On doing more good than war is bad

War is pretty bad. The whole point is to kill people, destroy infrastructure, and break down the state in the target area. Also it uses a lot of money.

That's why I was surprised to learn that - according to Vox (archived here) - one program promoted by George W Bush, 43rd President of the United States, seems to have done as much good as, and perhaps more good than, his two major wars did bad:

Take the Iraq War, the worst thing Bush did in his presidency, and the one that cost by far the most lives. The most conservative estimates — like Iraq Body Count's, which is drawn from media reports — place Iraqi casualties from the conflict at 100,000 to 250,000, with Iraq Body Count putting the figure at 216,000. Survey-based studies go higher: One estimating 2003 to 2011 excess deaths put the toll at 405,000; a famous 2006 Lancet study put the toll to date at 654,965; in early 2008 the British polling firm ORB put it at 1.033 million.

The highest of those estimates are extremely implausible; see this paper by economist Michael Spagat on the Lancet study (which finds evidence that some data was fabricated or falsified), and this one by Spagat and Iraq Body Count's Josh Dougherty on the ORB poll. But supposing for a second they were true, PEPFAR saved an estimated 1.2 million lives in its first four years; it has seen greatly expanded funding since, and saved millions more. The humanitarian toll of Iraq was tremendous, and all the more tragic for being totally preventable. But it was considerably smaller than the humanitarian gains of PEPFAR.

Let's count the costs of those programs too. PEPFAR cost around $65 billion, which I'll round to zero because the wars cost something like $2 trillion. Using $5 million as the economic value of a life (archived here), the war cost another <500k lives' worth of wasted resources. These numbers are very rough estimates. You can of course save lives more cheaply than $5M per life - PEPFAR is pretty cost-effective too by this measure. But I'm unconvinced that the opportunity cost of this $2 trillion was anything nearly so cost-effective. More likely we should think of it as a generic transfer from the US economy, in which case the $5M figure seems pretty appropriate.

Stopping wars still seems pretty great if we can find a way to do it cheaply and reliably - but it also seems pretty hard. It's excellent news that this developing-world public health program has a track record this good.

(These are all my personal opinions. Everything on my blog is my personal opinion. Except comments by others, which are their personal opinions. This doesn't represent the view of my employer.

Also, I'm not interested in a discussion of whether Bush was a good president on net.)

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