The End of Poverty by Jeffrey Sachs

Author:Jeffrey Sachs [Sachs, Jeffrey]
Language: eng
Format: epub
Published: 2011-08-18T09:49:06.667259+00:00

2 0 0 T H E E N D O F P O V E R T Y

Nonetheless, I presumed malaria to be an even more urgent issue, a truly life-and-death concern. I fully expected to find that whatever could be done to fight malaria was already being done. Surely, I thought, the world community would not simply be standing by while millions of children were dying each year. But when my colleague Amir Attaran and I began to run the numbers on the levels of d o n o r assistance to fight malaria, we barely found any numbers. T h e level of rich-country help to Africa to fight malaria was minimal, in the tens of millions of dollars per year when $2 to $3 billion was needed.

1 was shocked. I started to scour the World Bank and USAID Web sites and project descriptions. Surely we had overlooked a massive effort to help Africa fight the disease. But no, the original calculations were correct. Malaria was not on the policy radar screen. The IMF and World Bank were apparently too busy arguing for budget cuts and privatization of sugar mills to have much time left to deal with malaria.

Africa's AIDS Cataclysm

From these lessons, it was but a small step to HIV/AIDS. T h e same three questions applied for AIDS as for malaria. What does the disease do to economic growth and poverty? What accounts for Africa's special circumstances? And what must be done? The answers are similar, but they have one important difference: as of today there is no solid explanation for why Africa's AIDS prevalence is at least an order of magnitude higher than anywhere else in the world.

T h e simplest answer, widely believed, is that in Africa there is more sexual activity' outside of long-term stable relationships. The data, however, repeatedly cast doubt on that widely believed hypothesis. Perhaps the sexual networking is different in Africa (for example, there are more relationships between older m e n and younger women and more concurrent relationships, although not more lifetime partners). Perhaps HIV/AIDS is transmitted more easily in Africa because the population has other untreated ailments (malaria, other sexually transmitted diseases), or because m e n are much less frequently circumcised, or because condoms are less frequently used in casual sexual relations. Perhaps the viral subtypes (known as clades) are different in Africa. T h e truth is that nobody is sure. The only certainty is that HIV/AIDS is an unmitigated tragedy and a development disaster throughout Africa, especially in the hardest hit regions of eastern and southern Africa.

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