Reasons to Be Cheerful

Currently at the top of the pile:

Charles Kenny (2005), "Why Are We Worried About Income? Nearly Everything that Matters is Converging," World Development 33:1, pp. 1–19.

Summary. — Convergence of national GDP/capita numbers is a common, but narrow, measure of global success or failure in development. This paper takes a broader range of quality of life variables covering health, education, rights and infrastructure and examines if they are converging across countries. It finds that these measures are converging as a rule and (where we have data) that they have been converging for some time. The paper turns to a discussion of what might be driving convergence in quality of life even as incomes diverge, and what this might mean for the donor community.

Comments

[Auros]

I'm a little worried that, at least in education, part of the reason for convergence is that more and more US students have a completely worthless high school diploma.

[TDM]

This has been out for a while. The abstract can be found at:
http://dx.doi.org/10.1016/j.worlddev.2004.06.016

From the full paper:
Looking over time, a number of studies find a tenuous link between various health measures, for example, and growing income. Preston (1975) estimates that income could only account for perhaps 10-25% of the growth in life expectancy in the world as a whole between the 1930s and the 1960s. Looking at a wider range of measures, Easterly (1999) found that almost all of the quality of life variables that he could find (including infant mortality, life expectancy and war deaths per capita) were not correlated with the rate of growth in that country over the last 40 years, but instead with improvements over time common to all countries.

[anne]

TDM

We need to think through this important issue carefully, for many of the suppositions must be questioned in light of the southern African experience of this last generation. Amartya Sen appears to have certain misgivings in regard to India as well.

[anne]

The trappings of life now and 20 and 40 and 60 years can lead us to be optimistic about general well-being in Malawi beyond development numbers as such. Then, there is AIDS and gulf in well-being from developed to developing land becomes infinite.

[anne]

http://www.nytimes.com/2005/06/03/international/africa/03mozambique.html?ei=5090&en=b7488c073d4e6b97&ex=1275451200&partner=rssuserland&emc=rss&pagewanted=all

AIDS, Pregnancy and Poverty Trap Ever More African Girls
By SHARON LaFRANIERE

PATRICE LUMUMBA, Mozambique - They met a year ago on the dirt road outside her aunt's house, in this struggling township where houses are built from bound-together reeds and the only water comes from wells. Flora Muchave was 14. Elario Novunga was 22, nicely dressed and, Flora said, full of promises.

One stood out: Flora's family had been teetering on the edge of destitution since her father, a miner, died of AIDS in 2000. Elario said he would change that. "He asked me to have sex with him, and he guaranteed everything I would need," Flora recalled. "He said he would take care of everything for me."

He lied. Elario gave Flora the equivalent of about $4 and a baby, whose impending birth has forced her to drop out of sixth grade. Before Flora's mother died in May, apparently of AIDS, she forgave her daughter for ignoring her warnings about fast-talking men. But she sketched out a bleak future for her only daughter.

"Now," Flora recalled her sobbing from her deathbed, "you are going to suffer."

Flora Muchave's cautionary tale is nothing new; Africa claims the world's highest adolescent birthrate and the world's lowest share of girls enrolled in primary school.

But for the last 25 years, the trends had been positive. African girls, like girls elsewhere, were marrying later, and a growing percentage were in school.

The AIDS epidemic now threatens to take away those hard-won gains. Orphaned and impoverished by the deaths of parents, girls here are being propelled into sex at shockingly early ages to support themselves, their siblings and, all too often, their own children.

"AIDS is reversing the trends that were improving for girls," said Margie de Monchy, regional child protection officer for the United Nations Children's Fund. "We really have to look at the kinds of lousy choices - and sometimes no choices - that they have for survival."

With 12 million children orphaned in sub-Saharan Africa because of AIDS, suffering abounds among boys as well as girls.

But orphaned girls tend to fare worse...

[anne]

http://www.nytimes.com/2005/05/27/international/asia/27aids.html?ei=5090&en=24a2b27fd5721e2d&ex=1274846400&partner=rssuserland&emc=rss&pagewanted=all

Spread of AIDS in India Outpaces Scant Treatment Effort
By SOMINI SENGUPTA

MUMBAI, India - On an ordinary Thursday morning at the city's largest public hospital, an ordinary group of Indians sat around a table, exchanging advice on life and death.

A middle-aged man in a button-down shirt said he had long ago stopped having sex with his wife. A wisp of a woman sat quietly in a black burqa, her large eyes screaming bafflement at what she was being told. A plump woman in a brown sari requested that nothing be mailed to her home, for fear that her family would discover her secret. They were all living with AIDS.

Two counselors issued a stream of instructions. Come to the hospital yourself if you want free medicines. Don't send relatives. Don't go to your village for so long this summer that you cannot come back in time for your next dose. Never skip a dose. "There's no need to be afraid," one said, though the counselors' noses were shielded by surgical masks.

The scene in this sunny hallway of J. J. Hospital here in Mumbai, formerly Bombay, offered a front-line snapshot of the first efforts to treat AIDS in India, where stigma, poverty, an anemic public health system and the sheer scale of the pandemic combine in a daunting challenge. The government estimates that India has 5.1 million people infected with H.I.V., second only to South Africa.

Only a year ago did the government start offering free drug therapy. Today, in a country that famously exports low-cost generic AIDS drugs across the world, less than 2 percent of the half-million Indians who are likely to need it receive free treatment....

[anne]

Several times I argued with John Rawls and Lawrence Kohlberg that setting ethical problems in rich and poor countries would provoke different solutions. Rawls tended to agree, where Kohlberg was more of a universalist. Kohlberg would ask whether we might steal a drug to save someone dear to us were we too poor to afford the drug. Surely this seems to be a universal problem, but I was always struck by the ethical choice not applying to people for whom life saving drugs were beyond stealing. What of southern Africa or rural India where there are no drugs to be stolen? Now here is indeed a profound ethical question in what should and should not be taken for a measure of societal well-being.

South Africa can be remarkably developed. The trapping of life can seem remarkably present, yet more than 30% of adults are HIV/AIDS sufferers and where is there a recourse?

[anne]

http://www.calvorn.com/gallery/photo.php?photo=5375&u=17|15|...

House Wren Singing at Dawn
New York City--Central Park, Belvedere Castle.

They do care to sing in the morning...

[TDM]

AIDS is primarily a problem of behavior, where income often leads to greater promiscuity and prostitution which can make the problem worse. To preserve existing gains and continue advancement there is going to be much work on getting basic behavior, human, and women's rights to converge.

[anne]

http://www.hindu.com/2005/01/09/stories/2005010900161400.htm

January 9, 2005

India's poor need a radical package: Amartya Sen
The Hindu

IF THE Manmohan Singh Government is serious about ending the chronic under-nutrition that so many poor Indians suffer from, it needs to think seriously about the public provision of basic healthcare, nutritional support for children and income support for the unemployed poor, says Nobel Prize-winning economist Amartya Sen in an exclusive interview to Siddharth Varadarajan of The Hindu.

Siddharth Varadarajan: If one looks at the social policy commitments of the UPA Government — for example on education and employment — health seems to have something of a low priority. You have been involved in a recent study on the state of healthcare in rural areas. Based on those findings, what do you feel the Government's approach to health services should be?

Amartya Sen: We need a radical change in the way health delivery in the public sector occurs. India spends a lower percentage of GDP on public health than almost any other country, including those of similar income levels. The neglect here is massive, particularly because this has led to both the substandard delivery of public health and the development of an immensely exploitative private enterprise in healthcare that survives on the deficiencies — and sometimes absence — of public health attention.

What we found in the Pratichi Trust survey in West Bengal but also much more sharply in Jharkhand — and based on other information we have, the picture seems fairly widespread — is that when patients go to many of the primary health centres, they find no one there. Sometimes, when they find someone, they will be referred to private doctors. Also, the medical system in the public sector offers no diagnostics, even of basic illnesses like malaria or TB. Patients are usually told to go to private practitioners for testing. Sometimes the testing isn't very good and, in any case, the economic cost could be ruinous.

On top of that, the care that is often provided by the private sector comes from quacks. We found an incredible proportion of quacks in Jharkhand, particularly, but a significant proportion even in West Bengal, who provide almost no serious medical attention and instead give saline injections for malaria, which is not really known anywhere in the world as a cure.

These are modern quacks, not ojhas? ...

[Andrew Spark]

I think health awareness is a key area where about every thing which related to health care are visible progress has been made in modern time.