Tag: health

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Why it’s time for governments to take wellbeing seriously

100% happiness guaranteed
It’s not this easy…but it’s getting easier

Earlier in 2014, the Legatum Institute published the final results of their Commission on Wellbeing and Policy. I don’t know much about this think tank – it seems to lean rightwards, claims to be non-partisan, and is probably funded with oil cash, but they put together an all-star cast to advise this report:

  • Sir Gus O’Donnell (former head of the UK civil service)
  • Prof Richard Layard (a leading author in the field, wrote the book on ‘Happiness‘)
  • Prof Angus Deayton (economics prof at the Woodrow Wilson School of Public Service at Princeton)
  • Martine Durand (Head of Stats for the OECD)
  • David Halpern (ex-academic, now running the quasi-governmental Behavioural Insights Team (their ownership structure is worth a blog of its own))

It is a superb piece of work. If you’re interested in the role of government, public services, evaluation, economics, life, the universe, or indeed anything, you should read it. Lots of golden nuggets and summaries of vast amounts of academic research. It should be shaping the way governments work, everywhere.

Its main conclusion is a call for the greater use of subjective wellbeing data in policy making. It argues that we need to stop using money as a proxy for wellbeing in basic cost-benefit analyses. The logical second conclusion of the report is that we need better data. It’s not impossible – wellbeing really can be measured. And we’re getting better and better at it. As we get better data, governments will be able to take far, far better policy decisions, which in turn should increase our wellbeing. It’s fairly intuitive, but could be revolutionary.

Continue reading “Why it’s time for governments to take wellbeing seriously”
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Thinking

Mapping the post-2015 development debate – join in!

The post-2015 development agenda debate is generating a lot of words on what should follow the popular Millennium Development Goals (or MDGs) come 2015, which is the point at which they were supposed to have been met. There are hundreds of international meetings going on, as well as global and national consultations, plenty of think-tank reports, op-eds and news coverage. 

But for someone who’s interested in the discussion – and how decisions are being taken – it’s hard to keep up with what’s going on. So, inspired by an earlier effort by Jan Goossenaerts, I’ve started a new graph of the debate. It tries to bring disparate strands of the debate together in one place.

Debategraph
Mapping the post-2015 development debate

This is just a start. There is a vast amount of information missing. I’ve mainly based it so far on stories from my twitter timeline – there are many more voices out there, particularly in developing countries.

I have so far only mentioned a few specific goal suggestions – those made in Save the Children’s recent report. There must be more to add. And although it does seem like there will be a new set of goals (perhaps up to 2030), there is still room for a debate as to whether goals are the right tactic for improving global outcomes, or whether there are other ways of approaching the agenda.

There is also much to be discussed in terms of delivery and accountability. If the world isn’t going to meet the Millennium Development Goals by 2015, what’s to say any new goals will be met?

So join in. Anyone can edit the graph above. Debategraph is a fantastic tool, which allows many layers of debate, critique and argumentation. Give it a go: sign up, navigate back to the post2015 map and start adding material, links, or refining what’s already there.

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Reviewing

Review of ‘Inside Fortress Bill’ on BBC Radio 4

The point about global governance is that it ain’t a government. It’s just a jumble of people, organisations and states doing things that constitute governance. This includes very rich people essentially providing global public goods like healthcare. The Gates Foundation is a great example of this – in the absence of sufficient WHO/UN spending on health provision, the foundation steps up, with vastly larger budgets. But what does this mean for the private-public divide? Who’s accountable to who? Should global health governance really be set by the whims of a very very wealthy couple?

This radio programme (available until 10 January) was billed as a documentary in which “Katie Derham takes a ‘warts and all’ look at the Bill and Melinda Gates Foundation and examines the immense political power and global influence that it now wields.”

Except she didn’t really. She gathered a few critiques (relying heavily on Laurie Garrett of the Council for Foreign Relations) and put some of them to senior staff at the foundation.

They responded as you’d expect: acknowledging that improvements could be made, yet not dealing with the real issue about private foundations – they’re unaccountable to the people.

As the description of the programme put it (which was far more interesting and cutting than the actual interviews): 

“[Gates’ philanthropy] is a sharp contrast with his former persona of ruthless businessman flaunting competition law, buying off rivals and pursuing his goals with a vengeance. Critics believe his market-led philosophies can distort the picture, allowing Governments to be let off the hook, causing a brain drain in countries where they are backing aid, and the way that funds are distributed seems to be at the whim of the co-chairs who are beyond any form of accountability.”

A few points of interest from the programme below.

On the foundation…

  • the money is, of course, staggering: Gates has given $26.1bn, Buffett $36bn. 
  • the foundation sees itself as a catalyst – leveraging its funds by partnering with governments, corporations (which led it to Monsanto, upsetting many)…
  • …and it leverages Bill, too. His media value brings attention to stories otherwise untold. 
  • it places a strong focus on innovation and entrepreneurship (as befits its $500m campus, which the presenter shrugged off as ‘Bill’s own money’ – except that the foundation is Bill’s own money too, so that distinction doesn’t make sense)
  • and it places a high focus on tech solutions, such as spending on vaccine research that wouldn’t come from big pharma (e.g. leprosy, TB)
  • as the CEO put it: “we believe in capitalism as an effective approach to allocating resources in a society”

But…

  • Medecins Sans Frontieres choose not to accept funding from the foundation; a ‘strategic decision to keep some form of independence’ and they had ‘concerns about engagement of private sector and resulting conflicts of interest’ (MSF spokeswoman)
  • a majority of funding for global health programmes comes from the foundation, which leads to tremendous vulnerability for associated programmes and fields (Garrett)
  • what matters in global health is is increasingly decided by a small group of Americans in Seattle (Garrett). Ultimately the foundation answers to Bill and Melinda Gates and Bill Gates Snr.
  • “previously you trusted governments to do development, but now things have completely changed” (spokesman of a charity funded by GF) – has it?
  • ‘it shares very little substantive info on what it’s doing and how it’s work is going’ (GiveWell spokesman)

So…

  • there is a ‘responsibility for all of us to hold them to account; for us to help them succeed and stop them doing crazy things that billionnaires sometimes do’ (Matthew Bishop of The Economist and author of Philanthrocapitalism)
  • at least Bill Gates is spending, but perhaps he needs competition from another foundation – perhaps a Larry Ellison or a Steve Jobs Foundation might have done things differently (Matthew Bishop)