African child mortality: The best story in development

http://www.economist.com/node/21555571

by ph0rque • 14 years ago

79 31 14 years ago

economist.com

J3L2404• 14 years ago

Stories like this often don't get traction because it doesn't play into the news narrative. Doom sells.

EDIT: Why is that? Why does doom sell?

geuis• 14 years ago

People are gossip machines. We innately talk to each other, about each other. It's one thing that has led us to develop culture. Or it might be because of culture. Anyway, people spread good news: Good harvest!, job promotion, new baby! But we also spread rumors, true or not. When you combine small village communication, then ramp that up to mega cities, it can seem people only pay attention to the bad news.

Also consider that this entire statement is false. We hear good news all the time. I generally consider much on HN to be good, like this story. I see good things even on regular cable news. We have to be careful to see if we set up our own filters unintentionally. If all you think you hear is doom, go out of your way to find the good. You might. E surprised what you find.

InclinedPlane• 14 years ago

Doom tends to be fast and concentratedd. Goodness tends to be slow, steady, and diffuse.

philwelch• 14 years ago

Fear is a stronger motivator than hope. People are more motivated to inform themselves about threats than about positive things.

jacoblyles• 14 years ago

It's lame to be the guy who thinks the status quo is pretty good and that things are progressing nicely. It won't win you many friends at parties. Empirically, it's socially optimal to be the guy who insists we have to smash capitalism, or that the West is exploiting Africa and keeping it poor, or that if we don't cut our economic production by 20% in the next 10 years then nature will revolt and kill us all. Things like that sell.

lincolnq2• 14 years ago

You can fund insecticide treated bed nets in developing countries by donating to Against Malaria Foundation (http://www.againstmalaria.com), which is currently estimated to be the #1 most impactful charity for your dollar in the world, as determined by GiveWell (http://givewell.org).

tomjen33• 14 years ago

Honestly, why?

As long as Africa has to live of what we want to give them, they will always suffer.

If anything lend the money to make their own nets.

lusr3• 14 years ago

Are you honestly not aware that most of Africa was pillaged and plundered for centuries by European powers that greatly benefited from African resources - human and physical? Yet you expect Africa should recover from centuries of oppression without any assistance? You really recommend lending money, part of which, in the big scheme of things, was indirectly sourced from pillaging Africa?

Judging from your profile you are Danish. If so, you have benefited from the colonisation of Africa by your ancestors (http://en.wikipedia.org/wiki/Danish_Gold_Coast).

(Don't mistake me for a reparations supporter, but I do believe it's absurd to believe that "Africa" is where it is through its own actions and should therefore be solely responsible for growth and development.)

Symmetry2• 14 years ago

I'm always a bit worried about giving to humanitarian charities in Africa, just because it gives warlords a way to turn refugees into a lootable resource[1]. Aid organizations want to help refugees, and are generally willing to give warlords money in order to be allowed access to those refugees.

This was a big factor in the start of the Congolese Civil War. In Rwanada after the the genocide the perpetrators fled into Congo and many Hutus, fearing that the Tutsi forces would want revenge, fled with them. In the Congo the genocidaires were able to confiscate and resell part of the aid, and charge rent to aid agencies, and use the money buy weapons to arm the people there in the hopes of retaking the country. The new Tutsi Rwandan government, not willing to let this happen, decided to invade. And since Mobutu of Zaire had been harboring insurgents from all the other neighboring countries, they all decided to help. Thus began the Congo Civil War. However, rereading the section in Wikipedia on the refugee crisis it seems that Médecins Sans Frontières and most of the other independant aid organizations were smart enough to realize what was happening and leave so they couldn't be used - and it was the mostly UN that was still contributing money and supplies when the fighting started[2]. So maybe you should give money to aid organization after all.

[1]http://en.wikipedia.org/wiki/Resource_curse [2]http://en.wikipedia.org/wiki/Great_Lakes_refugee_crisis

lincolnq2• 14 years ago

I'm glad you know so much about this, but don't let your knowledge prevent you from doing the right thing. All I know is that Givewell seems extremely thorough, and holistic in their thoroughness. If there were a major effect such as the one you describe (warlords looting villages for bed nets), I expect that Givewell would recognize it and incorporate it into their estimates of cost-effectiveness for charities. Givewell is really very good. (If you want evidence for this, read some of their in-depth charity analyses and see how many factors they consider.)

And if the effect of warlords looting villages for their bed nets is not large enough to make a significant negative impact on the charity's effectiveness, then it still seems like one of the best possible uses of money to do good in the world.

learc83• 14 years ago

Fantastic news. I wonder how much of this is a result of the Bill and Melinda Gates Foundation's war on malaria?

chernevik• 14 years ago

It would be very hard to tell. The earliest and biggest public health improvements are driven by simple but powerful measures: increased calorie counts, clean water, improved sanitation. Only once these are satisficed do things like health care and immunizations begin to matter at the margin.

Something like malaria nets sounds cheap and simple enough to be a plausible driver. But even then, to a malnourished kid the nutrition probably matters first.

Even extensive efforts, occurring amid improvements on the fundamentals, would probably be lost in the noise.

rokhayakebe• 14 years ago

I think education and the internet also have lots to do with this decline. People in the third world have seen a huge increase in internet adoption, which facilitates second hand learning; they are now more aware and educated and can take better preventive actions. Great news.

kevinpet• 14 years ago

I hate these government-accounting style stories. The numbers reported in the graph are the percent change in infant mortality relative to the rate of change to meet MDG. Is it just me, or would it be more useful to illustrate an article about infant mortality rates by a graph of the actual numbers for infant mortality in these countries?

kristoffer• 14 years ago

I wonder how this will affect Africa as a continent. The article doesn't mention possible effects this could have on these nations, such an analysis would be interesting to read.

carleverett• 14 years ago

This backs up Hans Rosling's talk on "The best statistics you've ever seen" pretty well: http://www.ted.com/talks/hans_rosling_shows_the_best_stats_y...

The world is definitely improving - from a health perspective. Of course you could talk about overpopulation as a chronic global problem as well, but in my opinion education on birth control will improve enough over the next few decades to help combat that.

tomjen33• 14 years ago

My greatest problem with that talk is that he gloss completely over the countries that haven't improved (in particular Congo/Zaire) and never will.

redwood2• 14 years ago

The flip-side to reduced infant mortality is typically a population boom (at least this was the case in the 50s and 60s). I'm living in Bangladesh right now where the country really suffers due to over-crowding born out of that era which means there's not enough agricultural land to work for most people, leaving most people under-employed and impoverished.

Of course reduction in infant mortality is good, but it can be coupled with problems later if family planning is not also brought into families at the exact same time.

If family planning is delayed by one generation compared with the reduction in infant mortality, a country's population can rise exponentially very quickly which is highly destabilizing.

The Vatican and others stand in the way to realizing family planning everywhere...

dereg• 14 years ago

I think you're mixing up the causal relationship between infant mortality, population growth, and economic growth. High population growth does not necessitate low economic growth. In fact, it's economic growth that tends to determine the rate of population growth, not the other way around.

yaix2• 14 years ago

The other way around as well.

High population growth causes slow economic growth /per capita/ (because the available income is distributed among more people).

In the book "Poor Economics" the authors show how poor parents tent to invest most resources they have in only child's education. All the other children get much less education and therefore only low paying jobs, thus remain poor. Less population growth would have a direct positive economic effect on the society's average level of education.

High population growth is also very expensive in terms of public services, you need to build more schools, hospitals, police, etc. All that investment in /quantity/ prevents you from investing it in /quality/.

redwood2• 14 years ago

Are you talking about per capita economic growth?

Anyway once a non-industrialized population reaches a population saturation point such that more people cannot create more agricultural produce (like here in Bangladesh) there's a squeeze on per capita economic output of the country. Sure the extra labor can now be used to industrialize, in theory. But the problem is without capital to industrialize with (as is the case here) a cycle of poverty can form which gets worse.

lusr3• 14 years ago

But isn't the important question whether population growth is remaining below economic growth? And in that sense, it's a perfectly valid concern that an increase in population without an accompanying increase in economic growth is a serious problem. I live in South Africa where unemployment rates are already very significant; an increased population growth rate seems almost certain to make this situation worse.

Symmetry2• 14 years ago

It depends. If capital accumulation is an important limiting factor in your country's growth, as it is in most of Africa, then adding more people will tend to increase the overall GDP but decrease the per capita GDP. If you're at the productivity frontier, however, and you're more limited by your ability to figure out how to use more capital (innovation). In this case there is still a small marginal return on having more capital per worker, but every worker is also a source of more innovation so its really hard to say whether adding more people (up to a certain point) will increase or decrease the per capita GDP.

Generally speaking, when a country develops to a certain point it gets what's called a demographic dividend[1]. The population has been growing rapidly in the past, so there aren't that many old people to take care of. With wealth people start having less babies, though, so there are also a relatively small number of children to take care of relative to the number of working adults. Countries in this position can, if they manage to avoid messing up, grow very rapidly.

[1]http://en.wikipedia.org/wiki/Demographic_dividend

yaix2• 14 years ago

Right. Unfortunately, especially in Africa, the --- and --- religions are fighting their war of who can produce more children.

DanBC• 14 years ago

Countries with an AIDS / HIV rate of 20% don't have to worry so much about a population boom. You need people to work the land.

(http://www.irinnews.org/photo/Slideshow/43/Too-Poor-to-Farm)

This is great news - some really simple interventions make dramatic reductions in death rates. Things like "soap and hot water to wash hands" or "boil the stones used to cut the cord" have made a big difference.

Still, there's always more that can be done.

> The maternal mortality ratio in Ethiopia is 676 for every 100,000 births. This compares to an average of 290 per 100,000 births in developing countries, and 14 per 100,000 in developed countries,

(http://www.irinnews.org/Report/95356/ETHIOPIA-Still-too-many...)

And when you've prevented children dying in childbirth you need to ensure distribution of micronutirents.

(http://www.irinnews.org/Photo/Details/201112300839360722/A-y...)

Diarrhoea is the second biggest killer of children. A cheap course of Oral Rehydration Salts (ORS) costs about $0.50 us cents; this could save about three quarters of the 1.5 million deaths each year.

Recognising the weird fact that coca-cola gets everywhere while ORS doesn't, an aid worker decided to use the powerful distribution networks of commercial companies to distribute ORS.

(http://www.irinnews.org/Report/94996/GLOBAL-Follow-the-fizz-...)

He's not doing this through charity or subsidy. He's found a neat gap.

> Almost 30 years after British aid worker Simon Berry first pondered the Coca-Cola conundrum while working in Zambia, he is about to turn the puzzle into an opportunity he hopes will drastically reduce child mortality by adopting some of these strategies. And he wants to do so through commerce, rather than charity, or even, in the long term, through subsidy.

> Berry has isolated a gap in the market, literally in the spaces between crated Coca-Cola bottles trucked and biked to villages all over the developing world.

iRobot• 14 years ago

Step One achieved. Now if you could just feed and educate the little fellows and keep them from having too many kids and stop their (generally) useless and corrupt governments from destroying their countries and killing each other, the world would truly be a nicer place.

African child mortality: The best story in development

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