Quick takes on the Copenhagen Consensus Center's Halftime list

December 22, 2023

A friend sent me this recently:

These are the 12 “best investments” recommended by the Copenhagen Consensus Center to achieve the Sustainable Development Goals. That’s just a bit of PR — CC doesn’t do much to link these investments to the SDGs directly.

Each of the investments is based on a policy paper (linked here) by academics and policy-makers expert in that area. I at least skimmed each policy paper, and read most of them. These takes are quick; I wrote and edited this in two hours.

Here we go:

Agricultural R&D

The argument is, food is too expensive, and if it were cheaper, fewer people would be hungry. R&D is a public good and therefore underprovided, so governments should step up. The authors give “crop yield increases using precision genetic technolgoies” as an example of a desired intermediate outcome.

I’m all for cheaper food, but don’t think that this R&D is very underprovided. Just after WWII, sure, the science was so new that Norman Borlaug could only be employed by governments or non-profits. Now, there are boatloads of dollars for increasing Bihari rice yields 0.34% per growing season. See Mariana Mazzucato for the exact opposite of the argument I’m making.

Childhood immunization

Somewhere we’re doing great — and should be doing better! I’m a huge fan. Small cost, huge benefits. Let’s prioritize HPV, HepB, and MenA. And the pentavalent, because it’s cool.

Maternal and newborn health

This one’s huge. Childbirth is the most common human physical trauma — and 19 million births every year take place outside of a health facility. While we don’t have a good cross section of those 19 million and the 2.5 million babies who die in their first month,And 1.1 million of these are in the first 24 hours. the staff and equipment at even the most rudimentary health facility can avert the most pointless deaths. I’ve been to dozens of these facilities in Sierra Leone, and the default is no electricity, certainly no running water, and a single trained nurse. There’s a lot of progress to be made here, not for as cheap as immunizations, but lots of pain and death to avoid. If anything, CC is underselling it.

e-Government Procurement

Now things get weird.Their list is in an apparently random order, so things will get less weird again soon. Copenhagen’s claim is that poor countries lose a lot to corruption, and instituting online procurement systems will deter or punish much of this. This isn’t what the cost-benefit paper measures — the measured benefits come from prices for government contracts falling after e-procurement systems are implemented.Let’s follow this through. e-Procurment means more competition for contracts, so prices fall, so decreasing government expenditure. The impact in reduced expenditures is not obviously positive: in many poor countries, large fractions of government expenditures are financed by western aid agencies or DBs. So a fall in expenditure means a fall in rich-poor transfers. Alternatively, aid budgets to poor governments are set, so a fall in expenditures means that those funds can be spent on other, more productive expenditures. Idk. I would have been more interested in the corruption angle, although it’s understandably more difficult to quantify.

CC is overselling this one, but sure — net positive. Good luck.

Tuberculosis

Tuberculosis is terrible; it kills more people than malaria, typhoid, and cholera combined.

There’s been recent progress. CC’s proposal focuses on diagnosis and care, also touching on AMR. Elsewhere, a couple competent of people in my circle have started a new charity, Spiro, to work on this problem. In the longer term, vaccines are in the pipeline. Here’s Dylan Matthews beating one of his usual drums on the topic of how to move the needle faster and cheaper.

Nutrition

I was sceptical of this one, but the position paper brought me around. Once the very lowest fruit is picked (mostly, sufficient calories), the global health field is weak at scaling nutrition programs. We have a hard time finding the cheap, effective interventions in a field which should be full of easy wins.

CC’s main investment here is to provide micro-nutrients to pregnant women. The paper is vague on the benefits, but I’m hopeful there are big gains here. Their other recommendation, complementary feeding, attacks the insufficient calories problem. I’m bullish on both of these.

Trade

Back to the weird stuff. Specifically, CC calls for reductions in tariffs, reductions in effective distance, and increases in trade agreement depth.

The math works out. The authors of the CC report all have PhDs in economics; three of them are professors focusing exclusively on trade. Of course their model is good.

Using a structural gravity model, we simulate changes in three primary trade constraints: a 10% reduction in tariff levels, a 10% reduction in effective distance, and a 10% increase in free trade agreement depth. The projection leads to a roughly 5% increase in global trade by value.

There are no arguments in here which would surprise David Ricardo.But honestly if I got to explain one modern economic concept to him it would be stablecoins, and we wouldn’t have time to get to trade. In fact, if he got past the gravity model, he would find the political economy naive. Moving the needle 5% on these factors isn’t a matter of sending a policy paper to the USTR; it’s a massive political platform, requiring the coordination of the US, China, the EU, Japan, Singapore, the Gulf, the WTO, and Bono. It makes sense to exclude costs of political horse-trading from these models but — these costs would be large.I’m not claiming this is an impossible policy goal (that would be boring), but that the political economy would be so expensive that this should factor into the cost-benefit analysis. I made a similar argument to LM against global Esperanto education this morning.

On the margin, yes, let’s us as a world reduce tariffs, improve logistics, write better free trade agreements. But this one doesn’t belong in the same category as malaria, TB, or agricultural R&D.

Chronic disease

This is a bit of a catch-all for policies aiming to reduce cardiovascular disease, mental illnesses, and some cancers. CC’s recommendations in this category range from tobacco excise taxesA friend, JT Stanley, has recently started a charity to address this one. to “aspirin for suspected heart attacks.”Cool? But… this is the entirety of the recommendation. I don’t think doctors in poor countries haven’t heard of NSAIDs, and it’s not at all clear to me how the authors calculate the costs or counterfactual benefits of this one. Overall, the eight recommendations they make are all good ones, but the quantification here is weak, especially for the clinical recommendations.OK the authors say in the subtitle that they have eight recommended interventions, but in the body of the paper, they mention subsets of five, thirteen, ten, and fifteen interventions which pass their bar in various scenarios. $10 to anyone who can figure out which eight the subtitle refers to.

Land tenure security

This is an interesting one, and should have much bigger error bars than anything else on this list. The recommendations are a) create land registries, b) create institutions to improve efficiency and transparency, and c) “strengthen institutions and systems to resolve land disputes and manage expropriations.” The benefits claimed in the table are impressive:I can vent frustration in the sidenotes, right? Right. The numbers in the table show up nowhere in the paper which supposedly came up with those numbers. The numbers in the paper are close enough that I don’t think Bjørn Lomborg (whom we’re not discussing in this post) pulled them out of his butt but… come on dude. 4x the benefits of e-procurement systems, mostly through increased agricultural output and land values.

Quick thoughts:

Malaria

AMF should never have a funding shortfall ever again. Out of spite.

Skilled migration

Read Weinersmith. And, as with trade, don’t ignore the political economy costs.

Education

This is the most expensive, and ambitious, intervention on the list. Based on nothing but the title, my take was:

  1. 1 Identifying effective education interventions is hard,
  2. 2 Scaling them is harder,
  3. 3 Costs are larger than modeled,
  4. 4 Benefits are smaller than modeled.This last could be better written as ‘benefits fade faster than expected,’ but that’s not parallel.

I read the policy paper, and did not change my mind. The authors’ two recommended interventions are “structured pedagogy” and “teaching to the right level.” The details of these don’t matter,Lauren Gilbert at OpenPhil put out an article in Asterisk just this morning separately recommending these two interventions, citing the same two RCTs as CC. because my priors (refer to 1-4 above) are robust to any combination of teacher-time, scheduled text reminders, and lesson plans. The idea that we could cut $100 billion in education spending, replace that with ten billion better spent dollars, and reap half of a trillion in benefits per year… Well, there’s only one trillion dollar bill on this list, and this isn’t it.

Conclusion

That’s that. Copenhagen Consensus put together a good list, even if my snideness got away from me at times. Trade, migration, and maybe land tenure are the weird ones on this list; those are political problems, while everything else on the list is a problem of funding.

Quick takes on the Copenhagen Consensus Center's Halftime list - December 22, 2023 - Joseph Levine