An fascinating choice to head the World Bank

3/23/2012

President Obama nominated Jim Yong Kim, a Partners in Health original, good friend of Paul Farmer, president of Dartmouth College, anthropologist, MacArthur genius, and brilliant medical doctor to head the World Bank. Not a former banker nor politician in the US government. Very interesting.

Kim played an important role in the foundation of PIH and I learned the most about him through Mountains Beyond Mountains, which captures the mission of Paul Farmer in creating the Partners in Health organization. PIH was a bit radical in its inception by clearly stating a preferential option for the poor in health care, but since its exponential growth and publicity, this notion isn't so controversial. No doubt due to the success of both Farmer and Kim.

I think I read Mountains Beyond Mountains six or seven years ago (again CBT hat tip), but it is still at the top of my list of best books of all time. Despite my economist training and mathematical background, the drive of Farmer, a doctor and anthropologist, is actually what motivated me to study international development. If you haven't read MBM (and I haven't already hassled you about it), get off the computer and go to the library. Right. Now.

And just to be clear, its a good thing Obama didn't nominate Bill Easterly. As a clever and harsh critic of the World Bank, he wasn't quite up for the job.

9 Comments

ironmonkey285

3/23/2012 04:08:17

http://www.youtube.com/embed/4lHKJEp5e-8 HT Ezra Klein.

I'd love to see Bob Zoellick do this.

Haven't read the book. Maybe this summer.

Thoughts on the degree to which Kim would promote the pursuit of "low hanging fruit"? Evaluation?

Aine

3/24/2012 00:40:55

I would pay money to see Bob Zoellick do that.

Unclear on the degree to which Kim is in favor of evaluation; his anthropological background would make me think skeptical of the it. I did at one point see a PIH reference on a JPAL paper; it would be cool to see them team up.

ironmonkey285

3/24/2012 07:34:27

indeed. thoughts on Ngozi Okonjo-Iweala?

This oversimplifies the point, accuses Obama of something that is probably unwarranted.. nonetheless http://blogs.cgdev.org/globaldevelopment/2012/03/why-ngozi-okonjo-iweala-should-be-the-next-head-of-the-world-bank.php

Economists have found that certain treatments — such as oral rehydration for babies with diarrhea — are terrific bargains, while other investments in antiretroviral drugs for HIV/AIDS may not have as great a payoff. “You have to have the mind-set to allocate scarce funds, rather than approaching the problem as if we have unlimited resources for suffering people,” he says. And Easterly worries that too many doctors and public health experts, in his experience, are resistant to this approach. “Frankly,” he adds, “I see some danger signs in this kind of pick.”

Others are more positive. Felix Salmon, who’s been following the World Bank nomination process closely, comments: “Kim’s prowess when it comes to navigating Washington’s labyrinthine power structures is unknown; I hope he’s up to the job,” he writes. “But he’s going to bring passion and dedication to his task of poverty reduction, along with a welcome bias towards bottom-up rather than top-down solutions. And I suspect that the World Bank’s board will find it easy to rubber-stamp his nomination.” from:

http://www.washingtonpost.com/blogs/ezra-klein/post/the-pros-and-cons-of-having-a-doctor-run-the-world-bank/2012/03/23/gIQAj2JtVS_blog.html

Aine

3/25/2012 07:57:48

I seriously respect Pritchett's option on almost anything since he is brilliant, so I believe him that Okonjo-Iweala could be a better pick.

I think the Kim nomination is almost reflective of Obama generally in that he's a very fresh face to a bureaucratic policy institution and comes in with a very academic and refreshingly bottom-up approach to development.

However, I'm not sold on the notion that doctors can't do cost-benefit analysis or even that their priorities aren't economically efficient. Development isn't a zero-sum game and PIH has proved that. In Mountains Beyond Mountains, Kidder clearly documents the way Farmer and Kim actually get the price of tuberculosis drugs significantly reduced and treating treating the drug resistant strains becomes not only a medical priority, but an economic one as well.

The reality is that when it comes to health care, prices aren't as exogenous or constant as our models and analysis would assume.

ironmonkey285

3/25/2012 09:20:04

indeed, doctors of course do CBA..

a doctor's ambition and persistence can result in a rigorous pursuit of some outcome.. for some pursuits, the poor will probably be better off. for some pursuits, perhaps not. It does sound like he'd be a "searcher" (rather than "planner"), which is good.

Can't help but think it might be harder for a doctor to value non-health outcomes (whereas an economist could.. though maybe some economists undervalue health outcomes). And I also can't help but think that AIDS is the subject of far too much attention, relative to other concerns.. so his specific interest in/work with/commitment to this specific crisis may lead other needs underfunded. I'm neither a public health expert nor am I up on the cost-effectiveness-ratios or anything, but from what I recall it seems that the price of saving a person with antiretrovirals is not a great "buy", and that the (somewhat) endogenous costs of these antiretrovirals have a long way before they're more cost effective than anti-malarial etc..

This isn't to say we should give up on AIDS, of course.. but nonetheless.. also, a doctor might under appreciate the power of a demand that would be at work if Africa grew a lot.. and how many of their health and human capital and other outcomes would be better off if they could "just" grow.. not so easy for anybody to do, of course, whether doctor or economist or bureaucrat.. nonetheless

I agree with your point about obama shaking up the bureaucracy. And it fits, probably, with a narrative that he's "trying to do public health better".. and not just do it like a bureaucracy..

ironmonkey285

3/25/2012 09:20:08

ironmonkey285

3/25/2012 09:20:15

ironmonkey285

3/25/2012 09:20:17

ironmonkey285

3/25/2012 09:21:26

ha i just wanted to really emphasize my post! jk your blog kept telling me that i couldn't submit my post, so i pressed submit a billion times and look what happened

An fascinating choice to head the World Bank

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Aine Seitz McCarthy

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