Delivering healthcare to billions of the world’s poor

A review of Pharmacy on a Bicycle: Innovative Solutions for Global Health and Poverty, by Eric C. Bing and Marc J. Epstein

@@@@ (4 out of 5)

Despite the widespread conviction that the state of the world is deplorable and getting worse by the day, the human race has made measurable, even dramatic progress in some important ways. The collective state of our health is the most telling example. In part because of the eradication of smallpox, the near elimination of polio, and the significant recent progress on HIV/AIDS, humanity in general is living longer and healthier lives. Average life expectancy at birth in India around 1950 was 38 years; today it is 65. In China, it was 41; today it is 77. Over the same period, average life expectancy in the United States has risen from 65 to approximately 80. Numbers can be misleading, but these tell a compelling story.

Building on this amazing success story, major institutions — the United Nations, the U.S. Government, and the Bill and Melinda Gates Foundation, for example — have invested billions of dollars in recent years, targeting specific diseases, promoting the use of vaccines, and building public health infrastructure in developing nations. All these admirable efforts promise to continue the favorable trend in healthcare that has unfolded over the last half-century.

However, there is a hidden dimension in this picture. As Eric Bing and Marc Epstein explain in Pharmacy on a Bicycle, billions of poor people living in rural areas all too frequently fail to gain the benefit of these advances in healthcare. It’s fashionable to look on the world today from the perspective of the cities, but in spite of the massive migration of the last several decades, nearly half (49%) of the world’s population still resides in rural areas. Great numbers of these people live far from transportation hubs, often hours or even days of walking from the nearest road. It’s to these billions of people, nearly all of them desperately poor by American or European standards, that Bing and Epstein turn their attention in their illuminating little book.

Pharmacy on a Bicycle rests on a single, fundamental premise: “Most poor outcomes [in healthcare] are caused not by lack of effective medicines or medical know-how. The ability to prevent and treat many of these diseases inexpensively has been available for a very long time. But getting the right remedies to the right people in the locations where they are needed, in a way they will use them, and at a cost they can afford is continually a challenge. This is not a scientific problem. It’s a business challenge.”

Bing and Epstein argue that humankind has never before been in such a good position to meet this challenge. The costs of many widely-used drugs have fallen dramatically, and scientists have greatly simplified the treatment of many diseases by combining multiple drugs into single capsules or tablets. Extremely cheap diagnostic techniques that provide nearly instant assessments are now available. Through telemedicine, a single well-trained physician can now offer her or his expertise to much larger numbers of patients. The widespread use of clinical checklists and the application of franchising to the healthcare industry have both improved access and lowered costs. And new business models, successfully piloted in many countries, using bicycles, motorcycles, and trained village-level representatives, make it possible for healthcare agencies and for-profit companies to overcome the “last mile problem” that has traditionally limited most of the benefits of the market economy to population centers. “We are now at a tipping point to make lasting global health impacts,” the authors write.

One of the most promising recent developments is the now near-universal access to cell phones; by next year, the number of mobile phones is expected to be greater than the world’s population. “Mobile phones are now being used for patient education and awareness, treatment compliance, health care worker training, data collection, disease and epidemic outbreak tracking, and diagnostic and treatment support.”

Pharmacy on a Bicycle is intended to spark much wider adaptation of these advances by making them more widely known. The book presents a seven-point implementation model called IMPACTS, which encompasses innovation and entrepreneurship, maximizing efficiency and effectiveness, coordinating with partners, accountability, creating demand, task shifting (e.g., empowering nurses to take on some doctors’ responsibilities), and scaling. The book includes an abundance of excellent examples that bring these deadly-sounding prescriptions to life.

Eric Bing is an M.D. who also possesses a Ph.D. in epidemiology and an MBA. He’s the director of global health at the George W. Bush Institute at Southern Methodist University. His co-author, Marc Epstein, is an eminent and much-published professor of management at Rice University in Houston whose previous teaching posts were at the Harvard and Stanford business schools and INSEAD (European Institute of Business Administration).

 

Heads up: My new book will be in stores Sept. 9

My co-author, Paul Polak, and I are now putting the final touches on the manuscript, and it’s got months of design and production ahead. But the new book will be published this year by Berrett-Koehler, the San Francisco firm that brought out an earlier book of mine, Values-Driven Business: How to Change the World, Make Money, and Have Fun (co-authored with Ben Cohen of Ben & Jerry’s fame). The official publication date for the new book is Sept. 9.

Its title is The Business Solution to Poverty: Designing Products and Services for Three Billion New Customers.

It’s premature to tell you much about the book, but I thought you might like to know a little about my co-author, Dr. Paul Polak.

Paul Polak is widely regarded as the father of market-centered approaches to development. He started harnessing the energy of the marketplace 30 years ago when IDE, the organization he founded, sold one-and-a-half million treadle pumps to small farmers in Bangladesh, increasing their net income by more than $150 million a year. Over the past 30 years, he has had long conversations with more than 3,000 small farmers who live on less than $1 a day and walked with them through their fields. IDE has now enabled 20 million of the world’s poorest people to move out of poverty by selling them radically affordable irrigation tools made available through thousands of small village manufacturers, dealers, and well drillers, and opening smallholder access to markets where they could sell their crops at a profit.

Paul’s earlier book, Out of Poverty: What Works When Traditional Approaches Fail, has been widely used as a basic text on practical solutions to rural poverty. He is the founder and CEO of Windhorse International and co-founder and board chairman of Spring Health India, for-profit companies with the mission of bringing safe drinking water to 100 million poor rural customers in the world. Paul is the prime mover for creating and implementing the four social impact multinationals in this book, each designed to transform the lives of 100 million $2/day customers and generate annual sales of $10 billion.

Prior to founding Windhorse, in 2008 Paul established D-Rev, a nonprofit that seeks “to create a design revolution by enlisting the best designers in the world to develop products and ideas that will benefit the 90 percent of the people on earth who are poor, in order to help them earn their way out of poverty. Paul’s vision inspired Smithsonian’s Cooper Hewitt travelling exhibit, “Design for the Other 90 percent.” He was named by The Atlantic as one of the world’s 27 “Brave Thinkers” along with Steve Jobs and Barack Obama. He has also received the Ernst and Young Entrepreneur of the Year award and the Scientific American “Top 50” award for agricultural policy.

Paul graduated from medical school in 1958, worked for 23 years as a psychiatrist, creating innovative models of community treatment, and at various points in his career also worked as a farmer and a hands-on investor in oil and gas, real estate, and equipment leasing. He and his wife Agnes have been happily married for 53 years, and have three grown daughters. At the age of 79, he still puts in an 80-hour work week and loves what he does.

An engaging story about kids, playgrounds, and one hugely successful social entrepreneur

A review of KaBoom! How One Man Built a Movement to Save Play, by Darrell Hammond

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A little more than two years ago I found myself immersed up to my eyeballs in a new venture dedicated to fostering the spirit of play among disadvantaged children. That venture — a mission-driven, for-profit company — was the One World Futbol Project, just then founded by the husband and wife team of Tim Jahnigen and Lisa Tarver. Tim had invented an extraordinary new soccer ball that never goes flat, needs no pump or needle, and goes on playing even if it’s punctured. The Project opened for business shortly afterward during the 2010 World Cup in Johannesburg. Our goal was to distribute one million One World Futbols within three years to children and young people in refugee camps, war zones, impoverished villages, and low-income urban neighborhoods around the world.

What had drawn me to the One World Futbol Project when Tim and Lisa showed me a prototype ball late in 2009 was not the opportunity to give poor kids what would probably be their first ball to play with. For me, the Project wasn’t about play, or sports. I was drawn in by the way so many UN agencies, schools, and NGOs were using soccer as a teaching tool, offering games that helped children acquire insights and skills in conflict resolution, self-confidence, teamwork, gender equity, and HIV/AIDs awareness.

In other words, as I saw it, the One World Futbol could speed community development efforts where poor people lived. That, to me, was a no-brainer, since I’ve been concerned throughout my life with the challenges of global poverty. (Now I’m even writing a book on that topic.) As the business began organizing in the spring of 2010, I became one of four partners. Both Tim and Lisa have continued ever since to emphasize the importance of play in child development, and I even attended a presentation by Dr. Stuart Brown, one of the world’s leading authorities on play. Still, I didn’t get it.

Then I read Darell Hammond’s surprisingly powerful little book, KaBoom! I think I get it now: if kids are deprived of opportunities to play — not twiddling thumbs on video games but creating their own games and rough-housing out-of-doors — the ill effects are evident and provable in their later lives.

Less than 20 years ago, Darell co-founded KaBoom!, a nonprofit organization that builds playgrounds in disadvantaged neighborhoods in North American towns and cities. Darell himself grew up in difficult circumstances (though he didn’t see it that way), and he never finished college, but he proved himself to be a brilliant leader — enough so that he’s now Dr. Hammond, having received an honorary Doctorate from the college he briefly attended.

Since the mid-1990s, KaBoom! has built more than 2,000 playgrounds throughout North America, and it’s estimated that its training, advisory services, and online tools have enabled others to build 10 times that many over the same period. KaBoom! has become a model of social entrepreneurship and a superb example of how nonprofit leaders can equal the very best managers to be found in the private sector. These are all truly remarkable accomplishments.

KaBoom! (the book) is really three books in one. It’s Darell’s story, and the organization’s — an important story, told with charm and unflagging honesty. It’s an essay on the importance of play and the implications for public policy. And it’s a how-to manual for communities to build playgrounds themselves.

If you’re a social entrepreneur or just want to learn more about social entrepreneurship, you owe it to yourself to read at least the first half of this book.

Oh, and by the way: that goal of the One World Futbol Project to distribute one million balls in our first three years? With a generous boost from Chevrolet, we’re on track to meet it!

A technology maven’s vision of humanity’s bright future

A review of Abundance: The Future Is Better Than You Think, by Peter H. Diamandis and Steven Kotler

@@@@@ (5 out of 5)

Peter Diamandis envisions a world in which humanity triumphs against all its challenges, from climate change, overpopulation, and poverty to the planetary deficits in energy and water.

This is not science fiction. It’s an eye-opening survey of what one celebrated technology visionary perceives as a feasible future for our species.

As Diamandis writes, “Abundance is a tale of good news. At its core, this book examines the hard facts, the science and engineering, the social trends and economic forces that are rapidly transforming our world. . . The point is this: When seen through the lens of technology, few resources are truly scarce; they’re mainly inaccessible. Yet the threat of scarcity still dominates our worldview.”

Diamandis is unusually well qualified to write this book. He is a Harvard-trained physician and an aeronautical engineer with a master’s degree from MIT. Ever since the age of 8, he has been preoccupied with space exploration. He has founded or co-founded a half-dozen businesses and organizations involved in that field and is widely credited with being the seminal figure in jump-starting the private space exploration business with the $10 million Ansari X Prize that led to the flight of SpaceShipOne.

In Abundance, co-written with Steven Kotler and published February 2012, Diamandis veers far from the course he set in space, settling down to earth to explore how humankind can leverage emerging technologies to confront its most pressing problems. Though Diamandis’ focus is squarely on the exponential growth in speed, capability, and spread of information processing technologies, he is not a gadget freak. He recognizes the social and political context in which technology is brought to light, although he may downplay the ferocity of humanity’s innate resistance to change. He writes about “game-changing” technologies, such as the “Lab-on-a-Chip . . . a portable, cell-phone-sized device [that] will allow doctors, nurses, and even patients themselves to take a sample of bodily fluid (such as urine, sputum, or a single drop of blood) and run dozens, if not hundreds, of diagnostics on the spot and in a manner of minutes.” He cites other potential breakthrough technologies now being developed by such luminaries as inventor Dean Kamen and biogeneticist Craig Venter.

For anyone but a Luddite, Abundance is exciting to read. Diamandis clearly believes that the technological advances he writes about hold promise of a much brighter future for humanity despite the anticipated growth in the world’s population to nine billion by 2050. (He even points to growing “in vitro” meat as one solution to the fast-rising demand for protein by ever more prosperous people.) For a science fiction fan such as myself, it’s difficult not to get starry-eyed.

However, the flaw in his line of reasoning is that, no matter how promising these new devices and processes might be, it’s not practical to assume that they’ll be quickly adopted around the world. That Lab-on-a-Chip sound wonderful? Great! But how many years will it take to put one billion copies of that device into the hands of the nurses running rural health clinics in Western Kenya and Uttar Pradesh and everywhere else in our wide, wide world? And how much will that cost? And will the spread of the device be rapid enough to prevent what other futurists see as the inevitable pandemics of new communicable diseases? Similar questions arise about nearly every one of the marvelous inventions cited in Abundance.

Peter Diamandis, founder and chairman of the X Prize Foundation and cofounder of Singularity University, laid out his vision of abundance in earth’s future in a brilliant TED2012 talk. The themes he introduced onstage at TED are explored in depth in this book.

To give some sense of the exalted circles in which Diamandis travels, here are some of the trustees of the X Prize Foundation: Larry Page, Elon Musk, James Cameron, Dean Kamen, Ratan Tata, Ray Kurzweil, Arianna Huffington, and Craig Venter, every one of whom would figure in anyone’s list of the brightest and most innovative thinkers and doers in the world.

Books that helped me understand the world

During the last several years — mostly after I bought my first Kindle — I’ve spent a great deal of time reading, roughly half of it fiction, the other half non. I’ve gotten through hundreds of books and have reviewed the last 200 or so in this blog. It feels like a good time to cast a backwards look and identify those books that remain vivid in my memory — books that helped me understand the way the world works. Though most of the fiction I’ve read has been simply enjoyable, a few have touched me. None, though, have really nestled deep into memory and changed the way I view life and the world. I learn mostly from nonfiction. Whatever that says about my character — so be it.

Here, then, are the 20 nonfiction books that have impressed me the most in recent years. They’re arranged in alphabetical order by the authors’ last names. Those I’ve reviewed are boldfaced and linked.

Alexander, Michelle, The New Jim Crow. A shocking survey of the consequences of America’s so-called War on Drugs and the racism in our justice system

Banerjee, Abhijit, and Esther Duflo, Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty. A rigorous and balanced view of both top-down and bottoms-up development policies in the light of field research

Clark, Gregory, A Farewell to Alms: A Brief Economic History of the World. History as I like it: painted in broad swaths across the millennia, rejecting the myth that the “West” was destined to rule the world

Diamond, Jared, Guns, Germs, and Steel: The Fates of Human Societies. A brilliantly original view of world history from a geographer’s perspective, ascribing variable levels of development primarily to environmental and geographical factors

Easterly, William, The White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good. The case against foreign aid and top-down development, by a former World Bank economist

Elkington, John, and Pamela Hartigan, The Power of Unreasonable People: How Social Entrepreneurs Create Markets That Change the World. The liveliest and most insightful of several books on social entrepreneurs

Gladwell, Malcolm, The Tipping Point: How Little Things Can Make a Big Difference. The seminal book on understanding “six degrees of separation” and the way networks work

Harden, Blaine, Escape from Camp 14: One Man’s Remarkable Odyssey from North Korea to Freedom in the West. A riveting tale of the North Korean gulag, spotlighting the reality of repression in the Kim family’s private kingdom

Hochschild, Adam, King Leopold’s Ghost: A Story of Greed, Terror, and Heroism in Colonial Africa. One of the most troubling books I’ve ever read about the legacy of colonialism: the harrowing story of how the Belgian King destroyed the Congo and murdered millions of its people

Johnson, Chalmers, Blowback: The Costs and Consequences of American Empire. A scholar and former U.S. official demonstrates how the U.S. dominates the world through hundreds of military bases, undermining our nation’s reputation and robbing our society of the means to address pressing social problems

Larson, Erik, In the Garden of Beasts: Love, Terror, and an American Family in Hitler’s Berlin. An eye-opening account of U.S. official anti-Semitism in FDR’s Administration that shackled our Ambassador in Berlin who witnessed the outrageous acts unfolding in Nazi Germany

Mann, Charles C., 1491: New Revelations of the Americas Before Columbus. A revisionist view of Native American society in both North and South America, offering proof of huge populations and sophisticated civilizations in the present-day U.S. and in the Amazon Basin

Miller, Brian, and Mike Lapham, The Self-Made Myth: And the Truth about How Government Helps Individuals and Businesses Succeed. A clear-eyed look beyond the bounds of Right-Wing ideology at the immeasurable benefits and services every “self-made man” has received from U.S. society

Mukherjee, Siddhartha, The Emperor of All Maladies. An oncologist’s brilliant history of cancer and of the medical profession’s slowly developing success in treating it

Polak, Paul, Out of Poverty: What Works When Traditional Approaches Fail. How a former psychiatrist, laboring face-to-face with $1-a-day farmers in some of the world’s poorest countries, helped 17 million families escape from poverty

Priest, Dana, and William M. Arkin, Top Secret America: The Rise of the New American Security State. A Pulitzer-Award-winning Washington Post reporter and her researcher rip the cover from the enormous intelligence establishment built after 9-11

Skloot, Rebecca, The Immortal Life of Henrietta Lacks. A science reporter’s captivating ten-year search to understand the consequences of a medical crime committed in an overtly racist era before the rise of medical ethics

Ward, Vicky, The Devil’s Casino: Friendship, Betrayal, and the High Stakes Games Played Inside Lehman Brothers. The most intimate and candid account of how Wall Street played the central role in launching the Great Recession

Wrong, Michela, It’s Our Turn to Eat: The Story of a Kenyan Whistle-Blower. A vivid account by a Financial Times reporter of how corruption holds sway even in one of Africa’s most developed economies 

Must reading about global poverty and the contrasting approaches to ending it

A review of Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty, by Abhijit Banerjee and Esther Duflo

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Public debate about the way to combat global poverty has ricocheted between two extremes. One was summed up in 2005 in The End of Poverty by Jeffrey Sachs, the Columbia economist who spearheaded the UN Millennium Development Goals. The other was laid out by former World Bank economist William Easterly the following year in The White Man’s Burden. Sachs advocates massive government-to-government foreign aid. Easterly deplores foreign aid, convinced that it does more harm than good.

In Poor Economics, Abhijit Banerjee and Esther Duflo seek a path between these two extremes, emphasizing the Randomized Controlled Studies they and their colleagues had conducted to ascertain what works and what doesn’t. (As of 2010, they had completed more than 240 studies in forty countries around the world.)They characterize Easterly’s approach as demand-driven, since he believes that poor people must seek their own solutions — a conservative, free-market attitude. By contrast, Sachs’ approach is supply-driven, reflecting Sachs’ conviction that a government must provide for its people based on consensus thinking about what poor people need — a liberal, top-down attitude. (I find myself bemused that I’m on the right side of this debate.)

Banerjee and Duflo report that their observations and research results support each of these two approaches — and sometimes both — depending on what issue they study. Hunger, health, education, financial services, family planning, business development, policy options: each field offers up a unique picture of success and failure attributed to one or another of the two approaches. In other words, circumstances and details matter, all of which may vary from one country to another. There is no silver bullet, they assert, no panacea to eliminate poverty.

Poor Economics focuses on the overarching question of whether there is such a thing as a “poverty trap.” Sachs contends there is: poor people will be stuck in poverty unless and until they are given the resources to release themselves from the trap. In many circumstances, Banerjee and Duflo find scant evidence to support this assertion. In others, however, they see the need for government intervention in the lives of the poor because otherwise they will perceive no reason to act for themselves.

Rather than identifying a simple, unitary explanation why Sachs’ approach often fails, they emphasize “ideology, ignorance, and inertia — the three I’s — on the part of the expert, the aid worker, or the local policy maker.” These three I’s, they claim, “often explain why policies fail and why aid does not have the effect it should.” Banerjee and Duflo explain further: “The poor often resist the wonderful plans we think up for them because they do not share our faith that those plans work, or work as well as we claim.”

It would be difficult to find two scholars better prepared than Abhijit Banerjee and Esther Duflo to forge a middle course through the opposite poles of thought about global poverty erected by Jeffrey Sachs and William Easterly. Banerjee, an Indian economist who is also the son of two economists, holds an endowed chair in economics at MIT. He co-founded MIT’s Abdul Latif Jameel Poverty Action Lab with Duflo, a French economist and a former MacArthur Fellow (recipient of the “genius” award).

For anyone who seeks deeper understanding of global poverty and the ways and means of fighting it, Poor Economics is must reading. This book is the latest I’ve read in my ongoing effort to study world poverty. For a list of additional books on the topic, go to my reading list.

Narrowing global inequities: a reading list

Lately I’ve been working with Paul Polak on a book about how to end global poverty. (Berrett-Koehler will publish the book in 2013.) Paul’s previous book, Out of Poverty, was published six years ago, and this new work – provisionally titled The Business Solution to Poverty – represents the evolution of his thinking, six more years of work with poor people in developing countries, and the reading and relevant field experience I’ve had over the years.

As I’ve dug more deeply into the subject of global poverty, it has become increasingly clear to me that truly understanding how today’s glaring inequities have come about requires extensive knowledge in a wide array of topics, from Third World history to social psychology, development economics to the history of business and international trade.

Well, I confess I’m no expert in any of those fields. I’ve read widely in some, superficially in others, and I’m learning a lot.

My reading has emphasized economic history, the economics of poverty, colonialism, Third World development, social enterprise, and the ongoing debate about the impact of “foreign aid” (more properly, overseas development assistance). Along the way, I’ve reviewed in this blog many of the books I’ve read.

In previous posts, I’ve offered up reading lists on some of these subjects individually. Here, I’m sharing a compiled list. These are the books I’ve actually read. Where I reviewed a book, you’ll find boldfacing and underlining that signifies a link to my review. The books are listed alphabetically by the author’s last name.

Banerjee, Abhijit, and Esther Duflo, Poor Economics A Radical Rethinking of the Way to Fight Global Poverty. PublicAffairs, 2011. (review to come)

Bornstein, David, How to Change the World: Social Entrepreneurs and the Power of New Ideas. Oxford University Press, 2007.

——, The Price of a Dream: The Story of the Grameen Bank. Oxford University Press, 2005.

——, and Susan Davis, Social Entrepreneurship: What Everyone Needs to Know. Oxford University Press, 2010.

Clark, Gregory, A Farewell to Alms: A Brief Economic History of the World. Princeton University Press, 2007.

Cohen, Ben, and Mal Warwick, Values-Driven Business: How to Change the World, Make Money, and Have Fun. Berrett-Koehler Publishers, 2006.

Collier, Paul, The Bottom Billion: Why the Poorest Countries are Failing and What Can Be Done About It. Oxford University Press, 2007.

Collins, Daryl, Jonathan Morduch, Stuart Rutherford, and Orlanda Ruthven, Portfolios of the Poor: How the World’s Poor Live on $2 a Day. Princeton University Press, 2009.

Crutchfield, Leslie R., and Heather McLeod Grant, Forces for Good: The Six Practices of High-Impact Nonprofits, 2nd Edition. Jossey-Bass Publishers, 2012.

Diamond, Jared, Collapse: How Societies Choose to Fail or Succeed. Viking Press, 2005.

Easterly, William, The White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good. Penguin Press, 2006.

Elkington, John, and Pamela Hartigan, The Power of Unreasonable People: How Social Entrepreneurs Create Markets That Change the World.Harvard Business Review Press, 2008.

Govindarajan, Vijay, and Chris Trimble, Reverse Innovation: Create Far From Home, Win Everywhere. Harvard Business Review Press, 2012.

Guha, Ramachandra, India After Gandhi: The History of the World’s Largest Democracy. HarperCollins Publishers, 2007.

Hochschild, Adam, King Leopold’s Ghost: A Story of Greed, Terror, and Heroism in Colonial Africa. Houghton Mifflin Company, 1998.

Kamkwamba, William, and Bryan Mealer, The Boy Who Harnessed the Wind: Creating Currents of Electricity and Hope. HarperCollins Publishers, 2009.

Kidder, Tracy, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. Random House,2003.

Kristof, Nicholas D., and Sheryl WuDunn, Half the Sky: Turning Oppression Into Opportunity for Women Worldwide. Knopf, 2009.

Light, Paul Charles, The Search for Social Entrepreneurship. Brookings Institution Press, 2008.

Lynch, Kevin, and Julius Walls, Jr., Mission, Inc.: The Practitioner’s Guide to Social Enterprise. Berrett-Koehler Publishers, 2008.

Mehta, Pavithra, and Suchitra Shenoy, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion. Berrett-Koehler Publishers, 2011.

Moyo, Dambisa, Dead Aid: Why Aid is Not Working and How There Is a Better Way for Africa. Farrar, Straus and Giroux, 2009.

Polak, Paul, Out of Poverty: What Works When Traditional Approaches Fail. Berrett-Koehler Publishers, 2006.

Prahalad, C. K., The Fortune at the Bottom of the Pyramid: Eradicating Poverty Through Profits. Pearson Prentice Hall, 2004.

Sachs, Jeffrey D., The End of Poverty: Economic Possibilities for Our Time. Penguin Press, 2005.

Schwartz, Beverly, Rippling: How Social Entrepreneurs Spread Innovation Throughout the World. Jossey-Bass Publishers,2012.

Sullivan, Nicholas P., You Can Hear Me Now: How Microloans and Cell Phones Are Connecting the World’s Poor to the Global Economy. Jossey-Bass Publishers, 2007.

Wrong, Michaela, It’s Our Turn to Eat: The Story of a Kenyan Whistle-Blower. HarperCollins Publishers, 2006.

Understanding the day-to-day reality of global poverty

A review of Portfolios of the Poor: How the World’s Poor Live on $2 a Day, by Daryl Collins, Jonathan Morduch, Stuart Rutherford, Orlanda Ruthven

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This book makes a major contribution to our understanding of global poverty.

Portfolios of the Poor reports the findings of a series of detailed, year-long studies of the day-to-day financial practices of some 250 families in India, Bangladesh, and South Africa, including both city-dwellers and villagers. The authors conducted monthly, face-to-face interviews with each family, focusing on money management and recording every penny spent, earned, or borrowed in “diaries” that formed the principal source for their observations. In the process, they made discoveries that will surely be surprising to some readers:

• The poor rarely live from hand to mouth. “[N]o matter where we looked, we found that most of the households, even those living on less than one dollar a day per person, rarely consume every penny of income as soon as it is earned. They seek, instead, to ‘manage’ their money by saving when they can and borrowing when they need to.”
• Lack of money is just one of the financial characteristics of poverty. It’s equally important that poor people’s income is both unpredictable and irregular. Crops come in two or three times a year, yielding whatever the weather may permit and the market may bear; between-times a family may have no cash income at all. A son might get a job for a day but not again for a week or a month. Illness or injury may interrupt a family’s income. And so forth.
• Rather than helpless victims of their poverty, the authors found, the poor are remarkably sophisticated about the financial circumstances of their lives. “We came to see that money management is, for the poor, a fundamental and well-understood part of everyday life.”
• Microlending is just one of the financial services needed by the poor to lift themselves out of poverty. “[W]e saw that at almost every turn poor households are frustrated by the poor quality — above all the low reliability — of the instruments that they use to manage their meager incomes. This made us realize that if poor households enjoyed assured access to a handful of better financial tools, their chances of improving their lives would surely be much higher.”
• Most observers regard money-lenders as simply a scourge of the poor, as they are so very often. However, given the dearth of mainstream money-management alternatives, there are many circumstances in which it’s logical for poor people to turn to money-lenders for short-term cash loans. “One of the lessons from the diaries is that interest paid on very short-duration loans is more sensibly understood as a fee than as annualized interest.”

Scholars, activists, and policymakers alike have quarreled over the question of global poverty and what to do about it for more than half a century. More often than not, the disputes they air in official policy debates, in the news media, and in scholarly journals are grounded in statistics developed by the United Nations and the World Bank — figures that usually represent worldwide averages. Therein lies much of the trouble.

The most widely accepted benchmark for world poverty today is $2 a day per person, as determined by the World Bank. However, you have to dig deeply before you can understand what the World Bank and the United Nations actually mean by “$2 a day.” They’re not referring to those two one-dollar bills you may have crumpled up in your pocket or purse. To correct for economic differences from one country to another, they use the concept of Purchasing Power Parity (PPP).

In theory, PPP takes into consideration the sharp differences in how much $2 will buy in any given country as compared to the global norm. But in practice the experts have widely differing views on what method should be used to calculate PPP and, in effect, what is the global norm. As if that isn’t bad enough, the most commonly used techniques to calculate PPP are based on each country’s economy-wide standard of living. In other words, the definition of poverty might depend in part on the price of big-screen TV sets and BMWs or their equivalent. In hopes of correcting that problem, scholars have been writing papers for several years about “poverty-based PPP,” excluding anything but goods and services commonly demanded by people living at subsistence level, but none of the approaches they’ve proposed has yet been officially adopted.

The whole question of PPP, then, is so confusing — and so confused — that the authors of Portfolios of the Poor have rejected the concept. They base all their calculations simply on the prevailing exchange rates between local currencies and the U. S. dollar. To which I say, amen.

The four co-authors of this book are an intriguing bunch. Two are men and two women. (Daryl Collins, the lead author, is female.) All four are products of elite universities: Oxford, Cambridge, Harvard, and the London School of Economics, though only one, Jonathan Morduch, is currently an academic. Morduch teaches development economics at NYU’s Wagner School of Public Policy in New York; he is an expert in microfinance. Daryl Collins, Stuart Rutherford, and Orlanda Ruthven are all development practitioners with practical field experience — Collins with a Boston-based global consultancy, Rutherford with a microfinance institution he founded in Bangladesh, and Ruthven with DFID, the UK equivalent of USAID.

The best books I’ve read so far this year

You have to wait until December to see a list of “best books” in The New York Times Book Review, but right here in this space you can see my list for the first six months of 2012! Of course, it’s a short list, and quite specialized, since there are lots of categories of writing that hold no interest for me. And I don’t limit myself to books that were published after January 1, 2012 (though most were). After all, I’m not The New York Times. But, for what it is, here goes, in no particular order . . . with links to my reviews in this blog.

Nonfiction

The Passage of Power, by Robert A. Caro. Volume 4 in The Years of Lyndon Johnson. Robert Caro’s masterful portrait of Lyndon Johnson’s early days as President.

Confront and Conceal: Obama’s Secret Wars and Surprising Use of American Power, by David E. Sanger. Barack Obama’s foreign and military policy viewed from the inside.

The Power of Unreasonable People: How Social Entrepreneurs Create Markets That Change the World, by John Elkington and Pamela Hartigan. The power of unreasonable people, and how they’re changing the world.

The Self-Made Myth, and the Truth About How Government Helps Individuals and Businesses Succeed, by Brian Miller and Mike Lapham. A brilliant contribution to the public debate about politics and the economy.

The New Jim Crow: Mass Incarceration in the Age of Colorblindness, by Michelle Alexander. One of the most important books published in English so far this century.

Behind the Beautiful Forevers: Life, Death, and Hope in a Mumbai Undercity, by Katherine Boo. A searing look at poverty in India that reads like a novel.

The Quest: Energy, Security, and the Remaking of the Modern World, by Daniel Yergin. Daniel Yergin’s superb new book: a brilliant survey of energy issues.

Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion, by Pavithra Mehta and Suchitra Shenoy. Aravind: A social enterprise with scale and impact to match Grameen Bank.

1491: New Revelations of the Americas Before Columbus, by Charles C. Mann. Astonishing new evidence about the Americas before Columbus.

Trade Fiction

They Eat Puppies, Don’t They?, by Christopher Buckley. Washington and Beijing get what they deserve in this satirical novel of politics and diplomacy today.

The Windup Girl, by Paolo Bacigalupi. One of the best science fiction novels I’ve ever read.

The Orphan Master’s Son, by Adam Johnson. An unsparing tale of life in the living hell of North Korea.

Incendiary, by Chris Cleave. A wrenching portrait of the human cost of terrorism.

The Fear Index, by Robert Harris. A taut thriller about the world of multibillion-dollar hedge funds.

A Theory of Small Earthquakes, by Meredith Maran. A first novel from a brilliant nonfiction writer.

Mysteries and Thrillers

Mission to Paris, by Alan Furst. A truly superior novel of espionage at the dawn of World War II.

The Midnight House, by Alex Berenson. The Pentagon and the CIA take a lot of punishment in this novel of rendition and torture.

Harbor Nocturne, by Joseph Wambaugh. Joseph Wambaugh’s latest paints Los Angeles in many clashing colors.

The Limpopo Academy of Private Detection, by Alexander McCall Smith. An exceptional tale of Botswana’s #1 Ladies’ Detective Agency.

Buried Secrets, by Joseph Finder. A thriller that explores the intersection of high finance and high crime.

The Ghosts of Belfast, by Stuart Neville. A grim story of war and betrayal in Northern Ireland.

The Bridge of Sighs, by Olen Steinhauer. A fully satisfying murder mystery set in post-war Europe.

Breakdown, by Sara Paretsky. Sara Paretsky’s latest detective story hits home.

Believing the Lie, by Elizabeth George. Elizabeth George’s latest Inspector Lynley novel, unpredictable as always.

The Silent Oligarch, by Chris Morgan Jones. A refreshingly original new thriller that explores international intrigue with minimal violence.

Agent 6, by Tom Rob Smith. A superb suspense novel set in the USSR, Afghanistan, and the U.S.

Social Enterprise: A Resource List

Here are the books, periodicals, blogs, websites, and organizations I’ve come across in exploring the field of social enterprise. This is by no means a comprehensive list (although, so far as I can tell, it’s longer than any other I’ve found). And I haven’t read everything here or engaged with all the websites or organizations in the list — though I’m working on it.

I’ve boldfaced those items with which I am personally familiar and recommend as good sources of information and insight about social entrepreneurship. The books I’ve reviewed in this blog are linked to their reviews.

BOOKS

Bryan Bell, Editor, Good Deeds, Good Design: Community Service Through Architecture (2004)

David Bornstein, How to Change the World: Social Entrepreneurs and the Power of New Ideas, Updated Edition (2007)

—, The Price of a Dream: The Story of the Grameen Bank (1997, 2005)

— and Susan Davis, Social Entrepreneurship: What Everyone Needs to Know (2010)

Ben Cohen and Mal Warwick, Values-Driven Business: How to Change the World, Make Money, and Have Fun (2006)

Daryl Collins, Jonathan Morduch, Stuart Rutherford, and Orlanda Ruthven, Portfolios of the Poor: How the World’s Poor Live on $2 a Day (2009)

Jim Collins, Good to Great and the Social Sectors: A Monograph to Accompany Good to Great (2005)

Leslie R. Crutchfield and Heather McLeod Grant, Forces for Good: The Six Practices of High-Impact Nonprofits, 2nd Edition (2008, 2012)

J. Gregory Dees, Jed Emerson, and Peter Economy, Strategic Tools for Social Entrepreneurs: Enhancing the Performance of Your Enterprising Nonprofit (2002)

Cheryl L. Dorsey and Lara Galinsky, Be Bold (2006)

John Elkington and Pamela Hartigan, The Power of Unreasonable People: How Social Entrepreneurs Create Markets That Change the World (2008)

Vijay Govindarajan and Chris Trimble, Reverse Innovation: Create Far From Home, Win Everywhere (2012)

Adam Hochschild, Bury The Chains: Prophets and Rebels in the Fight to Free an Empire’s Slaves (2006)

Tracy Kidder, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World (2003)

Paul Charles Light, The Search for Social Entrepreneurship (2008)

Kevin Lynch and Julius Walls, Jr., Mission, Inc.: The Practitioner’s Guide to Social Enterprise (2008)

Johanna Mair, Jeffrey Robinson, and Kai Hockerts, Social Entrepreneurship (2006)

Pavithra Mehta, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion, (2011)

Alex Nicholls, Editor, Social Entrepreneurship: New Models of Sustainable Social Change (2006)

Jacqueline Novogratz, The Blue Sweater: Bridging the Gap Between Rich and Poor in an Interconnected World (2009)

Paul Polak, Out of Poverty: What Works When Traditional Approaches Fail (2009)

C. K. Prahalad, Fortune at the Bottom of the Pyramid: Eradicating Poverty Through Profits, Revised and Updated (2004, 2009)

Beverly Schwartz, Rippling: How Social Entrepreneurs Spread Innovation Throughout the World (2012)

Rupert Scofield, The Social Entrepreneur’s Handbook: How to Start, Build, and Run a Business That Improves the World (2011)

Cynthia E. Smith, Design for the Other 90% (2009)

Social Enterprise Alliance, Succeeding at Social Enterprise: Hard-Won Lessons for Nonprofits and Social Entrepreneurs (2010)

Jane C. Wei-Skillern, James E. Austin, Herman B. Leonard, and Howard H. Stevenson, Entrepreneurship in the Social Sector (2007)

Wilford Welch, Tactics of Hope: How Social Entrepreneurs Are Changing Our World (2008)

Muhammad Yunus, Creating a World Without Poverty: Social Business and the Future of Capitalism (2008)

PERIODICALS

Stanford Social Innovation Review (Stanford University), http://www.ssireview.org/

Innovations: Technology, Governance, Globalization (MIT), http://www.mitpressjournals.org/loi/itgg

BLOGS

Evan Carmichael’s Top 30 Social Entrepreneurship Blogs to Watch in 2012, http://www.evancarmichael.com/blog/2012/04/10/the-top-30-social-entrepreneur-blogs-to-watch-in-2012/

Skoll Foundation Social Edge, http://www.socialedge.org/

WEBSITES

World Resource Institute’s NextBillion.net, http://nextbillion.net/

CSRWire, http://www.csrwire.com/

Alltop’s Social Entrepreneurship Coverage, http://social-entrepreneurship.alltop.com/

Catalyst Fund’s Social Business blog, http://www.clearlyso.com/

Dowser.org, http://dowser.org/

E-180’s Top  25 Social Entrepreneurship Websites, http://blog.e-180.com/en/2009/02/our-top-25-social-entrepreneurship-websites/

ORGANIZATIONS

Institute for Social Entrepreneurs, http://www.socialent.org/

Ashoka: Innovators for the Public, http://www.ashoka.org/

Echoing Green, http://www.echoinggreen.org/

Skoll Center for Social Entrepreneurship (Oxford University), http://www.sbs.ox.ac.uk/centres/skoll/Pages/default.aspx

Social Venture Network, http://svn.org/

Social Enterprise Alliance, https://www.se-alliance.org/

Net Impact, http://netimpact.org/

University Network for Social Entrepreneurship, http://bit.ly/KwqWgz

BUSINESS SCHOOLS

Bainbridge Graduate Institute, http://www.bgi.edu/

Center for Responsible Business, Haas School of Business, University of California Berkeley, http://responsiblebusiness.haas.berkeley.edu/

Center for Social Innovation, Graduate School of Business, Stanford University, http://csi.gsb.stanford.edu/

Presidio School of Management, http://www.presidioedu.org/

Babson College, MBA in Entrepreneurship,  http://www.babson.edu/graduate/Pages/landing-graduate.aspx?gclid=CPm_1YL37rACFUQaQgodizXjug

Marlboro College Graduate School, MBA in Sustainability, https://gradschool.marlboro.edu/academics/mba/

Fuqua School of Business, Duke University, http://www.fuqua.duke.edu/student_resources/academics/concentrations/social_entrepreneurship/

Also see Aspen Institute rating of top 30 SUStainable MBA programs,  http://www.topmba.com/mba-rankings/sustainability-mba