Cost and Benefits: A Glimpse Into NDP6 Prioritisation

Every country faces a multitude of challenges and competing wishes for the future.

No nation, regardless of size or strength, can tackle every problem at once. Resources are always limited – including money, time, labour and attention. Therefore, policymakers in Namibia and around the world look to prioritise the best value-for-money policies.

Saying some things must come first is controversial because it also means saying many things won’t come first.

That is why explicit prioritisation is sometimes avoided. This happens even in incredibly important areas.

Often, the default approach is to instead insist that the world needs to address all issues at the same time, at full speed.

While well-intentioned, this has not been helpful.

TARGETING THE TARGETS

In the United Nations Sustainable Development Goals (SDGs), the world promised everything to everyone: To fix hunger and poverty, tackle corruption, climate change and war, improve education, provide jobs, healthcare and opportunities, along with a bewildering array of major and minor promises, such as developing more urban gardens.

While all these policies are desirable, not all are equally achievable with limited resources.

In total, the SDGs have 169 sprawling targets. However, having 169 priorities is the same as having none.

As a result, money has been spread thinly by development organisations, donors and governments across all these causes.

As a result, the world is falling short on every one of its promises. We need to focus on the most efficient policies first.

That’s why the Namibia National Planning Commission and the Copenhagen Consensus Centre have collaborated to undertake a rapid assessment of 62 policy approaches covered within Namibia’s Vision 2030 agenda that would boost the country’s development and well-being.

Data and economic science – especially cost-benefit analysis – can provide a useful input to help the government and citizens identify policies that would create the biggest return to society for every Namibian dollar spent.

TACKLING TB

Our joint rapid project applying economic science to local evidence can help Namibian policymakers to zero in on the most powerful investments.

Two policies in particular stand out.

The first is to focus on improving tuberculosis (TB) control. The TB burden in Namibia is the fifth highest in the world.

As in many countries, there is a stubborn gap between people developing TB and those who remain on treatment.

This gap is easily explained: Although medicine is highly effective, it needs to be taken for as long as six months, and some people will suffer from debilitating side effects.

Because the medication clears immediate symptoms, like fevers and weight loss in a couple of weeks, many people drop out of treatment too early – which increases the chance the disease will be passed on to others and can make the TB bacteria more likely to develop drug resistance.

Namibia could diagnose many more people and ensure more TB patients stay on their medication, generating vast benefits to society.

Better TB control would save lives now for relatively little cost, and reduce future transmission and public spending.

DIGGING IN ON AGRICULTURE

Another phenomenal policy highlighted is engaging in regional agricultural research.

The agricultural sector would generate high returns from research and development (R&D) interventions because relatively small investments upstream can lead to substantial improvements in the efficiency and yield of the entire agricultural sector.

Agricultural R&D at the regional level via the Consultative Group on International Agricultural Research has proven consistently beneficial, particularly in sub-Saharan Africa.

In total, spending on R&D for higher yields will generate long-term benefits for Namibian society worth more than 30 times the outlay.

Other excellent policies highlighted by the assessment include increasing the reach of sexual reproductive health and skills training for adolescent girls, promoting e-services and innovation by integrating information and communications technology in all sectors; standardising customs procedures with regional neighbours to facilitate trade while deepening regional integration; improving pupils’ transition to higher education; improving maternal and neonatal health; strengthening the material and technical base and improving the quality of primary health care; strengthening anti-corruption measures through e-government procurement; and strengthening corporate governance for public enterprises.

COST AND BENEFITS

Worldwide, there are never enough resources to do everything. Prioritisation happens every day.

It can either happen deliberately and with good information on costs and benefits, or implicitly based on other inputs like which issues happen to capture the public imagination.

Rather than offering definitive answers, the rapid analysis is offered as a contribution to public policy discussion and debate, and to bring new economic evidence to the table.

Above all, it is a reminder to focus on weighing the costs and benefits of policies, to ensure that every Namibian dollar spent from the public purse achieves the most good possible for all of society.

  • Mubusisi Mabuku holds a PhD and is the deputy chief of the National Development Advice, Macroeconomic Analysis and Modelling Directorate in the Namibia National Planning Commission
  • Bjorn Lomborg is the president of the Copenhagen Consensus

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