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In Public Health, Purpose-Built Solutions are the Worst Kinds of Solutions


Bee populations have collapsed for mysterious reasons around the world, but few places have been as hard hit as the Maoxian region of China. There, farmers must now lean small ladders against pair trees, climb up into their branches, reach upwards with slender rods, and pollinate every flower by hand. 

Pollinating flowers by hand is an example of a purpose-built solution. The farmers have a problem and they are devoting specific time and energy to solving it. Googling the words “purpose-built solutions” reveals that the words are almost universally regarded as positive. Companies brag that their products deliver “precise specifications” that are “right for you,” just like the farmers’ rods are right for every flower. Googling the words “side effect” brings up nothing good — mostly the unintended consequences of drugs. And yet, I suspect the farmers were happier when bees pollinated flowers as a side effect of gathering food.

There is a general principle at work here, and it offers a critical lesson for public health. Trying to achieve something directly cannot compete with thousands or millions of people achieving it as a side effect of something else they are already doing. Consider the kind of accurate,...Read more




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