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http://mo nthlyreview.o rg/2010/03/01/why-pro grams-fail

Why Programs Fail :: Monthly Review

Richard Levins ([email protected]) is a third generation subversive, an ex-f armer, ecologist, and veteran of the Puerto Rican independence movement, Science f or the People, anti-war, Marxist education, and other good causes. He teaches Human Ecology at the Harvard School of Public Health and is an adjunct f oreign researcher at the Cuban Institute of Ecology and Systematics. T his article is based on a lecture to the South Asian Student Association at the Harvard School of Public Health, May 7, 2009. Several generations of development programs have lef t the gap between rich and poor countries wider than ever. Decades of aid and f oreign investment have extracted many times more wealth than they bring in. Seventeen years af ter the Earth Summit at Rio, carbon dioxide continues to increase. T he non-prolif eration treaty has lef t us with more nukes, more countries possessing nukes, more sophisticated nuclear weapons, more willingness to use them. T he f anf are of the Green Revolution has died down, and f armers are still being displaced to cities that cant accommodate them. T he f irst homes of the Green Revolution are now importers of f ood. Agricultural yields have increased, but so has hunger. Millennial development goals will not be reached. It is not that no programs work. T here have been dramatic successes such as the eradication of smallpox, the near eradication of polio, the containment of plague. But meanwhile, new diseases have burst f orth, old ones have returned, malaria, tuberculosis, and diarrheal disease remain the big killers in much of the world. T he destruction of wetlands f orces migratory birds to f raternize and share their viruses with domestic f owl. Industrialized agriculture has become the petri dish f or antibiotic resistance, and big corporations are in a mad race to grab up the f armland of Af rica. T he T hames is now clean enough to allow salmon to return, but the Colorado River barely trickles to the sea. Forests are protected in Japan and Europe, but at the expense of f orests of Indonesia and the Philippines. T here are more urban clinics, but the megacity is a historically new environment, vulnerable to diseases too virulent to survive in small, sparse populations. We may get a f uel-ef f icient car, making it easier to commute longer distances, and if China achieves the automobile density of Euro-North America, the equivalent of one third of the area devoted to rice production will have to be paved over. Aquaculture moves into the niche lef t by declining oceanic f isheries, but the ensuing salinization threatens already stressed water tables. Increases in productivity, which could give us more tranquil lives, result in longer workweeks, f aster pace, and industries designed to compensate f or the stresses of multitasking and insecurity, while the pharmaceutical industry, which cant wait f or new diseases to emerge, invents them, turning any variation in human physiology or behavior into a market f or its products. Most of these problems are well known to you, reported in technical and popular journals and the more literate television and radio programs. T he missing step is to put them all together, to f ocus on the system that makes all of our crises prof itable. T here is a pattern of a sort: narrowly f ocused technical solutions reshuf f le crises. When one program af ter another f ails again and again, and when the f ailures are not random but somehow always benef it the owning class, we have to ask, How come? When people, just as smart as we are, regularly design programs that f ail to achieve their stated goals, what are they ref using to deal with? T here are several possible answers. First, the problem cannot be solved. Abundance, justice, and sustainability are incompatible. T his answer is a dead end, like special creation, and carries with it just a whif f of self -serving. If it is true that we are doomed, then what remains is to speculate as to what might be a successf ul successor species f or us. But it is also commonly observed that those who see their own way of privilege threatened also see this as

universal disaster. Second, we are doing the right thing but have to try harder, with more investment, more aid, more f ree trade. In support of this is the observation that most international pledges of aid remain unf ulf illed. But more important, the neglected places have f ared better ecologically than where development programs have been most vigorously pursued, and economic recession seems to provide the only respite that capitalism grants to the f orests and waters. It is not that they (not we) want people to be without health care, but that they want accessible health care, subject to the constraint that it is controlled by a private insurance business whose primary goal is prof it. It is not that they want to leave people without medicine, but that they want them to buy medications f rom a private, f or-prof it pharmaceutical industry. It is not that they want medical costs to rise, but that costs should be contained only to the extent that prof it is not harmed. It is not that they deplore medical research, but that they want the f ruits of intellectual labor registered as intellectual property, and pref er research that is at least potentially marketable. T he third type of explanation is systemic and operates on at least three levels: the political economy, the institutional organization of the knowledge industry, and the intellectual biases and constraints that can turn small-scale ingenuity into large-scale disaster. Political economy: In a capitalist economy, goods and services are commodities. Commodities are produced f or sale, to make prof it. T he important thing about commodity production f or us is that there is no necessary relation between the usef ulness of something and its economic value or prof itability. Agriculture is not about producing f ood but about prof it. Food is a side ef f ect. While the majority of the worlds f armers are subsistence f armers, the bulk of the worlds f ood is produced as commodities by a small f raction of f arm operators. Health service is a commodity, health a by-product. Development is about investment opportunities and markets, not correcting decades of plunder and exploitation. We, that is, they, are really trying to do something quite dif f erent f rom the goals stated at numerous conf erences, and perhaps succeeding at it all too well. We must consider institutional f ragmentation and the enclosure of the intellectual commons. Medical schools are isolated f rom agricultural schools, usually the f ormer in large cities and the latter in rural areas. Departmental barriers help f reeze the f alse dichotomies that disrupt our understanding of the world: social/biological, physiological/psychological, genetic/environmental, quantitative/qualitative, individual/social, random/deterministic, whereas the new creative approaches should be sought in their zones of interpenetration. T hen the rules f or recognition, academic promotion, standards f or f unding under discrete programs, time limits f or degrees, def initions of the domains of journals, all conspire to reinf orce the boundaries between f ragments. T he hierarchical arrangement of the disciplines promotes the reductionism that satisf ies the economic needs of the corporations. A clarif ication is needed here: there is nothing wrong with reduction as a research tactic, the search f or the internal parts of something, its smallest units. What is wrong is reductionism, the illusions that the smallest parts are in some way more f undamental, that once we know what something is made of , we understand it, that oxidation is more real than exploitation. Knowledge is the product of a knowledge industry that is owned. Its owners establish the boundaries of the legitimate, determine the rules f or who is recruited, who is excluded, the research agenda, the domain of acceptable theories, and provide the vocabulary f or dismissing inconvenient ideas as f ar out, not mainstream, unproven, ideological, or other indications of taboo. T hey create the art of administration: the inventing of excuses to justif y decisions taken f or other reasons, and the conviction that this is being practical, realistic, etc.

Science prides itself on self -correcting mechanisms to catch error, which is supposed to create objectivity even when individuals may be f allible. We have become quite sophisticated about preventing idiosyncratic errors. We now know that we should wash our glassware, that experiments need controls f or comparison, that the experimenters expectations can inf luence the outcome of an experiment, and so we have invented blind and double-blind designs. Work might be repeated in another lab. Peer review can protect journals f rom careless mistakes. We can f ilter out random results by statistical tests, and we never, never divide by zero. T hese procedures work f airly well. But they are completely useless against the shared biases of the whole scientif ic community, the assumptions and constraints that have become part of the common sense of our colleagues, our teachers, our f unders. T he intellectual structure of our programs is still caught in the philosophy of seventeenth century reductionism that grew up with capitalism in Euro-North America. Science is always f lawed, all theories are limited and each has a f inite lif e span bef ore being replaced by a better theory. Science boasts of being self -correcting. But the correction of the inevitable errors, an essential part of the development of knowledge, is prevented or retarded by generic conflict of interest. In recent years, the prof essional journals and universities have recognized generic conflict of interest: situations in which researchers have economic stakes in the outcomes of their research that inf luences their reports and determine what to include and what to withhold. Scientists might be shareholders in corporations whose products they def end, or receive f ees f or testimony in court against claims that a chemical or physical exposure is harmf ul, or win grants f or sponsored research, or they may be courted with invitations to lecture in delightf ul places and paid with generous honoraria, or they may prescribe treatment at their own private clinics. Disclosure statements detailing possible conf lict of interest have become part of the ef f ort to protect the intellectual integrity of science and scholarship. T hey encourage our skepticism about claimed benef its of patented drugs. T his may be working more or less well. But it does not touch on generic conf lict of interest, the coziness and overlapping outlooks among corporations, government and international agencies, universities, major f oundations, honorary societies, think tanks, and prestigious journals that has created a kind of Nomenclatura,generic conflict of interesta kind of inf ormal Social Register. T his is the pool of people who consult each other, review each others grants, allocate awards, invite each other to give prestigious lectures, give each other jobs and prizes, set the intellectual agendas, teach each other when to raise eyebrows, and generally show mutual appreciation while guarding the boundaries of the respectable. Prof essors are increasingly obliged to mobilize resourcesjargon f or raising money. T he money can be raised f rom government agencies, corporations, f oundations, NGOs, and private individuals. Among the government agencies f or public health and policy prof essionals, the Def ense Department, the National Institutes of Health, the Agency f or International Development are especially prominent. Among international agencies, the World Bank is preeminent f or any development studies. T heref ore, the quality of proposals is determined by donors. And f or corporations, not all knowledge is equally convertible into commodities. T hus the quest f or culpable genes is more f undable than the study of the industrial origins of cancer, the invention of new pesticides more f undable than studying the protective ef f ects of mixed plantings, f inding ways to supplement the nutrition of peasants on thirteen cents a day is more legitimate than helping them organize f or land ref orm. Studying the f inancing of public-private partnership is more popular than examining how universal f ree health care could work. And, f or those who are uncomf ortable with the obvious and deliberate blindness of the organs of progress, there are articulate scholars working at the outer, most humane, f ringes of respectability who catalog the f aults and petty idiocies of the system but reject f undamental questioning of the grand idiocy of investing our hopes in more rational greed. But if the f unding is constrained, so is support f or students and their potential employment. T heref ore, students are trained in the reductionist tradition and encouraged to f ocus narrowly, especially since any detours toward greater breadth take time, and you hear those student loans ticking away. T he available courses are in the f ields of the prof essors, the more expensive kinds of research are subcontracts of the major prof essors grants, preparing students f or similar kinds of research. And there is always the

possibility of a job in one or another organ of the network. T here is nothing underhanded about any of this. Within this world, they may sincerely like and admire each other. It was natural, some years ago, f or the American Academy of Arts and Sciences to establish a membership section f or business but not f or labor. It is not necessary to be a grantee or a shareholder in a company to know that you are potentially a consultant or guest. C. Wright Mills described the workings of this Nomenclatura in generic conflict of interest. Each separate act makes sense within a shared common sense; it is practical, proven, etc. Of course universities need donors. Of course students have to be prepared f or the kinds of jobs they might get. Of course bankers are experts in f inance, and generals are the knowledgeable guests to invite as commentators on matters of war. When the sum of all the rationalities is irrational, the whole system has to be examined. Generic conf lict of interest creates a great dilemma f or students and f aculty who want to f ace f ully and broadly the problems conf ronting our species. We have to navigate in a terrain of a mixture of conf lict and cooperation with our institutions and colleagues. We may share an excitement about the evolution of the virulence of bacteria or the interactions of pollutants in complex mixtures, or how traditional knowledge can be integrated with scientif ic knowledge. But we balk at collaboration with colonialist institutions such as the World Bank or terrorist agencies such as USAID. And we have to f ind ways of promoting a more holistic, complex, integral approach to scientif ic problems. In so doing, we can f ollow a series of dialectical clues: T he truth is the whole. A problem has to be posed large enough to f it a meaningf ul solution. No matter how small the problem you work on, always ask, Where is the rest of the world? even within courses with restricted vision. T hings are more connected than they seem, even across disciplinary boundaries. Parts determine wholes, but wholes also determine parts. T hings are snapshots of processes when a temporary balance of opposing f orces creates a transient stability f or long enough to warrant a name. T hings are the way they are because they got that way, have not always been that way everywhere, need not be that way. Always ask, Why are things the way they are instead of a little bit dif f erent? And Why are things the way they are instead of very dif f erent? Apply all these tools also to ourselves and our own f ields of work. T hat way, we can cope with the dual nature of science: on the one hand, the millennial unf olding of human knowledge, and on the other, the property of a knowledge industry that creates the paradox of a growing rationality in the small, at the level of the laboratory, and a growing irrationality at the level of the enterprise as a whole. In order to work toward that combination of understanding and humane commitment, of cooperation and challenge, we couldnt do better than f ollow the advice of my grandmother when she sent me of f to start f irst grade: study hard, learn all they can teach you, and dont believe everything they say.