Geography

Proposed and experimental methods

Methods that are proposed, under trial, approved in some places, or tried and then failed. Each shows a stage label and an evidence rating. A stage label shows how far a method has progressed, not whether it works. The stage labels are explained on the environmental factor page.

• Drone delivery of medical supplies to remote facilities (Approved but not scaled, B). Fixed-wing drones fly blood, vaccines, and medicines from central stores to clinics that are far away by road. In Rwanda, 12,733 blood product orders were delivered by drone between March 2017 and December 2019, the mean delivery time was 49.6 minutes, 79 minutes faster than estimated road delivery, and expired blood units fell by 7.1 per month, a 67% reduction at 12 months (Nisingizwe et al., 2022). In Ghana's Western North Region, a study led by staff of the operator Zipline found 30% shorter vaccine stockouts, 44% fewer missed vaccination opportunities, and vaccination coverage 13.1 to 37.5 percentage points higher in served districts (Kremer et al., 2023). Ghana's government owed Zipline about GH¢175 million in 2026, the debt had forced Zipline to shut three of six distribution centers in October 2025, and the health minister said only 10% of services covered hard-to-reach areas and 4% were emergency deliveries (GNA, 2026).
• Low-cost malaria vaccines (Approved but not scaled, B). Malaria is a large part of the tropical disease burden linked to geography. See "Infectious disease environment" in the environmental factors for the trial results and rollout of the R21 and RTS,S vaccines.
• Fast internet links as a way to reduce the cost of distance (In wide use, contested, D). The gradual arrival of submarine internet cables in Africa was used as a natural experiment. Difference-in-differences estimates from 3 datasets covering 12 countries showed large positive effects on employment rates, also for less educated workers, with little or no job displacement across space, driven mainly by higher-skill jobs, more firm entry, higher productivity, and more exporting, and average incomes rose (Hjort and Poulsen, 2019). Less educated workers gained less than others. An independent comment for the Institute for Replication found that the employment and night light effects "largely are not robust" to alternative geocoding of survey locations and were sensitive to a correction for a satellite change at the end of 2009 (Roodman, 2024). No reply from the authors was found.
• Not shown to help: highways linking remote regions to large cities (In wide use, contested, B). Better roads are often proposed to reduce the isolation of remote areas. China's National Trunk Highway System linked large cities and also connected many small counties along the way, and using planned least-cost routes to separate the effect of the roads from where they were placed, connection to the network reduced GDP growth in non-targeted peripheral counties, mainly through slower growth in industrial output, as lower trade costs pulled production toward the large cities (Faber, 2014). The evidence comes from one country.
• Reversed: self-governing charter zones in Honduras (Failed or reversed, B). Charter zones that give a remote or underdeveloped area its own rules are also proposed as a way around the costs of geography. See "Extractive institutions" in the societal factors for the Honduras case, where the Supreme Court declared the zone framework unconstitutional on September 20, 2024.
• Reversed: genetically modified mosquitoes in Burkina Faso (Failed or reversed, B). Gene-modified mosquitoes have been proposed to cut the malaria burden of tropical regions. See "Infectious disease environment" in the environmental factors for the Burkina Faso project, whose activities were ordered stopped in August 2025.

Sources cited on this page

1. Gallup, J. L., Sachs, J. D., & Mellinger, A. D. (1999). Geography and economic development. International Regional Science Review, 22(2), 179-232. C Limited
2. Acemoglu, D., Johnson, S., & Robinson, J. A. (2001). The colonial origins of comparative development. American Economic Review, 91(5), 1369-1401. C Limited
3. Sachs, J. D., & Warner, A. M. (2001). The curse of natural resources. European Economic Review, 45, 827-838. C Limited: contested
4. Kremer, M., Luby, S. P., Maertens, R., Tan, B., & Więcek, W. (2023). Water treatment and child mortality: A meta-analysis and cost-effectiveness analysis (NBER Working Paper No. 30835). National Bureau of Economic Research. link B Moderate
5. Faber, B. (2014). Trade integration, market size, and industrialization: Evidence from China's National Trunk Highway System. Review of Economic Studies, 81(3), 1046-1070. link B Moderate
6. Hjort, J., & Poulsen, J. (2019). The arrival of fast internet and employment in Africa. American Economic Review, 109(3), 1032-1079. link D Contested: (changed from B on October 8, 2026, because an independent reanalysis found the main effects not robust and the dispute is unresolved)
7. Nisingizwe, M. P., Ndishimye, P., Swaibu, K., Nshimiyimana, L., Karame, P., Dushimiyimana, V., et al. (2022). Effect of unmanned aerial vehicle (drone) delivery on blood product delivery time and wastage in Rwanda: A retrospective, cross-sectional study and time series analysis. Lancet Global Health, 10(4), e564-e569. link B Moderate
8. Roodman, D. (2024). The arrival of fast internet and employment in Africa: Comment (I4R Discussion Paper No. 148). Institute for Replication. link B Moderate
9. West, T. A. P., Wunder, S., Sills, E. O., Börner, J., Rifai, S. W., Neidermeier, A. N., et al. (2023). Action needed to make carbon offsets from forest conservation work for climate change mitigation. Science, 381(6660), 873-877. link B Moderate

Every source for this factor is listed on the environmental factor page.