In the early nineties, the economist Jeffrey Sachs was known as a “shock therapist,” for advising the Soviet Union on its controversial transition to a free-market economy. Since then, Sachs has shifted his focus to poverty alleviation and international development, becoming one of the most visible academics in the world. His book “The End of Poverty,” from 2005, imagined a globe free of the worst forms of destitution; Sachs also attributed misgovernment in much of Africa to poverty, rather than the other way around. (This thesis was much debated by other economists and development experts who were more skeptical about the impact of foreign aid.) From 2002 to 2016, Sachs was the director of Columbia University’s Earth Institute; he is currently a professor at the university and an adviser to the United Nations. He endorsed Bernie Sanders for President in January and has occasionally advised the senator.

I recently spoke by phone with Sachs about the coronavirus and the challenges that the crisis poses to international coöperation and the world economy. His upcoming book is “The Ages of Globalization.” In our conversation, which has been edited for length and clarity, we also discussed the root causes of American decline, why some poorer countries have so far avoided large outbreaks, and how Donald Trump has failed to meet even the low expectations that internationalists have for the United States.

One dominant theme in the coverage of the coronavirus has been the supposed trade-off between the economy and our health. In a short-term or a long-term sense, do you accept that premise?

The only way to have a viable economy and society is to control this epidemic. So it’s not really a trade-off. The question is how to be effective in controlling the epidemic and driving the transmission of the disease to very low levels. Simply letting the virus run through the society would be unacceptably costly, and that’s why essentially no country in the world is doing that. The real issue is to be effective in the response, and unfortunately the United States has not been effective so far.

Did any lessons you learned working in countries around the world inform your opinion of how to deal with this latest crisis?

There are many aspects of any major crisis that are similar in character, in that they require governments to assess the situation with sophistication, to identify options, to come up with strategies, and to implement them. Crisis management has a lot of common points. The nature of the crisis could be geopolitical. It could be a climate-related shock or a disease.

I would say the core issues are the capacity of political leaders and their inner team, and the capacity of the institutions of governance—agencies, departments, and ministries—to be able to process information in a timely way and to be able to harness expert advice and evidence in a timely way. We live in a complicated world. If you try to wing it, as Trump does, you end up with more than forty thousand deaths. If you want to solve a problem, you have to be systematic about it, and know whom to turn to and how to listen and amass evidence. For politicians, that doesn’t necessarily come naturally, and for our President it doesn’t come at all.

Is there some leader Trump reminds you of whom you’ve worked with?

Trump is the worst political leader I have experienced in all of my professional life, which is forty years of working with governments at a high level. I’ve never seen anything like the narcissism of this man, and here we are, a country so rich in expertise, in resources, in capacities, and yet we’re watching a complete failure of a political response—with a massive loss of life—in real time. It’s quite shocking, because Trump not only does not know how to approach this issue but he blocks those who do.

Something you’ve become known for is this idea that one of the reasons there are bad governments in the world is because of poverty, rather than looking at poverty as the result of bad governance. Is that a fair summary?

Yeah. That certainly is one part of it, absolutely. Politics comes in many shapes and forms, and I was arguing that in many poor places you have potentially high capacity to address problems, except that the resources aren’t there for that. So the argument was that helping poor countries could actually accomplish something, because what they most fundamentally lacked was resources.

You have just finished saying that Trump is the worst leader you’ve ever seen. And we are seeing leaders all around the world, even in rich countries, handling this pandemic disastrously. These are countries with immense wealth, with immense scientific knowledge, and immense resources, and the governance is still in many cases atrocious. So does that make you think at all differently about your theory?

Well, my point was that the quality of governance is not intrinsically linked to one’s G.D.P. per capita, and that a poor place, if it had more resources, could often accomplish a lot. And I’d say the converse is that a rich place that’s badly governed accomplishes very little. So it’s consistent with that idea that you don’t simply say rich means good governance and poor means bad governance. That actually was my point fifteen years ago. It remains my point today—that here we have rich countries but their political systems are failing the people.

Poor countries could have good responses, in fact, but often lack the means to carry them out. We don’t lack the means to carry out good responses in the United States; we lack the leadership to do so, and there are reasons for that. Basically, American politics has become deeply corrupt over decades, and it became so corrupt that normal governance already collapsed many years ago. And people with resources and knowledge know it, but they haven’t cared, because things have more or less gone on O.K., and the stock market has been booming, and even though in almost any private conversation Trump is viewed as a complete dolt and a complete incompetent, that was more or less laughed off as manageable because he wasn’t doing too much damage, either.

That’s the real situation. Nobody here has viewed government as actually very functional for a long time, and not because it couldn’t be. It has been increasingly designed to fail. Specifically, it’s been designed to respond to powerful lobbies that want deregulation or tax cuts or some special privileges rather than to function in a normal way. And powerful people shrug their shoulders at that, because for the élites that’s been O.K., but it obviously hasn’t really been O.K. for a long time. We’ve had rising death rates. We’ve had the deaths of despair. We’ve had the failure to come to grips with climate change. We’ve had widening inequalities and massive suffering. But it hasn’t mattered in such a visible way.

So what you were saying before was that these countries don’t have the resources to have good governance, but you’re saying now that if you do have the resources you still need all these other things that, in America, we either once had and don’t have anymore or have let go because of the way our ruling class has behaved?