Sally Struthers, biblical prophet

We Americans are rather quick to preach to the rest of the world, but controversial ethicist Peter Singer points out in a cogent essay for The Chronicle of Higher Education that there is one area in which we as a nation are scandalously derelict: Though the wealthiest nation in the world–not to mention one that benefits handsomely from selling all manner of goods and services to the Developing World–we are unconscionable skin-flints when it comes to aid to the world's poorest.  That' s an ugly reality that Americans desperately need to confront.

It has a lot of eye-opening facts and insights, but for me the most interesting part of his piece is his philosophical indictment of rank and file American consumers.  It's by no means "out of our hands." When we look away from the suffering, individuals like you and me are not merely selfish but morally culpable by not doing more. He argues that when you factor in how negligible the financial outlay required would be for most of us along with the gravity of the situation, it is somewhat akin to letting somebody drown when you could easily intervene.

Over a billion still subsist—"live" is not really the right word–on less than a dollar a day, and 27,000 children die of preventable diseases every day. Remember Sally Struthers' famous pitch from the "Save the Children" commercials during the 1980s? ("For the price of just a cup of coffee a day, you can save a life.") That's even more true in our day as we fork out several dollars for designer drinks without a thought to the expense. 

America's Shame – (behind a pay wall, alas)

Reducing the number of people living in extreme poverty throughout the world is clearly one of the great moral challenges of our time. Although the issue is by no means absent from what we study and teach, as educators in the United States we appear to be falling short in the task of ensuring that our students are adequately informed about world poverty, its consequences, and the ways in which it can be reduced. Is it possible that some of the reluctance to deal with the topic stems from the fact that it may have uncomfortable conclusions for our own lives?

Struthers' slogan, so widely parodied, was a profound call to arms that many of us still fail to heed.

Speaking of this travesty of misplaced priorities, listen to Esther Duflo and Jeffrey Sachs piercing insights on world poverty and how little we actually do as a nation at a conference organized by The New Yorker:

I find the discussion inspiring, a reminder of how noble and important a calling economic development work can be.

Jerry Falwell infamously blamed the terrible destruction of Hurrican Katrina on America's (to his mind) overly tolerant attitudes towards gays and abortion.  I find such neat, monocausal explanations for modern disasters hard to swallow for a variety of reasons (one being that if you look at historical context surrounding events that are invoked by preachers, one often sees far worse offenses going unpunished or even seemingly being  "rewarded" with good fortune; to be taken literally, these narratives require a very selective review of history).

But if we're going to take such a fire & brimstone approach, I say that if something screams out to the heavens for judgment, it surely must be how the world's most wealthy, pampered and blessed societies basically sit by as huge numbers of people around the globe die or  suffer from a host of problems that could easily be prevented, remedied, or significantly mitigated if we really cared.

Update: I'm going to be naughty and post Singer's entire article. It's just so powerful and enlightening. Information wants to be free. I understand the economic imperatives that publishers must contend with, but given the importance of the topic doubly unfortunate (and ironic) for this piece to be locked away behind a subscription wall.  The people that most need to ponder these observations are the least likely to subscribe to The Chronicle of Higher Education.

Don't tell his critics, but his proposed tax is eminently "Islamic" in spirit. Islam is very supportive of free enterprise and hard work, but with the critical difference that wealth that is purified through regular, modest donations to charity (i.e., zakat) is little better than ill gotten gains.


America's Shame

Reducing the number of people living in extreme poverty throughout the world is clearly one of the great moral challenges of our time. Although the issue is by no means absent from what we study and teach, as educators in the United States we appear to be falling short in the task of ensuring that our students are adequately informed about world poverty, its consequences, and the ways in which it can be reduced. Is it possible that some of the reluctance to deal with the topic stems from the fact that it may have uncomfortable conclusions for our own lives? If we take seriously the idea that the value of a human life does not diminish when we cross national boundaries, then we ought to be giving a much higher priority to reducing world poverty. I have in mind a broad re-envisioning of what we teach.

We should not limit so important a topic to specialized courses on international development (valuable as they are). The issue should be prominent in anthropology, cultural studies, economics, ethics and sociology. In political-science courses, we should ask why we pay so little attention to people living in poverty outside our borders. Psychology courses could take up the factors that limit our willingness to give to distant strangers. Engineers might increase the amount of class time they devote to how their skills can be applied to assist the world's poorest people. Medical schools could focus more on the global burden of disease and how it might be reduced, and law students should be prompted to think about an international legal regime that allows American oil companies to buy oil from dictators who pocket most of the proceeds. Programs could also be produced to help to educate the broader public. Nor should we shy away from reconsidering our emphasis on teaching in fields that have timeless artistic and cultural value. It is legitimate to ask: In a situation in which more people die each year from poverty-related causes than
died in any one year during World War II, how much should we be spending on the refinement of our artistic sensitivities and those of our students?

I began to think about our obligations to the poor in 1971, when I was a graduate student in philosophy at the University of Oxford. A few years earlier, such a question would not have been considered one for philosophers to discuss. The prevailing view then was that the business of philosophy was to analyze the meanings of words. The linguistic analysis that preoccupied philosophers was supposed to be ethically neutral. We would discuss whether the statement "You ought to return the book you borrowed" expressed an attitude or stated a fact, but not whether it was always obligatory to return a borrowed book — let alone to give to the poor.

The student movement of the 1960s demanded that the university become "relevant." In response, with war raging in Vietnam and civil disobedience against it at draft offices across the United States, a few philosophers began to revive discussions of the criteria for a just war, and of our obligations to obey the law. When a crisis broke out in East Pakistan (now Bangladesh) and nine million refugees poured across the border into India, I wrote an article, "Famine, Affluence and Morality," which appeared in the first volume of Philosophy & Public Affairs. (The journal's title was itself a manifesto, an assertion that philosophy did, after all, have something to say about public affairs.)

Over the 37 years since that article appeared, I've written about many other issues in applied ethics — our treatment of animals, new reproductive technology, euthanasia, globalization, climate change, and what we eat. At the core of my work is a desire to draw attention to points at which conventional morality causes, or fails to alleviate, a significant amount of suffering that could be reduced. What we owe the poor is part of that core.

The World Bank defines extreme poverty as not having enough income to meet the most basic human needs for adequate food, water, shelter, clothing, sanitation, health care, or education. One widely quoted statistic is that a billion people are living on less than one U.S. dollar per day. That was the World Bank's poverty line until 2008, when better data led to a new poverty line of $1.25 per day. As a result, the number of people whose income puts them under the new poverty line is 1.4 billion.

On hearing the "$1.25 a day" figure, the thought may cross your mind that in many developing countries it is possible to live much more cheaply than in industrialized nations. But the World Bank has already made that adjustment in purchasing power, so those it classifies as living in extreme poverty are existing on a daily total consumption of goods and services — whether earned or homegrown — comparable to the amount of goods and services that can be bought in the United States for $1.25.

The 1.4 billion people living in extreme poverty are likely to be hungry for at least a part of every year. Even if they can get enough food to fill their stomachs, they will probably be malnourished because their diet lacks essential nutrients. In children, malnutrition stunts growth and can cause permanent brain damage. The poor may not be able to afford to send their children to school. Even the most basic health-care services are usually beyond their means.

That kind of poverty kills. While life expectancy in rich nations averages 78 years, in the poorest nations — those classified by the United Nations as "least developed" — it is below 50. In rich countries, fewer than one child in 100 dies before the age of 5; in the poorest countries, one in five does. Unicef, the United Nations Children's Fund, estimates that nearly 10 million children under 5 die each year from causes related to poverty. That's 27,000 a day — a football stadium full of young children, dying every day (along with thousands of older children and adults who die from poverty every day as well). Some children die because they don't have enough to eat or clean water to drink. More die from measles, malaria, diarrhea, and pneumonia — diseases that don't exist in developed nations, or if they do, are easily cured and rarely fatal.

Describing a case in Ghana, a man told a researcher from the World Bank: "Take the death of this small boy this morning, for example. The boy died of measles. We all know he could have been cured at the hospital. But the parents had no money, and so the boy died a slow and painful death, not of measles but out of poverty."

Unicef, Oxfam, Doctors Without Borders, and many other organizations are working to reduce poverty and provide clean water and basic health care, and those efforts are reducing the toll. If the groups had more money, they could do more, and more lives would be saved.

Despite the recent economic downturn, we are nevertheless living in a time that is particularly opportune for reducing extreme poverty worldwide. The first decade of the 21st century has seen the proportion of people unable to meet their basic physical needs shrink to less than it has been at any time in history, and perhaps at any time since human beings came into existence. At the same time, the proportion of people with far more than they need is also unprecedented. Those in affluent societies work an average of only six hours a week to earn enough to buy an adequate amount of food.

Most important, rich and poor are now linked in ways they never were before. Real-time moving images of people on the edge of survival are beamed into our living rooms. Not only do we know a lot about the desperately poor, but we also have much more than before to offer them in terms of better health care, improved seeds and agricultural techniques, and new technologies for generating electricity. More amazing, through instant communications and open access to a wealth of information that surpasses the greatest libraries of the pre-Internet age, we can enable them to join the worldwide community — if only we can help them to get far enough out of poverty to seize the opportunity.

The economist Jeffrey Sachs has argued convincingly in The End of Poverty (Penguin Press, 2005) and Common Wealth: Economics for a Crowded Planet (Penguin, 2008) that extreme poverty can be virtually eliminated by the middle of this century. We are already making progress. Although the figure of 1.4 billion people living in extreme poverty is an increase from the one billion that we thought there were before the World Bank recalculated its poverty line, in 1981 the comparable figure was 1.9 billion. In 1960, according to Unicef, 20 million children died before their fifth birthday because of poverty. In 2007, Unicef announced that, for the first time since record keeping began, the number of deaths of young children had fallen below 10 million a year. Public-health campaigns against smallpox, measles, and malaria have contributed to the drop in child mortality, as has economic progress in several countries. The decline is even more impressive because the world's population has more than doubled since 1960.

To do better, however, we need to dispel some prevalent myths — myths that our students too often embrace. When I speak about world poverty at Princeton University, where I teach, or at campuses around the country, students often suggest that America is a generous country: It's already doing its part.

When my students cite American generosity, I show them figures from the Organisation for Economic Co-operation and Development on the amounts given by all the group's donor members. The students are astonished to find that the United States has, for many years, been at or near the bottom of the list of industrialized countries in terms of the proportion of national income given as foreign aid. After several years of vying with Portugal and Greece, we fell to the absolute bottom in 2007. Norway led the way, giving 95 cents per $100, followed by Sweden, Luxembourg, the Netherlands, Denmark, Ireland, and Austria. Other rich countries give less than 50 cents, with the average that year 45 cents; the United States gave only 16 cents of every $100 earned.

The ignorance of Americans about their nation's role in aiding the world's poorest people is widespread, and it has been shown in many surveys. Asked by the Gallup International Association in 2005 whether the United States gives more, less, or about the same amount of aid as other wealthy countries do in terms of percentage of national income, only 9 percent of Americans gave the correct answer; 42 percent of the respondents said the nation gave more than four times as much as was true at the time. At the extreme, 8 percent of Americans thought that the United States gave more
than a quarter of its national income as aid, a portion that is more than 100 times as great as the actual amount.

Americans also suffer from gross misconceptions about how significant the country's aid is as a percentage of all federal spending. In four surveys that asked Americans what portion of government spending goes to foreign aid, the median answers ranged from 15 percent to 20 percent. The correct answer is less than 1 percent.

A majority of people in those surveys further said that America gives too much aid — but when asked how much America should give, the median answers ranged from 5 percent to 10 percent of government spending. In other words, people wanted foreign aid cut — to an amount that is five to 10 times as much as their country actually gives.

Some observers contend that such figures are misleading because the United States gives more than other countries in private aid. But although we give more private aid than most rich nations do, we still trail Canada, Ireland, and Switzerland in private aid as a percentage of national income. Adding nongovernment aid, of 8 cents per $100 earned, to government aid leaves the nation's total contribution at no more than 24 cents of every $100 earned, still near the bottom of the international aid league.

Moreover, the majority of U.S. aid is not directed to helping the extremely poor. The leading recipients of official U.S. development aid are, in descending order, Iraq, Afghanistan, Sudan, Colombia, and Egypt. Iraq alone received about one-fifth of the U.S. foreign-aid budget in 2007. Iraq and Afghanistan are the top recipients because of their central role in the war on terror; Egypt has ranked near the top for decades because it is an important partner in U.S. efforts to stabilize the Middle East. Colombia is not an especially poor country — its aid is associated with the attempt to suppress cocaine cartels. Only about a quarter of U.S. aid goes to countries classified by the OECD as "least developed."

Another obstacle to giving is the belief that most aid is wasted by corrupt regimes and never reaches the people for whom it is intended. That things sometimes go wrong is inevitable in any large-scale human enterprise, but most critiques of aid focus on government-to-government assistance or on giving by institutions like the World Bank. Aid by nongovernment organizations is less susceptible to diversion because it is given not to governments but directly to communities and grass-roots organizations working with the poor. Misappropriation happens, of course — but the poor
live on so little, and need assistance so much, that even if some aid is wasted, the remainder will almost certainly do much more good than the money we donate would have done for us, had we retained it.

A 1995 Duke University study of more than 500 lifesaving interventions in the United States put the median cost of saving a life at $2.2-million. In 2008 the U.S. Environmental Protection Agency valued a generic American life at $7.22-million, while the Department of Transportation uses a figure of $5.8-million. (Government agencies use such figures to judge whether measures that save lives by, for example, reducing air pollution or building safer roads are economically justifiable.) In contrast, when, an organization dedicated to rigorous evaluation of the
cost-effectiveness of aid, studied the work of the nonprofit group Population Services International in preventing HIV infection in Africa, it calculated a cost of $200 to $700 per infection avoided. Bear in mind: In countries where antiretroviral drugs are not available, an infection prevented is likely to be a life saved. Other organizations, according to GiveWell, save lives for amounts ranging from $250 to $3,500.

It is reasonable for governments to spend more to save the lives of their own citizens than to save the lives of people in other countries. We all give more when our compatriots are facing tragedy. The tsunami that struck Southeast Asia just after Christmas 2004 killed 220,000 people and rendered millions homeless and destitute. It prompted Americans to give $1.54-billion for disaster-relief work, the largest amount that they have ever given after any natural disaster outside the United States. But that was less than a quarter of the $6.5-billion that Americans gave the following year to help those affected by Hurricane Katrina, which killed about 1,600 people and left far fewer homeless than the tsunami did. An earthquake in Pakistan in October 2005 that killed 73,000 people elicited a comparatively small $150-million in donations from Americans.

But how great should the contrast be between what we are prepared to spend to save an American life and what we are prepared to spend to save the life of someone in another country? A hundred times greater? A thousand times greater? Ten thousand times greater? The last of those figures seems to be the current approximate ratio, and that should make us uncomfortable.

Ignorance is paralyzing. If people believe that their country is doing vastly more to fight world poverty than it really is, they will see no need to add to the effort. The same is true if they believe that aid given to nongovernment organizations will never reach the poor. On those issues, the facts are clear. They simply need to be better known.

On the effectiveness of aid, there is, admittedly, more room for debate. To settle it, we need more research of the kind carried out by the Abdul Latif Jameel Poverty Action Lab, at the Massachusetts Institute of Technology, led by Esther Duflo and Abhijit Banerjee. To show that an experimental drug is effective, pharmaceutical companies carry out trials in which they randomly choose who will receive a new drug and who gets the standard treatment. Duflo and Banerjee have applied the same method — as far as the circumstances permit — to aid interventions. If you want to know whether offering a free, nourishing meal to schoolchildren in poor areas will improve attendance and educational achievement, start by randomly selecting some schools to receive that assistance, matching them with other schools that do not. (If that sounds tough on the children, remember that aid organizations don't have the resources to provide interventions wherever they are needed.) That particular intervention does work, but some others that look plausible do not.

We also need support for trial aid projects that can, if successful, be scaled up. The Earth Institute at Columbia University, under the direction of Jeffrey Sachs, has joined with the United Nations Development Programme and Millennium Promise, a nongovernment agency, to provide expertise for the Millennium Villages project, which tests the impact of a modest amount of assistance in agriculture, education, health, and infrastructure on extremely poor rural villages in sub-Saharan Africa. More universities should be doing that kind of work, which has an aid component and a
research element.

Once we and our students have a better understanding of the facts about extreme poverty and aid, the next step is to discuss the moral implications: What obligations do affluent people have in a world in which more than a billion people live in extreme poverty? In my new book, The Life You Can Save: Acting Now to End World Poverty, I draw a parallel with a situation in which you come across a small child who has fallen into a pond and is in danger of drowning. You know that you can easily and safely rescue him, but you are wearing an expensive pair of shoes that will be ruined if you do. We all think it would be seriously wrong to walk on past the pond — in fact, most people think it would be monstrous. Yet most people don't think it wrong to buy expensive shoes that they don't need rather than give the money to an organization that would put it toward interventions that could save a child's life. Although the parallel between the two situations is not exact, even after exploring the differences, I do not think we can justify our sharply differing moral judgments. We should conclude that when we can save the life of an innocent human being at a modest cost to ourselves, we should do so.

If I am correct, the vast majority of us who live in developed nations are not living an even minimally decent ethical life. Almost all of us spend money on luxuries — after all, even bottled water is a luxury when the water that comes out of the tap is free. Should we be spending money on that, and on other unnecessary items with much larger price tags, when the money we are spending on things we don't need could save a life?

To answer that question, we and our students should read, think, and reach our own decisions. There is a growing philosophical literature on the topic, most of which agrees that we have some obligations to the poor (although there is no consensus on how demanding those obligations are). Relevant books include Peter K. Unger's Living High and Letting Die (Oxford University Press, 1996); Brad Hooker's Ideal Code, Real World (Oxford, 2000); Liam B. Murphy's Moral Demands in Nonideal Theory (Oxford, 2000); Garrett Cullity's The Moral Demands of Affluence (Oxford,
2004); Kwame Anthony Appiah's Cosmopolitanism (Norton, 2006); and Thomas Pogge's World Poverty and Human Rights (Polity Press, 2002, 2nd ed., 2008). Libertarians, like the Canadian philosopher Jan Narveson, remain outside that consensus. They argue — for example, in Narveson's 2003 article "We Don't Owe Them a Thing! A Tough-Minded but Soft-Hearted View of Aid to the Faraway Needy" — that since we have not harmed the poor, we have no obligation to help them. The moral foundations of that position are difficult to swallow, but even if we could accept them, the fact
that climate change is being caused largely by industrialized nations, while the harm it causes falls predominantly on developing nations, undermines the factual basis for the claim that we have not harmed the poor, or at least not many of them.

If we grant that the United States ought to be giving more foreign aid, we should be led to give more ourselves. That means reaching for our checkbooks and credit cards. Both in my book and on its related Web site,, I've suggested a realistic standard for how much we can ask of people, proportionate to their income. The standard is not overly demanding, but it will still challenge many people — including educators — to give more than they are giving now. Since our students may ask us how well we are living up to the moral arguments we are presenting to them, failing to meet the challenge could lead to awkward moments in class.

My argument raises another question for psychologists: How can we encourage people to give more, and change the culture of our society so that giving a significant amount becomes normal for people who think of themselves as living an ethical life? (I suggest a progressive scale, starting at 1 percent of annual income for those who are middle class and earn less than $105,000 a year, and rising to 33.3 percent for those earning more than $10-million.) There is a body of research on giving behavior, but the experimental exploration of what can motivate people to give to distant
strangers is still in its infancy. Deborah Small, George Loewenstein, and Paul Slovic have done pioneering work on the difference between giving to help identifiable victims and to help statistical victims. They and others doing experimental work in the field were brought together in July 2007 at a conference at Princeton on "Experimental Approaches to the Study of Charitable Giving."

My argument about our moral obligations to the poor has led me to suggest that our educational institutions give more emphasis to teaching and research that focus on world poverty and what can be done about it. The converse is that we should give a lower priority to areas of study that have no obvious connection with world poverty or with, say, climate change or avoiding war or, indeed, with any similarly large and pressing problem. That will no doubt incense some of my colleagues who think that we should study art, languages, history, mathematics, or philosophy for its own sake. I agree that, in an ideal world, studying epistemology, classical music, and Italian Renaissance art would be part of every cultivated person's education. But we live in a world in which 27,000 children die every day from preventable causes.

In such a world, it is difficult to deny that some areas of study are an indulgence. It's not wrong to pursue them. Arguably we need some indulgences, some pursuits that broaden our gaze and refresh our spirits before we turn back to more-urgent problems. But indulgences need to be placed in a setting in which it is clear that they are not the most important thing in our lives, or in the education we offer.

Peter Singer is a professor of bioethics at Princeton University. His latest book, The Life You Can Save: Acting Now to End World Poverty, was published this month by Random House.