The Great Escape is escape from ill-health and deprivation.  The author exemplifies it through the story of his own family.  Deaton’s father was brought up in a coal mining village and his first employment was at the pit. Leslie Deaton became an engineer by studying at night school. A victim of tuberculosis, he lived to the age of 90. 

        Leslie’s son became a Professor of Economics and emigrated to the United States. In turn, his two children, both Princeton educated, are respectively financial planner and hedge fund manager.  It is perhaps surprising that as fine a writer as Deaton records this evolution from coal face to hedge fund with no sense of irony. 

       Yet the near elimination of infant mortality and premature death amongst adults is indeed an inspiring story. Deaton spells out a key lesson: the main sources of these advances  are environmental changes achieved by collective action – better sanitation, pre and post natal advice, and reductions in the incidence of infectious diseases and exposure to them. The consequences of  individualised expenditure in what Deaton describes as the physician-patient healthcare system are relatively minor.

       That observation helps drive Deaton towards his central conclusion. Continued  large scale  poverty and deprivation is avoidable, and the result of political and organisational failure in the countries in which such poverty and deprivation persists. This analysis leads to a stinging attack on foreign aid, which Deaton believes simply underwrites such political and organisational failure.  The Great Escape is a thoughtful work, extensively illustrated with data, from a distinguished economist who tackles a central controversy of our time in a style refreshingly free of ideological baggage.