What do we really know about the spread of AIDS in Africa?
Emily Oster, a University of Chicago economist, looks at the statistics on AIDS in Africa and comes up with the conclusion: Everything we know about AIDS in sub-Saharan Africa is wrong. We look for root causes such as poverty and poor health care, but we also need to factor in, say, the price of coffee, and the routes of long-haul truckers. In short, there is a lot we don’t know; and our assumptions about what we do know may keep us from finding the best way to stop the disease. Watch the video:
It must be noted that a South African documentary film maker Al J Venter – in the mad, bad days of the late 1980s / early 1990s, first pointed out that the areas of highest HIV prevalence in Africa at the time lay along major truck routes. I remember Somali truckers in Zambia in the 1970s, who drove the “Hell Run” between the Zambian Copperbelt and the port of Dar es Salaam in Tanzania; Al Venter noted that Uganda, Kenya, Tanzania, Ethiopia and the then Zaire, Rwanda and Burundi were intimately linked (sorry for the pun) by truck trade routes.
And sex workers service truckers…who take the fruit of their travels home.
On viewing this talk in its entirety – took a while; we’re in Africa where bandwidth is narrow – I was a little shocked at the blithe assumption that the HIV prevalence statistics for the whole of Africa can be written off in one slide. This is complete crap: in South Africa (>6 million infected) the UN AIDS data and the antenatal survey data and the direct saliva test data all come out at around the same number. Which is that 11% of the total population is infected. Extrapolating back from mortality figures is horribly flawed, inasmuch as it relies on assumptions made concerning time taken to develop AIDS and to die after diagnosis, which may differ widely from country to country, let alone for any other reason. Like people in different income groups being differentially affected, for example. I would look at what Nicoli Nattrass [Google her] says in contrast to the above: this is another economist who has done sterling work in figuring out just how much it costs to ignore treatment options for HIV infected people, rather than poking holes in assumptions as to how many people are infected.
Ed, it would be worth leaving this comment on the original TED page too:
http://www.ted.com/talks/view/id/143