Ep 79: Bjorn Lomborg and the 12 Best Policies to Help the World

0:00if you ask most rich people, what is it you worry about, of all these things, get people out of poverty, get them out of hunger, fix climate change, fix wars, fix, corruption, stuff like that people will say oh climate, we should do climate, we should do climate, what do you know? the only one and unfortunately many rich people act as if climate is really the only thing we care about and the second thing is that it's not where you can typically get the biggest bang for your buck so again if you want to do good for the world you really have to ask yourself should i be spending money for instance on education and get 65 for every dollar spent or should i spend it on environment and if we're very lucky on climate you can get a couple of dollars back on the dollar Maybe we should start with the education bit.

0:53Today, we're speaking to Bjorn Lomborg. He's a famous thinker, writer, intellectual. His new book, Best Things First, is a very well-reasoned look at how we could help the most people most efficiently. He first became really famous for the skeptical environmentalist 20 years ago. Bjorn likes to look at what people are doing, where they might be wrong. Sometimes people get offended because he comes to conclusions they don't like, but it's hard not to agree with Bjorn when you're talking to him. He's such a reasonable guy. Bjorn's not afraid to challenge the narrative, take you where the evidence leads.

1:19One of my favorite thinkers. I think you'll enjoy meeting him. I'm Joe Lonsdale. Welcome to American Optimist. Bjorn Lomborg. Bjorn, thanks for joining us. Thank you. It's great to be here. Bjorn, I've been a fan of yours for over 20 years. You were working on some more controversial things in the past, which I love and I want to talk about. I think your recent book, Best Things First, it's a little bit of an all over branch. You're talking about how to fix the world, how to focus on what matters in a way that I think hopefully everyone can agree with. Yeah, it really is something that everybody should get together on.

1:47I think though, that it is very controversial because it exactly says, where can you spend money and do the most good? If you start talking about what are the smartest things to do, it also inevitably means you say, there's a lot of stuff that we shouldn't be doing. There's a lot of things you put dollars into, you get less than dollars back, or maybe you only get a few dollars equivalent, which is not nearly as good. You won at 15, I think was the ratio, I recall you said. We set the cutoff point where you spend a dollar and you end up doing$15 worth of good. Actually, the outcome that we get for it.

2:16So we find 12 amazing things that the world should be doing. We find an average, they will give you$52 back per dollar spent. Now, it's not a get rich quick scheme. And we should just write that. We're helping a lot of people. It's going to help a lot of people. You're actually going to be able to turn it into dollars because if you could, it would already been fixed, right? This is about making sure that kids don't die from easily curable infectious diseases and we get more nutrition and we get better education. All these other things, some of which I'm sure we're going to talk about. And I remember you referred at the beginning to these SDG promises, Sustainable Development Goal promises.

2:51And these are different than the original Millennial Development Goals. Because I remember the Millennial Development Goals, which you actually are quite positive on, despite being from the UN and these other countries. I guess there were 18 things overall and they were positive overall? Yeah, so there were 18 or 21, depending on how you measure it. But actually, we just cared about eight of them. So they were basically get people out of poverty, get them out of hunger, get kids in school, stop moms from dying, stop kids from dying, and get more water and sanitation to everyone. There's nothing about making people virtue signal and woke.

3:24No, no, no. No, it was very basic. Very basic, just solve problems. And look, if you look around the world and if you realize that most people don't live like rich people do, we're a very, very rarefied group of people, 1.5 billion people out of 8 billion people. Most people have much more immediate issues like their kids are going to die maybe tonight, that they don't get enough food, that they don't get enough good education, so on. These have very simple basic problems that we should be focused on dealing with. And so what I try to do with this new book is basically get people to think about where is it that we could do the most good for the next dollar?

4:03Because after these eight actually worked quite well into 2015, billions of dollars flowed in, like the world got much better. We helped all these people, you know, millions less people dying. Then the new development goals were sustainably focused and there's 169 of them. And a lot of them maybe are more what we call luxury beliefs. They're things that rich people care about, but they weren't as focused on the core. They're partly luxury beliefs, but partly they're just unbelievably everything. right i mean they basically promise you everything to everyone all the time everywhere and and if you promise everything it's like having no priorities and of course that's exactly what the world has that's what happened is no one focused on it we just we just spread the money out thinly and everything and a very large part of this is also if you ask most people if you ask most rich people what is it you worry about of all these things get people out of poverty get them out of hunger fix climate change fix wars fix corruption stuff like that people will say oh oh climate We should do climate.

4:56And look, climate is one of the many things we need to fix, but it's certainly not the only one. And unfortunately, many rich people act as if climate is really the only thing we care about. And the second thing is that it's not where you can typically get the biggest bang for your buck. So again, if you want to do good for the world, you really have to ask yourself, should I be spending money, for instance, on education and get$65 for every dollar spent? or should I spend it in an environment? And if we're very lucky on climate, you can get a couple of dollars back on the dollar. Maybe we should start with the education bit.

5:31Basically, you think for about$35 billion a year, which on the grand scheme of the aid that we waste is not actually that much. And for that much, you can save 4.2 million lives annually. You can make the poorer half of the world, I think you said more than a trillion dollars wealthier every year. So that's a good return. Let's focus on the education bit. So obviously, I think we're all for education. When I see people saying spend money on education, I get very skeptical these days living as I do in 2024, where you have crazy people running governments everywhere, wasting money. So what does it actually mean to spend money in education?

6:00Because there's lots of bad ways to spend money. Oh, God. Yes. Yes. So the problem is that we used to think the big issue was get kids in school. And obviously, if you're not in school, there's no way you're going to learn. But the problem is now we've gotten pretty much all kids in school. Remember, there's about half a billion kids in primary school, mostly in developing countries and poor countries most of them are learning virtually nothing there's one great example i give in the book uh the the un has actually asked about 60 000 kids uh this very simple question you have to read it in order to see why it doesn't work you have to get them to read this following sentence vj has a yellow hat red pants and blue shoes what color is the hat now if i just say it to you, it's not very hard because you can remember this thing.

6:49But if you read it, it's harder. But if you actually read it, by the time you get there, if you can read a little bit but not very well, you just have no idea what it's referencing back to. And so 80 % of kids in poorer countries, when they're 10 years old and they've gone to school for three or four years, cannot answer this question. Wow. And that tells you you're basically getting terrible education. That, of course, means they're not going to be able to be participants in a very productive society. How do you get education to be better? Well, as you point out, there are lots of ways to spend money and not do very much good.

7:22So Indonesia has actually shown the way in a couple of these ways. They build a lot more schools. And yes, it means it's easy to go to school, but you don't actually learn more. They doubled the pay for teachers. It made the teachers much happier, but it didn't actually increase the productivity of the kids. They didn't learn anymore. These schools end up focusing more on the pay for administrators and teachers than they do on the outputs for the educational results. Well, no, it was actually for the teachers. But the point is, so the idea was that it should get the teachers for not having to drive taxis at night as a second job.

7:55That sounds like a good thing. Unfortunately, we now know that it have no impact whatsoever on learning outcomes. The real issue here is to say, when you have 25 or 50 kids in one grade, they're all over the place. Some of these kids are far ahead and some of these kids are far behind. If you have one teacher to try to teach them all, he or she will inevitably have to sort of hit somewhere in the middle and miss a lot of the kids that are far ahead and a lot of the kids who are far behind. That's no way to teach. Ideally, the teacher should teach each kid at his or her own level. You want to personalize it to a level which needs technology or which needs levels.

8:33Exactly. Exactly. You can't do this with teachers, but you can do this with technology. And so what we know, this has been studied heavily, we know that if you get these kids in front of a tablet one hour a day, the tablet has educational software. This software will very quickly catch up on where exactly that student is and teach him or her at that level. The personalized technology teaching is way ahead of teachers. It's just where it is right now. My friend Joe Lamont in town runs a school called Alpha Harris Technology. He's been telling me about this. We're all focused on this in the tech world.

9:02Oh, wonderful. So I think things are going to change. I'll tell you what, though. There's other things, too, that you need to see here. Have you heard of Roland Fryer's work in this area? No. Roland's an economist at Harvard. He grew up poor in a black community and went back to these communities and said, how do I fix this? And he tested all sorts of ways of spending money. And a lot of people said smaller class sizes. A lot of people said whatever else. You know what the number one intervention was to get these kids to learn? It was to pay them for great grades. Pay them for? For good grades.

9:25And the reason was, is it turned out that in a lot of these poor communities, the kids don't actually care about their grades or their school because they think it doesn't matter. So there's all sorts of levels at which you have to actually make the kid care as well as teach them correctly, which I think is very interesting. Yes. So I don't know this result. One of the things we found, if you actually, for instance, pay teachers for the grades, which is, they end up cheating because that, you know, there's a lot of dysfunction in this. So, but this is one of the ways that we really know you can dramatically improve outcomes.

9:54So if you do this tablet one hour a day, remember that means you don't get to have the tablet. You share it with a lot of other kids. It costs about$31 per kid per year. but the benefit is that this kid will learn about three years of normal schooling just from that extra the tablets make a ton of sense i think my friends said for two hours a day you can learn almost everything in chicago they started giving out the tablets you heard what happened is that people lose them and steal hundreds of them and sell them but you probably shouldn't give them out exactly that's very true yeah but and and and the important part is when we've done this we've done this with some of the best economists in the world uh so uh uh uh angrist from uh university of Oxford is one of the leading guys on this.

10:34And they, of course, know that when you start doing this with tablets, some of them are going to get stolen. Some of them are not going to be used. Some of them are not going to be recharged. Some of the teachers won't know how to do it. There's lots of incompetence around the whole world. This does not assume that everybody does it the smartest possible way. No, but it's simple enough. It assumes that everybody is moderately smart and reasonably engaged in doing this. And then we know that you can actually get so much out of it that for every dollar you spend, you'll deliver$65 of benefit. That's a fantastic outcome.

11:06I agree. Well, I think done right with the outputs being measured and accountability with the tablets, I think that's really cool. We focus a lot on accountability here as one of our obsessions. You probably know that in America, vocational schools, for example, when you tie the budget to the student's salaries, which they can't game, they have like twice the results basically. Oh, wow. So it's like, it's a huge difference. So there's a lot of things like this, which in A, that drive me crazy because when you don't have accountability, it's it gets wasted yeah yeah and and look what we're trying to do is simply say instead of instead of saying it to everyone i'm sorry could we do all of this differently you know that doesn't work we're simply trying to push people to what are the smartest things this is true for philanthropies if you're going to spend your money you should spend it on one of these 12 amazing things and you should have usaid spend more of its money on these smart things usaid should be more accountable too which is on these things yes that would be that'd be positive i'm always curious how much is actually being stolen with grift.

11:58That's a whole other question, I guess. I'm curious. Another one you say is tuberculosis, which it sounds like a 19th century conversation to someone living here, that this is actually such a big deal. So what's going on with tuberculosis? So we fixed tuberculosis, right? I mean, in the 1800s. It's like Charles Dickens is what you hear about. It totally is. In the 1800s, every fourth person in the US and in Europe died from tuberculosis. Really? One fourth? Yeah. Like there's by far the leading cause of death. It was called consumption back then too, right? It was consumption. And we fixed it because it's just antibiotics.

12:30This is not rocket science. So we fixed it back in the 1930s. We stopped sending people to sanatoriums and all that stuff. And so out of mind. Now, the problem is we didn't fix it for the poor half of the world. Now, they're much lower incidence. So it's not every fourth person that dies from tuberculosis, but it's a huge problem about 1.4, 1.6 million people die each year from this. This is not rocket science. We know how to fix it. There are two things you need to do. You need to have people take their medication. One of the problems is you have to actually take your medication for half a year.

13:04Have you ever gotten like two weeks that you have to take an insulin or something? It's a lot to remember. It's hard to remember. I'm trying to do statins right now to try to go from good to great in that, but it's like, but I don't remember every day. Okay. I actually have an app that reminds me all the time. There you go. That's good. But yes, half a year, hard to do. The other part is that a lot of people don't want to know that they have tuberculosis. They're kind of hoping that I don't because in Kenya, for instance, if you get tuberculosis, it has so much social stigma that a quarter of everyone who gets diagnosed lose their marriage.

13:40So obviously you sort of go to the doctor and kind of say, please tell me I don't have tuberculosis. And the doctor who's often private will oblige and say, you know what, it's probably just cough. Here, take some VIX kind of thing. So we want to change that. And there's a very, very clear path to do that. You test more people and you make sure that they get better ways of taking their medication. So you get like an app, you get sort of games, you get tuberculosis anonymous. I don't know. Every week we meet up and we say, I took all my meds, that kind of thing. That's the way you make sure that more people take it.

14:15Now, that has costs, but it's very, very small cost compared to the fact that we could actually stop about a million people dying each and every year. It'd be one of the best things we could do. For every dollar spent, we estimate we could do$46 worth of good. Again, that seems pretty straightforward. It's shocking thinking we've done all these mosquito nets and AIDS programs, but we just haven't gotten rid of tuberculosis. Why was that left out when we did all these other things? So part of it is that it sounds like, you know, Diggins and 1800s. it's also because it's not sexy in the same way so look for instance hiv aids which is wonderful that we actually managed to do so much about it but it was also much more of a disease that everyone and especially in the west also had something we were very aware yeah we were very worried that it would you know sort of invade all of the u.s so we were much more concerned about this tuberculosis we've already had it's interesting we're not scared of ourselves so therefore we hadn't thought to help them.

15:11Yeah. And, and, and, and also remember if you get HIV, you have it for life. So everyone who gets it will be a campaigner for get more money to it. But people who get tuberculosis and get cured, they don't talk about it because it's stigma. This is a stigma they don't want to know. No, I've never had tuberculosis. I don't know what you're talking about. So, you know, there's this whole sense of, of, of most people in the developing world don't want to talk about it. But again, we need to talk about it because it kills 1.5 million people. Let's jump into a couple more of the 12. One of them I remember was e-procurement, which I thought was kind of random because you're like tuberculosis kind of fits in with normal things.

15:48Like why is e-procurement on the list? What does that even mean? Yes. It's totally sort of, wow. But remember, most purchases across the world are actually made. The biggest single purchaser is the government. I know my companies sometimes sell to them. There you go. Yeah. And this is typically terribly corrupt. So we did this work in Bangladesh. They have this setup where everything, you know, like a good British former colony, they have the setup that you hand in close to envelope with your bid that has been registered in a very special. As American citizens, we can't work in these countries because they keep telling us we have to pay the consultants and to do these things.

16:28And obviously it's against the law. Yes. But, and the point is, of course, they've already decided, you know, among the local elite who gets the job. And so they put goons up outside the office where you're coming in with your sealed envelope. So, you know, they're very simple ways that you actually push up the price and get that corruption to the ruling families. If you put everything on eBay, essentially, that's what e-procurement is. You put it online. Make them bids for it. It becomes much harder to make it corrupt. So what we know is it simply means countries get better produce at lower cost.

17:03I think this is probably partially true. I want to push back a little bit because I think bureaucracies in the West are very good at making these things corrupt. So I'll give you an example, just as a context. Like when our friend's company with the tunnels, right, was going to do a big underground station, they said, let's just use the top government contractor because we don't do the giant underground station. And the government contractor they hired, they looked at it and it's going to be a little over$300 million. and they said, well, that seems way too expensive. This is the one the government always uses.

17:29They looked all around and they found one that was willing to do it with all the regulations and rules for like$225 million. And they still said, that seems ridiculous. Like it's just too much. And so they did it themselves and it ended up costing them$30 million. And so the government's in the West. And it turns out these firms, in order to become the firms that work with the government, have to jump through thousands and thousands of pages of regulations and rules. So I do think that they ultimately find another way to make it corrupt with something with bureaucracy. It seems very unlikely that we're going to get rid of all corruption.

17:59This is not a get rid of all corruption scheme. It's a way to get rid of some of the corruption, the easy corruption. And so they actually, in Bangladesh, we helped the government in setting up a situation where they took 4 % of their spending and put it online. And we could just simply see the prices drop. It just gets so much better. You get more competition and you got lower super profits, essentially. This is just a great way to say you get more for your tax dollar. I'm sure there's still corruption. I'm sure there's still - They'll find ways to create new bureaucratic hurdles as they do in the UK and here.

18:33But it's going to be harder. And that's all you can - We'll have to take lessons from Europe at that point, but that's totally fair. It's probably not quite as bad. The other nine, what's another one of your favorite? I'm curious. What were you surprised by? So I try not to have favorites. I'd like to ask, what's your favorite kid, right? But one of the things I was very, very surprised about was the fact that every year 300 ,000 moms die in childbirth and 2.3 million kids die within their first month. Why is that happening? This basically happens because giving birth is still terribly, terribly dangerous.

19:08We've sort of fixed it in the West. It's not really a big problem here. It's still somewhat dangerous here, but not nearly as dangerous. Not nearly as dangerous, but it's terribly dangerous there. And there are some very, very cheap things that you can do. Let me just give you one example. So about at least 700 ,000 kids each year, but probably many, many more come out and don't start breathing. We know that this is true in rich countries, for instance, 5 % in Europe. So they'll come out, most of them start crying and breathing right away. Some of them need that slap in the back, but about 5 % of them just don't start breathing.

19:43You have to put a mask on top of them, put in positive air pressure, get air in their lungs, and then many of them will start breathing. But if you don't have that little hand pump, or if the woman is not in an institution where they have this, the kid will probably die. So if you get more women in to give institutional birth, and when you get in there, they have these basic things. This is not rocket science again. This is having that ventilator. It costs, what,$65? But there's parts of Africa and stuff where they don't have this. Yes. It's also running water. It's about having disinfectants.

20:20These are not rocket science things, but we need to get them. They cost fairly little. And so we estimate for about$3 billion a year, you could save 166 ,000 moms each and every year, and you could save 1.2 million kids' lives each year. What is it about USAID? and European A and nurse society that just wouldn't have figured that out. Because that doesn't sound that complicated. That seems like an obvious one to go for. And the real reason is it's because there's tons and tons of tons of things we should do. Oh, we should do this good thing. That's a good thing. This was the sustainable development goals conversation.

20:58There's all these different things. So it's not that they're not looking at maternal and newborn health, but it's because they're also looking at a thousand other things. And what we try to do is to say, look, of all these thousand things, these are some of the 12 best things. It'd be surprising if we found the only 12 things in the world. We really tried to look hard, but there's probably a 13th and maybe a 14th. But this is 12 of the very, very best things. This is where we should focus first. So one of my, I want to ask you about one that's not on your list, which I think is probably controversial.

21:27But one of my views is, I have all these friends who like, they work on like water for people and food for people in these places. and I said, guys, the only reason anyone's ever going to die of a problem with water or food is because they live in a country that doesn't have property rights. It seems like very obvious if you look around the world, if you can get property rights and you can get a decent court system, like just basic, basic properties of freedom and the stuff that caused the West to win, that would actually make it so these people stop dying of all these things. Wouldn't there be a really, really good return on working to go in and teach people about markets and property rights and try to work to push the government in that direction?

22:01Because it seems like it's not that expensive. Would that count if there's someone who is quite good at doing that? Would that count as like a good risk reward return? Because it would probably make the place work a lot better. So one of the things we focus on is actually getting more clear property rights for land. Remember, the vast majority of poor people in the world live off of the land and they have very little protection. It's very corrupt who owns what in these countries. So that would be an incredibly good thing. It would have a lot of impacts in the short run because you need to get a lot of it through courts and that will be expensive, but the overall long-term productivity gain will be significant.

22:36It's huge. Absolutely. So we should definitely be focusing on having better land rights. With that said, I'm not sure just simply knowing that you own land necessarily means that you will be able to drill that well, because it'll still be costly for you to do that. And unless you are able to borrow against it, and certainly again, remember water is typically one of those things, especially in poor countries where girls don't have all that much value. You just send the girls far off. 100%, but in a broader societal sense, once you have property rights, there's going to be some small number of people who are able to build there as opposed to having to leave.

23:14So if you're a smart young person in a place and there's not property rights, you have to leave if you want to build a better life. Whereas once you have property rights, you can now create a business that you're going to own. You can create, you can build, you can iterate, you can employ people. So the whole society is just going to be a lot wealthier. You're going to be able to afford education. you're going to be able to afford health from a large societal sense of support. I think you're absolutely right. I mean, I think that's also what the history of basically a civilization has shown us, is that once we get the opportunity to have a well-functioning economic system, that requires a lot of different things.