We know malaria is a big problem and we know fake drugs are a big problem. What do you get when you put them together? Bad news. A recent paper by Martina Bjorkman-Nyqvist, Jakob Svensson and David Yanagizawa-Drott (ungated version here) shows how bad this problem is in Uganda, and provides an innovative way to deal with it.
David has started a discussion that I find intrinsically interesting and one that well-designed impact evaluations can help clarify: why don’t more people adopt low-cost efficacious health technologies? We may be able to think of examples in our own lives – i.e. “why don’t I take vitamins more regularly?” or “why, if diabetic, don’t I self-test my blood sugar more frequently?” These same questions also resonate for large-scale health programs in many settings.
Diseases like malaria, diarrhea and intestinal worms plague hundreds of millions of people in the developing world. A major puzzle for development researchers and practitioners is why the poor do not purchase available prevention technologies that could reduce the burden of these diseases. While much of the recent literature has focused on price elasticities of demand and behavioral explanations, another potential explanation is that liquidity constraints prevent the poor from undertaking profitable health investments.