For the World AIDS Day, there is a sign at the World Bank that states that taking ARVs reduces rate of HIV transmission by 96%. If this was last year, a sign somewhere may well have read “A cheap microbicidal gel that women can use up to 12 hours before sexual intercourse reduces HIV infection risk by more than half – when used consistently.” Well, sadly, it turns out, so much for that.
Since I reviewed, back in April, the paper by Ashraf, Field, and Lee on the effect of providing vouchers for injectable contraceptives to women in reducing unwanted pregnancies in Lusaka, Zambia, I had been worrying about the use of these modern, convenient, and reliable technologies in those parts of the world in which HIV is highly prevalent.
In this article in the NYT from a few weeks back, there is this quote from Dr. Stefano Bertozzi, director of H.I.V. and tuberculosis for the Bill and Melinda Gates Foundation:
An interesting, recently revised working paper by Duflo, Dupas and Kremer looks at the effects of providing school uniforms, teacher training on HIV education, and the two combined. This paper is useful in a number of dimensions – it gives us some sense of the longer term effects of these programs, the methodology is interesting (and informative), and finally, of course, the results are pretty intriguing and definitely food for thought.
Each year almost 4 million children die within the first four weeks of life, many from preventable or treatable causes. Much programmatic aid is now devoted to devising ways to ensure that simple effective health practices, such as ensuring a more sterile birth environment, are adopted on a wide scale. A number of recent evaluations from South Asia suggest that the active involvement of local women’s groups in problem solving can be among the most cost-effective interventions to prevent deaths.
I’m currently attending this large conference in lovely Toronto and trying to pack-in as many sessions as possible. A handful of papers have stood out to me – two evaluations of on-going pay-for-performance schemes in health and two methodological papers related to the economics of obesity.
Given the massive debate in the U.S. about government health insurance, the just released results of a new experiment are justly making headlines. In 2004, the state of Oregon, due to budgetary shortfalls, closed its public health insurance program for low-income people. In early 2008, the state decided it had enough budget to fund 10,000 new spots. Given that it expected demand for these new slots to far exceed supply, the state Government opened up a sign-up window, getting 90,000 people to sign-up for a waitlist, and then used random lottery draws to select people from the waitlist.
A piece in this week’s Nature reports that a large vaccine trial for HPV, which can cause cervical cancer, is in trouble in India due to serious violations of ethical rules and informed consent.
Economists have long noted that the price mechanism can be effective at modifying human behavior. Psychologists classify this aspect of behavior motivation as extrinsic motivation, meaning that the behavior is induced by external pressure. If I increase my hours worked due to an overtime premium then I can be said to exhibit extrinsic motivation - I am responding to the price schedule offered me. In contrast to extrinsic motivation, psychologists posit intrinsic motivation as arising from within the individual.
Numerous recent discussions on the future of development financing focus on the delivery of results and how to mainstream accounting for results in aid flows (see here for one review paper by Nemat Shafik). This “results based approach” to aid is gathering steam in many contexts.