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The Illusion of Sustainability

Author

Listed:
  • Michael Kremer
  • Edward Miguel
Abstract
Rather than provide development assistance indefinitely, foreign aid donors increasingly seek to help communities sustainably provide local public goods themselves. We examine various strategies for sustainably fighting intestinal worms through voluntary local mobilization. Intestinal worms affect one in four people worldwide, but can be controlled by taking medicine twice annually. Since much of the resulting treatment benefit comes through reduced disease transmission, standard public finance analysis provides a rationale for subsidized treatment. Randomized evaluations suggest several efforts to replace subsidies with sustainable worm control measures were ineffective. A drug cost recovery program reduced take-up by 80%. A mobilization intervention designed to boost drug take up failed. Health education did not affect behavior. People were less likely to take drugs if randomly exposed to more information through their social network. In this context, using external interventions to promote sustainable voluntary provision of local public goods (like worm control) appears unrealistic.

Suggested Citation

  • Michael Kremer & Edward Miguel, 2004. "The Illusion of Sustainability," CID Working Papers 112, Center for International Development at Harvard University.
    • Handle: RePEc:cid:wpfacu:112
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    References listed on IDEAS

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    More about this item

    Keywords

    Cost recovery; Intestinal worms; Social learning; Sustainable development; Peer effects; Cost sharing; User fees; Africa; Sustainability;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • O22 - Economic Development, Innovation, Technological Change, and Growth - - Development Planning and Policy - - - Project Analysis
    • Q01 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - General - - - Sustainable Development
    • Z13 - Other Special Topics - - Cultural Economics - - - Economic Sociology; Economic Anthropology; Language; Social and Economic Stratification

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