Misleading means

IN FRONT of the skyscrapers on the esplanade in Panama City, joggers puff along a path in the morning heat, as men and women do push-ups and bench-presses. In this part of Panama the enemies are fat and diabetes. But a short flight away indigenous communities living amid fearsome overcrowding on the tropical islands of Guna Yala (formerly San Blas) are so poor and malnourished that their young children can die for lack of a boat fare to get to the nearest health clinic. Parts of Guna Yala are, says an official from the Inter-American Development Bank (IDB), “hell in paradise”. This disparity between the rich-world health worries of city dwellers and the parlous situation of the poorest is prevalent across Central America. But until recently the IDB says it has never been measured or dealt with directly.

Enter two of the world’s richest men, Bill Gates, a founder of Microsoft, and Carlos Slim, a Mexican telecoms magnate. Together with the government of Spain, the IDB and eight regional health authorities, their charitable foundations set out in 2010 to survey and tackle the problem. The alliance between billionaires and bureaucrats has been fruitful. It has revealed the depth of the inequality and shown how entrepreneurial thinking can be applied to seemingly intractable problems.