Does It Take a Village?

Eight years ago, when Jeffrey Sachs launched an ambitious project to fight global poverty, he surely didn’t suspect that it might end up calling into question his work as one of America’s leading economists. In the 1980s and ’90s, Sachs had made headlines with his work advising reformist governments in Latin America and Eastern Europe — a record that firmly established him as a first-rank public intellectual and ensured him easy access to the offices of presidents and prime ministers from Warsaw to Moscow. There’s a reason the New York Times once described him as “probably the most important economist in the world.”

Then, in 2005, Sachs embarked on his most ambitious undertaking yet. He vowed to attack the root causes of poverty by establishing a series of model villages across Africa that would demonstrate the efficacy of targeted measures to address the corrosive lack of health care, education, and employment that keep so many people around the world in a pernicious “poverty trap.”

“We can banish extreme poverty in our generation,” he wrote that year in Time. “We have enough [financial resources] on the planet to make sure, easily, that people aren’t dying of their poverty,” he later told a reporter. Sachs dubbed his experimental communities “Millennium Villages” in a nod to the Millennium Development Goals, the ambitious set of targets for the eradication of extreme poverty and hunger agreed on by world leaders to much fanfare at a United Nations summit in September 2000. His villages, Sachs argued, would show how those goals could be met.

The effort seemed perfectly suited for someone of Sachs’s unique gifts. It required heavyweight stature in the policy world — and star power, too. Sachs undoubtedly has both. Director of Columbia University’s Earth Institute, he is also a special advisor to U.N. Secretary-General Ban Ki-moon and to several African governments, including those of Ethiopia, Kenya, Nigeria, and Uganda. He has, at various times, recruited investor George Soros, fashion designer Tommy Hilfiger, and U2’s Bono to assist him with the Millennium Villages, and his battle against poverty has been featured in Vanity Fair as well as The Diary of Angelina Jolie & Dr. Jeffrey Sachs in Africa, a 2005 documentary film based on the pair’s visit to one of his villages in Kenya that aired on MTV.

These days, though, Sachs is increasingly on the defensive, assailed by a growing number of critics for what they say are fundamental methodological errors that have arguably rendered his Millennium Villages Project (MVP) — now consisting of 14 village clusters scattered across Africa and covering half a million people — worthless as a showcase for what can lift the poorest of the poor out of their misery. In May 2012, shortly after an editorial in Nature, the influential science journal, scolded Sachs and his colleagues for unreliable analysis, Sachs and his team were forced to admit they had committed a basic error in an academic paper intended to prove their project’s effectiveness. “The project’s approach has potential, but little can be said for sure yet about its true impact,” Nature stated. Edward Miguel, an economist at the University of California/Berkeley, puts it this way: “No one takes the Millennium Villages seriously as a research project — no one in development economics.”

This isn’t just an obscure academic debate about research methods. It’s also an argument that cuts to the heart of how aid to the world’s poorest people should work. At one end of the spectrum, polar opposite from Sachs, are skeptics such as his longtime intellectual foe, economist William Easterly, who tend to view aid as having a pernicious, debilitating effect, creating a culture of dependency. In between are economists, such as Abhijit Banerjee and Esther Duflo, who doubt that attacking poverty is as simple as Sachs would have it and instead advocate highly specific small-scale changes that can make for what they call a “quiet revolution” of sustainable progress. And real money is on the line: Although the several hundred million dollars expended on Millennium Villages so far is not an immense sum in the world of development, billions more would likely be spent if Sachs succeeded in getting others to adopt his approach. The World Bank estimates that 49 percent of sub-Saharan Africa’s population of some 875 million lives in severe poverty on $1.25 or less per day. That’s approximately 429 million people, more than 800 times the number covered by Sachs’s project. With rival aid programs fiercely competing for support from government and private donors, funding for the villages is conceivably money unavailable for less flashy but possibly better-conceived projects.

Sachs vigorously contests harsh assessments of MVP. “We are developing many new tools that are innovative and being widely adopted,” he wrote in an email to Foreign Policy. (He later canceled a scheduled telephone interview.) “Many governments, such as in Nigeria, Rwanda, and Senegal, are asking for our collaboration to take MVP lessons to regional and national scale.” A senior Kenyan government official, Charity Ngilu, who as health minister worked closely with Sachs in getting MVP off the ground in her country, credits Sachs for focusing Kenya’s attention on the crucial need to prevent diseases such as malaria. Sachs’s involvement spurred the distribution, free to users, of some 10 million anti-mosquito bed nets and thereby made a “huge difference in a very short time” to combat the disease, she said in an interview arranged by Sachs’s office.

But political and philanthropic successes and even such examples do not amount to proof or even, necessarily, a convincing case that mvp is succeeding as a demonstration of how to eliminate poverty. The question, rather, is a more rigorous one: Does MVP indeed show, by the evidence gathered so far, that it is, as Sachs claims, the path for ending poverty?

Zack Seckler/Getty Images

SACHS, BORN IN DETROIT in 1954 and made a full professor of economics at Harvard University at the wunderkind age of 28, began his quest to end global poverty after a mixed record in advising Eastern European countries and Russia on how to make a transition from centrally planned communist economies to the free market. (His prescription, for countries to follow what was widely called a “shock therapy” remedy of rapid price decontrols and privatizations of state assets, worked well in Poland but not in Russia, which lurched to a corrupt, thuggish form of crony capitalism from which the country still has not escaped.) He then shifted his focus to sub-Saharan Africa, which he visited for the first time in 1995, feeling an “increasing urgency to understand the development challenges in the world’s most distressed region,” as he later wrote.

Sachs’s idea for the Millennium Villages grew out of a visit to rural southern Zambia in the mid-1990s. He observed that chronic diseases, such as AIDS and malaria, were not only a threat to the health of rural Africans but also a reason villages remained mired in severe poverty. Illness on its own contributes to low economic productivity. For example, “When children die in large numbers” from diseases like malaria, “parents overcompensate and have more children, with devastating results,” Sachs wrote in The End of Poverty: Economic Possibilities for Our Time, his bestselling 2005 book. “Too poor to invest in the education of all of their children, the family might educate just one child, usually the elder son. If children in malarious regions manage to survive, they enter adulthood without the proper education they need to succeed.”

His trips to Africa left him convinced that there are two crucial ingredients to attacking extreme poverty, and these insights became the basis for the design and implementation of MVP. The first key is to target the village as the unit for aid, not individual households, and to provide an integrated package of aid to address a spectrum of needs, including health care, education, agriculture, and infrastructure. This tack was a departure from the usual method of providing aid for very particular purposes.

The second key is money. Sachs vehemently argued that extreme poverty in rural Africa (and elsewhere) is not attributable to corruption or other aspects of flawed governance, but to a lack of sufficient funds. With sub-Saharan Africa as the single biggest need, he estimated that donor countries — the rich world — had to increase global aid assistance from $65 billion in 2002 to $195 billion in 2015 (measured in constant 2003 dollars). “[T]he focus on corruption and governance is exaggerated,” he wrote in The End of Poverty. “Africa’s governance is poor because Africa is poor.”

It was a seductive argument coming at a time when the idea that “corruption is the culprit,” as Sachs put it, was ingrained in mainstream thinking about efforts to address poverty — a deeply pessimistic mindset that also stymied fresh thinking on the matter. (In his book, Sachs cites a typical assertion from Paul O’Neill, U.S. President George W. Bush’s first Treasury secretary, on the futility of aid to Africa: “We’ve spent trillions of dollars on these problems, and we have damn near nothing to show for it.”)

Aid activists hailed Sachs as a savior. “In Jeff’s hands, the millstone of opportunity around our necks becomes an adventure, something doable and achievable,” Bono declared in the foreword to The End of Poverty. “His voice is louder than any electric guitar, heavier than heavy metal. His passion is operatic, he’s physically very present, animated. There is wildness to the rhetoric but a rigor to the logic.”

Soaring rhetoric aside, the advantages and drawbacks of Sachs’s approach are on vivid display in the Ruhiira Millennium Village, founded in 2006 in a banana-growing region in southwestern Uganda. Sachs’s program annually spends about $100 per person on investments including roads, electricity, water, fertilizers, pesticides, medicines, medical equipment, schools, teachers, and training for the nearly 60,000 people in the cluster of villages served by the Ruhiira project.

That might not seem like a great deal to citizens of the developed world, but this inflow of cash certainly has had a tangible impact. School enrollment has surged, not least because students now study in a proper schoolhouse rather than under the banana trees. There’s clean water piped from tanks, and a solar panel powers five new computers. The school’s motto, “Education is wealth,” is printed on a yellow sign on a wall. A village bank boasts a portfolio of more than $200,000 in loans at minimal interest rates — a stark exception in a credit-starved country. A local health center, now staffed by eight professional health workers, tends to an average of 80 patients a day. The clinic has a laboratory that can diagnose tuberculosis, HIV, and malaria. (A baseline survey at the project’s beginning had found that some 17 percent of the community’s residents had malaria parasites.)

Ruhiira certainly seems to be doing well, with the average maize yield up from 1.8 to 3.9 tons per hectare, the number of children getting a meal in primary school up from 5 percent to 74 percent, and the malaria rate “approaching zero,” according to MVP. But, as critics point out, the same can be said of Uganda as a whole. Economic and social conditions in Uganda have improved significantly in recent years, as they have in much of sub-Saharan Africa. The share of the Ugandan population with access to improved water sources increased from 58 percent in 2003 to 68 percent in 2010, while the share living below the poverty line dropped from 31 percent in 2005 to 25 percent in 2009. Life expectancy at birth rose from 48.4 years in 2003 to 54.1 years in 2011, and gross national income per capita more than doubled from $250 in 2003 to $510 in 2011, according to the most recent World Bank statistics.

So which part was Uganda — and which part was Sachs?

We’ll never know because, as Sachs’s critics have pointed out, he failed to include a system of controls in the project so that comparisons could be made to similar communities that didn’t benefit from the same aid. Sachs has long demurred on ethical grounds, without fully elaborating on why he felt that way. The message was clear: In his conception of MVP as a groundbreaking demonstration project — “a new approach to ending poverty,” as Sachs titled one talk in 2006 — not only was there no plan to use comparison villages as a way to measure progress, but Sachs was personally opposed to any such plan.

This issue of measurement was precisely the one that tripped up Sachs and his team in 2012. In what Sachs at first trumpeted as a significant milestone for MVP, he published a study with colleagues in the Lancet, the prestigious British medical journal, on child-mortality trends. The study claimed that the Millennium Villages were reducing deaths of children under age 5 at a rate three times faster than the rural rate in African countries as a whole. “There is a hidden revolution at work that can transform the lives of a billion of the poorest people on the planet,” Sachs wrote on CNN’s website in a follow-up piece on what he called the study’s “scientific results.”

Just a few weeks later, however, in a letter in the Lancet, Sachs’s team had to acknowledge that the three-times-faster assertion was “unwarranted and misleading” — an acknowledgment that came only after independent development experts flagged a basic error in the composition of the baseline for the child-mortality comparison. It was a humiliating climb-down for a man who had, just a few months earlier, nominated himself for the World Bank presidency. The letter was published 12 days after the editorial in Nature faulting Sachs and his colleagues for shoddy analysis. The primary author of the original Lancet paper, Paul Pronyk, subsequently left the MVP team. (Pronyk declined to comment to FP.)

As critics see it, Sachs botched his project by not putting in place a system by which progress (or lack thereof) at the Millennium Villages could be objectively measured, evaluated, and compared with trends in surrounding rural communities. “The idea that it is a demonstration project has failed because we’re seeing that the evaluation wasn’t thought through enough,” says Jonathan Morduch, a prominent development economist at New York University’s Wagner Graduate School of Public Service. “It was a mistake and a real loss — a real loss for the world community.”

At the project’s outset, Sachs resisted the idea of ongoing monitoring and assessment of MVP by independent experts unaffiliated with the project, as urged by Berkeley’s Miguel and Nancy Birdsall at the Center for Global Development, a Washington think tank on whose board Sachs once served. “Jeff felt it wasn’t necessary,” Birdsall told FP.

Stewart Paperin is the executive vice president of Soros’s Open Society Foundations (OSF), which is MVP’s single largest donor by far, having given about $75 million to the project’s charity, Millennium Promise. Paperin notes that OSF did pay for a one-time independent assessment of MVP, three years into the project, which suggested that the initiative continue. The problem is that comprehensive, continuing evaluation, including control villages, for an aid project is “really expensive,” he says. “If he has one problem, and I’ve said this to him, [it] is that he overpromises,” Paperin says of Sachs. At the same time, Paperin says that OSF remains fully committed to funding the project and that other funders are still committed as well. “No one thought this would cure poverty in five or 10 years,” Paperin says of MVP. “But that’s how you go out and raise money. You make bold statements.”

NOW, EVEN COLLEAGUES sympathetic to Sachs are wondering how he could have left his prized reputation as a social scientist so open to question. The answer, Birdsall suggests, is that Sachs, to his detriment, has tried to combine his role as MVP’s biggest advocate with his position as a university researcher pledged to let facts speak for themselves. “It’s very hard to be the main patron and promoter and the originator — it’s his baby — and to have an independent credibility as an academic. I don’t think Jeff has succeeded,” Birdsall says.

No one is a more relentless critic of Sachs and MVP than Michael Clemens, a staff economist at Birdsall’s think tank and Sachs’s former student who was prominently cited by Nature for his role in sharply questioning the flawed study on child mortality published in the Lancet. Clemens first met Sachs at Harvard in 2001. At the time, Sachs was director of the university’s Center for International Development (he left Harvard for Columbia in 2002), and Clemens was a research fellow at the center while pursuing a Ph.D. in the economics department. “I idolized him,” Clemens wrote of Sachs in an email to FP. “I wanted to be exactly the kind of economist I saw in him: brave, rigorous, relevant.”

But admiration turned into disillusionment with Sachs’s claims for MVP as a solution to global poverty without, in Clemens’s mind, any good evidence to support that position. “The MVP is unproven,” Clemens wrote. “It has neither proved that it can accomplish what it set out to accomplish eight years ago, nor has it proven that it can use aid better than other interventions that could use scarce aid dollars to do more good for more people.”

Clemens is an unmatched warehouse of archival information on what he sees as the manifold methodological deficiencies of MVP. “I was baffled by Jeff’s early position that it is unethical to have comparison villages. It was an untenable position,” Clemens said. “From the first day, the goal of the MVP has been to scale up massively, across the continent and the world, diverting large fractions of all foreign aid to interventions of its type. The only ethical way to expose hundreds of millions of people to an intervention, the only ethical way to divert those resources from other potentially helpful uses, is to be sure that the intervention does what it claims. It’s very difficult to do that without comparison to sites that didn’t get the intervention.”

“Michael deserves much kudos for work on the MVP and for exposing the sloppy analysis in the evaluative work,” Angus Deaton, a professor of economics and international affairs at Princeton University’s Woodrow Wilson School of Public and International Affairs, says of Clemens.

Sachs has responded testily to the criticisms. In September 2010, in an email shared by Clemens with FP, Sachs admonished Clemens for “unprofessionalism” for giving a draft research paper critical of MVP to Financial Times columnist Tim Harford. “Your actions are very disappointing,” Sachs wrote, copying Clemens’s boss, Birdsall, and “do a disservice to many people.” After Berkeley’s Miguel wrote critically of MVP on a blog, Sachs responded in an October 2009 email. According to Miguel, Sachs wrote: “Please add your highly constructive voice to the debate, not in dumping on what we’re doing, but on the positive and hard-fought search for solutions in very difficult settings.”

Miguel recalls being taken aback by Sachs’s missive: “I was really shaken up.” Years ago, he was a research assistant for Sachs while he was a graduate student in Harvard’s economics department. “He’s truly brilliant,” Miguel says. “We’re all so puzzled by the kind of hysterical attacks on anybody who criticizes Millennium Villages.” He admits to being hesitant to talk to FP about Sachs because “he’s a very powerful person.”

While Sachs can be faulted for flaunting his mighty self-regard, the criticism he is encountering on MVP also reflects an important evolution within the development community and its more insistent demands for tough, transparent assessments of aid programs. There was once a time when it was enough to say you were aiming to fight poverty. Now, would-be saviors are being asked to test and demonstrate their results. And the ironic twist for Sachs is that his onetime acolytes, a new generation of researchers like Clemens and Miguel, are at the forefront of the push for greater rigor.

THE MILLENNIUM VILLAGES PROJECT is now in the eighth year of what was conceived as a 10-year demonstration project, to be wrapped up in 2015. Even though detractors say it is too late to salvage research value from the experiments at the original villages, Sachs is now scrambling to respond to the criticisms he has long deflected or rejected.

The prompt for his apparent turnabout appears to be the Lancet debacle. The episode was discussed at a Millennium Promise board meeting at which the board told Sachs, “You shouldn’t have errors” in such studies, according to Paperin of Open Society Foundations. A chastened Sachs called Birdsall. “He basically said, ‘Yes, you had a point'” about the need for a system of independent evaluation, she told FP — an argument she had made at the project’s inception.

Asked to respond specifically to Birdsall’s comments, Sachs fired off an email to FP, saying: “Given all that this project is doing, learning, and benefiting, the fact that you are focusing on this shows that you have little conception of what this project is about, why it is useful, and how it is contributing.”

Sachs had also called Robert Black, who heads the international health department at the Johns Hopkins Bloomberg School of Public Health in Baltimore, to ask him to chair a new committee of outside experts to advise on the design of an independent evaluation of MVP. Black agreed, and the panel, known as the International Scientific Expert Advisory Group, met for the first time on Nov. 12 in New York, with Sachs in attendance. In an interview several days after the meeting, Black, who noted that he was just getting started on his task, readily conceded that “it’s impossible” now to do “control trials,” which he generally advocates as a valuable research method, on the original Millennium Villages. But “that doesn’t completely invalidate a rigorous evaluation being done of what’s been achieved,” he said. “It’s a matter of how to make the most of the information coming out of the villages.”

Last August, meanwhile, MVP launched a new experiment in northern Ghana encompassing the village of Nabari and a cluster of nearly three dozen other neighboring villages, totaling about 30,000 people altogether. Unlike southern Ghana, whose economy has been lifted by oil extraction, the country’s north remains mired in severe poverty. Britain’s Department for International Development is providing funding of about $18 million over five years. A British-based development advisory firm is under contract to provide independent evaluation of the project, and there will be 68 comparison villages as a tool to assess progress. It seems that Sachs’s initial objection to comparison villages, on ethical grounds, no longer stands.

Meanwhile, state-of-the-art thinking in the development field is in flux. There is no consensus on what works best to get rid of extreme poverty. Sachs still has his defenders. Klaus Leisinger, chairman of the European-based Novartis Foundation for Sustainable Development and a member of the board of Millennium Promise, says that the Sachs approach of “integrated development” — attacking poverty all at once on multiple fronts — is easier to do now than in the past because of mobile communications technologies allowing for global coordination. But Sachs’s many critics say that his “big-package approach is an anachronism relative to the ideas that development economists have gravitated toward,” as New York University’s Morduch told me. Humility is the watchword of the day, he said: “Today’s typical projects are narrow, easier to evaluate, and pitched as part of a layering of independent interventions. A sanitation project here. A school intervention there. A legal reform.” And Jeffrey Sachs doesn’t do humility.

After several decades that saw the largest poverty reduction in history — with the number of “extremely poor individuals” falling most spectacularly in China, from 683 million in 1990 to 156 million in 2010, according to the World Bank, and not because of foreign aid and well-intentioned foreigners but because of booming economic growth — some analysts now argue that the best medicine for poverty is reforms to scale back the role of the state in the economy and to open sheltered markets to global investors. Sachs counters that poverty in rural Africa remains so extreme that without aid programs there can be no platform for market-based economic growth.

As for Sachs himself, the charitable view among economic development specialists is that he “stands for being ambitious,” in Morduch’s words, representing the hope of what aid can accomplish if not yet the reality of having done so, while the harshest perspective is that he is a traitor to his field. As Princeton’s Deaton put it, “He stopped being an academic a long time ago and became a propagandist for aid.”