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What caused the HIV epidemic in Africa?

Shanta Devarajan's picture

Damien’s earlier post called into question one commonly-held view of the cause of the spread of HIV in Africa, namely male promiscuity. 

A paper by Pauline Leclerc and others (hat tip to Mark Gersovitz) seems to show that there is even greater uncertainty.  Leclerc and co-authors tried to simulate the dynamics of the epidemic in Zambia but found that the parameters needed to fit epidemiological models were beyond what the data would allow. 

In short, thirty years later, it appears as if we still don’t know what caused the disease to spread the way it did on the continent.  Perhaps there is no single set of causes, and that the evolution of the disease is different in different parts of Africa.  Perhaps we should move beyond epidemiological models and look to other disciplines for the answers. 

At any rate, to fight the epidemic effectively, we need to know how and why it became an epidemic.

Benin under water

Daniel Sellen's picture

I've written before about floods in Niger and Abidjan, but these experiences left me poorly prepared for what I saw in Benin a few days ago.

Half the country is under water, and it's still raining.

We recently received a request from the President of Benin to assist with recent flooding. I was asked to go take a look, get a feel for the scale of the problem, find out what Government and donors were doing about it, and make some recommendations for Bank action.

 After booking my flight, I did a Google search which revealed no details, even from OCHA, the UN's humanitarian branch. So I was sceptical about finding the type of damage I had seen elsewhere in the region over the past two months. If there was a big problem, the international press didn't seem to know about it. If they did, perhaps they were too tired of Haiti, Pakistan, or spoiling the euphoria following the rescued miners.

Evaluating the Millennium Villages

Gabriel Demombynes's picture

Here’s the quick summary of a new working paper I have co-authored with Michael Clemens of the Center for Global Development:

When is the rigorous impact evaluation of development projects a luxury, and when a necessity? We study one high-profile case where it is a necessity: the Millennium Villages Project (MVP), an experimental intervention in rural Africa. We compare development trends inside versus outside the villages in three countries, and show that estimates of the project’s effects depend heavily on the evaluation method.

The impact evaluation currently planned by the MVP is unlikely to yield adequate estimates of its effects on Africans in general, for five reasons we explain. But it is not too late to carefully measure the project’s effects, by making small and inexpensive changes to the next wave of the project.

Michael’s own blog post gives more details about the paper. The paper uses publicly-available data from the MVP mid-term evaluation report and Demographic and Health Surveys  (DHS). Field visits played no role in the study.

But after the study I found myself wanting to learn more about a couple of the places behind the statistics. So after we completed the analysis, during September 26-28, I took a trip with several World Bank colleagues to the western edge of Kenya. We visited two village clusters in Nyanza Province: first the MVP site in Bar-Sauri, and then the town of Uranga, 50 km to the west, which is not an MVP site.

Here’s a picture of me pressing the flesh with the kids at Nyamninia Primary School in Bar-Sauri:

Delivering Aid Differently – The New Reality of Aid

Wolfgang Fengler's picture

This month Homi Kharas and I published a book titled “Delivering Aid Differently – Lessons from the Field”. We launched the book yesterday at the University of Nairobi.  Here is a summary of the main messages:

We live in a new reality of aid. Rich countries delivered US$ 3.2 trillion of aid to poor countries between 1960 and 2008, and it is a US$ 200 billion dollar industry today. Despite disputes and convulsions, the core of the aid industry has changed little over the past few decades. Now the new pressures on the aid systems may be too strong to resist fundamental change.

Africa's great strides towards the MDGs

Gabriel Demombynes's picture

This week’s Millennium Summit has given data mavens like myself motivation to take a second look at the development indicators for the countries where they work.

For Kenya (my current focus, along with Sudan) a rich source of information is the recently published report for the 2008-09 Demographic and Health Survey.

Below I’ve graphed several indicators from the Kenya DHS from 1998, 2003, and 2008-09. We see that there have been substantial gains along several lines. School attendance rates rose with the introduction of free primary education earlier in the decade. Vaccination rates increased sharply between 2003 and 2008. Access to improved water sources also expanded, and phone access jumped as the mobile revolution hit Kenya.

The Multidimensional Poverty Index Debate: rounds 2, 3, 4 …

Gabriel Demombynes's picture

There has been a first-class debate on various blogs on the Multidimensional Poverty Index (MPI), including here, in this blog. Here’s a brief round-up:

Rivalité fraternelle au Burkina Faso

Damien de Walque's picture

L’école, une opportunité rare, objet de choix stratégiques dans les familles.

“Ici, pour les parents, l’école n’est pas une priorité”. Cette réflexion, empreinte de fatalisme, est souvent entendue comme explication des taux de fréquentation scolaire faibles dans certaines régions d’Afrique. Une étude récente menée dans la Province du Nahouri au Burkina Fasosuggère que la situation est plus complexe.

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