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Escape From Poverty And Disease

Angus Deaton, a famous economist, has a book, The Great Escape. This outlines humanity’s escape from poverty and disease. He outlines the progress that we, collectively, have made and gives his thoughts on what needs to be done.

The Great Escape

The title of the book is well chosen. It probably works better if you have watched the 1960s movie as much as I have. This film was famously shown most Christmases on British TV back in the days when there was very little choice. (There has been another great escape from only having 3 channels to watch on tv but that is probably a little less consequential than an escape from poverty and disease).

The story works because, spoilers, in the movie some escape but far from all do. Although humanity collectively has made a great escape from poverty and disease this has not been universal. I don’t want to be too negative, there has been progress almost everywhere. Still, as Deaton notes, this has been far from an equal blessing. Not all have made the escape at the same time and traveled the same distance.

… for every one thousand children born in England [which had relatively high life expectancy] in 1918, more than a hundred did not live to see their fifth birthday…..Today [2013] children in sub-Saharan Africa [the area with the lowest life expectancy] are more likely to survive to age 5 than English children born in 1918.

Deaton, 2013, page xi
Look at this great video from Hans Rosling

Helping Everyone Escape

Deaton warns against thoughtless optimism. (I see more knee-jerk negativity than thoughtless optimism but it is obviously right to avoid both). More importantly, the fact that the escape has been uneven brings with it an obligation to try and ensure everyone can get away from poverty and disease as we (hopefully) continue to make things even better on average. (And indeed better for all, including those at the back and front of the pack too).

As an economist, Deaton is keen to emphasize that he knows money isn’t everything. He notes that a lot of progress in health can be made even without large movements in income. (Although having a decent level of living is a good thing in itself).


Overall, Deaton isn’t a fan of aid. He thinks rich countries do things because they feel they should do things. The things they do might help the rich country firms, not the recipients. Policies have been foisted on poorer countries. He argues that the whole aid industry fosters corruption and strengthens dodgy regimes

It was a bleak view of aid. I don’t know much about it to be honest. I hope that he is overstating the problems although there are obvious challenges. (And a few solutions he threw out seemed like they could have some practical challenges too). He even doesn’t like randomized control trials much. This came from worries about generalizability beyond the test environment which is a fair worry but nothing is perfect so I’m not sure I was totally with him.

In many ways, the least satisfying part of the book was what we should do to help those who haven’t escaped. It seems a bit too resigned to some people dying much younger than others until things work themselves out. That said, it remains a very interesting book, packed with insights on the world.

For more on progress see here, here, here, here, here, here, and here

Read: Angus Deaton (2013) The Great Escape: Health, Wealth, and the Origins of Inequality, Princeton University Press

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