Exploring the Millennium Villages Project: has it improved lives in Africa?

Two leading global philanthropists, Jeffrey D. Sachs and Bill Gates, debate the impact and progress of the Millennium Villages Project, which aims to improve lives in 20 African countries over the course of 10 years.

Exploring the Millennium Villages Project: has it improved lives in Africa?

Passion blinded him to the realities on the ground

Idealistic ‘Field of Dreams’ approach was doomed to failure, according to Bill Gates.

BONO calls economist Jeffrey Sachs “the squeaky wheel that roars”.

To me, Jeffrey Sachs is the Bono of economics — a guy with impressive intelligence, passion, and powers of persuasion who is devoting his gifts to speaking up for the world’s poorest.

So I was not surprised that a journalist would find Sachs to be a compelling central character for a book — and a good way to draw readers into the potentially dry subject of international development.

In The Idealist, Vanity Fair writer Nina Munk draws a nuanced portrait of Sachs and his Millennium Villages Project — a $120m (€88m) demonstration project intended to show the world that it’s possible to lift African villages out of poverty through a massive infusion of targeted assistance. It would have been easy, and perhaps more marketable, for Munk to draw a caricature, overly accentuating Sachs’s negative qualities at the expense of his great gifts. But she doesn’t.

Munk spent six years researching for the book, getting to know Sachs well and living for extended periods in two of the 15 Millennium Villages. Unlike most books about international development, Munk’s book is very readable. It’s a valuable — and, at times, heartbreaking — cautionary tale. While some of the Millennium Villages succeeded in helping families improve their health and incomes, the two villages that Munk spent the most time studying — Dertu, Kenya, and Ruhiira, Uganda — did not come close to realising Sachs’s vision.

When Sachs first started planning the project, he came to our foundation for support. We were already a big supporter of his efforts at Columbia University’s Earth Institute and felt it was invaluable to have him focused on the needs of poor countries. His pitch was intriguing. He was picking a handful of villages to be the focus of intense interventions in health, education, and agriculture — all at once.

His hypothesis was that these interventions would be so synergistic that they would start a virtuous upward cycle and lift the villages out of poverty for good. He felt that if you focus just on fertiliser without also addressing health, or if you just provide vaccinations without doing anything to help improve education, progress won’t be sustained without an endless supply of aid.

My colleagues and I had a number of concerns about Sachs’s approach. We questioned his assumptions about how quickly the gains would materialise, what would happen when the MVP funding was phased out, how much governments would contribute to offset the high costs per person costs, and how feasible it was to measure progress (given the likelihood that people from the surrounding area would stream into their villages once the MVP aid started flowing). So we decided not to invest in the MVP directly, although we were happy to keep supporting his other work.

So what went wrong? For one thing, the villages that Sachs picked experienced all kinds of problems, from drought to political unrest. For another, the MVP took an idealistic ‘Field of Dreams’ approach. MVP leaders encouraged farmers to switch to a series of new crops that were in demand in richer countries, and experts on the ground did a good job of helping farmers to produce good crop yields by using fertiliser, irrigation, and better seeds.

But the MVP didn’t simultaneously invest in developing markets for these crops. According to Munk: “Pineapple couldn’t be exported after all, because the cost of transport was far too high. There was no market for ginger, apparently. And, despite some early interest from buyers in Japan, no one wanted banana flour.”

The farmers grew the crops, but the buyers didn’t come. Of course, Sachs knows that it’s critical to understand market dynamics; he’s one of the world’s smartest economists. But in the villages Munk profiled, Sachs seems to be wearing blinders.

Warren Buffett likes to say: “The rearview mirror is always clearer than the windshield.” Through that rearview mirror, we can see that the project never had an economic model that could sustain successes once the MVP dollars ran out. All of the interventions involved — health, agriculture, infrastructure, education, and business seed money — make sense if carried out carefully, over time. But I am surprised by how little Sachs dug into country budgets, and that he didn’t work to convince governments to commit to additional taxation to fund more of these interventions domestically.

Through the rearview mirror, we can also see that many of Sachs’s ideas have proved to be exactly right. Munk details his 2007 fight with international aid donors who refused to distribute insecticide-treated bed nets for free because they favoured a market-based approach whereby people would pay a small amount for each net. To put it mildly, Sachs didn’t make any friends in the process of advancing his case for free bed nets. Through increasingly ruthless tirades, he wound up alienating potential allies who want to defeat malaria just as badly as he does. But history will show that Sachs was absolutely right. We have since seen that the free model has allowed for much broader distribution of bed nets — and much greater reductions in malaria — than market models.

In the end, I hope poverty fighters will not let the MVP experience stop them from investing and taking risks. In the world of venture capital, a 70% or 80% failure rate is considered a great track record. In the world of international development, critics hold up every failure as proof that aid is like throwing money down a rat hole. When you’re trying to do something as hard as fighting poverty and disease, you will never achieve anything meaningful if you’re afraid to fail.

* Bill Gates is co-chair of the Bill & Melinda Gates Foundation.

Project critic did not spend enough time in villages with us

Mortality rates are down and governments are getting involved, says Jeffrey D Sachs.

IN his review of Nina Munk’s error-filled and out-of-date book, Bill Gates oddly abandons the rigorous approach to measurement and evaluation that defines his foundation’s invaluable work. He simply accepts Munk’s assertion that the Millennium Villages Project — an ongoing development project across more than 20 African countries — has failed. In fact, it is flourishing.

This credulousness is puzzling. Munk’s book covers only a sliver of the first half of a 10-year project, and only two of 12 villages. And she never “lived for extended periods in the Millennium Villages”. Munk spent an average of around six days per year — around 36 days over six years — actually visiting the villages, and usually at a stretch of two to three days.

Moreover, she came to the story as a reporter for the magazine Vanity Fair, with no training or experience in public health, agronomy, economics, or African development.

Worse, Munk’s observations frequently seem to have been, at the very least, greatly exaggerated for narrative effect. Does Bill Gates really believe that I advocated specific crops without worrying about whether there was a market for them, or that I failed to consider national taxation in my ongoing advice to government leaders? Moreover, the agricultural strategies and choices in the project have been led by African agronomists, some of the very best in Africa — often working hand in hand with Bill’s own agricultural staff in the Alliance for a Green Revolution in Africa.

Bill will be happy to know that the project will be properly and professionally evaluated next year — on time at its conclusion (and at the end of the Millennium Development Goals in 2015). The assessment will be based on the very considerable data that have been collected over the past decade, and on extensive new survey data that will be collected in 2015.

The evaluation will include comparisons with areas surrounding the Millennium Villages. In fact, I hope that the Bill & Melinda Gates Foundation will help to carry out the detailed, independently supervised survey work needed for a full evaluation of this complex project.

Let me provide some more good news, based on the detailed data on community health delivery, morbidity (disease), and mortality that the project collects each month. Mortality rates are down sharply in the Millennium Villages.

In fact, the current evidence, to be examined in greater detail next year, suggests that the bold goal of reducing under-five mortality rates to below 30 deaths per 1,000 births has been achieved or is within reach by 2015, and at a remarkably low cost to the health system.

Recently, one of the Gates Foundation’s senior staff members visited the Millennium Village site in northern Nigeria. Afterwards, he confirmed to me personally that he and his team were deeply impressed by what they saw of the Millennium Village health system in operation.

So let me take this opportunity to reiterate a challenge that I have posed to Bill. He can pick any district in rural Africa, and our team will work with the local communities using the Millennium Village health approach to reduce the under-five mortality rate to below 30 in 1,000 — a rate which is characteristic of many middle-income countries — at an annual health-sector cost of just $60 per person. And we will do it in five years or less.

That success, I believe, would help Bill and others to recognise the remarkable value of investing in low-cost rural health systems that follow the design principles of the Millennium Village Project.

Finally, given concerns, shared by Bill about the project’s sustainability and scalability, it is no small matter that host governments are strong advocates of the approach. These governments’ leaders have seen the Millennium Villages day in and day out over almost a decade. They are putting their own money and policies behind expanded implementation of the project’s guiding concepts.

For example, Nigeria has used the concepts for national-scale delivery of health and education services in all 774 of the country’s local government areas. Governments across the region have taken over €73.5m in financing from the Islamic Development Bank to scale up the project concepts themselves.

Around a dozen countries are now starting or have approached the Millennium Village Project to help them start their own Millennium Villages. And the Pan-African Youth Leadership Network, Africa’s own young people, recently visited the Millennium Village in Senegal and requested support to expand the Millennium Village Project’s techniques and strategies in their home countries and regions.

This spread of the Millennium Village approach throughout Africa shows that African political and community leaders consider the its methods, strategies, and systems to be highly useful in combating poverty in rural Africa. Nina Munk’s book is out of date and misses the mark. I invite Bill Gates to visit one or more Millennium Village sites on an upcoming trip to Africa to see first hand why the approach is of such practical interest across the continent.

lJeffrey D Sachs is Professor of Sustainable Development, Professor of Health Policy and Management, and Director of the Earth Institute at Columbia University. He is also Special Adviser to the United Nations Secretary General on the Millennium Development Goals.

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