McDonald's approach to health works in Africa

Heather Wilhelm:

What can the government do for you? As politicians, pundits, and voters gear up for January's Iowa caucus, one consistent answer seems to float behind the talking points: pretty much everything. Whether it comes to government-funded preschool, subsidized community college, universal health care, tinkering with free trade, or saving the family farm, Democratic politicians are promising the moon - and, according to polls that could likely make Ron Paul weep, a surprising number of Republicans share similar ideas.

It has, in short, been a rough year for fans of economic liberty, and they're not likely to find consolation in Des Moines, Dubuque, or Davenport. They might, however, try looking 8,300 miles to the east, where a quiet revolution is taking place - a revolution that is shoring up education, providing better health care, thriving through free trade, and, yes, even saving the family farm. It's a revolution spreading through the poorest communities in Africa, fueled by a force often brushed aside by promise-happy candidates: free markets.

"Before the country of Kenya existed, before the government of Kenya existed, and before any of today's charitable organizations existed, there were people buying, selling and trading things," says Greg Starbird, vice president of the HealthStore Foundation, a Minneapolis-based organization working for better, accessible health care for Africa's poor. Founded in 1997, HealthStore bases its operations on a familiar, often vilified, and, for some, surprising model: McDonald's.

"The basic formula is to use the franchise model to deliver health care to the developing world," Starbird says. "For many of the top diseases affecting millions of people - and killing around 30,000 children a day - there are treatments and products that could be delivered for less than $5. But they're not getting to the people who need them."

Thus far, with a system based on local ownership, basic incentive structures, and, yes, charging for medicine rather than giving it away, HealthStore has thrived. Since 2000, their market-based drug shops and medical clinics have mushroomed throughout Kenya, treating almost 700,000 patients a year while addressing problems endemic to rural and slum-based health care: counterfeit drugs, shortages, scalability, and sustainable operations.

Around the globe, similar organizations are tapping into simple market economics to tackle massive problems - problems that, by extension, are related to the hot-button issues on America's political plate. The Scojo Foundation, founded five years ago in response to the lack of eye care in the developing world, has trained over 1,000 "barefoot optometrists" in nine countries, unleashing entrepreneurship with a multiplier effect.

In countries like Ghana, private schools for the poor are thriving, fueled by the leadership of scholars like James Tooley. The One Acre Fund, founded by recent MBA Andrew Youn, is "making markets work in places that they have not before" - namely, by training rural subsistence farmers in Kenya and Rwanda for better productivity and profits, part of which are repaid to the Fund. Youn's market-based practices tend to measure up: 98% of farmers repay while gaining up to 400% in food yields.

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The market has magic where it is tried. The examples given here were largely ignored in a weekend story in the NY Times about how Malawi was prospering because of fertilizer subsidies. That is not too surprising since the Times favors the control freak model of governance. My question is why not try the HealthStore model in this country? In fact Walmart may do just that with in store clinics.