I’m a fan of Tim Harford, aka the Undercover Economist, and author of a very interesting blog at the FT. He is an excellent example of the division of labour, one of his favourite things, successfully hoovering up dull economics papers and rolling out readable prose. His second book, The Logic of Life, is not really about Africa. It is mostly about how cities are great, and how people who live in the country are carbon-hungry subsidy-hounds. It’s really good.
The undercover Africanist
But there are a couple of relevant sections, including a useful discussion of post-colonial African agriculture drawn from Bates’ Markets and States in Tropical Africa. Harford also discusses disease and development. He argues that malaria control is of secondary economic importance to AIDS control because, while malaria mostly affects children, AIDS primarily affects economically more productive adults. (He’s not totally heartless, just an economist.) He also argues that disease control is itself secondary to, and follows from, the establishment of institutions that incentivise economic innovation and wealth creation.
Won’t somebody please think of the children?
I think he might be wrong about malaria. This is mostly guesswork on my part. But, judging by the notes, it was also mostly guesswork by Harford – so wild conjecture is allowed (and fun of course).
Even if we just consider malaria in younger children – the least economically productive demographic – the disease has a spillover impact on household economics. First, children don’t suffer an illness alone: they are nursed, probably by a more economically-productive family member. Serious treatment probably involves a time-consuming trip to a non-local medical facility. Sickness in the young therefore removes important child labour from the household economy, and the labour of healthy adults. Second, the high likelihood of a child dying creates a rational incentive to have more children. Pregnancy, childbirth and post-natal care reduce the availability and productivity of female household labour for lengthy periods. High childhood mortality reduces the eventual economic payoff for this sacrifice. And, third, medical facilities spend an inordinate amount of time on childbirth or treating childhood malaria, skewing medical provision away from temporarily-sick, but otherwise economically-productive adults.
AIDS and malaria
Harford goes on to argue – correctly I suspect – that AIDS is a more significant direct economic problem than malaria. But in areas with a high incidence of both diseases, AIDS and malaria may be linked. AIDS has already reduced the stock of econimcally productive adults and created a scary number of child-headed households: their economic viability is thus under great pressure from childhood malaria. And, in adult-headed households, child mortality may increase AIDS infection rates. First, the replacement of childhood malaria victims by (un)knowingly HIV-positive parents, perhaps with a new partner, is a rational choice with socially harmful consequences. And second, pregnancy does not just reduce the domestic and agricultural productivity of women, it may also temporarily remove their sexual labour from the household. Bored and impatient fathers thus have an increased incentive to find another sexual partner, and the corollary increased risk of contracting and passing on AIDS.
Disease and development
Harford ultimately argues that disease has been controlled elsewhere after economic growth, and that growth was secured by establishing institutions that preserved and encouraged the creation of economic wealth. True enough, I expect. But it is also true that the technology to control malaria already exists, and where these technologies are imperfect, the incentive to innovate certainly exists. African history has been marked by efforts to control, direct and increase labour power (if not always productivity). So if African governments need to create or reform economic institutions then a good place to start might be anti-malarial projects that protect and encourage such ‘wealth in people’.
Tim Harford, The Logic of Life: The Rational Economics of an Irrational World:
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