By Simon Johnson, co-author of White House Burning
A decision on choosing the next president of the World Bank is expected this week – perhaps as early as Monday. The Obama administration nominated Jim Yong Kim, president of Dartmouth College and a noted public health expert. The reaction to this nomination from development economists and people experienced in the business of lending to poor countries has been overwhelmingly negative.
They are making a big mistake. Mr. Kim would make an excellent World Bank president.
There are three issues. First, should the president of the World Bank continue to be an American? Second, should this position be held by someone with a primary background in economics and finance? Third, should this job go to a person – like Mr. Kim – who has specialized on public health?
The job of running the World Bank should not necessarily go to an American – just as the job of Managing Director at the International Monetary Fund should not be presumed to go to a European. The divvying up of these important positions is a de facto arrangement that became established in the 1940s and 1950s, but it has really outlived its appropriateness.
There should be an open competition for both positions – and Mr. Kim faces appropriately strong competition from Ngozi Okonjo-Iweala, a well-respected Nigerian finance minister and former senior official at the World Bank.
There is no question that the White House wants this job to go to an American, mostly because no administration likes to be the one to give up such prerogatives. And gone are the days when anyone put up by the United States would necessarily be chosen – even the controversial Paul Wolfowitz went through with surprisingly little pushback, although he ran into trouble subsequently.
But Mr. Kim is a brilliant nomination, precisely because he is so far from the mold of standard World Bank presidents. For a full write-up of his accomplishments, see this piece by Anjali Sastry and Rebecca Weintraub. (Sastry is one of my colleagues at MIT, where she teaches a very successful course that integrates global health and management issues, follow her @anj_sas; Weintraub is a physician and prominent public health specialist.)
The World Bank does not need “more of the same” in terms of vision from its leadership. Like it or not, the World Bank will continue to issue bonds and make loans to countries for infrastructure and other projects, typically at an interest rate that is somewhat below what is being charged by the private sector. It will also try to raise donor funds that can be shared with very poor countries, preferably in a productive manner.
The World Bank will also continue to struggle having a profound impact on people’s lives with these standard development lending activities. To understand this point, look at two books. Bill Easterly’s The Elusive Quest for Growth is a brilliant account of what has gone wrong – repeatedly – with thinking about development, including but not limited to the World Bank. Daron Acemoglu and Jim Robinson’s new bestseller, Why Nations Fail, provides all you need to know – and probably more than you can stomach – about why some countries stay so poor. The very sad truth is that powerful people in some places do very well, in their own estimation, when the rest of the country remains in ruins. And there is nothing the World Bank – or anyone else in development economics – can do to break through and share prosperity more broadly in those places. (You can follow Easterly and Acmeoglu/Robinson on twitter: @bill_easterly and @WhyNationsFail; the conversation around @WhyNationsFail is particularly lively and informative at present.)
But public health is different. In contrast to the lack luster performance of development economics over the past half century, public health intellectuals and officials have completely transformed health outcomes around the world. This process started early in the 20th century but really picked up pace in the 1940s and 1950s (for more historical background and medical details, see “Disease and Development,” a 2007 paper co-authored with Daron Acemoglu.)
The very poorest people in the world did not participate fully in this global health transformation – partly because of the problems outlined in Why Nations Fail. But leaders like Mr. Kim – and in fact Mr. Kim himself – are leading a second breakthrough, in which better health services are being delivered even to very poor people in some of the most difficult conditions imaginable.
There is a great deal more to be done. The World Bank does good work supporting public health initiatives, but it could do much more. If Mr. Kim becomes World Bank president – and preferably stays in that position for a decade – we should expect to see a great deal more progress.
The task now is to mobilize private donors, pharmaceutical companies, and officials in a robust coalition focusing on improving health and increasing life expectancy. The mortality of children under the age of 5 is likely to be a top priority in that context. Reducing maternal mortality should also get a great deal of attention.
All of this is completely achievable. Public health has done well in the past half century. We should provide more resources and encourage greater success. Save and improve millions of lives.
Mr. Kim is exactly the right person to lead the next transformation of global health outcomes.