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HIV/AIDS, the silent war in Africa

Damien de Walque's picture

Under-5 mortality is often used—perhaps implicitly—as a measure of “population health”.  But what is happening to adult mortality in Africa? 

In a recent working paperi , we combine data from 84 Demographic and Health Surveys from 46 countries, and calculate mortality based on the sibling mortality reports collected from female respondents aged 15-49. The working paper is available here and the database we used for the analysis can be found here.

We find that adult mortality is quite different from child mortality (under-5 mortality)1.   This is perhaps obvious to most readers, but is clearly illustrated in figure 1. While in general both under-5 and adult mortality decline with per-capita income, and over time, the latter effect is much smaller for adult mortality, which has barely shifted in countries outside Africa between 1975-79 and 2000-04.

But in sub-Saharan Africa, contrary to under-5 mortality everywhere and to adult mortality outside of Africa, adult mortality increased between 1975-79 and 2000-04 and the relationship between adult mortality and income became positive in Africa as indicated by the upward sloping line in 2000-04.

This diverging and dramatic trend for sub-Saharan Africa is mainly driven by the HIV/AIDS epidemic. 

How can Zimbabwe avoid having the world’s worst Human Development Index?

Martin Ravallion's picture

Each year the mass media and many governments look keenly at the country rankings by the Human Development Index (HDI). In the 2010 Human Development Report, Zimbabwe has the lowest HDI in the world at 0.14 on a (0,1) scale (UNDP, 2010). The next lowest is the Democratic Republic of the Congo (DRC), with 0.24. (Norway is highest, at 0.94.)

It is natural to ask: what would Zimbabwe need to do to get its HDI up to the level of the DRC or better? Zimbabweans will no doubt have a strong interest in knowing the answer, as will those interested in the HDI in general.

There are three components to the HDI, for life expectancy, schooling and income. Let’s look at these in turn.

MVP evaluation session at Oxford

Gabriel Demombynes's picture

I am at Oxford for the annual conference of the Center for Study of African Economies, which runs through Tuesday.

Here's the program with links to many of the conference papers.

Plenary sessions, including my presentation on the Millennium Village Project evaluation, will be broadcast live on the web, and the recording will later be posted on the CSAE website.

I'll present a short version of the paper, which was co-authored with Michael Clemens of the Center for Global Development. This will be followed by a presentation from John McArthur, CEO of the Millenium Promise organization. Our session will be the last of the conference, on Tuesday 6-7 p.m. UK time (2-4 pm East Coast U.S. time.) 

For background, here are the first, second, third, and fourth earlier posts on the paper and check out our podcast, the MVP response, and commentary from Julian Jamison, Chris Blattman, Eric Green, and Bill Easterly and Laura Freschi.

Here's also video of an extended talk on the MV paper which Michael and I gave in DC in December:

Africa on the brink of a take off

Shanta Devarajan's picture

Dear friends,

Today we are trying something new.

I wanted to share with you the reasons why I think we can be optimistic about Africa's development prospects, but rather than writing something up, I thought of using video.

Please, share your feedback, not only on whether you agree that Africa is on the right track, but on the video itself. If you like it, I would like to do more of this short video "Development Talks" with the readers of this blog.

Let me know what you think.


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: