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African child mortality: The best story in development (economist.com)
79 points by ph0rque on May 19, 2012 | hide | past | favorite | 31 comments



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...


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.


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


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/.


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.


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.


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.


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


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).


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


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.


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.


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.)


It's one thing to say Africa is responsible for its plight (OP didn't say that), it's another to say they're stuck in a vicious cycle of dependency on northern help that we should not feed. Not sure that applies to bed nets though...


I have benefitted from african colonisation in that I get access to tea, coffee and chocolade.

If you are thinking about the slave trade (and when people talk about Africa a lot are) just remember that the europeans brought the slaves from other, stronger, tribes: meaning Africa was itself as responsible as was my ancestors.

Except it is of course complete bullshit. A continent cannot have any guilt, nor can should I be guilty for what my ancestors have done. The only people responsible are the people involved. A man cannot be guilty because of the blood in his veins.

As for how much Africa was hurt take a look at present day Zimbabwe -- it is a completely failed state. Back when the evil white farmers were occupying it, it was a net producer of food and the breadbasket of Africa.


Zimbabwe was a net producer of food and breadbasket of Africa, because the entire black population were pretty much 'slaves' of the white farmers.Its easy to be successful when you don't have to worry about the cost of labor, or even providing decent working conditions. The government pretty much had to worry about providing services only to the white people (a small fraction of the entire population) , so in effect there was plenty for everyone. You may want to ask the black inhabitants of Zimbabwe if they are pining for the old days when they were considered less than human. I don't much care for the "help Africa" movement, but please do some basic fact checking before you go on your next ignorant rant.


Nobody said you're guilty of anything. But you are asking why African countries are deserving of aid and I'm giving you an answer: because many African countries are in the position they are in because of colonial powers.

When you study the history of the continent you will see that a good part of the reason for its present levels of political instability, inequality and poverty has to do with an imbalance of power and wealth created due to colonialism (and associated racism).

If you think all that the colonial powers did was buy and capture slaves I think you should go do some reading and educate yourself about the impact of colonialism.


Chocolate and Tea have nothing to do with Africa.

Chocolate came from Latin America and Tea came from Asia.

For better examples try: metal ores, natural rubber and a whole slew of other compounds that were (and are) basic ingredients for our industry.


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?


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.


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.


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.


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


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.


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.


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.


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?


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.


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


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


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.




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