There’s is a lot of buzz these days about sustainability–whether we’re talking about development programs, how we grow our food and live our lives, or even a specific set of large-scale goals recently adopted, which I agree with William Easterly… miss the mark just a bit. It certainly seems on the face of it like bringing about long-term change that doesn’t require additional inputs is a noble idea. However, I want to examine a specific example that shows tangibly why this might hinder achieving our development goals and then argue that sustainability alone shouldn’t be the standard by which programs are judged.
Michael Kremer and Edward Miguel, of Harvard and MIT respectively, co-authored a great paper in 2007 entitled “The Illusion of Sustainability.” (First off, I must say that I like the fact that this is the title, not of an op-ed, but of a serious piece of original research. Though it’s true that one paper can’t make the general point in a comprehensive manner, at least it shows a bit of savvy regarding how to market your research as opposed to giving others the opportunity to miss the point). The study itself looks at how to make a deworming intervention “sustainable.” Initially, children are given deworming medication for free, and then the results of peer influence in spreading the intervention are examined. In addition, the authors investigate charging a low, highly-subsidized price, adding in health education, and using a mobilization strategy where people verbally committed to purchase and take the drugs.
The results read like the kind of thing that most would fear to publish: Peer effects are actually negative, meaning that those whose contacts received the drugs for free were less likely to take the drugs themselves. Charging even a highly subsidized price drastically reduced the number of people taking the drugs. Health education messages had no effect (though as a behavior change guy, I’m not surprised here and think it’s just more evidence for the need for behavior change communication). The public commitments didn’t change a thing. Total failure.
In this case though, the main point is that none of these strategies led to “sustainability.” However, the drugs have been shown to more than pay for themselves in the benefit they bring to the community–they just don’t seem to have much private value, even if people get to experience them, learn about them from their friends, learn about their health benefits, or feel social pressure to follow through on their commitment. The authors actually show that the deadweight loss from taxation would have to be unrealistically high, even for developing countries, to mean that their free provision by the government wouldn’t be a net benefit to a country.
Sure, it would be great if people would begin to purchase the drugs and use them of their own accord. But ultimately, aren’t we seeking the biggest impact, not the trendiest labels we can put on our programs? If we need to continue to subsidize drugs that have positive externalities to see the benefit or to include maintenance fees in our proposals instead of assuming communities will maintain their own roads?
I’m not arguing that encouraging sustainability shouldn’t be a goal, but it’s just bad policy to choose only projects that claim sustainability rather than demonstrating that more benefit could be produced by allocating 10% of project fees to ongoing maintenance. What we really need is sustainability to be incorporated into a measure of program efficiency, rather than being a goal in itself.
What do you think? Is sustainability the only thing that matters? Or is it never really possible to have a truly sustainable program in the field?
