The Eyes of Millions of Children Are on Washington this Week

A debate has emerged around where developing countries should invest their resources, including the funding they receive from entities like the World Bank. Should they invest in "infrastructure," or in more "human development" -- such as health, nutrition, and education?
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Washington, D.C. is usually under the watchful eye of policy wonks and journalists. This weekend, however, the eyes of millions of children will be on D.C. as their fates are determined by the world's financial leaders, descending on Washington for the Spring Meetings of the IMF and World Bank.

The World Bank and IMF might sound like impersonal behemoth financial institutions, but the World Bank has been the single largest funder of development and global poverty programs since its inception immediately following WWII. Grants and "soft loans" (with below market or even zero interest rates) allow countries to invest in physical and human infrastructure -- from roads and electricity to vaccinations and primary schools. How the dollars get deployed is largely up to the recipient governments, who must ask themselves: What investments will yield the greatest economic growth?

Over the past few years, a debate has emerged around where developing countries should invest their resources, including the funding they receive from entities like the World Bank, as well as loans from other countries. Should they invest in "infrastructure" -- clearly needed -- or in more "human development" -- such as health, nutrition, and education?

That discussion will continue to play out this week as Africa's Finance and Health Ministers come together to talk about investing in health, and understanding what the issues have been that have prevented further progress. The economists who put the forum together looked at the tremendous economic and health improvements in Asia, and tried to see if there might be some applicability to Africa.

Looking at China, Malaysia, South Korea, and Thailand revealed that improvements in health, for instance the decline in infant mortality, came before the strong uptake in the economy. South Korea and China showed the most dramatic drops in mortality (or improvements in life expectancy), long before the economic uptake, but all four countries clearly show the importance of addressing health first.

This makes sense even to those of us who aren't trained economists. Sick workers don't produce healthy businesses. I've seen firsthand new factories built in Africa that soon closed as absenteeism from malaria and tending to sick children made the workforce too unreliable. Conversely, when workers are nourished, healthy, and not distracted from the burdens of sick children, they are infinitely more productive.

The humanitarian reason for keeping the world from preventable and treatable diseases should be enough, but the economic reasons should help guide our investment decisions as well. Finance ministers must recognize the symbiotic relationship between health and economic development: investment in health is investment in wealth. Recent analysis shows that every dollar invested in malaria commodities yields a $40 return in the form of productivity from healthier communities and workers.

Funds from the World Bank can't be the only investments in health, and they aren't. The truth of the matter is that most of the budget for health in Africa comes from the governments themselves, including increasingly from their own internal resources, like minerals. With the African continent having the fastest GDP growth in the world, how can that increasing wealth be converted to improving health? Of the 4.4 million lives we must save by December 2015 to meet the health Millennium Development Goals, around 2.6 million must be saved in Africa, and 1 million of those lives are in three countries: Nigeria, the Democratic Republic of Congo, and Ethiopia. Nigeria is already setting an example of using its mineral wealth for social good. Thanks to the leadership of President Goodluck Jonathan and Minister of Finance Ngozi Okonjo-Iweala, the Oil Subsidy Reinvestment Fund will generate income for public programs, including life-saving commodities.

I can say as a businessman, and after conversations with other businessmen bullish on investing in Africa, that things like malaria and child deaths sap productivity, and do not enable an attractive investment environment. With the world's eyes on Washington this week, let's encourage the financial leaders to see that healthy people are at the heart of healthy growth.

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