Tuesday, June 26, 2007

What's next for Muhammad Yunus?

What do you give a guy who has won the Nobel Peace Prize? How about suggesting he try to win another?

Now he looks pretty pleased in the snap here - and he deserves all the kudos that are his due. But what would it take to get Muhammad Yunus and other microfinance institutions to keep at it - and make small loans available to entrepreneurs throughout the developing world who want to launch socially beneficial businesses in the water and sanitation sector?

$20 puts a woman in the handmade soap-making business. Wrap the bars of soap in hygiene promotion messages, and you've got a job with enormous social benefits. Throw in a local language cartoon like Bazooka Joe and you'll have kids begging to wash their hands - think Scooby Doo toothpaste.

$100 would allow a village to buy a few bags of cement, a shovel, and a mold for a cement pit latrine slab. Add a few donor dollars as a social marketing grant to kickstart the latrine business (this things rarely sell themselves), and you have a job with enormous social benefits. When the villager can no longer keep up with growing demand in his village - inshallah - he franchises the model, expands the business, and expands its social benefits.

$3,000 - $10,000+ provides an entrepreneur the opportunity to launch a water pumping business or water purification business. Depending on local externalities, this could involve a borehole and an electric pump. This could involve arsenic removal technology, UV water purification, protecting a spring, rainwater catchment and myriad other options.

What I'm asking for is not a revolution. We didn't need a revolution to kill smallpox. We won't need a revolution to kill polio, Guinea worm or even malaria. What we need is a little creativity. We need to take what we already know how to do with microfinance for betel nut juice sellers, bricklayers, bicycle repairmen and so on and reapply and customize those skills and financial models to the water sector.

Saturday, June 23, 2007

Tony Blair and Safe Water

What the global safe drinking water issue lacks is sex appeal. To remedy this I give you:

Tony Blair

Matthew Yglesias: "What Blair needs to do is find himself a nice, fairly uncontroversial issue to work on. HIV/AIDS is always a solid choice, but I think Bill Clinton's cornered that market. Access to safe drinking water would probably be a good idea."

Good idea indeed.

Diarrhea: the unloved red-headed stepchild of the global health debate

We all know that 1.1 billion people do not have access to safe drinking water around the world, primarily in rural communities. We all know that 2.6 billion people do not have adequate sanitation facilities. So let’s jump right into this discussion of issues related to the global safe drinking water crisis with a shout out to what is arguably the world’s largest, most solvable but least compelling public health challenge: diarrhea. For reasons which remain obscure to me, diarrhea remains under-discussed at dinner parties and cocktail hours. But so was HIV/AIDS until a few years ago, and diarrhea also kills millions of people (mostly children) in a very unappetizing fashion.

2008 is the International Year of Sanitation. Will this accomplish anything other than give me the opportunity to say the “S” word in public at the Blue Salon last weekend? Will it result in anything consequential being done by developing or developed countries to tackle this issue?

I am humbled and inspired by Dr. Larry Brilliant’s recent words about diarrhea. In February 2007 he stated “We need to reduce population growth…And the best way to control population is through increasing child survival (and) educating girls…” He continued: “It is counter-intuitive, but eradicating smallpox and vaccine-preventable disease, stopping diarrheal diseases and malaria are the best family planning programs yet devised. With fewer childhood deaths, you get lower fertility rates.” Diarrhea kills five times as many children as does HIV/AIDS, twice as many as malaria, four times as many as measles. And those are just mortality statistics.

How about diarrhea-related morbidity? You can’t compete with the negative health, social and economic impacts of 4 billion cases of diarrhea each year. This isn’t the sort of diarrhea where you spend the evening on the couch getting caught up on Netflix and eating Pedialyte ice pops to rehydrate – all within paces of a bathroom with a nice flushing john. This is the sort of diarrhea which keeps children from school, which keeps adults from working or farming, which prohibits communities and nations from pulling themselves up to the next rung of the economic development ladder. And kills two million kids each year.

Diarrhea is not just treatable, it is preventable. It is preventable through the provision of safe drinking water, adequate sanitation and hygiene education throughout the developing world. So what’s the best way for the international community to invest its limited donor financial commitments? Where’s the best return for governments in the developing world to invest their healthcare resources?