Afghan poppies flower again for pain?

A public health expert raises again the plan to divert Afghan opium into worlwide pain relief.

Amir Attaran, a professor of public health at Ottawa, has just published an article in a reputable epidemiology journal in support of licit opium production in Afghanistan. Short version:

  • There’s a huge unmet need worldwide for pain relief from morphine;
  • So let’s shift Afghan opium production into licit channels, rather than vainly trying to destroy it.

Basically, he makes the same case I did here two years ago (here and here), though with proper references and all. References and peer review are powerful medicine – fair enough – and this time the topic’s been picked up in the high-frequency blogosphere by Charli Carpenter and Matt Yglesias.

Attaran doesn’t cite the 2009 paper by Greenfield, Paoli, and Reuter (GPR below), criticising a similar scheme, and published in another proper academic journal edited by our own Mark Kleiman. So I’ll have a go here at a rejoinder.

From the GPR abstract (footnote):

Legal medicinal opium production is an improbable answer for at least five reasons (their numbering, my reformatting):
1. illegal production will continue;
2. diversion from the legal market to the illegal market is inevitable;
3. diversion will involve further corruption;
4. there may not be a market;
5. Afghanistan lacks the institutional capacity to support a legal pharmaceutical industry.

I have two issues with this: the framing, and a straw man fallacy under point 2 over diversion. Let’s start with the straw man (the variant is attacking a weak version of the opposing case rather than the strongest).

Continue reading “Afghan poppies flower again for pain?”

We Are All Kissinger Now

We have met Dr. Kissinger, and he is us.

Henry Kissinger has come under withering outrage for volunteering to his famously anti-Semitic boss these words of realpolitik concerning the emigration of persecuted Soviet Jews to Israel:

And if they put Jews into gas chambers in the Soviet Union, it is not an American concern.  Maybe a humanitarian concern.

How horrible, we think.  But we don’t think about the Democratic Republic of the Congo.

What does that have to do with anything?  Everything.

Nearly five and a half million people have died in the Congo’s ongoing civil war.  And no, this isn’t just about war casualities.  It is a crime of world-historical proportions: more than 200,000 women raped, forcible recruitment of child soldiers, and continuing atrocities committed by all sides and particularly the Orwellian-named “Lord’s Resistance Army.”  If you are talking about numbers of people slaughtered, Congo puts Darfur to shame.  I’m proud to say that the American Jewish World Service, with which I’ve been involved for a while, supports several human rights organizations there, but the security and human rights situation is so bad there that AJWS can’t even list them on its website for fear of brutal and violent reprisals.

And what has been the American official response to this monstrous disaster?  Yawn.  Is it ignoring the popular will?  Hardly.  Most Americans don’t know and don’t care about what is happening in this far-away place about which we know little.  And why?  It’s not really regarded as being central to US vital national interests.  It’s not a principal national security concern. I recently discovered that here at RBC “Human Rights” is listed as an “older thread.”  Yawn again.

In other words, the ongoing atrocities in the Congo aren’t really an American concern.  Maybe a humanitarian concern. 

So maybe there is some justification for the attacks on Kissinger.  But perhaps it’s time to press the pause button on the self-righteousness and look in the mirror.

Which dark continent again?

High-speed trains for Tangier, not Milwaukee.

Via Atrios and Steve Benen, an unsurprising report :

Talgo Inc. will shut down its Milwaukee train manufacturing operations in 2012, leaving only a maintenance base, because plans for a high-speed rail line between Milwaukee and Madison have been abandoned, the company announced Friday.
The Spanish-owned company acted after the federal government withdrew nearly all of the $810 million in stimulus funding for the rail project, which Governor-elect Scott Walker [R] had vowed to kill. Talgo had hoped to land contracts to build two trains for that line.

Meanwhile from Africa, an update :

France has finalised a 400-million-euro deal to supply Morocco with high-speed TGV trains. The French group Alstom is to provide the north African country with 14 high speed train sets that will enter service in December 2015 on the Tangiers-Casablanca route.

Why do Republicans hate trains, like Mrs Thatcher? I don´t mean just ¨think uneconomic¨. Subsidies for shopping malls are fine to Governor Christie of New Jersey, just not for needed rail tunnels. It´s not only His Majesty King Mohammed VI Whom God Preserve and the Chinese Politburo – their kind of people – who are train fans. I can´t imagine the Romanovs, the Kaiser, Emperor Dom Pedro II of Brazil, Viceroy Dalhousie and the American robber barons of the Gilded Age without their private carriages. Ayn Rand´s heroine Dagny Taggart runs a railroad. Booze, women, music, and zooming past the contemptible houses of the peasantry: for a plutocrat, what´s not to like?

From December 19, you can catch a TGV from Paris to Figueres in Catalonia (zooming definitely, take your own booze, women and music – pas question). This is just right, if you are famous and lucky, for dining at El Bulli at nearby Roses before it closes.

Jim DeMint is an Extremely Important Person

Jim DeMint thinks it’s so critical that you know how important he is that he doesn’t mind if a few thousand folks in Africa die over it.

So now South Carolina Republican Senator James DeMint has decided to shut down the Senate over the next three months unless he and his staff have personally reviewed any and all legislation.  DeMint announced that he will put a hold on all bills, which essentially will mean taking a week to overcome his obstructionism: even if all other 99 Senators support a non-controversial bill, because the Senate runs on unanimous consent, DeMint will require a cloture vote to consider the bill, which means 30 hours of debate, and then another cloture vote to allow debate on the bill, which means another 30 hours of debate.  That’s what a “hold” is: it’s a threat to make yourself a royal pain in the rear unless you get what you want, and DeMint is very good at that.  And now, being just a pain means defeating the legislation, because there is not much time in a lame-duck session.

In other words, Jim DeMint has decided to remind everyone in the country that he is an Extremely Important Person, and thus play to the rabid GOP base.  What he doesn’t want you to know is that his little hissy fit will have real consequences to real people.

Senator James DeMint (R-Romper Room)

Consider a bill like S.384, the Casey-Lugar Global Food Security Act, a piece of legislation that is close to my heart: I just got back from DC to lobby for it on behalf of the American Jewish World Service, and found that Congress probably won’t be able to take up the bill in the lame duck session because Jim DeMint has decided to remind people that he is an Extremely Important Person.  And so the bill will die. (To assist in bringing it up again in January, please consider contributing to AJWS’ efforts here: that’s my fundraising page, and the money raised there goes to food security efforts.).

By way of background, a recent United Nations study reports that more than 925 million people worldwide suffer from severe hunger and malnutrition. 

925 million starving people?  Shouldn’t we do something about that?  You don’t understand: Jim DeMint is an Extremely Important Person.

Casey-Lugar would (among other things) create an emergency fund to purchase food in countries where starvation is at its worst: as Roger Thurow and Scott Kilman observe in their recent spectacular book, Enough: Why the World’s Poorest Starve in an Age of Plenty, in many countries suffering from hunger, farmers have food but can’t get it to starving populations, and in any event, current US law forbids purchasing food on site, delaying distribution by several months and impoverishing developing country farmers.  Most importantly, Casey-Lugar would begin to shift US aid policy away from just giving food to people toward making the poor self-sufficient by allowing for US assistance to develop agricultural capacity in the Global South.  For example, as Thurow and Kilman show, Ethiopia has made great strides in recent years toward food security by creating an agricultural futures market that stabilizes agricultural prices, allowing farmers to make a profit but keeping prices at more affordable levels.  Casey-Lugar would enable more experiments of this kind, and authorize (although not appropriate) $7 billion in funding for it and for the emergency fund.  A good short backgrounder can be found here.

An agricultural futures market like the Chicago Board of Trade?  That’s hardly socialist.  Who could be against that?  Well, you see, you don’t understand: Jim DeMint is an Extremely Important Person. Casey-Lugar is not an earth-shattering piece of legislation: at this point, it doesn’t seem even to be all that controversial.  It even has two Republican co-sponsors in the Senate (Lugar — of course — and Susan Collins). It passed the Foreign Relations Committee — which DeMint sits on — unanimously.

Well, maybe Jim DeMint will see all of this, and will deign to allow the Senate to take up the bill.  Or maybe not.  After all, Congres still has to take up all 12 appropriations bills, which of course the Republicans could also filibuster.  And who knows how many other good, small bills will die because Jim DeMint wants you to know that he is an Extremely Important Person.

DeMint claims he is a Christian: I have no idea, but I take him at his word. Conceivably, hundreds of thousands of people in the Global South could die because of the failure to pass this pretty non-controversial bill.  Theoretically, aren’t Christians supposed to be against that?  Well, maybe so, but these people aren’t nearly as Extremely Important as is Jim DeMint.

How about this, Senator?  Every time you come into a room, a band will play Hail To The Chief.  That seems to be really what is interesting to you.  The rest of us would like to act like adults.  In the meantime, if you want to try to make sure that DeMint has as little influence as possible in the next Congress, you can drop a few dollars here.

Naughty world, good deed

The Financial Reform Act surprisingly includes the long-awaited requirement for natural resource companies to publish what they pay to kleptocrats.

Amid the encircling gloom,  a surprising good deed that wasn’t picked up by the sphere at the time. It deserves much more play than it’s been getting. IMF in-house blogs may not be widely read, but you’d expect more traction from a White House press release.

Go to HR 4173, now Public Law 111-203,the Dodd-Frank Wall Street Reform and Consumer Protection Act (pdf, text). On page 845 (sic), you find Section 1504,  “Disclosure of payments by resource extraction issuers”.

Money graf:

… Not later than 270 days after the date of enactment …. the Commission [SEC] shall issue final rules that require each resource extraction issuer to include in an annual report of the resource extraction issuer information relating to any payment made by the resource extraction issuer, a subsidiary of the resource extraction issuer, or an entity under the control of the resource extraction issuer to a foreign government or the Federal Government for the purpose of the commercial development of oil, natural gas, or minerals…

This is the fruit of  a decade-long campaign by NGOs focussing on corruption in oil and mining. especially Global Witness and Transparency International, gradually picking up influential supporters: George Soros, Tony Blair, Richard Lugar, the European Parliament, and even some major players in the industry, like Newmont Mining and Statoil. In the end a group of senators (Cardin,  Durbin, Feingold, Johnson, Leahy, Lugar, Schumer)  shoehorned this little change into the enormous financial reform bill. Nothing to do with the last financial crisis of course, but it makes a sort of sense as part of the general clean-up.

The problem is a classic one of collective action. If you are a normal oil company (and not like the former Elf-Aquitaine deeply corrupt and spook-ridden yourself), you should have nothing against publishing the amounts you pay the governments of host countries. But look what happened to BP in Angola in 2001: they announced their intention to do just that,  and got a letter from Sonangol, the Angolan state oil company, threatening loss of the concession. Reproduced here, pages 41-42. It was copied to BP’s competitors just to make the point clear. BP caved in, wouldn’t you? But now they have no choice. Oil and mining companies will face embarassing meetings with officials in Angola, Equatorial Guinea, Kazakhstan, the two Congos, Burma, places like that. Good.

The target here isn’t common-or-garden corruption: a Gucci attaché-case of banknotes here for the Minister, a free shopping trip to Paris for his wife there, a consultancy for a nephew or two. In fact, this will likely increase by substitution. We are talking here of the organized looting of billions, flowing into private armies and police forces, palaces, giant offshore nest eggs, and networks of patronage. In Angola, the siphon at one time was sucking in up to 40% of GDP (according to a Transparency International paper for an OECD conference in 1973). For the looters, section 1504 is not only a financial disaster but an existential threat, as the numbers will be used by domestic opponents, democratic and otherwise. Stand by for fireworks.

The only real reason oil and mining companies should worry is partial coverage. Won’t they lose concessions to companies from countries that allow concealment?  It shouldn’t be too difficult, given all the positive noises that have come out of international summits for years, to secure similar measures within the OECD. Russia and China will be harder. But it’s a good sign that the Hong Kong Stock Exchange introduced a similar transparency measure in June, presumably with a nod from Beijing. Good pragmatic thinking: unconstrained kleptocracies make for unstable partners.

Why now? This was a sound idea ten years ago. Maybe the Gulf oil spill just weakened the oil and mining lobby enough to tip the balance, on an issue that was never life-and-death for them.  We can be sure the hidden lobbyists for the kleptocrats were fighting hard against the reform to the end. Maybe it was displacement activity: Dodd, Frank and company realized the core financial reform was weak, and grasped at an extraneous one to salve their consciences. Anyway, good work by Lugar and friends.

The Cost-Benefit Analysis of Compassion

If you believe than US foreign policy should serve moral and humanitarian goals, then Afghanistan might be the worst place to start.

Time’s new cover represents an outstanding example of how a picture is worth a thousand words.  It’s hard to look at Aisha and consider withdrawing from Afghanistan.

But let us think about it another way.  Consider the hundreds of millions of people around the world living in horrid, oppressed, degraded conditions.  27 million people are enslaved; millions of women suffer from forced prostitution, female genital cutting, fistulas, honor killings, and worse.  Millions in Africa die each year from malaria and AIDS.  And as bad as this is, it overlooks the seemingly more prosaic, but similarly horrific condition of grinding, miserable poverty, living on less than one dollar a day.

The United States could fight these problems in countries where it would not require fighting a protracted, bloody, brutal, probably-unwinnable war, perhaps where governments either care about their population or at least simply neglect them.  And if it did so, it could save, improve, and empower tens of millions of people brutalized just as much as the woman on the cover of Time.

If we are serious about empowering women and fighting poverty — and we should be — we should use all the money and effort we are expending in Afghanistan, and turn toward other severe problems that do not demand the lives of thousands of American young people.  If fighting in Afghanistan derives from genuine geopolitical concerns — a case that has simply not been made yet — then of course that is another story.  But to support the Afghan war on the basis of humanitarian concerns misses the larger picture and runs the risk of making a mockery of humanitarianism.

How To Eliminate Female Genital Cutting

If the New York Times editoral board really wants to get rid of female genital cutting, then it needs to understand the actual work going on in the Global South.

Today the New York Times editorial board endorses the Girls Protection Act which would criminalize anyone taking a girl out of the country to have the female genital cutting (“FGC”) procedure.  There is nothing really wrong with the Act, or with some of the other measures the Times endorses, such as education campaigns in those immigrant communities where the procedure is still endorsed, hot lines for pediaticians, and safe harbors at international air terminals.

But that really misses the point.

Three weeks ago, I was lucky enough to participate in a delegation of rabbinical students to Senegal, sponsored by the American Jewish World Service.  We went there to see the work of Tostan, a pathbreaking community development NGO that has done far more to eliminate FGC than any of the paths that the Times talks about or that Congress has addressed.  Why?  Because Tostan operates bottom-up, not top down.

AJWS was one of the first big backers of Tostan, because it saw that the Tostan method was effective.  Molly Melching, Tostan’s founder and executive director, spoke to us about her organization’s approach.  Instead of telling rural communities what they should do, Tostan asks them what they want, empowers them through education on the issues that they care about, and as this process takes hold, the communities often come around to rejecting FGC.  Tostan’s motto is “community-led development,” and my experience was that they live that model.  (Incidentally, that’s why Tostan insists on calling it “cutting” instead of “mutilation”.  People generally react badly when you tell them that they are mutilating their children; it’s about efficacy, not political correctness).

So instead of marching into a village and telling people to end the practice — which they won’t, because they want their daughters to be able to get married, and traditionally without FGC they will not be seen as eligible — Tostan listened to villagers, heard that they were interested in improving health care, and worked with them in developing their own capacity.  Only then did villagers begin to talk about a variety of health problems that unsurprisingly were connected to FGC.

The results are impressive: when Tostan started their work, estimates were that 5,000 villages in Senegal practiced FGC; today, 4,300 of them have publicly declared that they are abanding the practice.  That’s particularly important, because it means that the thousands of parents who didn’t like the practice but went along with it because they thought there was no choice now know that there is one).

I’m particularly proud of AJWS’ role in this.  Instead of developing its own vision of development and implementing it itself, it looks for local partners known for their integrity and efficacy and supports them.  Just as important, it is flexible with its grantees.  Melching explained to us that AJWS had originally funded Tostan to do early children education work, but that Tostant found that the villagers really wanted to do health care work.  No problem, said AJWS: respond to the needs on the ground.

Don’t believe the story?  Take a look at Nick Kristof and Sheryl WuDunn’s recent book Half the Sky: Turning Oppression Into Opportunity for Women Worldwide.  There’s a whole chapter on Tostan, with a considerable amount devoted to its partnership with AJWS.

Oh yes — and while you’re doing that, make sure to give a big contribution to AJWS here.  Reward good behavior.  It’s really worth it.

Ghana 2, United States 1: In Which I Destroy My Political Career

Go Black Stars!

…which I never had to begin with, so it’s really not that much of a loss to anyone.

At first, I was very disappointed with the outcome of the game, but thinking it through, I’m glad.  Although better off than most Africans nations, Ghana is a very poor country — more than a quarter of its people live on less than $1.25 a day, and it has lower human development indicators than Cambodia, among others.  It is the last African nation in the first African-hosted World Cup, and (like most nations around the world) absolutely stark raving mad about their Black Stars.  The United States is the wealthiest country in the world, where we can be and are distracted by just about anything.  This just means a whole lot more to a whole lot more Ghanaians than it does to the United States.

Go Black Stars!

Which lost continent?

New high-spped line under construction – in Morocco.

In a Christmas card from friends in France:

Rémi and Magali … are off to Morocco for a year to build the first TGV line there.

Yes, this is actually happening. From the website of Moroccan railways :

I can’t swear that high-speed rail is really the best way for Morocco to invest its scarce capital, and the project has certainly been greased by a lot of pressure and money from France. Even so, this is the right kind of prestige project, unlike jet fighters or motorways to the airport. It plausibly has large and broadly spread externalities, at least to the urban middle class, if not the peasantry, and is going to be powered in good part by solar thermal energy.

In this area the USA is falling behind not just Europe and China, but Africa. You should be shocked, shocked.

Should we be cheerful about African progress?

When Tyler Cowen linked to this bit of feel-good about conditions in sub-Saharan Africa by Charles Kenney, I was annoyed by its casual use of data.

For example, Kenney mentions average growth in GDP per capita of 67% between 1950 and 2001 as if that were an encouraging statistic. But 67% over 51 years is just about 1% per year (remember, growth compounds), and implies about 72 years to double.  Doubling every two generations isn’t what I’d call rapid growth, when it starts from such a low base.

And of course GDP per capita is far from a perfect measure of welfare.  It ignores distribution, which means that a billion dollars to a dictator’s Swiss bank account is as much “growth” as an extra $100 for each of 10 million families.  I suspect the kleptocrats’ share in national income has grown since colonial days.  Moreover, that figure doesn’t measure either resource depletion – the oil Nigeria sells now it can’t sell later – nor environmental degradation.

Surely Kenney is right to say that GDP also leaves out some gains, for example in education and sanitation. Kenney stresses the increase in life expectancies. But he doesn’t mention that since the AIDS epidemic sub-Saharan Africa has been making progress backwards on that measure. Kenney gives the life expectancy in Niger as 57, and cites the increase (from 40 in 1962) as evidence that health gains can be made largely independent of income gains. But the latest U.N. Human Development Report puts Nigerien life expectancy at just under 45 years.

So no, the situation isn’t hopeless.  But it ain’t good, either.