Brookings Global Economy and Development Conference “What Works in Development? Thinking Big and Thinking Small” Breaking Out Of the Pocket: Do Health Interventions Work? Which and In What Sense?

Despite likely strong medium-term growth prospects for many poor countries, there will remain serious pockets of poverty for the foreseeable future. People in these pockets are unhealthy, uneducated and low income. Interventions to improve health in these pockets, by targeting child mortality, are appealing as ways to increase welfare, and a package of health measures is likely to have more effect than single interventions. Increasing access to education should presumably be bundled with health improvements. Robust sustainable delivery mechanisms also need to be established. Research design should move towards testing the plausible set of ideas in this regard, sometimes implemented as packages of measures rather than single interventions, using the high standards of medical science. Still, it remains unclear if improving health and education by themselves will substantially eliminate these pockets of poverty. We also need an appropriate experimental research design that will examine the effect of adding to the bundle of interventions a variety of more direct measures that could increase productivity. Copyright ©: Peter Boone and Simon Johnson, 2008. 1 Boone: CEP, London School of Economics and Effective Intervention; [email protected]. Johnson: IMF, MIT and NBER; [email protected]. The views expressed here are those of the authors, not those of any organization, governments, or other individuals. BROOKINGS GLOBAL ECONOMY AND DEVELOPMENT CONFERENCE 2 “The only things that matter in this fallen world are transportation and sanitation.” -Rudyard Kipling, 1913