When Hans Rosling, the TED talk phenomenon and professor of international health, was a young doctor in Mozambique in the 1980’s he was berated by a visiting friend and medic for not providing better care for a seriously ill child that been brought into his health clinic. Hans provided the child with a feeding tube for oral rehydration, but his friend thought the baby deserved an intravenous drip, which would increase her chances of survival but take more time.
Hans reasoned that they couldn’t make that level of care standard treatment for the relatively small number of children who visited his district hospital, and with the time saved from treating patients at a ‘good enough’ level he could prevent many more of the 3,900 children expected to die in his district every year by training health workers, and vaccinating children. He describes this as the ‘cruel calculus of extreme poverty’, but in subsequent years he put his data-driven utilitarianism to work on identifying the many positive trends in the world.
Rosling’s book, Factfulness, published posthumously in collaboration with his son and daughter in law, sets out to prove to us that the world is getting better, and to try to explain why so many of us think the opposite. Whether you
are a development expert or an armchair pundit you will be confounded, and it is thrilling to have one’s assumptions challenged in Rosling’s company. Public audiences all over the world consistently overestimate poverty in the world (the majority of the world live in middle income countries), underestimate life expectancy (the global average is 72) and the number of children vaccinated (80%) and generally think the world is quantitively worse than the data indicates. He describes many reasons why our instincts steer us in a pessimistic direction – we separate the world into rich and poor, fear disaster, and generalise based on information that is nearly always outdated.
If you were around in the 1960’s you had empirical reasons to worry about a rapidly growing population, but childbirth rates slowed and then flatlined in subsequent decades, and in Rosling’s words we have now reached ‘peak child’ with the average birth rate being a little over two per mother. (The population will carry on growing as we have more adults)
Its disturbing to realise that the development sector reinforces some of the instincts he identifies as getting in the way of understanding the world better. Our expert papers may distinguish between low income, fragile and middle income states, but our public communication rarely escapes the rich world, poor world dichotomy… and we almost certainly aren’t sufficiently celebrating the progress that has been made on fighting extreme poverty.
But Rosling’s desire to tell a positive story also suffers from the pathology he ascribes to other – the tendency to believe in destiny. He clearly thinks progress on extreme poverty is inexorable because of economic growth and technological advances, despite many signs that it is changing shape and that progress is slowing – as India and China’s economic dynamism lift billions out of poverty, Nigeria and DRC become the poster children for accelerating poverty amidst growth, and poverty in a predatory state.
Rosling doesn’t wrestle with the rise in fragile states or human displacement, perhaps because it wouldn’t fit his meta-narrative that things were bad but are now getting better. At one point, he claims that there is no country in the world in which child mortality is increasing – and I was amazed when I tried to prove him wrong to find that even in Yemen, DRC, and Syria it is still improving. But the story on maternal mortality, (which he doesn’t feature), is grim and increasing in all of those states.
As Paul Collier points out in The Bottom Billion, there isn’t just dismal performance for the countries where the poorest live, but for those countries that have really fallen apart there is often no usable data. I’d add that even for those countries where there is good data, it doesn’t always tell us much about the quality of their development, like the Factfulness ‘democracy’ graph showing the rising share of humanity living in democracy, which doesn’t feel like a good guide to its health given the growing challenges to democratic norms and fair elections.
Rosling says that it makes him angry to be called an optimist, because that makes him sound naïve. But amongst over 80 graphs in the book none illustrates a negative trend, which suggests he was very comfortable being professor of the half-full glass. He is exceptionally good at it, and Factfulness will penetrate the hide of the most determined pessimist. It is the corrective we all need as we head off on holiday, listening to fake news, and melting under a raging climate.
Matthew Spencer is campaigns and policy director at Oxfam GB, @spencerthink
And here are the three authors, before Hans’ death
And just because it’s so brilliant, here’s a taste of Hans in his pomp: 200 Years, 4 Minutes – The Joy of Stats