Next month, world leaders will gather at the United Nations in New York to agree on the Sustainable Development Goals: The targets that will succeed the 18 set in the year 2000 by the Millennium Development Goals. The list of potential targets is impossibly long: 169 in all, toward which trillions of dollars will be spent. How they are prioritized will be profoundly important to the lives of billions of people.
The Copenhagen Consensus, a research organization that I head, asked 82 eminent economists from around the world to carry out a cost-benefit analysis of the proposed targets, in order to establish which are likely to do the most good for people, the planet, and global prosperity over the next 15 years. It turns out that one of the best ways to help is by focusing on improving the lives of children.
Our analysis identified 19 targets that would do the most good for every dollar spent. In fact, each dollar spent on these 19 targets would do four times as much good as spending the same money on all 169. It is not surprising that the top 19 include interventions improving the fortunes of the young; after all, they will grow up to become the workers and leaders of tomorrow.
Opportunities start at birth, or not. Although the child mortality rate has been reduced by two-thirds since 1970, a horrifying number of children still die in their first years of life. In 2013, 6.3 million children died before their fifth birthday. Nearly one-third were newborn babies who lost their lives because they were born prematurely or because of complications during birth.
We know from experience that it is perfectly feasible to target a 70 percent reduction in child mortality, but that doing so will be expensive, requiring the construction of effective health services to deliver high-quality care before, during, and after birth. And yet our research shows that it would be money well spent. Taking into account a variety of far-reaching positive effects, we find that every dollar spent on neonatal care generates about $9 in benefits. Among the additional positive effects would be more capable health services, providing better care to people of all ages.
Keeping kids healthy and well fed are two other highly cost-effective targets. Since 1970, the international community has managed to vaccinate most of the world’s children against measles, tetanus, whooping cough, diphtheria, and polio. These interventions likely save three million lives a year, a phenomenal achievement.
There is an opportunity to do much more. For about $1 billion a year, vaccination programs could be expanded to prevent childhood pneumonia and diarrhea, saving another million lives annually.
In economic terms, each dollar spent would deliver $60 worth of welfare for the world’s youngest people. Tackling malnutrition would be another effective use of development dollars. Kids who do not get enough to eat during their vital early years do not develop properly and remain disadvantaged throughout their lives.
A target to lower chronic malnutrition by 40 percent, by ensuring better access to micronutrients and sufficient food, would have a remarkable impact. It would help children’s brains develop normally, allowing them to stay in school longer, learn more, and be more productive later in life. Every dollar spent on better nutrition for the young produces $45 of social benefits.
Improving the quality of education is another worthy goal, as even the healthiest, best-fed children will struggle to learn when their schools are substandard. To be sure, improving the quality of education is not easy; even rich countries struggle to do so. But it turns out to be exceptionally valuable to focus on very early education.
The best education target would be to triple the number of children attending pre-school in sub-Saharan Africa, the world’s most deprived region. Not only would this be relatively cheap; it would also provide children with a life-long yearning for learning and boosting their life chances.
It is morally right that every child should be given the best chance to survive, eat well, stay healthy, and receive an education. Now we also know that it is among the best investments we can make. Healthy, well-educated kids grow into productive adults, capable of providing a better future for their own children, creating a virtuous circle that can help build a better, more prosperous world.
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