Earlier this month, India marked a milestone anniversary: With the passing of its third year without a case of polio, the country is officially considered polio-free. There remain only three countries in the world in which polio is endemic — Nigeria, Pakistan, and Afghanistan — and all three continue to suffer for the same man-made reason.
While polio has nearly been wiped out in the rest of the world, it is on the rise in Pakistan, the infected children just more casualties of the endless jihad. The disease also has made what one hopes is a temporary comeback in Syria and Somalia, for similar reasons. Throughout history, disease has killed more people during war than soldiers or bombs.
Polio had been around for a long time, but it was the early 20th century before polio epidemics became common. Karl Landsteiner identified the polio virus in 1908, and Jonas Salk’s vaccine was rolled out to the world in 1955. Albert Sabin’s less expensive and more usable oral vaccine came into use in 1962. By 1979, the combination of the Sabin vaccine and a March of Dimes campaign had all but eliminated polio in the United States — the only cases were imported or the (very rare) consequence of vaccination.
That same year, the Rotary Club decided to raise money to vaccinate every child in the Philippines. Inspired by a successful campaign there, the organization decided that it would take on polio worldwide. Other organizations signed on, from government agencies to the World Health Organization, and in a remarkably short period of time, polio’s incidence had been reduced by 99 percent. The last 1 percent is tough, and expensive. For every dollar Rotarians contribute to polio eradication, the Bill and Melinda Gates Foundation contributes three more.
But the main obstacle to completely eradicating polio is not money, but culture: In Pakistan, Afghanistan, Syria, and rural Nigeria, local culture is a source of endless war and a source of skepticism about the efficacy and probity of Western medicine. The latter is an unfortunate factor around the world: Even in the United States, there are occasional outbreaks of polio, for instance among non-vaccinating Amish in Minnesota. It is the prevalence of vaccination that keeps those outbreaks from becoming epidemics, and the recent rise of superstitious movements against vaccination here are a fresh reminder that we in the developed world are really in no position to laugh at the quaint ways of the backward people in exotic climes.
The key features of the campaign to eradicate polio are that it has largely been privately led — indeed, politicians have been and remain its principal roadblocks — and that it is very narrowly focused, ambitious in scale but not in scope, to some extent amenable to piecemeal implementation, and carries a positive net economic effect. It is an exercise in the right way to go about reshaping the world.
“Reshaping the World” is the theme of the 2014 World Economic Forum in Davos, Switzerland, where the great and the glamorous gather in a cool, dry place to sort out the troubles of the humble and squalid in the deserts and jungles of the world. It’s easy — and fun — to laugh at the global do-gooders as they mix with global evil-doers ranging from atomic ayatollahs to petty potentates, the pope sharing his Franciscan sensibilities with well-intentioned businessmen even as Beijing’s sinister laogai wardens lurk nearby.
But the cynic must in the end be a little disappointed: The do-gooders do a fair measure of good. They are sometimes feckless and they often have bad politics — so-called family planning and global warming being two voguish obsessions — but, like the Rotarians, they sometimes manage to focus on a well-defined problem and bring enormous resources to bear on it. I do not share all of Bill Gates’s views, but there is no debate on where malaria comes from, and $2 billion buys a lot of mosquito nets. Never let the partisans of politics convince you that only the state can provide public goods — or even that the state is the best provider of them.
Mr. Gates’s annual letter, in which he notes the many ways in which the human race has become radically better off during his lifetime, is worth reading. Of particular interest is Mr. Gates’s projection that if things continue along their current course, there will be almost no countries left that meet our definition of “poor country” by 2035. “Specifically,” he writes, “I mean that by 2035, almost no country will be as poor as any of the 35 countries that the World Bank classifies as low-income today, even after adjusting for inflation.” That would be a remarkable development.
Not remarkable enough for our attention-hungry legal adversary Michael Mann (who currently is suing National Review for poking fun at his hockey stick, which is not a Canadian euphemism). Mr. Mann took to Twitter to complain that Mr. Gates’s relative optimism fails to account for global warming, which in the monomaniacal mind of Mr. Mann renders all other progress moot. “Like the guy who jumps off a building and announces halfway down ‘Fine so far!’” is how he describes Mr. Gates.
Global warming and polio are precisely opposite sorts of issues. Even if one assumes Mr. Mann’s views about anthropogenic global warming, such policy prescriptions as might be distilled from those views are intensely complicated. You can do polio piecemeal: First the United States, then North America, then the Philippines, etc. But global warming is global: Reducing coal consumption in the United States would not necessarily reduce the amount of greenhouse gasses being emitted into the atmosphere, and might even increase that amount as reduced American consumption effectively discounts coal and increases the amount of it burned in China, by dirtier plants. With apologies to Johnny Cash, you don’t do it one piece at a time.
Polio is a problem that is, if not fully solvable, then manageable in a very straightforward fashion: You buy the oral vaccines, you distribute the oral vaccines, and each vaccinated community becomes another brick in the firewall against epidemic. There is no similarly straightforward approach to global warming: Should we start with agricultural emitters, transportation, industrial facilities, power generators? Most important, polio vaccination is an obvious economic net gain — especially at 60 cents a dose. The Intergovernmental Panel on Climate Change suggests that global warming could impose some significant economic costs, but even taking its estimates as gospel it is far from obvious that the costs of preventing such effects as are predicted are preferable to the costs of adaptation. Thus we have nearly succeeded in wiping out polio but will at the global level do absolutely nothing about global warming other than to endure panicked lectures on it, nodding sagely as the occasion demands.
A great deal of the progress that the world has made over the course of the last 50 years is owed to targeted efforts against diseases such as polio and smallpox, as well as the development of better infrastructure and superior public-hygiene practices. Those efforts have been made possible in no small part by the growth and integration of the global economy, which, in addition to being in its own right the preeminent force for improving the lives of the world’s poor and rich alike, throws off enough money to fund charitable and governmental development work. As Mr. Gates notes, among the most important policies that the rich countries can undertake to improve the lives of the poor are “opening their markets and cutting agricultural subsidies,” which, happily, is the right thing to do from their own self-interested point of view as well. There are authentic conflicts of economic interest in the world, but, subtracting the interests of rent-seekers and entrenched market incumbents defending their political privileges, there are fewer of them than we imagine.
In 1961, India was not only suffering from polio but was, as it so often was, on the verge of famine. In no small part as a result of the work of the Ford Foundation, which helped Indian farmers introduce superior rice strains, that situation was miraculously reversed. Production was trebled, real prices halved. India went from basket case to breadbasket, and is today a major rice exporter, sending out a record 11 million tons in marketing year 2012–2013.
Americans are a bit crabby right now, and not without just cause, economic and political. When we look at places like India, we tend to see economic competitors taking our jobs. (“Our jobs,” funny phrase.) What we should see is a world that has been to some extent remade — peaceably and cooperatively, to a remarkable extent — in our own image. From Mr. Gates and his fortune to Mr. Salk and his vaccine, to the horrific but necessary sacrifices that rolled back first fascism and then Communism, to leading the way toward freer trade, the United States played an indispensible role in making possible what is by any material measure a better world. Of course there are costs. But rather than looking around the world and despairing that progress elsewhere means more economic competition for us, we 21st-century Americans ought to take some satisfaction in the fact that the current state of the human race — warts and jihadists and AIDS notwithstanding, still better than it ever has been — is in no small part the result of an unlikely project that got under way when a half-organized gaggle of obscure provincials decided they’d paid enough tea taxes. Of course an American businessmen’s lunch club took the lead in eradicating polio around the world: Who else is going to do it?
— Kevin D. Williamson is roving correspondent for National Review.