Numbers, engineering, and other things people in public policy tend to dislike

Work in international development is a study in constraints.

Work in international health takes this rule and ups the ante by virtue of sheer complexity.

Here’s one example: many vaccines are temperature sensitive, and can be spoiled by fleeting exposure to heat (for instance, 80% of tetanus vials will no longer be potent after 3 hours at 65 degrees Celsius – an entirely achievable temperature in the back of a metal truck). Vaccine vial monitors have by and large minimized the issue of administering ineffective doses, but the primary problem of spoilage remains. This can happen if, say…

  • A drought in Kenya decreases output of hydroelectric dams, resulting in rolling blackouts in the relatively well-developed city of Nairobi that subsequently cut power to refrigerators.
  • Crumbling rural infrastructure and poorly-managed roads slow delivery trucks to a crawling pace, virtually negating cooling systems (if there are any).
  • A health care worker without proper training mishandles the package. This, of course, could happen anywhere, but is much easier to come across in locations with high rates of illiteracy.
  • A flimsy source of funding to a rural clinic is cut, preventing payment of any electrical bill.
  • Et cetera. And the potential impact can be just as varied: a waste of labor, time, physical resources, and money in a setting where none of those things are readily available, not to mention the potential health impact upon a population (worse if the vaccines are administered anyway and a sense of entirely unwarranted protection is developed; worse still if this a HPV vaccine distributed to potential rape victims, or whatever other awful scenario you can think up). Implementing an effective aid program requires very careful and systematic prediction of where things can go wrong, and failsafe plans for when things not-thought-of do. Similarly, post-program analysis can also benefit from more rigorous methodology, such as with use of controlled studies to evaluate the effectiveness of aid (here is a fantastic study on the effectiveness of various methods of HIV prevention among adolescent girls).

    This particular way of framing complex problems in international affairs is not only beneficial but essential to forming strong policy. A thoroughly analytic, numerically focused perspective is invaluable in constructing effective development programs: building a bridge in Nicaragua, a complex of biosand filters in El Salvador, an economic program to support schools in Pakistan. This isn’t a thought process I’ve ever had to implement in a political science or policy studies course, but instead is incredibly reminiscent of the manner in which I’ve had to approach design problems in engineering classes – and I’d like to argue that it places people with this sort of training in a key position in policy agencies. Only so much can be learned from reading case study after case study; students intending to enter high-stakes fields need more trial-and-error, more hands-on practice in program development and design. USAID doesn’t hire systems engineers, but they should if we ever intend to become serious about development.

    Numbers, engineering, and other things people in public policy tend to dislike

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