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The author of The Progress Paradox, Gregg Easterbrook, writes a weekly column for ESPN.com called Tuesday Morning Quarterback during football season. I didn’t get a chance to read it Tuesday because I was still in Vegas. I love Easterbrook because he’s not afraid to tackle social issues in the middle of discussing the merits of good run-blocking. Buried in the middle of this week’s football news he wrote the following:

Last week the British Medical Journal, a technical publication, released a survey in which physicians said sewers, not antibiotics or vaccines, were the greatest public health advance of the past two centuries. Those who live in the favored cities of the West should never take sanitation for granted. The construction of sewage systems in European and American cities, beginning in the late 19th century, dramatically lowered rates of disease, to say nothing of making cities more livable; lowered disease in turn helped Western nations grow more productive and affluent. Today much of the developing world is held back by the fact that its citizens are often sick, and thus not productive. Open conduits of sewage run down the streets of many large developing-world cities; raw sewage pours directly into the Ganges, where bathers are supposed to go for purification rites. In many developing nations the No. 1 need is clean water: clean drinking water, buried sewer systems and modern wastewater treatment plants. The United States appears to have wasted nearly $1 trillion in Iraq. That sum could have brought modern public sanitation to the 25 largest cities of the developing world, and made America the hero of the world’s poor for generations.