At that point, I teamed up with President Olesegun Obesanjo of Nigeria to help prepare a major Africa-wide summit on malaria in Abuja, Nigeria in April, 2000. My colleagues, including several world-class malariologists at Harvard – Andy Spielman, Awash Teklehaimanot (visiting from WHO), and Anthony Kiszewski – and I wrote a key background report that demonstrated the massive burden of malaria on economic development in Africa and also stressed the opportunities at hand to control the disease.
At about this time, I received a call from Dr. Gro Harlem Brundtland, who had recently been appointed Director General of the World Health Organization. Brundtland was former Prime Minister of Norway and, without doubt, one of the world's most skilled political leaders. In the mid-1980s, she had chaired the famous Brundtland Commission that launched the concept of sustainable development. She said to me, "If you want to get someone's attention about the health crises in Africa, 'show them the money.' Help them to understand the economic costs of the disease pandemics, as well as the economics of disease control. Above all, propose practical solutions, based on a rigorous emphasis on economic costs and benefits."
Brundtland suggested that I chair a commission of macroeconomists and public health specialists to do just that. The WHO Commission on Macroeconomics and Health (CMH) was born. I chaired the Commission for two years, from the start of 2000 to the end of 2001. In December 2001, the CMH published its report, Investing in Health for Economic Development. This was the work of 18 commissioners, including Harold Varmus, Nobel laureate and former director of the National Institutes of Health; Supachai Panitchpakdi, who would go on to lead the World Trade Organization; Robert Fogel, the Nobel laureate economic historian at the University of Chicago; and Manmohan Singh, the former Finance Minister and future Prime Minister of India. In addition to this stellar Commission, we drew upon six task forces that included more than 100 specialists from around the world. The Commission and task forces had senior representation of the IMF, the World Bank, and several donor agencies.
The Commission gave me a wonderful opportunity to test my favorite hypothesis about collective rationality, which is that if you put people of strongly opposing views in a room together, and infuse their discussion with data, background studies, and unhurried time for debate, it is possible to bridge seemingly irreconcilable positions among the members of the group. I have come to call this process analytical deliberation. It works. The Commission was deeply divided at the start on who was "to blame" for Africa's roiling disease crisis: Africans for their mismanagement, the pharmaceutical industry for the greed, the rich world for their malign neglect. Did Africa need more aid, or just to use better those resources that it had at hand? Could anti-AIDS drug treatment be applied in Africa? On these and a dozen other issues, the first day of the two-year process was contentious, to say the least. On the last day, when the report was issued, we had reached a consensus that extended not only to the 18 commissioners and 100 or so experts in the working groups, but also to major representatives of the pharmaceutical industry and the NGO community. We worked diligently and assiduously to bring forward evidence and a consensus on three basic issues: