The 12 Most Efficient Ways to Help the Poor

Best Things First: The 12 most efficient solutions for the world’s poorest and our global SDG promises
Bjorn Lomborg | Copenhagen Consensus Center, USA | 2023, 290 pp

For two decades, Bjorn Lomborg has worked with hundreds of economists worldwide through his think tank, the Copenhagen Consensus, to study and offer practical, cost-effective solutions to the world’s pressing problems of health and poverty. Seven Nobel Laureates have participated in these deliberations, yielding useful benefit-cost research for the betterment of all. The goal is eminently practical: Find the best thing to do for the maximum benefit at the least cost. Hence, the title of his latest book, Best Things First: The 12 most efficient solutions for the world’s poorest and our global SDG promises.

When everything is a priority, nothing is a priority. For Lomborg and his colleagues the United Nation’s Sustainable Development Goals (SDGs) are a classic case of pretending “to say yes to everything” with 169 sprawling vows and more than 4,000 words in which “everything has been promised to everyone.” He does not use the term, but the SDGs are, essentially, unfocused and lacking adequate benefit-cost analysis or a keen sense of relative risk. The SDGs are contrasted with the much more successful Millenium Development Goals (MDGs), which were comprised of eight short, powerful goals and just 18 specific targets.    

To improve upon the SDGs, Lomborg et al. studied “100 potentially great policies to find the very best solutions” to global problems. This work, in turn, generated 12 efficient policies — “concrete, achievable, relatively inexpensive, and incredibly efficient” — to improve the lives of those living in the poorer half of the world.

“For about $35 billion per year, we can save 4.2 million lives annually, and we can make the poorer half of the world more than a trillion dollars [US] better off each and every year,” claims Lomborg. 

Fantastic vision

Ending tuberculosis, reducing the death rate from chronic diseases, increasing agricultural yields, avoiding hunger for a hundred million people and improving learning for the poor with the concomitant increase in future incomes are just some of the good things envisioned in Best Things First.  Among the other best 12 policies identified by the Copenhagen Consensus are those to address malaria (by means of “long-lasting insecticide treated net”), e-procurement (to fight corruption), land tenure security (to incentivise borrowing, investment and productivity), and other creative, cost-beneficial solutions.

Each of the 12 policies or programs is supported by an in-depth paper or report prepared by an international team of economists. All of the papers are accessible online and in Cambridge University Press’s Journal of Benefit-Cost Analysis, vol. 13, S1, 2023.

The various ideas and investments proposed are quite innovative. To take one example, education (Chapter 5): 80 percent of students, a third of a billion, are not even achieving minimal skills despite a doubling of spending in the poorer half of the world. The Copenhagen Consensus proposes two policies to increase basic reading and math proficiency at a very reasonable, small cost. “One helps students learn more effectively, while other policy helps teachers teach better.”


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Notwithstanding that students are grouped by age in class, one of the best investments is to teach according to students’ learning level rather than age. Using tablet technology and software has been extensively studied and tested to allow for “a best-practice education that delivers very efficient and engaging instruction,” in native languages, allowing differential teaching or learning for students falling behind. without disrupting the progress of the rest of the class.

Practical steps

The recommendation for teacher education is “structured pedagogy.” This technique provides teachers, many of whom lack necessary education or skills, with a set of “semi-scripted lesson plans, training in how to use them and coaching them as they are used.” In Kenya, instruction is given in both Swahili and English. Each teacher gets 140 “sequential, semi-scripted lesson plans in both languages, making it easier to plan lessons and follow instructions.”

Lomborg provides a stunning table (Table 3.1 on pages 32-33) listing all 12 of these ‘best” investments with annual benefits, in lives saved and dollars, costs and, most revealing, benefit-cost ratios. All the benefit-cost ratios are positive, generously so, with benefits wildly exceeding the cost. The highest BCR is 125 for e-procurement innovations. In other words, for every dollar invested, $125 dollar in benefits results. The lowest is 18 for nutrition. Childhood immunisation generates a BCR of 101; maternal and newborn health measures show a BCR of 101. The BCR for the education proposals described above is 65. These are incredible numbers that would be the envy of most environmental regulators in the developed world.

Best Things First also provides a very helpful appendix, at least to the reader new to the discipline of benefit-cost analysis, outlining the concept and related matters such as discounting and the value of a statistical life, important elements of the calculation made by economists.

Each of the 12 policies proposed is discussed in a single chapter offering much more detail than this review can describe. The economists are identified along with their paper and the place to access it. Best Things First presents to the reader and the global community a well-researched, thoughtful menu of programs to improve the condition of humanity at a cost that is reasonable and, thus, more likely to be adopted and implemented successfully.


G. Tracy Mehan, III, is executive director for government affairs with the American Water Works Association and adjunct professor at Antonin Scalia Law School, George Mason University (Arlington, VA, USA).

Image credit: Pexels

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