Something's gotta give

Government gets off too easy in the ex-President's new book on philanthropy, writes Jeffrey Sachs in Fortune.

By Jeffrey Sachs, Fortune

(Fortune Magazine) -- Bill Clinton's new book, Giving, is a who's who of organizations and individuals that have crossed paths with him in the world of philanthropy and volunteerism. Readers are given a privileged seat at the table of the annual Clinton Global Initiative, where private-sector leaders make pledges of noble and often highly innovative undertakings.

As Clinton rightly reminds us, what these individuals are doing is important and at times world-changing. Giving will be a useful guide, and an inspiration, to the many people around the world who are stepping forward as volunteers of time, money, and creativity to a burgeoning range of good causes.

clinton_foundation.03.jpg
Former president Bill Clinton is too pollyannaish in his new book about volunteerism.
clinton_book.jpg

Still, something is missing. Perhaps inevitably in an election year, there's no edge, no priorities, no worrisome gaps - only wonderful ideas, friends, and accomplishments. Worse, there's no asking whether and when the good works add up to real change.

We wince, for example, at Clinton's description of the "historic Israeli-Palestinian peace accord" of September 1993 and the many good works in its wake.

Since the accord actually collapsed, what are the lessons? We are not told. We wince again at Clinton's praise for the outpouring of volunteer efforts in New Orleans after Hurricane Katrina, since we also know that New Orleans has not, in fact, been rebuilt.

The problem is that the great policy-wonk President has gone private. Government is a side note, mentioned in passing in the penultimate chapter.

Clinton does not explain that the efforts of individuals and nongovernmental organizations are world-changing when they point to new strategies, approaches, and technologies that can then be taken to scale through government support and partnership. That is the model Clinton himself has effectively used, for example, in expanding access to AIDS medicines.

Consider one of his (and my) favorite people, Dr. Paul Farmer. This remarkable individual helped change the world by showing that HIV-infected individuals in impoverished settings can be treated effectively with hightech anti-retroviral medicines.

Farmer proved that impoverished people would adhere to even complicated drug regimens and that their infection would respond favorably to the medicines. Yet his example, as of the year 2000, involved several dozen patients in Haiti.

It is the Global Fund to Fight AIDS, TB, and Malaria, and institutions like it, backed by governments, that have enabled Farmer's early successes to be taken to a global scale.

We live in a time of diminished, and sometimes nonexistent, public leadership. Volunteers can rebuild some houses in New Orleans, but when public action fails, as is the case in that forsaken city, private efforts are utterly overwhelmed.

Similarly, climate change will not be solved by the wonderful voluntary actions to conserve energy described in the book. Clinton mentions his frustration at being unable to pass a carbon tax but leaves the impression that actions by local governments, companies, and individuals will somehow do the job anyway.

The public-sector inaction has now lasted a full generation. During his presidency, Clinton was unable to get a hostile Congress to follow his lead on climate change and health reforms, and he largely bypassed the issue of aid for Africa until his final year in office.

The Bush administration, for its part, has made a tradition of public-sector incompetence and indifference. The Clinton Global Initiative is a wonderful annual get-together of forward-looking people, and it surely spurs increased interest and action.

But in the end we need the voice of political leaders, and their ability to deliver budgets and services. Perhaps Clinton will have the ear of the next President. Top of page