“Good job you!” shouts Pauline Bika, as a group of schoolchildren completes the hokey-cokey. “Good job me!” choruses her class. Ms Bika runs a small government primary school in Edo state, in southern Nigeria. It is reached by a mud track that starts not far outside Benin City, the state capital. Her school has 140 pupils, but only three teachers. She seems both pleased and a little embarrassed to offer a visitor a plastic chair.

For all that it lacks, Ms Bika’s school has one advantage. At the start of last year the state education ministry gave each of her teachers a small tablet with a black-and-white touch screen. Every two weeks they use it to download detailed scripts that guide each lesson they deliver. These scripts tell the teachers what to say, what to write on the blackboard, and even when to walk around the classroom. Ms Bika says this new way of working is saving teachers time that they used to spend scribbling their own lesson plans—and her pupils are reading better, too.

That is sorely needed, for much of the education given in much of the world is strikingly bad. Across the developing world many schoolchildren learn very little, even when they spend years in class. Less than half of kids in low- and middle-income countries are able to read a short passage by the time they finish primary school, according to the World Bank. Across sub-Saharan Africa, as few as 10% can (see chart). Experiments like those under way in Nigeria mark one attempt to improve things. They also face fierce opposition from critics who are convinced they mark a wrong turn.

The reforms in Edo began in 2018. Godwin Obaseki, the state governor, says that poor schools are one reason youngsters have often left the state for greener pastures (some fall victim to people-traffickers promising better lives in Europe). Since then, the government has provided tablets and training to more than 15,000 teachers. They in turn have given the new lessons to more than 300,000 children, most of them in primary schools. On any given day pupils throughout the state receive identical lessons, as dictated by the tablet.

The training and technology are provided by NewGlobe, an education company founded in 2007 by three Americans (Pitchbook, a data firm, valued the company at $250m following a funding round in 2016). NewGlobe developed its approach while running a chain of low-cost private schools, mostly in Kenya, under the brand “Bridge International Academies”. A study by academics including Michael Kremer, a development economist at the University of Chicago, found that, over two years, children who attended NewGlobe’s primary schools made gains equivalent to almost a whole year of extra schooling, compared with their peers in other schools.

F is for factory

Though Edo was the first state in Nigeria to strike a deal with the firm, NewGlobe’s approach has since also been applied in Lagos, the country’s biggest city. The firm is starting work in Manipur, a state in north-eastern India, and in Rwanda. Around a million children are now studying in classrooms that use NewGlobe’s model—far more than its private schools have ever been able to reach.

Although it seems able to find plenty of clients, the company provokes ferocious arguments among educators. Its private schools have long faced energetic opposition from trade unions and some international NGOs, many of whom hate the idea of profit-seeking companies playing any role in education. Others resent the application of mass production to what they see as a skilled, artisanal profession.

Dennis Sinyolo of Education International, a global group of teachers’ unions, says scripted lessons “undermine teaching” and encourage “rote learning and exam drilling”. He says good lesson plans are written to match local contexts, and the needs of individual students. The freedom to change tack mid-lesson is invaluable if a lesson plan is not working. “There’s no one-size-fits-all in teaching,” he says.

Visits to schools in Edo provide some perspective on what is going on. There are doubtless many ways to teach a scripted lesson badly. But the idea in Nigeria is that they will tend to make classes more compelling. The scripts enforce instructional practices that are routine in many rich-country classrooms but often neglected in poor ones. These include techniques such as pausing frequently to pose questions to the class, instead of delivering long lectures at the blackboard, or encouraging pupils to try to solve a problem by chatting to the child sitting next to them.

Detailed, prescriptive lesson plans are also supposed to relieve teachers of the burden of having to write their own. That, advocates hope, will leave them more energy for other jobs—such as making sure their charges stay engaged. Teachers in Edo have been trained to lead their classes in short games and songs whenever they think pupils have grown restless (hence the hokey-cokey). Ms Bika says things are better than in the past. Before, bored children would occasionally wander home during the day. Inattention was sometimes punished with the cane.

The changes do more than alter teaching styles. A study published in 2010 estimated that on any given day around a fifth of Nigeria’s primary school teachers were absent from their classrooms. Earlier research suggested as little as one-third of class time is used productively. In Edo, tablets register when teachers arrive. They can tell if a teacher has scrolled through a lesson faster than appropriate, or if they have abandoned one halfway through. Beneath lies a low-tech foundation: a team of officials—about one for every ten schools—that observe lessons and coach teachers, helped by data from the tablets.

The depth of its scripting and the whizziness of its tablets set the work in Edo apart from many other attempts to improve schooling. But the programme has things in common with a broader family of reforms burdened with the clunky name of “structured pedagogy,” most of which are less controversial. This argues that isolated splurges on goodies such as textbooks often fail to bring benefits. Making big improvements seems to require pulling several levers at once. So the idea is both to give more materials to pupils and better lesson plans to teachers, alongside fresh training and frequent coaching.

In 2020 a panel convened by the World Bank and other bodies concluded that these are some of the best things education reformers can spend money on. In the past few years the approach has been applied in Gambia, Ghana, Nepal and Senegal. One programme in Kenyan government schools helped push up the number of children reaching the national standard in English by 30 percentage points.

E is for everywhere

But it is not only in poor countries where tightly structured approaches to schooling are gaining a following. In America, for example, there is growing awareness that schools have been clinging to modish but ineffective “child-led” ways of teaching reading that other developed countries such as Britain have junked. Literacy programmes that were dismissed as old-fashioned are coming back into favour.

McGraw Hill, an American publishing company, sells a series of highly scripted courses aimed at primary-school children. Bryan Wickman of the National Institute for Direct Instruction, a charity in Oregon, says that using the simplest, clearest language possible is crucial when teaching the smallest children. He says the idea that lessons based on scripts must inevitably bore children should surprise anyone who enjoys other things that are performed from scripts, such as plays.

Success For All, a programme used in some British and American schools, puts much faith in “co-operative learning”—which involves encouraging children to solve problems together in small groups. But much else that goes on in its classrooms is structured and scripted. Such prescriptiveness helps teachers adopt techniques that research suggests work well, says Nancy Madden of Johns Hopkins University, one of Success for All’s creators. These include giving pupils quick and frequent feedback and keeping up a rapid pace to keep children interested.

Ms Madden says teachers who have grown familiar with her programme’s techniques are not expected to keep following scripts to the letter. But when, in the past, her team relied mostly on training workshops to spread their approach, they found that only a fraction of teachers kept up the new practices once they were back in their classrooms.

She admits that teachers sometimes bristle at the constraints that scripts impose: “It is not what they teach you in teacher school.” Sceptics often come round, she says, when they see kids making swift progress. Mr Wickman points out that other expensively trained professionals, such as pilots and surgeons, also have procedures that they must follow to the letter. After some initial complaints (similar to those expressed by dubious teachers) such regimented approaches have become widespread in those fields. They help reduce mistakes, and spread better ways of doing things.

Back in Edo, Mr Obaseki’s transformation still has plenty to prove. An analysis published in 2019 by the state government and NewGlobe claims that during the first year of the reforms children learned as much in a single term as they were previously learning in one year. But the project has yet to undergo a rigorous independent evaluation. Much of the existing evidence that supports scripted schooling relates to basic literacy and numeracy among the youngest children. In Edo, lesson scripts are being used to teach almost every subject, and are being applied to teenagers in junior secondary schools.

Whether strict scripting is necessary remains a topic of debate. (The World Bank panel, for instance, argued that word-for-word scripts are less effective than simpler guides.) In 2018 rti, an American non-profit group, analysed 19 school-reform efforts it had been involved in across 13 countries, including Ethiopia and Uganda. It concluded that programmes with slightly less prescriptive guides—a page of notes per day, say, rather than a full-on script—produced better results. Advocates of a more relaxed approach say another advantage is that leaving teachers with a bit of freedom to tinker can help win their support.

Yet Edo’s approach appears to have persuaded most local teachers of its worth. Mr Obaseki, the state governor, says school staff had long felt ignored and unappreciated; he says that providing more training and equipment has brought fresh motivation. He insists that support for the project among unions was crucial to his re-election, in 2020. It has, he says, been “one of my best investments”. ■

The most saccharine song of 1980 was “There’s No One Quite Like Grandma”, performed by the St Winifred’s School choir from Stockport, England. It shot to the top of the British charts as kids everywhere gave it to granny for Christmas. “Grandma, we love you,” they sang. “Grandma, we do. Though you may be far away, we think of you.”

Today, as the once-cherubic choristers start to become grandmas and grandpas themselves, grandparenting has changed dramatically. Two big demographic trends are making nana and gramps more important. First, people are living longer. Global life expectancy has risen from 51 to 72 since 1960. Second, families are shrinking. Over the same period, the number of babies a woman can expect to have in her lifetime has fallen by half, from 5 to 2.4. That means the ratio of living grandparents to children is steadily rising.

Surprisingly little research has been done into this. The Economist could not find reliable figures for how many living grandparents there are, so we asked Diego Alburez-Gutiérrez of the Max Planck Institute for Demographic Research in Germany to produce some estimates by crunching UN age and population data with models of kinship structures in each country.

We found that there are 1.5bn grandparents in the world, up from 0.5bn in 1960 (though the further back one goes, the fuzzier the estimates become). As a share of the population they have risen from 17% to 20%. And the ratio of grandparents to children under 15 has vaulted from 0.46 in 1960 to 0.8 today.

By 2050 we project that there will be 2.1bn grandparents (making up 22% of humanity), and slightly more grandparents than under-15s. That will have profound consequences. The evidence suggests children do better with grandparental help—which usually, in practice, means from grandmothers. And it will help drive another unfinished social revolution—the movement of women into paid work.

Since fertility rates and life expectancy vary enormously from country to country, the age of the grandparent has not yet dawned everywhere (see chart 1). They are 29% of Bulgarians but only 10% of Burundians. Their average age varies widely, too, from 53 in Uganda to 72 in Japan (see chart 2). To understand what a difference plentiful grandparents make, a good place to start is in a country where they are still scarce.

Consider Senegal. Most rural Senegalese are subsistence farmers. Although fertility has dropped from 7.3 babies per woman in 1980 to 4.5 today, large families remain the norm. Children under 15 outnumber living grandparents by 3.5 to 1.

Amy Diallo, an 84-year-old matriarch wrapped in a blue and white hijab, has to think carefully when asked how many she has. “Thirty,” she concludes, looking up from her cross-legged position on the floor of her home in Tally Boubess, outside Dakar, the capital, on a street where horses and carts jostle with sheep and cars.

As the oldest member of her family, she commands respect. She offers moral guidance to the young: be honest and pious, uphold tradition and stop hitting your younger brother. Every year she leads a family pilgrimage to Tivaouane, a Muslim holy city, with children, grandchildren, great-grandchildren and various in-laws, perhaps a hundred in all.

Grandparents pass on traditional beliefs, stories, songs and a sense of history. More prosaically, they bring an extra pair of hands. That helps both parents and children. A study in rural Gambia, for example, found that the presence of a maternal grandmother significantly increased a child’s chance of living to the age of two. In sub-Saharan Africa the odds of being in school are about 15% higher for children living with a grandfather and 38% higher for children who live with a grandmother.

As for Mrs Diallo, she has never worked outside the home. But she has helped some of her offspring to do so. Ndeye, one of her daughters, got a job in an office despite having eight kids herself, because Mrs Diallo helped out with the children.

Yet for all her sense of love and duty, Mrs Diallo cannot babysit all 30 grandkids. The state offers little help. Unlike Ndeye, many of Mrs Diallo’s daughters and granddaughters have never worked outside the home. This is common: barely a third of working-age women in Senegal are either in work or seeking it. Grandparents in the poorest countries do their best, but there are not enough of them.

She’s there in times of need

In richer places, fertility has fallen much further than in Africa. A typical Mexican woman, for example, can expect to have only two children, down from nearly seven in 1960. Mexico’s ratio of living grandparents to children is three times higher than Senegal’s. Mexican abuelas thus have more time to lavish on each grandchild.

Irma Aguilar Verduzco lives with her daughter, also called Irma, and two grandchildren, Rodrigo and Fernanda. She cooks, does school runs and reads with her grandchildren. Ever since he was three, Rodrigo, now 16, has liked to take a cup of coffee and sit down for a chat with his grandmother. Fernanda, now 12, still likes to get into bed with her. Irma junior, meanwhile, has long worked 12-hour days, currently as a manager at the Maya Train, a big rail project. She is divorced, and says her ex-husband “does not help”. She “could not have done anything” without Irma senior’s help.

Grandmothers are the main source of non-parental child care for young children in Mexico, especially since covid-19 forced many nurseries to close. They watch over nearly 40% of sprogs under six. Before grandma moved in, Irma was struggling. “There is no understanding or flexibility for working mothers in Mexico,” she complains. Her kids were often home alone. “Sometimes I paid people to look after them but it was hard to afford and hard to trust people.” One day, years ago, Rodrigo came home from nursery with a broken bone; Irma suspects mistreatment. With her mother around, she feels relaxed.

Miguel Talamas of the Inter-American Development Bank and his colleagues have tried to estimate how much Mexican grandmothers help their daughters get paid work. They looked at what happened to families after grandmothers die. An abuela’s death reduced by 27%, or 12 percentage points, the chance that her daughter was in the labour force, and reduced her earnings by 53%. (The same study found no effect on the employment rate of fathers.)

Living with grandparents is not always easy. They may have outdated ideas or demand too much deference. In India, where couples traditionally live with the husband’s parents, a genre of television drama turns on the fraught relations between wives and mothers-in-law. A study of rural Indian women in 2018 found that those who lived with their mummyji (mother-in-law) had little freedom. Only 12% were allowed to visit friends or relatives alone.

A grandma who enforces old-fashioned norms of wifely subjugation can make it harder for her daughter-in-law to work outside the home. But an intriguing study finds that on average, this effect is outweighed by the help the mother-in-law gives with domestic chores. Such help has become more concentrated as India’s fertility rate has fallen, from six in 1960 to just over two today. Madhulika Khanna of Amazon and Divya Pandey of 3ie, a think-tank, looked at what happened to Indian women if mummyji died. They found the daughters-in-law were 10% less likely to do or seek paid work, probably because they had to spend more time collecting firewood and minding their children. Even overbearing grandmothers can inadvertently do their bit for female emancipation.

Rich countries generally provide services that help women juggle child-care and work. But many parents seek extra help from grandparents nonetheless. Old-age pensions help, by allowing grandparents to give up work. According to one survey, 50% of very young children, 35% of primary-school-aged children and 20% of teens in America spend time with their grandparent in a typical week.

This can make a big difference. Janice Compton of the University of Manitoba and Robert Pollak of Washington University crunched American census data and found that living within 25 miles of a grandmother raised the labour-force participation rate for married women with small children by 4-10 percentage points.

“Granny nannying”, as some call it, can have downsides, too. A British study found grandparents are more likely to leave their wards near fire hazards than nurseries or nannies. Studies from America, Britain, China and Japan suggest that a child around grandparents is more likely to be obese, though whether this is due to spoiling or other factors is unclear.

To us a book she’ll read

And although grandmas help daughters return to the workforce, that often means withdrawing from it themselves. “There is a clear trade-off,” says Mr Talamas. Back in Mexico, Hermelinda Coapango Vázquez works as a manicurist but takes appointments only at times that fit around caring for her grandson. “My grandson is my life,” she says. “I don’t have a partner and I am not one for having lots of friends.” A study from Brazil found that when children aged 0-3 were randomly assigned formal childcare, the family collectively earned more, mainly because grandparents and older siblings were freed up to work.

Another pitfall is that families that rely heavily on grandma for child-care are less likely to move and find a better job. A study by Eva Garcia-Moran of the University of Wurzburg and Zoe Kuehn of the Autonomous University of Madrid found that west German women who lived near their parents in-laws earn about 5% less and commute for longer than their peers.

Children parented solely or mostly by grandparents tend to be worse off than their peers. In America, where roughly 2% of children are raised primarily by a grandparent, Laura Pittman of Northern Illinois University found more emotional and behavioural problems among such adolescents than their peers. That is perhaps not surprising. If children are not living with their parents, it is often because something has gone badly wrong: a father in jail; a mother dead or incapable. In these circumstances, living with a grandparent is usually far better than the alternatives.

Katie Clark, a 68-year-old from Baton Rouge, Louisiana, has had sole custody of one grandchild and has temporarily cared for five others because of her daughter’s addiction to opiates. She took charge of her daughter’s first baby soon after she was born. About 12 years later, the daughter arrived, homeless, with five more. She abandoned her children in Katie’s home, before returning with police to demand them back. The daughter currently has custody of the five children, and Katie fears she is neglecting them again. The child raised entirely by Katie is now at university.

In rural China, grandparents help reduce the harm caused by the government. Under the apartheid-like hukou (household registration) system, rural Chinese who move to cities are treated as second-class citizens. Their children are barred from local public schools, so they are often left behind with their grandparents in their parents’ home village. But rural schools are often dire. Grandparents, though well-meaning, are often barely literate. Scott Rozelle of Stanford University finds that more than half of toddlers in rural China are cognitively delayed, partly because their grandparents do not realise that it is important to talk to them.

In Chinese cities the story is different. The one-child policy (which became a three-child policy in 2021) was always enforced more strictly in cities than the countryside. So many urban families consist of four grandparents, two parents and just one child. Thus, there is no shortage of caring hands. Urban children often live with grandparents during the week and see their hard-working parents on weekends.

Nurseries are pricey and distrusted in China. Grandmothers often retire in their 50s to watch over the precious only grandchild. This works well enough. The labour-force participation rate for Chinese women is, at 62%, slightly higher than America’s. “If you want to give your child a good education, you have to work hard to earn a lot of money,” says Zhou Bao, an architect and mother in a “4-2-1” family who has used both sets of grandparents for child-care. But “in the process of making money, you can lose the time spent with your child.” And she expresses a common fear that grandparents tend to spoil their only grandchildren. “They can be too attentive,” she says, “making them less independent.”

The Communist Party promotes traditional values, such as family members caring for each other so the state does not have to. In Beijing the government even set up a school in 2005 to teach grandparents how to look after children better. But the next generation may not wish to shoulder the same responsibilities. Few middle-class parents today expect to be bringing up their children’s children in a few decades, reckons Dan Wang of Hang Seng Bank. If they opt out of grandparenting, that could make it harder for their daughters to combine motherhood and work, fears Ms Dan.

Just stays a little while

Overall, looking after kids appears to be good for grandparents. Those who spend time with their grandchildren report lower levels of depression and loneliness. But one can have too much of a good thing. Youngsters can be exhausting, frustrating and objectionable. A study in Singapore, with mainly ethnically Chinese families, found that many looked after their grandchildren more out of duty than because they relished it. Many find it harder as they age. Some are squeezed in the “grandsandwich generation”—relied upon to help both their grandchildren and their own ailing parents. Some hanker for a more relaxing retirement. Grandma Irma in Mexico admits she would like to travel more as her grandchildren grow more independent.

One place where grandparents have plenty of time to relax is Sweden, where a strong welfare state means parents seldom rely on them. For each child, a Swedish couple can take 16 months of parental leave, for most of which the state pays them most of their previous wages. (The man must take three months, or they are lost; many split the time off equally.) Afterwards, there are subsidised nurseries, and the norm is for both parents to go back to work. Since child-care is everywhere, Swedes find it relatively easy to move cities to find a better job.

“Once in a while a grandparent might pick up a kid from pre-school or babysit, but not always,” says Andreas Bergh of Lund university. Rather than allow a daughter to go back to work, grandparents might enable her to go out to dinner with her husband. Grandparental help is “a bonus”, says Andreas Heino of Timbro, a think-tank in Stockholm.

Subsidies for parental leave are so generous that even entrepreneurs take a fair chunk of it. Sandra Kastås runs two companies in Stockholm. When her son was born in 2021 she took two months off, then spent a year working half-time, as did her husband, an IT specialist. Despite her hectic schedule, Mrs Kastås expects no regular help from her parents. They live on Gotland, a remote island, and do not visit often. Her mother “shows her love by sending gifts”, such as books and jumpers she has knitted. She talks to her grandson, on FaceTime. “He hugs the phone when she calls. It’s cute,” says Mrs Kastås.

Most Swedes are happy with their system. But some of the elderly complain of loneliness. Nearly half of Swedish households consist of one person, the highest level in Europe after Finland. In a population of 10.4m, some 900,000 people are over 60 and living alone. Of these, a fifth are considered socially isolated, meaning they do not meet friends or family more than twice a month. During the pandemic, Swedes joked darkly that it would be easy to isolate the elderly because “We don’t visit our grandparents much anyway.” Immigrants from places such as Africa or the Middle East are often shocked at how atomised Swedish families are.

Lars Tragardh, a historian, praises Sweden’s “statist individualism”. The state looks after people as individuals, so they can make their own choices and not have to rely on others, he says. Parents elsewhere envy the help that their Nordic peers receive, despite the higher taxes needed to pay for it. Still, even the most generous welfare state cannot offer love.

Helena Paues, who works for an association of local authorities in Sweden, describes how her father enjoys taking her dyslexic son, Wille, to museums. “He loves facts and science. I think his grandfather has taken him to all the museums in Stockholm: the science museum, the Viking museum, and so on. They have a very close bond. My father also struggled with learning to read and write when he was young.”

In the summer, the grandkids stay at their grandparents’ summer house, swim in the lake, and drink lemonade in a tree house. They clamour to do the same thing every year. Ms Paues says her father instils values such as respect for others. “He doesn’t need to talk about it, he does it by being himself. He teaches them that their opinions matter, because he listens to them.” She concludes: “As a child, you need more grown-ups than just your parents.” ■

Some years have a way of giving countries, even continents, a shove in a new direction. In 1945 Europeans decided that the state had to take the lead in establishing a modern economy, a broader welfare state and a more peaceful continent. In 1979 a doubling of oil prices, which followed a decade of stagflation, brought about a swing away from cosy co-operation between the state and business towards a bigger role for markets and private enterprise. Might 2023 be another such year? It comes as a decade of low interest rates is ending, as high energy prices and inflation return to the world economy, and as war stalks Europe. It also comes in the wake of one of the deadliest pandemics in history and as China retreats from closer global integration.

If these trends were to presage broad political shifts in rich countries, you might expect politics to move left, if only in reaction to the mainly centre-right governments that dominated rich democracies during the previous decade. That already appears to be happening. In 2022 in the Bavarian Alps, at a meeting of the G7, a group of rich countries, Joe Biden could look around the table (see picture) and count five other leaders from the centre-left: those of Canada, France, Germany, Italy and, stretching a point, Japan—Kishida Fumio describes himself as a dove on foreign policy. (An election later moved Italy to the right.) In contrast, when Mr Biden’s Democratic predecessor, Barack Obama, met his counterparts in 2010, all of them came from the right or centre-right.

This might, of course, be just an unusually synchronised swing of the pendulum, rather than the start of a broader shift. The right-wing success in the Italian general election of late 2022 is a reminder of the importance of national exceptions. Still, there are reasons for thinking that something more profound may be going on than just bashing whoever happens to be power. It is something that cuts across national borders.

Public opinion appears to be shifting to the left in rich democracies. In the United States, the share of respondents to surveys by the Pew Research Centre who said that banks had a positive impact on the economy fell from 49% in 2019 to 40% three years later (see chart 1). The decline for tech companies was comparable and for large companies greater; only a quarter of Americans thought they were a net plus. This seems a far cry from the 1980s’ belief that private enterprise would solve many of the world’s problems.

Anti-corporate sentiment is only a start. Half or more of respondents in America, Britain, France and Germany told Pew that their economies needed major change or a complete overhaul. The majority of those demanding greater reform described themselves as on the left. The public’s desire for sweeping changes may be underpinned by climate-change worries and a belief that not enough is being done about them. In another Pew poll in 19 countries, three-quarters of respondents described climate change as a major threat, making it a bigger concern than even the world economy and pandemics (see chart 2). On the face of it, people want more than business as usual.

The possibility that 2023 might prove to be some sort of turning-point is supported by the sort of tectonic shifts that lead to broad change, even if they rarely make headlines. For decades, the working-age share of the world’s population grew, producing more workers relative to children and retirees, and providing a so-called “demographic dividend” to the global economy. That exerted downward pressure on interest rates and wages, and pushed in the direction of greater income inequality, faster economic growth and high valuations of large companies. But as Charles Goodhart and Manoj Pradhan, both economists, point out, these trends can change—and sometimes quickly. The working-age share of the world’s population has been falling for ten years, interest rates have started to rise and the value of companies has sunk, at least as measured by the adjusted price-earnings ratio of S&P 500 companies, which dropped from 39 at the end of 2021 to 27 in December 2022.

Whether all this translates into a significant change of direction for democratic politics, however, is a different matter. For that to happen, public opinion or economic shifts are not enough. The turning points of the past were made possible not just because political parties espoused new beliefs but also because they were able to make the compromises needed to put ideas into practice. It is far from clear that political parties have the mandates, power or will to do that now.

Margaret Thatcher and Ronald Reagan won landslide victories in the 1980s, but such decisive outcomes have become rarer. Between 1980 and 1996 the winner of the American presidency took the popular vote by a margin of almost ten points. From 2000 to 2020 the margin was less than 2.6 points. Joe Biden has the additional problem of managing a divided government. In Britain, the governing party won an average of 48% of the vote in elections from 1945 to 1960; since 2010, the winners’ share has been less than 40%. Voter turnouts have fallen sharply in most rich democracies. Parties cannot count on big popular mandates. And even if they get one, they may not last. In the French presidential election of April 2022 Emmanuel Macron beat Marine Le Pen convincingly by 59% to 41%. In legislative elections two months later, his party lost its majority and Ms Le Pen’s National Rally won more new seats than any other party. Like Mr Biden, Mr Macron is weakened by divided government.

In Europe in the 1960s parties were mass movements, with millions of members. No longer. Take Britain. The six parties in Parliament (excluding those from Northern Ireland) now have a combined membership of 846,000, below that of the Royal Society for the Protection of Birds. Voters are also more fickle, while fewer people see parties as vehicles for advancing political goals. “Our partisan allegiances”, Robert Talisse of Vanderbilt University in Nashville, Tennessee, told the BBC “have become lifestyles, rather than principled views about what the government should be doing”. Parties have become expressions of narrow interest groups—or in some cases, megalomaniac egotists—rather than of broadly based social movements.

In the absence of mass membership and with elections turning on ever-finer margins, the incentives in most democratic countries are for parties to keep as many of their supporters as possible happy and not to take risks. That is not good news for anyone expecting a new direction in politics. There may be an appetite for broader change, but governments and hopeful oppositions will be cautious of taking advantage of it.■

MENUMATU NALLO’s group meets beneath a tree in Kambia, a town in north-west Sierra Leone. Some 40 women (and a few men) gather on plastic chairs. Brandishing picture cards, Ms Nallo reminds her neighbours which foods are good for pregnant women to eat. She implores young mothers to feed newborns only breast milk, and to reject cups of water offered by well-meaning relatives. Ms Nallo likes to open her sessions with a Christian prayer. She ends them with a Muslim one.

Mother-and-baby groups are an important defence against sickness and malnutrition in this corner of Sierra Leone. Illiteracy makes it difficult to share messages in other ways. But for a year after covid-19 arrived in Sierra Leone, such gatherings could not happen. Mohamed Bangura, a health worker, says parents avoided bringing small children to hospitals. Many went unvaccinated; some underfed kids got no food aid. At least one of the toddlers fidgeting on laps at Ms Nallo’s meeting has the tell-tale discoloured hair of malnutrition.

In the lottery of life, well-off and supportive families and societies give children a big leg up. But random shocks during early childhood can make a big difference, too. In Indonesia, for example, children who are born in years with lots of rainfall tend to be wealthier than average in adulthood. In America, research shows that people who were in utero in late 1918, at the height of the Spanish flu, were 5% less likely to complete high school and earned a bit less as adults.

The world’s most recent pandemic, too, has dealt children under five years old a bad hand, with possibly long-lasting effects. The problems include much higher rates of malnutrition, scanter attention from stressed-out care-givers, and reduced access to pre-schools. The clearest data come from rich countries, but the worst impacts will probably be in poor ones.

The pandemic can hurt babies before they are born. Small children are much less likely than adults to get very ill if they catch covid. But pregnant women are a bit more likely than average to get severe symptoms, which increases the risk that their children will be born prematurely or have a low birthweight. The pandemic also caused many expectant mothers to undergo extreme stress, which studies show can affect unborn children. Research in Sweden, for example, has found that children of women who lose a relative while they are pregnant are more likely to suffer attention deficit disorder, anxiety or depression when they grow up.

The number of newborns getting their shots fell significantly during the pandemic. The share of small children fully inoculated against diphtheria, tetanus and pertussis—a benchmark for vaccine coverage more generally—went from 86% before the disaster to 81% last year. In the first two months of 2022 there were around 80% more cases of measles worldwide than in the same period of 2021, in part because of fewer jabs. Polio is popping up in places where it had not been seen for decades.

Diets have worsened, too. Even before the disaster more than 45m children under the age of five (around 7% of the total) suffered from wasting, the most acute form of malnutrition. Around 150m (or 22%) suffered stunting, in which prolonged malnutrition stops children’s brains and bodies developing properly. The pandemic pushed up food prices, while also forcing many adults to stop work. In 2021 a group of researchers warned that by the end of this year the number of children with wasting could rise to 60m—a roughly 30% increase since the start of the pandemic.

Stress and distraction made some parents more distant. LENA, a charity in Colorado, has for years used wearable microphones to keep track of how much chatter babies and their care-givers exchange. During the pandemic the number of such “conversations” declined. Jill Gilkerson of LENA notes that parents who had to start home-schooling older children might have had less time for little ones. But getting lots of interaction in the early years of life is essential for healthy development, so these kinds of data “are a red flag”.

Children starved of stimulation at home also had fewer chances to find it outside. In 2020 early-childhood education “went literally to zero” in many parts of the world, says Jaime Saavedra of the World Bank. Virtual schooling was hardly an option for tiny tots. In developing countries pre-schools tended to stay closed longer than grade schools because of safety worries. These were often exaggerated: though small kids are not keen on social distancing or masks (of the non-Batman sort), they are less likely to get sick from covid.

At a pre-school and crèche in São Paulo, in Brazil, toddlers are back to smearing their lunches on tables after closures that lasted far longer than in most places. But Claudia Russo, the head, says many of them went hungry during lockdowns. She laughs at the idea that they could have continued learning at home: “Can you imagine how difficult online classes are with children aged zero to three?” Even when her pre-school reopened, Ms Russo says, lots of children stayed away.

In school-age children, the pandemic’s impacts are obvious in test scores. Measuring the cost to babies and pre-schoolers is harder. Tools for tracking early child development are not as sophisticated, and the impact of shocks in early childhood can take years to appear. Researchers are focusing on detecting delays among children in the phase of early development from conception to two years of age. But they often lack good enough data from before the pandemic to make rigorous comparisons, warns Emily Oster, a health economist at Brown University. Others have been forced by covid to change how they do their studies (by donning masks when examining children, or switching from in-person tests to parental surveys). That makes changes over time hard to detect.

A study published in October weighed the findings of eight early experiments, carried out in America, Canada, China and Kuwait. It concludes that in most regards babies born or raised in the first year of the pandemic are doing no worse than infants before them. But they were more likely to score poorly on tests that measure early communication skills. One of the study’s authors, Alireza Shamshirsaz of Boston Children’s Hospital, says it is impossible to say whether lagging children will swiftly catch up, because the social changes during covid are unprecedented. As children grow up, he says, researchers may find more reason for concern.

For the millions of young children who went hungry because of the pandemic, poor outcomes are easier to predict. Children who suffer from malnutrition risk “lifelong, irreversible consequences” even after their diet recovers, says Saskia Osendarp of the Micronutrient Forum, a research and advocacy group. Hunger has a wretched impact on growing brains. A study in five low- and middle-income countries found that stunted children complete one fewer year of schooling. Another study of data from dozens of developing countries estimated that stunting reduced earnings by 22%. Women who were stunted in childhood are more likely to suffer complications during childbirth. Their own children are also more likely to be malnourished.

Suffer the little children

Perhaps the firmest evidence relates to missing pre-school. Researchers in Latin America, where nursery closures were especially lengthy, have lately found large declines in the share of children acquiring skills needed to make a good start in school. By late 2020 three- and four-year olds in Chile were performing very poorly in simple language tests, says Florencia López Bóo of the Inter-American Development Bank. She says the effect was as if their mothers had lost five years of education (children with better-educated parents tend to do much better in tests).

The number of pre-schoolers who would fail a benchmark test of academic, physical and emotional development rose about 13% globally in the pandemic’s first year, according to estimates by academics in Africa, America and Europe. They are likely to score lower marks during their school years; that could mean lower wages. UNICEF, the UN agency for children, thinks pre-school closures during 2020 alone could cost children $1.6trn in lost lifetime earnings, equivalent to 1.7% of global gdp.

Though widespread vaccination has made covid-19 much less lethal, conditions that harm young children persist. Malnutrition is “perhaps even worse than in 2020, when covid hit hardest,” says Ms Osendarp. Many emergency support programmes put in place during the pandemic expired just as new challenges to food supplies—such as Russia’s invasion of Ukraine—turned up. In July the WHO and UNICEF said that a combination of low vaccination rates and high rates of malnutrition threatened to “create the conditions for a child survival crisis”.

In Brazil, the share of people who cannot consistently get enough food has risen from 9% in 2020 to 16% this year, reckons Rede PENSSAN, a charity. Luciana Quintão of Banco de Alimentos, another NGO, says she recently watched in alarm as a pregnant woman filled a shopping basket with instant noodles. The global nutrition situation is “continuing to deteriorate”, says Yvonne Forsen, who leads the World Food Programme (WFP) office in Sierra Leone. Projects such as the mother-and-baby groups, which the WFP is supporting, do good. Still, “You solve one problem and then you realise there’s another problem waiting down the road.”

Renewed efforts to feed and vaccinate small children are essential. But providing more and better pre-schooling would also help. The fear is that pre-schools will henceforth find it harder to compete for funding and attention, since primary and secondary schools are demanding more resources to help pupils catch up. Investment in pre-schools had been growing, says Amanda Devercelli of the World Bank: “I worry that some of the momentum we had before the pandemic could stall.”

The latest detailed figures, from the end of 2021, suggest that pre-school attendance in England was still only about 80% of the level before the pandemic. That may be because parents are still worried about infections, or because hard-pressed families have become less keen to pay. Enrolment in American pre-schools plummeted by 25% from 2019 to 2020, according to census data, and seems not to have fully bounced back. Some American nurseries still require small children to spend their days in masks. That does little for their health or others’. It may, however, make school less educational and less fun.

All this means that teachers in early primary grades will have a lot more work to do. In many countries lots of children were already repeating their first year, in part because they turn up wildly unprepared. This makes for big class sizes, which in turn make lessons less effective. This cycle could now grow more entrenched, worries Ms Devercelli. Small children will end up paying the price. ■

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“My cousin and I were driving in the car one day and my mouth started moving before my brain knew what it was saying,” says Angus Barge, a 30-year-old who lives in London. “And I basically told him that for the previous six months I’d been struggling to get it up.” Erectile dysfunction (ED) affected more than just his romantic life, says Mr Barge. He lost confidence and had trouble concentrating at work because he was preoccupied with the problem. After a long silence, Mr Barge’s cousin, Xander Gilbert, told him that he had been struggling with the same thing on and off since he was a teenager.

Their experience is not unusual. Surveys of men in America, Germany and Spain have found that around 20% suffer from ED at some point in their lives. Women can struggle with sex too. Surveys suggest that around half of British women experience sexual difficulties that had lasted for more than three months in a given year. In Canada, researchers found that nearly 40% of women and 30% of men aged 40-59 had some sort of sexual problem, such as low desire, pain during sex, erection problems or difficulty reaching an orgasm.

No laughing matter

Getting help is tricky. Overstretched health services struggle to provide quick treatment. Many doctors end up prescribing drugs like Viagra to men whose problems are psychological, not physical, because there is nothing else they can do. A mix of embarrassment and ignorance means many of those suffering from sexual dysfunction never seek treatment in the first place. In France, for example, only a quarter of people with sexual problems contact a doctor. Mr Barge says he scoured the internet for solutions to his problem, trying various pills and supplements to no effect.

Sexual problems remain cloaked by shame and embarrassment, rather as mental-health ones did two or three decades ago. Patients are often reluctant to seek treatment; many doctors see the problem as trivial. Even in the liberal countries of western Europe, sex education mostly focuses on preventing diseases or unwanted pregnancies. Even dedicated sexual-health clinics tend not to have much to offer those struggling to have satisfying sex. Fortunately, that is beginning to change.

Sometimes sexual problems can be an early hint that something is wrong elsewhere in the body. ED is often a purely psychological issue, especially in younger men. But in many cases it is at least partly caused by a narrowing of the genital arteries. That makes it an early warning sign of possible heart trouble. Suffering from ED is as good a predictor of heart disease as a history of smoking or a family history of coronary artery disease.

Sometimes the issues are simply distressing rather than potentially fatal. A clutch of British universities runs a decadal sexual-health survey called Natsal, one of the biggest in the world. In the most recent survey, completed in 2012, 7.5% of sexually active women reported painful sex, with a quarter having symptoms “very often” or “always” and for at least six months.

Not all problems are strictly medical in nature. Discordance in sexual desire is a common problem. The most recent instance of Natsal also found that 38% of men and 49% of women with a partner said that the amount of sex in their lives was “about right”. Nearly all of the rest, both men and women, said they wished for more. In many cases a gap between partners is related to differences in the level of enjoyment derived.

That matters. Besides being miserable for the individuals involved, sexual dissatisfaction is a big reason why marriages and long-term relationships break down. Data from places as diverse as America, Denmark and India suggest that problems with physical or emotional intimacy are a leading cause of between 20% and 50% of divorces. (Which in turn often make adults poorer and children less happy.)

As Mr Gilbert found, sexual problems can affect work, too. A study published in 2019 examined 52,000 men in countries including Brazil, China, Germany and Spain. It found higher rates of absenteeism from work in men with ed (7.1% compared with 3.2% over a six-month period), as well as substantially lower productivity when they were in the office.

Embarrassment—on both sides of the doctor’s desk—means that sexual problems often go untreated. Even in the Netherlands, where people are more open about sex than in most other countries, patients want the doctor to open the discussion, says Woet Gianotten, a Dutch sexologist and emeritus professor at the University Medical Centres of Utrecht and Rotterdam. But medics can often themselves be reluctant. Many, says Dr Gianotten, assume that if the patient does not mention a sexual problem all must be well. Kristen Mark, who teaches a course on sexuality to medical students at the University of Minnesota, says that a lot of time in the course is devoted to practising plain speaking. “If they are talking to a patient we don’t want them to have this awkward look on their face as if that’s the first time they’ve ever said the word ‘vulva’.”

If embarrassment can be overcome, there are plenty of treatments available. Some doctors recommend a few sessions of “mindfulness”, a trendy sort of meditation that helps to refocus the mind away from whatever is causing anxiety. The patent on Viagra, a popular medicine for erectile dysfunction, expired in 2020, meaning cheaper, generic versions of the drug are now widely available. In women, menopause is a frequent cause of sexual problems. Women in rich countries have had access to hormone-replacement therapy for many decades. Besides treating hot flushes and insomnia, it can also help relieve the sexual symptoms of menopause.

Different levels of sexual desire, meanwhile, are often related to differences in the level of enjoyment derived. Another sexual-health survey, this time for Indiana University, found that, in America, men have orgasms in consensual sexual encounters about 85% of the time, compared with 63% for women. The reasons for the gap are complex but much has to do with misplaced ideas about what “normal” or “good” sex is, says Dr Mark. Since talking frankly about sex is difficult, many people absorb tropes from Hollywood or the porn industry. Unsurprisingly, these do not translate well to real life.

Letting the light in

Despite the prevalence of sexual problems, very few countries have made their treatment part of routine primary care. France stands out for its attitude to post-natal women. Childbirth can wreak havoc with a woman’s pelvic-floor muscles. Among other problems, that can stop them having sex for a long time after giving birth. French women are entitled to appointments with a pelvic physiotherapist, starting just six weeks after birth. The Netherlands allows disabled people, such as those with paralysis, to request sessions with specially trained sex workers. (In the past the cost of the service was covered by social insurance but after cuts to social spending it is no longer free.)

Some governments are beginning to focus on promoting pleasure as much as treating the lack of it. In many cases, this new approach was prompted by the covid-19 lockdowns. Single Dutch people were allowed to meet with a “sex buddy” when contact between households was restricted. Irish health authorities gave their citizens recommendations on masturbation. Colombia’s health ministry dispensed guidance on the use of sex toys and consensual cybersex.

For those who prefer not to take sex tips from bureaucrats, the sex-toy industry offers another avenue for relief. Savvy marketers are positioning their products as “wellness devices”, in an attempt to escape the industry’s grubby aura and to align with shifting attitudes among customers. Perhaps as a result, it is growing fast. PwC, a consultancy, reckons about 25-30% of adults in America, Britain and France use sex toys. A third bought their first device in the past three years. Walgreens, an American chain of chemists, and Boots, its British subsidiary, now offer dildos and vibrators on their websites, alongside ibuprofen and false eyelashes. PwC puts the size of the global market at $19bn in 2021, up from $11bn in 2016, making it roughly as big as the market for hair-styling products.

Apps are another popular option. Mr Barge’s and Mr Gilbert’s heart-to-heart led them to found Mojo, an app that provides exercises, education and support groups for those with erectile dysfunction. Mr Barge reckons that many users whose issues are psychological see an improvement within six weeks or so. A Spanish startup, Myhixel, offers app-based therapy for premature ejaculation. Germany has approved an app to treat vaginal pain made by HelloBetter, a startup, which users can pay for with their medical insurance.

Information can be particularly hard to come by in poor countries, which often have stronger taboos around sex. An Indian website called Agents of Ishq, started by Paromita Vohra, a film-maker, is one attempt to fill that gap. It features humorous video skits, comics and other entertaining materials that cover things like consent for sex and masturbation (including an annual masturbation poetry contest). It also publishes stories about sex and desire submitted by ordinary people. Many of the comments, she says, are along the lines of “Oh, I’m not alone…somebody else also feels that way.”

Some experts, meanwhile, think the problem might be better addressed with prevention rather than attempts at curing problems after they arise. Although most teenagers in rich countries attend sex-education classes at school, the focus tends to be on avoiding bad things, such as diseases or unwanted pregnancies. Discussion of pleasure is often conspicuous by its absence. In poor places, the subject is often not discussed at all.

At the very least, says Mojo’s Mr Barge, sex education in schools should aim to be realistic, and to cover health, pleasure and potential problems. It should aim to remind teenagers that “sex isn’t like it is in films and it doesn’t always go right. And even as young, healthy people, you’re going to have problems and that doesn’t mean you’re broken. It’s perfectly normal for sex not to go to plan.” ■