Infant and child mortality has fallen precipitously in the last few centuries, and life expectancy has increased dramatically. We have made a lot of progress in the protection of public health, but we are still wasting staggering amounts of life that gets snuffed out early by disease and war. Consider diarrhea, which is an inconvenience in wealthy countries but a matter of life and death for some of the poorest people in the world. As the CDC reports, “Diarrhea kills 2,195 children every day—more than AIDS, malaria, and measles combined.” We can reduce this by letting people cross borders.
A Malthusian or a misanthrope or a representative of the more extreme strains of environmentalists might respond “good,” repeating with Ebenezer Scrooge, “If they would rather die they had better do it, and decrease the surplus population.” As I wrote a few years ago for Forbes, there is no such thing as a “surplus population.” Every baby born brings into the world an extra mouth to feed, it is true, and a pair of hands that aren’t as productive as the hands of his older brothers and sisters thanks to the iron law of diminishing marginal returns, but he brings—most crucially—a brain with which to have new ideas, with which to solve important problems, with which to create great artwork or great music or a great new way to score touchdowns on third-and-three if the defense is guarding against the read option.
I once looked through 19th-century health inspector reports for a project, and I was really surprised and saddened by just how high mortality was. I’m saddened today by the degree to which children die of easily-preventable diseases in poor countries. I wonder: what would we enjoy today had infant and child mortality been lower in 1884?
What poems weren’t written, what tools weren’t invented, what songs weren’t sung, and what land wasn’t tilled because so many people died in infancy or early childhood?
What will our children miss out on because what for them is a stomach ache and a few doses of Pepto-Bismol is a death sentence for their counterparts a few thousand miles away?
We are wasting massive amounts of what economists call human capital—the mental abilities and skills people use to produce goods and services—because of the global disease environment. It looks at first like it would be an easy fix: just give them water filters and whatnot, and provide them with the governance capacity to develop high-quality infrastructure. That’s a lot easier said than done, and it’s much easier blogged about from the comfort of an Alabama Starbucks than implemented on the ground.
For all the faults of western governments, we at least do public infrastructure reasonably well (the Jefferson County, Alabama bankruptcy notwithstanding). Rather than focusing our attention on going over there in order to “fix” their infrastructure and do for them what they can and should be able to do for themselves, we would do far better to work on finding ways to help them come over here. Permanently.
