Twelve good causes to save the world this Christmas

We all want to improve the lives of those in need around the globe – but knowing which policies actually work is crucial, says Bjorn Lomborg

At Christmas, many of us think about ways to help those in need. There are no end of options: we are bombarded with advertisements and leaflets encouraging us to donate to good causes. Amid all the tearjerking campaigns, it’s hard to decide which to give to. One temptation is to give a little money to everything.

Governments face a similar problem. There are a bewildering number of challenges facing the world, each with dedicated organisations and interest groups promoting potentially promising solutions while calling for substantial resources. But we can’t possibly support every cause. So where should rich world governments best focus their finite fiscal firepower to make the world a truly better place?

The world has actually made a comprehensive list of all the challenges it wants to fix. The UK Government – along with nearly every other government in the world – agreed on the list, known as Sustainable Development Goals, in 2015. It contains 169 ambitious pledges that would deliver a much better world by 2030.

The Sustainable Development Goals promise to end hunger, poverty, and communicable diseases; fix war, climate change, pollution, and corruption; handle biodiversity; improve education; reduce inequality; and ensure jobs and social security, alongside hundreds more promises including improving sustainable tourism, ensuring there is more organic produce for everyone, and setting aside urban parks for the disabled.

Reading through the very long list shows there is no shortage of ways to do good, but leaves the reader feeling exhausted. The big problem is that by promising everything, the lengthy to-do list lacks any kind of focus.

The full additional cost of delivering all the promises is upwards of £8trillion, which would – implausibly – require a near-doubling of the global tax take. Not surprisingly, no country has that amount of cash lying around and therefore we’re failing on almost every one of the promises.

Even António Guterres, the UN Secretary-General, admits these promises are empty. In September, at a conference to mark the midpoint of the Sustainable Development Goals campaign, he said: “Today, only 15 per cent of the targets are on track and many are going in reverse. Instead of leaving no one behind, we risk leaving the sustainable goals behind.”

Make no mistake, on most measures the world is becoming better off.

For most of us, there is no better time to be alive, thanks to the inroads we have made against extreme poverty, hunger, and illness. But while the world is getting better, even on the best trend, we’ll fall far short of delivering on the politicians’ promises in 2030, and likely to be at least half a century late.

Moreover, by promising everything, we have not sped up progress. Instead, it’s inevitably encouraged governments and philanthropists to spread resources thinly across a vast number of policies. It’s the same as if, in our own giving, we donate £1 to 100 charities, instead of choosing an effective way to spend a bigger sum. We could do so much better if we were to focus.

This would be true even for Elon Musk, who with almost £200billion would bankrupt himself trying to fund less than one week of the world’s grand promises. The truth is that only politicians wanting to sound righteous promise everything.

In reality, some policies deliver few results at high cost or don’t work at all, whereas other policies deliver amazing results at low cost. Surely, the sensible approach is to focus on the latter first. So what should we do?

Finding the smartest policies is the project I have worked on over the past decade with more than 100 top economists and several Nobel laureates. Looking at all the promises agreed to by world governments, where can an additional pound (or rupee, shilling, or dollar) achieve the most good first?

We use cost-benefit analysis to identify the price of a policy and its economic, social and environmental effects. Some policies sound alluring, but actually deliver no good whatsoever. One famous example is the “one laptop per child” approach that was touted as a revolutionary game-changer in education in the early 2000s, gaining enthusiastic support from politicians and philanthropists.

It was supposed to provide each child with “the laptop that saved the world”. Yet, when the policy was finally evaluated using the research gold-standard of a randomised controlled trial, the finding was that there had been “no impacts on academic achievement or cognitive skills” whatsoever.

Of course, the reality is that most policies do some good, and many deliver more good than their cost.

For instance, sanitation is still lacking for some 3.6 billion people. The benefits of providing sanitation include not only less spreading of disease, but can also be time-saving when people don’t have to go far to find sanitation options.

Unfortunately, providing even basic sanitation has significant upkeep costs. The installations must be continuously kept clean to make people want to keep using them. On average, our calculations indicate that each £1 spent will deliver £3 of social benefits. Not bad, but still far from the best outcome possible for that money.

Of all the Sustainable Development Goals agreed to by governments, climate policies are likely the single most expensive component. The world already spends more than one trillion pounds annually in an attempt to rein in temperature rises. Climate change is a significant global concern and a real problem, yet one of the most effective solutions – delivering a globally coordinated, efficient carbon tax – would produce about £2 of benefit for each £1 spent.

More extreme climate policies such as those needed to keep temperatures to the Paris Agreement’s 1.5C target or

Missed goals

Fifty years late

Pick winners, dodge losers

Cop28’s net-zero carbon emissions would achieve much lower benefits per pound. This finding suggests that with limited resources, more funding should first be applied elsewhere. But where exactly?

When our researchers analysed policies across all the 169 Sustainable Development Goals, we identified some bad policies, many so-so policies, and a good number of quite sensible policies. But among all the options to do good in the world, we found just 12 breathtakingly efficient policies that deliver at least £15 back for every £1 spent.

Here they are, in no particular order, with the average number of lives saved and economic benefits for each year between 2023-30. Perhaps the most important number cited is the benefit-cost ratio (BCR), which tallies how many pounds of benefit you would get back for each £1 put in.

Sometimes, this can hit three figures – more than £100 back for each £1 put in. If we can’t do it all – and nobody can – these are the 12 policies we should focus on first.

They all centre on the poorer half of the world because that is where a limited amount of money can achieve the most good first. They also cover a wide range of topic areas: education, side-effects.

Because the medication clears the immediate tuberculosis symptoms such as fevers and weight loss in a couple of weeks, many drop out of treatment too early, which increases the chance that the disease will be passed on to others and can make the tuberculosis bacteria more likely to develop drug resistance.

The smart policy is to diagnose many more people and ensure that more tuberculosis patients remain on their medication. Our new study shows an additional £4billion spent annually would ensure at least 95 per cent of people with tuberculosis will receive a diagnosis. It could also provide simple ways to make sure people complete six months of medication – perhaps with incentives to complete the treatment, or support groups for patients to encourage each other.

Extra resources would mean that all high-risk, vulnerable populations could access periodic screening. It would mean that 50 million people could access appropriate treatment, including 4.7 million children and 3.3 million people with drug-resistant tuberculosis. In addition, 35 million people would have access to preventive treatment.

By mid-century, these additional resources will allow us to avoid 27 million deaths, along with untold human suffering. The total benefits, expressed in economic terms, mostly from avoided deaths, would exceed £2trillion. Each £1 spent will generate £48 of social benefits for the world. tuberculosis, free trade, maternal and newborn health, agricultural research and development, malaria, e-procurement, nutrition, land tenure security, chronic diseases, child immunisation, and skilled migration.

Learning is one of the few things that will make us all better off, and everyone in principle agrees that we need much more of it. Yet we have a learning crisis in much of the world. While the world has succeeded in getting most children and adolescents into school, many of them aren’t learning. A substantial portion of students in poor and rich nations alike don’t have a basic competency in maths or reading — what’s known as the minimum proficiency level (MPL).

Achieving a MPL for lower-primary students, for instance, involves reading the sentence: “Vijay has a red hat, a blue coat, and yellow socks”, and being able to correctly answer the question: “What colour is the hat?” Similarly, a basic level of mathematics involves understanding that if two people equally share six pieces of cheese, each person gets three pieces of cheese.

Of the roughly 467 million primary school pupils in the poorer half of the world in 2020, nearly 80 per cent could not pass even these simple tests. Over the past 25 years, poor countries have doubled their per-student spending, with almost no change in learning. Indonesia doubled education spending to pay teachers more and achieve some of the lowest class sizes in the world. However, a large, randomised controlled study showed this had no impact on student learning.

We need smarter policies. A team of top educational economists, headed by Noam Angrist, from Oxford University, has identified the two best options. The first proven approach helps pupils to learn more effectively. Almost universally, school classes put all nine-year-olds in one grade, 10-yeardebilitating olds in another, and so on. But many of the children in each of those classes are either far behind and ready to give up, or far ahead and bored.

The effective policy uses tablets to teach students one hour a day. With existing educational software, the tablet quickly assesses the level of the student and starts teaching exactly at that level. It means that one hour a day, that student is taught at his or her right level, boosting learning. After just one year, testing shows that the student has learned what would normally have taken three full years. Malawi, in east Africa, is now implementing this policy.

The second proven strategy is “structured pedagogy”, helping teachers to teach better. It is hard to be a good teacher in many worse-off countries. Teachers typically get paid less than the average level for jobs requiring a similar level of skills.

Many teachers are only slightly better educated than the children they teach. One study of African primary school teachers showed that nearly one-inthree mathematics teachers could not do double-digit subtraction.

Providing a full year of semistructured teaching plans, coaching, and encouraging text messages, structured pedagogy helps teachers make lessons more engaging and useful. Studies show it delivers learning that is equivalent to almost one extra year of schooling. A trial in part of Kenya of structured pedagogy proved so successful that the approach was adopted for the whole country.

Each extra year of learning not only boosts a child’s lifelong prospects, it also brightens a country’s economy. For nearly £8billion – a relatively small sum – we could get one of these policies to 90 per cent of all students in the poorer half of the world. Improved learning means higher salaries when children grow up, so this smart educational policy would deliver long-term economic productivity growth worth almost £500billion. Each £1 spent will deliver £65 of social benefits.

Another phenomenal policy is focusing on the eradication of tuberculosis, the infectious disease that killed more people in the past year than any other. In rich countries – where virtually nobody dies from tuberculosis any longer – attention has moved on and we scarcely hear about it. Even in poor countries, where the wealthier can afford treatment, it is often the poorest, most disconnected and disadvantaged that suffer from this disease.

Like with nearly every other Sustainable Development Goal, the world is far behind on its promise to tackle tuberculosis. Research by a group including Imperial University’s Nimalan Arinaminpathy shows that a dramatic reduction in tuberculosis is not only possible, but also promises to be one of policy-makers’ most effective priorities leading up to 2030.

Each year, more than 10 million people develop tuberculosis. Because of a lack of resources, we only diagnose around six million cases. Many of the untreated people go on to die. Those who don’t die will continue to spread the infection. And the six million who are diagnosed and offered treatment are in for a rough time. They must take medication for as long as six months, and some will suffer from Smart policies to deliver greater learning and eradicate tuberculosis are just two of the 12 ways we could turbo-charge efforts to do good in the world. To make major inroads into malnutrition and hunger, we need to fund a “Second Green Revolution” that’s focused on improving crop productivity and resilience to enable farmers in poor countries to feed more people for less.

Each £1 will deliver £33 in higher yields. We should accompany this by targeted delivery of micronutrients to expectant mothers and nutritional information to better feed young children, delivering £18 for each £1 spent. For most women, the day they give birth is still the deadliest in their lives. We should boost maternal and newborn health through a simple package of basic emergency obstetric care and more family planning. This could save the lives of 166,000 mothers and 1.2 million newborns every year, delivering an astounding £87 back on each £1 spent.

It’s also vital to expand simple and proven childhood immunisations for the world’s poorer half, delivering more vaccines for rotavirus, which is the most common cause of diarrhoea in young children; pneumococcal vaccines to avoid deaths from serious infections and meningitis; and increased coverage of the measles vaccine. For £1.3billion per year, this could avoid half-a-million deaths annually, mostly of very young children, delivering £101 for each £1 spent.

Other life-saving policies include a focus on reducing malaria across

Africa through bed-nets and expanded treatment. This would deliver £48 per pound spent and save 200,000 lives each year. Even in the poorer parts of the world, most people now die from chronic diseases, and we can tackle cardiovascular disease with very inexpensive hypertension drugs, along with population-level policies designed to reduce the level of salt and fat in diets. Each pound spent returns the investment 23 times.

Some of the smart policies would dramatically expand opportunities for those living in the poorer half of the world. Take, for example, the deceptively simple approach of improving land ownership records: this would give people more security which means more people would dare to invest in the long-term productivity of their land – for instance through irrigation and planting fruit trees – that only return their investment over decades. Although it would increase short-term land ownership disputes, it would increase economic growth in the long term. Each pound spent can deliver £21 in social benefits.

Workers relocating from poor to rich countries become much more productive, essentially pulling them out of poverty. Mass migration is a politically charged topic, but highlyskilled migration of doctors and engineers, which is typically seen as less problematic. Increasing the total skilled migration pool by 10 per cent is relatively moderate and will deliver great positives to these individuals and the rich receiving countries, while remittances will make even the sending countries better off. In total, each £1 of costs would produce £20 of social benefits.

Corruption is an enormous, global problem with few good solutions.

But one stands out: e-procurement. Putting most government procurement online can dramatically increase competition, reducing public prices and delivering more goods for public spending. The cost is exceptionally low, delivering 125 times the investment.

Increasing trade is no longer in fashion, but it should be. When all nations do what they do best and trade, total benefits increase dramatically. Freer trade comes with costs for the vulnerable in traditional manufacturing centres, but even here the benefits outweigh the costs by seven-to-one. For the poorer world, our research shows in a world-first that benefits are 95 times higher, boosting income by £131billion each year.

Each of these policies will deliver exceptional returns on investment. We should do all 12. By design, this would deliver the most good the world could possibly achieve and would be the best Christmas gift for the world. Delivering all 12 smart policies for the poorer half of the world would cost less than £28billion each year, but save 4.2 million lives annually and create economic benefits worth almost £900billion each and every year. Including the benefits of avoided deaths, each £1 spent would deliver an astounding £52 of social benefits.

Of course, no single philanthropist or government can do everything.

But each government can achieve a lot of the smartest solutions. The UK spends £12.4billion each year on development aid, so just reallocating resources as old programmes expire could rapidly see a significant shift towards the smartest solutions first.

Globally, the rich world spends more than £160billion annually. Similarly, this short but effective list should inspire private donors from the UK and abroad to spend their philanthropy mostly within these 12 best ideas. Globally, philanthropy spent more than £400billion ($550billion) in 2021, with the UK contributing £10.7billion.

But even as we’re approaching Christmas and the new year, each of us can also make a difference. In our own, small-scale charitable efforts, we should not give a little to a lot of causes. Instead, we should focus first on organisations that tackle nutrition, maternal and newborn health, and the other 10 issues on the list. We should applaud and support philanthropists and companies that give to these top solutions.

Crucially, we should push our politicians to stop promising everything and urge them to start promising the best things first. When the UK is doing a bit of everything, it forgoes the opportunity to do the best things first. We need to start demanding that our politicians put the most money where it does the most good. At low cost, we could achieve amazing results, and truly make a wonderful new year and a wonderful rest-of-the-decade for the world.

Read more about the 12 best solutions and their impact in Lomborg’s book ‘Best Things First’. All research can be read for free at copenhagenconsensus.com

Focus on the numbers

On the first day… stop teaching by age

The big health issue

Other smart policies

Wishing us all a better rest-ofthe-decade