 Salt Reduction Campaign Chronic Diseases
17 Crop Advisory Text Messages Hunger and Malnutrition

Remember: You can still go back and vote in all of the various polls today and you can vote today on population. we’ll be finalizing the Slate readers’ list at the end of the series.

We’ve seen little change at the top and the bottom of the poll, but the relative positions of the different proposed sanitation investments is interesting. Top-ranked is the Reinvented Toilet, an endorsement of the Gates Foundation’s work to generate innovation to create the coveted ‘smartphone’ of sanitation.

Community-led sanitation efforts received a middling ranking, while the worst-ranked option was sanitation as a business. This seems in line with Slate readers’ low ranking for other priorities involving private business (breaking up the fertilizer market, and crop advisory text messages).

The concept of “overpopulation” has been much discussed to date, and I’m fascinated to see how Slate readers will rank today’s investment option—of the promotion of family planning to meet the need in high fertility African countries of women who would like to delay their next child’s birth but are not on contraception.



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