Infected

On how to manage the economic health of a developing country, my views can perhaps be summarised in one sentence: The role of leadership, or Government, beyond ensuring property rights and enforcing contracts, is to proactively facilitate the creation of jobs in export oriented and import substitution manufacturing while simultaneously investing heavily in provision of education relevant to current times to the masses with specific focus on mentoring entrepreneurs.
On health, I had a simplistic outlook that wealth will take care of health; I had never considered a reverse causation, until last week when I had a rather weirdly fascinating discussion with a gentleman friend of my Boss in the latter's office. And to indulge in a bit of light political humour: Everyone has a boss!
And no doubt about our guest being a Gentleman in the truly English sense of the word; generally dressed in his bespoke three piece suits, with a hat even, and I venture one of those rare persons who still has his afternoon tea! So why was this background necessary? Well to understand my bewilderment on his question, which was the foundation of me getting wiser; where do you think the waste goes when you flush your commode after answering a call of nature?
With my limited knowledge on waste management, I hesitantly responded into the gutter and than all the way into the rivers which form part of one of the World's greatest canal systems. He smiled, right you are; oh by the way the gentleman is from the medical profession. And then he started a series of questions which he himself answered to come to a worrying conclusion.
In summary: the population of Lahore, which was the example used, has roughly 10 million people. On average, a normal person produces one pound of poop every day, which means daily 10 million pounds being dumped in and around Ravi. Over the years, this waste seriously impacted the eco system of the great rivers with the fish population becoming negligible and mostly inedible; except that the common man still drinks the very water from this very irrigation system where fish cannot survive. The result being infections which, coupled with malnutrition, seriously stunted the growth of the population. The conclusion: expecting even average economic performance from a population suffering from infectious disease is being rather over optimistic, isn't it?
And then memory recall: the youth will be surprised to know that in the good old days tap water was drinkable, in fact bottled water was not even in our wildest imagination. Some of the infectious disease that is breaking news today was unheard of back then. Piles of garbage and waste were never a serious problem in our mega cities.
"For decades, it was thought that the causality ran in only one direction - as incomes rose, health improved. Recent years, however, have seen increased attention paid to assessing the reverse effects, as health has come to be seen as a key driver of economic development.... that epidemics of infectious diseases can have sizable economic impacts - both in the short and long term - and that their management and control require investment in national and international health systems", Harvard said that, in a paper by Messer Bloom and Canning, curtsey, as always Google.
You live and learn!
According to the paper quoted above, health impacts income via its intermediate effect on education; healthy children attend school more often and learn better which encourages their parents to continue investing in their education. Secondly good health boosts labour productivity, which frankly is a no brainer. Thirdly good health promotes saving and investments; rather obvious if you have low medical costs. Finally, the authors conclude that health affects a country's population age structure with potentially huge impacts on economic developments.
So, in a nutshell, we need a healthy and educated population to achieve the kind of economic growth which IMF teams dream about when they develop their reform programs; easier said than done! Unfortunately, in our case we cannot even keep our mega cities, which are responsible for the nation's economic growth, from becoming great big garbage dumps, let alone manage all the waste being dumped into the rivers.
Except that the formula is out there if anyone is interested. Economic growth requires job creation, well-managed cities create jobs, for which the condition precedents are cleanliness, justice and education; perhaps not in that order. On a micro level, dividing the country into cities and focusing on them, with the primary objective of creating sustainable jobs is simpler, which coupled with certain key macro decisions related to trade can quickly result in quality economic growth. Accordingly, my economic strategy above gets modified by the following addition, "in a clean and healthy environment".
(The writer is a chartered accountant based in Islamabad. Email: [email protected])