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Do malaria interventions cause human suffering through population growth?

041614_1200_Theimpactof3People often ask me this. I mostly find the question annoying since a dead kid is, well, a dead kid.

The thinking, however, isn’t entirely illogical and can, of course, even be traced back to Malthus himself. Malthus believed that helping the poor would only increase their misery through worsening conditions of crowding and starvation. If Malthus had lived in 2013 and were concerned with welfare policy, he’d probably be a card carrying member of the Republican Party.

For the record, I despise Malthus (and his spawn, Paul Ehrlich). I can’t think of a more cynical and heartless thinker. It’s disturbing to me that his ideas continue to permeate today, despite being wrong at best and simply hateful, at worst. More disturbing is how eagerly his ideas are absorbed by even otherwise well meaning people.

“It’s obvious,” I’ve heard people say while implicitly suggesting the some lives (ours) are worth more than others (theirs). As cliched as it may sound, I think that every human has both a right to live and the right to a life that is healthy and meaningful. Not saving kids from malaria compromises the ability to do either.

So far, though, no one really knows whether life saving interventions in developing countries fuel population growth. Does saving a child’s life simply increase the number of mouths to feed, thereby straining resources and insuring misery for everyone? David Roodman, a public policy consultant working on behalf of GiveWell, a group which does analyses on the effectiveness of charity programs, has searched the published literature to find the answer.

I think the best interpretation of the available evidence is that the impact of life-saving interventions on fertility and population growth varies by context, above all with total fertility, and is rarely greater than 1:1. In places where lifetime births/woman has been converging to 2 or lower, family size is largely a conscious choice, made with an ideal family size in mind, and achieved in part by access to modern contraception. In those contexts, saving one child’s life should lead parents to avert a birth they would otherwise have. The impact of mortality drops on fertility will be nearly 1:1, so population growth will hardly change.

He goes through the available data and finds evidence to suggest that averted child deaths are associated with a decrease in the number of births over the lifetime of a woman. This is somewhat non-controversial. It has long been noticed that economic development and increased access to medical care is associated with decreased lifetime fertility.

Where things become controversial is in the case of developing countries, where saving a child’s life might not have the same effect on reducing births overall. This might be true in the short term, and Roodman finds evidence to suggest this. A short term reduction in child mortality might not yield immediate results.

The issue might be more nuanced, however. Merely providing malaria interventions such as insecticide treated nets to prevent disease without increasing access to quality health services might lead to a situation where population increases quite rapidly. I would think that this might explain why some of the most malarious countries in the world are experience the most rapid population growth. Malawi would be an example.

The strategy, then, is incomplete and Roodman’s analysis might suggest that we need to take a holistic approach to include both malaria prevention and reproductive health services.

I would, however, suggest that the problem is more complicated, particularly when reflecting on Kenya, where the most effective method of reducing fertility has probably been the imposition of school fees. The issue then isn’t merely a matter of saving kids and Depo shots, it’s also a matter of finances. If people can’t afford kids, they won’t have them, but the only way to arrive at economic barriers to reproduction is to have an economy, which is exactly what a country like Malawi doesn’t have.

I like to think that we are doing better now…..

Every once in a while, you run across something that just gives you the chills.

“A report presented to the World Health Organization (WHO) in 1948 states: “It is not enough to quote that about 3,000,000 deaths are caused yearly by malaria in the world, or that every year about 300,000,000 cases of malaria occur …… that malaria is prevalent in tropical and subtropical areas where food production and agricultural resources are potentially very high, and that, by affecting the mass of rural workers, it decreases their vitality and reduces their working capacity and thus hampers the exploitation of the natural resources of the country. At a time when the world is poor, it seems that control of malaria should be the first aim to achieve in order to increase agricultural output” (WHO, 1948).

Snow RW, Amratia P, Kabaria CW, Noor AM, Marsh K: The changing limits and incidence of malaria in Africa: 1939-2009. Adv Parasitol 2012, 78:169-262.

Today is World Health Day!

dengueToday, April 7th. is World Health Day, an annual event sponsored by the World Health Organization to help bring attention to pressing public health issues.

This years event focuses on vector borne diseases like dengue fever and Chagas disease, which are transmitted through a third party host such as Aedes mosquitoes or triatomines (kissing bugs).

Both of these diseases are becoming increasingly relevant as the world urbanizes. Dengue and malaria form a complementary nexus of diseases. Malaria is largely associated with rural areas, and rarely found in cities, where dengue fever is almost exclusively found in urban areas. Generally speaking, dengue is a disease of development, where malaria is a disease of the lack of development.

While known to be distributed widely through Latin America and Southeast Asia, dengue has yet to make it on Africa’s radar yet, simply (in my opinion) because not enough people are looking hard enough. Africa, as the most rapidly urbanizing area of the world will eventually face a double burden of dengue and malaria and health facilities aren’t yet prepared to deal with it.

Do field research projects do the world any good?

IMG_3931It’s a reasonable question to which no one really has an answer. I work in a field site located on Lake Victoria, the office of which is based out of the International Centre for Insect Physiology and Ecology (ICIPE) station on Mbita Point.

We do malaria field surveys and have a large health and demographic surveillance system that has monitored births, deaths, migration and health events of nearly 50,000 people over the past six years.

The goals of the project are to monitor changes in demographics, outbreaks and changes in the dynamics of the transmission of infectious diseases and gauge the effectiveness of interventions.

While I view those as scientifically important, I don’t think that people on the ground experience any immediate benefit from scientific research activities. In fact, I’m pretty sure that, unless they’re getting a free bednet, it’s mostly an annoyance. Of course, we appreciate their cooperation and they are free to tell us to bugger off at anytime.

We are seeing rapid declines in malaria incidence, infant mortality and fertility in the communities we study. This is, of course, cause for celebration. Less kids are dying and people are having fewer of them.

In fact, the shift in the age distribution was so dramatic from 2011 to 2012, that we thought it an aberration of the data: the mean age of 12,000 people rose nearly two years from the beginning of 2011 to the latter part of 2012. Old people died off, and fewer babies were there to replace them, resulting in an upward shift in the age distribution. Cause for celebration in an area where women normally have anywhere from 5 to 10 children, who often end up malnourished, poorly housed and uneducated.

But we have to ask ourselves, how much of this is representative of trends in communities similar to the ones we study and how much is directly influenced by the presence of the research station itself?

A recent article in Malaria Journal documents the positive impacts that a research facility had on the local community:

To make the community a real partner in the centre’s activities, a tacit agreement was made that priority would be given to local people, in a competitive manner, for all non-professional jobs (construction workers, drivers, cleaners, field workers, data clerks, and others). Of the 254 people employed at the CRUN, about one-third come from Nanoro. This has strengthened the sense of ownership of the centre’s activities by the community. Through the modest creation of new jobs, CRUN makes a substantial contribution to reducing poverty in the community. In addition, staff members residing in Nanoro contribute to the micro-economy there.

Another crucial benefit for Nanoro and CRUN stemming from their productive engagement was electrification for the area. This was made possible by the mayor of Nanoro leading the negotiations for extending the national electrical grid to the CRUN, and with it, to the village of Nanoro. Electrification spurred a lot of economic activity and social amenities that enhance the wellbeing of the community, such as: (1) improved water supply through use electricity instead of generator; (2) ability to use electrical devices, such as fans during the hot season (when temperatures can reach 45-47°C), lighting so students can study at night, the use of refrigeration to safely store food and the extension of business hours past sunset.

Health care services have been improved through CRUN’s new microbiology laboratory. Before this laboratory was established, local patients had to travel about 100 km to the capital city, Ouagadougou, for the service.

This agrees with my experience on Lake Victoria. The presence of the research facility (built originally in the 1960′s) and the subsequent scale up of research activities has been transformative for the area. As more and more people have moved to the area, a bridge to Rusinga Island has been built, two new ferry routes have been installed, the existing ferries have been upgraded, power has been extended to the area and finally, after years of waiting, a paved road has been built from Kisumu to Mbita Point.

..which brings back me to my initial question. It is clear that the building of research facilities can be a major spur for economic development and economic activity in a previously desolate and marginalized area. In case of Mbita Point, it is possible that these gains can be sustained even following an eventual cessation of research activities and strangled funding. In this sense, field research projects are doing at least some of the world good.

However, the gains which these communities are experience really have little to do with the research projects themselves and more to do with the influx of employment and infrastructure that come with research stations and research projects. This is non-controversial and I’m sure that the locals appreciate it.

But the quality and goals of research need to be assessed. Are the results we are seeing truly representative of communities which may be similar to the Mbita Point of the past? Are we unnecessarily influencing the outcomes of the research and then perhaps inappropriately generalizing them to contexts which little resemble our target communities? From a scientific perspective, this is troubling.

Of greater concern, however, are we claiming that gains against malaria are being made, when in fact, morbidity and mortality in communities we haven’t looked at is increasing? This could result in a dangerous shift away from scaled up ITN distributions or even a total reduction in international funding. If this happens, kids will die.

What I’m reading now March 23, 2014

Well, it should really be, what I was reading two weeks ago, but… details, details….

TOEThe Tyranny of Experts: Economists, Dictators, and the Forgotten Rights of the Poor Generally speaking, I like Bill Easterly’s views on aid and development. Easterly questions traditional models of development, arguing that top down strategies which rely on purely technical solutions rarely work, and often do more harm than good. Here, Easterly again makes the argument that the development world is full of bumbling technocrats, who fail to see the simplicity of the real problem of African development.

Note, however, that I do not share the views of uninformed cynics, which laugh at the “folly of development” and the evils of foreign aid indiscriminately. Easterly is often propped up by cynical opponents of foreign aid as a spokesperson for why we shouldn’t be given money to poor people, or by Ron Paul style non-interventionists who are quick to dismiss anything the United States does outside it’s borders, not to suggest at all that the United States alone is responsible for development. To me, and call me stupid, the issue is far too complex to boil down to a black and white view of a few self satisfied cynics. Debates over what works and what doesn’t work in development are far more interesting to me than debates of whether development is “good” or “bad.” But… I digress…

Easterly argues that what’s missing from the picture is the guarantee of true democratic rights, that is, legal restrictions on the powers of government. The reason democracy is faulty in Africa, is that most African governments equate democracy with merely having elections, when, in fact, democracy is a function of checks on the ability of government to stifle opposition and the guarantee that citizens are fully protected under the law. He is absolutely right. The structures of African governments (in general) were initially constructed to support a colonial model, which guaranteed that power would be held by a privileged (white) few. However, post-independence, few governments have made substantive changes to the ways in which they govern, despite having had, in most cases, nearly 50 years to do so. Easterly lays blame with development organizations, which offer highly technical solutions to basic problems, but are weak-kneed in demanding that governments work to guarantee basic rights to their citizens.

While I agree that democracy is about more than just having elections, and agree that basic rights must be guaranteed in order to have a free state, I wonder if he gets so caught up in the grand academic thought process, and misses some of the details. His treatment of Asia is quite limited, for example. There, most governments achieved their developmental goals without guaranteeing the rights of citizens and sometime achieved them under incredibly authoritarian and sometimes brutal one party systems. While I don’t think that the end of development is worth the means of authoritarian brutality, it must be pointed out that many governments (for example, South Korea and Taiwan) only loosened their grip after they had an educated middle class which demanded increased freedoms and rights (see the work of Ha-Joong Chang and Joe Stiglitz for a reasonable treatment of the subject). While Africa and Asia are two very different places, any discussion of development has to include both.

Easterly makes me feel good, though, in his preface. Mentioning anywhere that markets are good things in a discussion of development will have one branded as a rabid right winger, which is just a pathetically myopic view (or merely a by-product of total ignorance). The tired argument of market vs state which dominates political discussions in the US (and elsewhere) is merely a distraction from the real argument we should be having, which is over rights vs. non-rights. Are rights being protected or not? Is there proper representation or not? You can have any type of free market system you like or even a heavy welfare state, but if the guarantee of basic rights to free speech, assembly, expression and representation aren’t there, you don’t have a democracy and you probably don’t have continued development of the type that matters most.

But, I’m not a political scientist, and could easily rant on aimlessly for hours to no end whatsoever.

Politics in West Africa – Sir Arthur Lewis (1965) - Sir Arthur Lewis was a Nobel Prize winning economist from St. Lucia. He wrote this fantastic little book on the state of West African politics following independence in 1965. It’s just as relevant now as it was back then. His scathing criticism of authoritarian African governments and the multitude of missed opportunities for development for African countries were both timely and eerily prophetic. I’m particularly drawn to his criticism of viewing Africa through a Marxist lens, pointing out that, outside of a few foreign corporations, there are few true capitalists and that the plentiful nature of land compromises efforts to commodify it, and thus create a European style, class based system. He also points out the problems with the one party state, pointing out that the one party state was often created by force following independence, rather than consensus. In fact, the nature of the independence movements themselves compromised the creation of true constitutional democracies, which guarantee the rights of the minority. Independence movements were created to topple minority rule. Great book.

ATSAgainst the State: Politics and Social Protest in Japans I can’t put this book down. An excellent account of the fight to stop the building of Narita airport in the 1960′s, the implications of which were more than merely a struggle of some farmers unwilling to part with land. The struggle for Sanrizuka was a culmination of the coalescence of a wide variety of actors, many of which had little in common ideologically, reacting to an ever disconnected state. Apter rightly points out that despite strict rules on social behavior and self-control, Japan’s history is filled with examples of social change brought about not through discussion, but incredible and coordinated violence.

VOFCThe Violence of Financial Capitalism (Semiotext(e) / Intervention Series) I bought this book thinking it might be an interesting perspective on the financial crash and the events which followed it. I was somehow let down to find that the book didn’t really live up to it’s striking title. Marazzi views the crash as not an aberration, but rather another aspect of capital accumulation by financial elites, a tool of undermining labor and a method of creating conditions of social change which benefits a minority of privileged individuals. While I don’t really argue that these things didn’t (aren’t) occurring, the treatment of the subject was far too academic and disconnected for me to get behind. It is possible that I’m just not well informed on the particular academic perspective of this author. I will have to read it again.

Development as a faith-based activity: the role of the RCT in alleviating poverty

DSC_0060The essence of epidemiologic field trials is the RCT (randomized control trial). A random set of people get some sort of treatment (like a new drug), another random set of people don’t and we compare the results. It’s pretty simple stuff.

The trouble with RCTs is that they don’t necessarily work well when people from the two groups are able to influence each other’s outcomes. As a simple example, a trial of a vaccine which prevents people from getting infected with some pathogen might have impacts on people who don’t get the vaccine, since the number of opportunities for transmission are reduced. This is a welcome outcome (and may even be the point of the study), but it doesn’t help us to understand exactly how effective the vaccine is in the individuals who actually receive the vaccine.

Many RCTs make the (flawed) assumption that individuals are independent entities, following a long tradition of statistical analysis. This is a reasonable assumption to make in some cases, but entirely wrong in others (i.e. most public health outcomes).

Development economists have recently adopted the RCT as a means of evaluating the effectiveness of programs intended to relieve poverty or improve human well-being. On the surface, there’s nothing wrong with adopted public health methods to deal with economic problems, as most public health problems have their roots in economics. Jeff Sachs, or course, would argue that many economic problems have their roots in public health problems.

The major problem with RCTs is that while we do our best to control for all of the possible other factors that might impact outcomes given a particular treatment, without a trove of detailed data and prior knowledge of context and contingencies, we really have no idea at all whether and how some public health intervention works. Epidemiology tends to fall back on the “reasonable suspicion” argument, backing up claims of effectiveness with potentially reasonable assumptions of causal pathways. This is clearly quite easy when doing drug trials, where animals models and a century-plus of medical research has given us a reasonably clear pictures of the pathophysiological pathways that might lie between drug and outcome.

But with issues of human behavior and economics (which is essentially a science which seeks to uncover mysteries of human behavior), the causal pathways are much more difficult to assess and the factors which lie between intervention and outcome are for more difficult to measure. For example, assessing the outcome of an education program on reproductive behavior is really, really difficult without monitoring all of the possible things that happened between the time that a woman attended an NGO sponsored event at a clinic and the time when she chose to use or not use a condom. In fact, we can’t even really verify that she used the condom, since we weren’t around to observe it.

But we assume, and assume to the point of falling back to faith that our efforts did what we intended them to do.

Lant Pritchett, a Harvard economist that I’m a great fan of for his work on economic measurement in developing countries, penned an interesting article on the website of the Center for Global Development seemingly questioning the merit of the RCT as an rigorous and necessary evaluation tool for poverty alleviation development programs.

First of all, the argument that RCTs had, until recently, been used sparingly, if at all, and yet are important in achieving good outcomes sits in kind of embarrassing counterpoint with the obvious fact that lots of countries have really good outcomes. That is whether one uses the Human Development Index or the OECD Better Life Index or any social indicator—from poverty to education to health to life satisfaction—there is a similar set of countries near the top. (In the HDI the top five are Norway, Australia, USA, Netherlands, and Germany. In the OECD Better Life Index they are Australia, Sweden, Canada, Norway, and Switzerland.) No one has ever made the arguments that these countries are developed and prosperous because they used rigorous evidence—much less RCTs—in formulating policy and programs. While one might have faith that RCTs can help along the path to development, RCTs didn’t help for those that are there now.

It is very true that development in the United States occurred without the help of RCTs. In fact, malaria elimination in the United States occurred without any of the complex set of interventions that we’re so desperately selling to malaria-endemic countries. It’s even true that, despite more than a decade of research on ITNs, that we aren’t really sure whether the declines in malaria that we’ve seen all over Sub-Saharan Africa are due to ITNs or just simply due to processes associated with urbanization and development (as in the US). Actually, a lot of research is telling us that the declines in malaria might be false and that we are simply suffering from a paucity of accurate measurement in malaria endemic countries.

And this is where Pritchett comes in. He’s right. Research in developing countries is inherently challenging to the point where the conclusions we draw from research are somewhat contentious at best, and the result of blind faith at worst.

But coarse and incomplete data and loose assumptions shouldn’t discourage public health (or even economic) professionals from doing research in developing countries. While I have issues with the condescending, neo-classical nature of RCTs in economics (another discussion, but can a peasant lady’s behavior in Western Kenya be reduced to that of Homo economicus? ), the truth is that policy makers don’t care about data. They care that people are making the case for action in an impassioned and convincing way. While academics should strive to be as rigorous as possible, the sell won’t happen based on our complex data collection strategies and statistical methodologies. They (and the public) are convinced through impassioned calls for action.

Why can’t Africa grow?

I’m reading an article on African firms and why they don’t seem to grow.

There is an urgent need for job creation in Africa yet something seems to be stunting firm growth. This column shows that African firms are about 20% smaller than their counterparts in other locations. It suggests small firms put the brake on growth as the burden of dealing with government and labour costs may increase with size, or perhaps as they start facing trust issues between managers and workers.

Wow. This pretty much sums it up. African business can’t grow because of onerous regulation, corruption and a general problem of too many people wanting too much of the pie.

I wondered for a while why ladies selling bags of rice, for example, might choose to sell the same rice right next to one another for the exact same price to the exact same market. All of them would make much more money and market prices would be much lower and more competitive if a few of them would band together and form multi-lady shops. I thought it might be because the ladies don’t trust one another to enter such a relationship, but I’m thinking that raising the profile of an enterprise might invite all kinds of new and expensive problems. It still might be true that the ladies don’t trust one another, however.

The overall price level in Africa could also be a factor in determining the size of firms (Gelb et al. 2013). Relative to low-income comparators like Bangladesh, Vietnam and also India, African countries are considerably more costly. In absolute terms, and excluding South Africa as a middle-income country, the average purchasing power parity for a sample of African countries is about 20% higher than the average for the four poorest comparators (Bangladesh, Indonesia, Philippines and Vietnam). Africa’s higher costs may result in a lower level of competitiveness and consequently, in a distribution of firms that is different (smaller) than distributions in other countries. African firms may also face a steeper labour cost curve; as firms become larger and more productive, their labour costs increase more in other regions of the world.

Africa is just about one of the most expensive places to do just about anything, simply because you have to do and provide so much on your own. Our research activities come at incredible expense despite the fact that labor is far, far cheaper. If you need power, you have to figure a way to deliver it yourself. If you need skills, you have to pay to train up people to perform the duties you need. If you need supplies, you have to order them from overseas since very little of what you need is manufactured on the continent.

Next, I’m looking at the graphic below and seeing that Africa only spends about .8% of all worldwide R&D dollars, despite housing a sixth of the world’s population and even including South and North Africa.

RD

Is malaria prevalence really declining?

Malaria study areas. Note the non presence of the DRC and  Angola.. along with all of the other areas that are missing. Do we really know what's going on with malaria?

Malaria study areas. Note the non presence of the DRC and Angola.. along with all of the other areas that are missing. Do we really know what’s going on with malaria?

The development community (and the world) has been celebrating dramatic and unprecedented reductions in the number of malaria cases around the world throughout the past decade and a half. Billions of dollars have been thrown at the disease, which is a major killer of children and an incredible hindrance to development.

A new study which just appeared in Malaria Journal, however, calls this optimism into question.

This review presents two central arguments: (i) that empirical studies measuring change are biased towards low transmission settings and not necessarily representative of high-endemic Africa where declines will be hardest-won; and (ii) that current modelled estimates of broad scale intervention impact are inadequate and now need to be augmented by detailed measurements of change across the diversity of African transmission settings.

So, our ability to accurately determine whether transmission intensity has declined is hampered by the fact that most studies of the disease occur in areas of low transmission. This would make sense. It is much easier for us to evaluate the malaria situation in Kenyan context than in the Democratic Republic of Congo due to availability of surveillance infrastructure, official mechanisms which allow research projects to move forward, and security issues.

The obvious problem with this, is the relationship of governance, economy an instability to malaria itself. People in the poorest countries are at the highest risk for malaria and people in the poorest parts of the poorest countries are at the highest risk of all. The trouble is, despite being the populations we are most concerned about, they are the hardest to reach, and the hardest to help.

Worse yet, the estimates of malaria prevalence found in a number of studies were considerably lower than estimates for the entire African continent.

The combined study area represented by measurements of change was 3.6 million km2 (Figure 1), approximately 16% of the area of Africa at any risk of malaria [9]. The level of endemicity within these studied areas (mean PfPR2-10 = 16%) was systematically lower than across the continent as a whole (mean PfPR2-10 = 31%) (Figure 2). While 40% of endemic Africa experienced ‘high-endemic’ transmission in 2010 (PfPR2-10 in excess of 40%) [9], only 9% of the studied areas were from these high transmission settings.

This is a huge issue and one that shouldn’t be limited to malaria. While it is helpful to hear good news of malaria declines in formerly afflicted areas, we need to be careful about overstating the impact of interventions. Funding for malaria projects such as the distribution of insecticide treated bed nets was incredibly high throughout the 00′s but it is unlikely that trend will continue. Offering an positive picture can show that our efforts are valuable, but might also lead policy makers and donors to suggest that money be put toward other goals. If Sri Lanka is any indication, where malaria was nearly eliminated at one time but experienced a rapid and devastating resurgence, even a brief relaxation of malaria control efforts could erase current gains completely.

Malaria might have determined the economic trajectory of the world…. through institutions

SettlersIt’s an old paper, but I just came across The Colonial Origins of Comparative Development: An Empirical Investigation
by Daron Acemoglu, Simon Johnson and James A. Robinson, originally published in the The American Economic Review back in 2001.

They take rough data of settler deaths back in the seventeenth and eighteenth centuries and plot them against the GDP of several countries from 1995. I’ve included the plot on the right. What they found was that a higher number of European settler deaths was associated with a long term decline in economic output.

Settling in the seventeenth and eighteenth centuries was a dangerous business, particularly in Sub-Saharan Africa and less so in what is now the United States, New Zealand and Australia. Malaria and yellow fever were responsible for killing up to 100% of groups brave enough to attempt the journey.

Acemoglu, et al.’s argument is as follows:

1. There were different types of colonization policies which created different sets of institutions. At one extreme, European powers set up “extractive states,” exemplified by the Belgian colonization of the Congo. These institutions did not introduce much protection for private property, nor did they provide checks and balances against government expropriation. In fact, the main purpose of the extractive state was to transfer as much of the resources of the colony to the colonizer. At the other extreme, many Europeans migrated and settled in a number of colonies, creating what the historian Alfred Crosby (1986) calls “Neo-Europes.” The settlers tried to replicated European institutions, with strong emphasis on private property and checks against government power. Primary examples of this include Australia, New Zealand, Canada, and the United States.
2. The colonization strategy was influenced by the feasibility of settlements. In places where the disease environment was not favorable to European settlement, the cards were stacked against the creation of Neo-Europes, and the formation of the extractive state was more likely.
3. The colonial state and institutions persisted even after independence.

They argue that the disease environment determined the nature of settlements, which determine the nature of institutions which, in term, determined the economic trajectory of a country.

Interestingly, they control for all of the things that one might control for, such as distance from the equator and the percentage of inhabitants that were European, being landlocked and the ruling power, ruling out the effect of some obvious potential influences. Property rights, a solid judiciary and limits on political power in the colonies and upon independence, they argue, had a greater effect on long term GDP, and the development of those institutions was enabled or inhibited by early settler mortality.

It’s a fairly compelling argument, though not without its critics.

A few gems from the paper interested me. One, the return on investment in the British colonies during the nineteenth century was a whopping 25%, far more than one could have expected domestically. In the late 19th and early 20th centuries, this dropped so that returns on colonial and domestic investments were the same.

I found (finally!) a reference to indicate the willful choosing of high altitude and thus less malarious areas for colonial settlements. Note that in Europe and the US, the location of cities is often along river ways and sea sides, where in Africa large cities tend to be placed inland (with some exceptions). There has been no industrial revolution in Africa and little regional trade (a condition which persists to this day) so that cities along water based shipping routes are not necessary. Extraction in Africa was largely done by rail, further alleviating the need to be close to rivers.

Egyptian instability is crushing Kenya’s economy

Coffee prices since 2000

Coffee prices since 2000

One of the problems with African economies, is that they tend to rely on receiving export revenues from just a few items. Some economies, like Nigeria and Angola, rely on oil. Oil economies are expecially problematic as the extraction process creates very few jobs, and revenues tend to flow directly into the pockets of corrupt politicians and middle men.

Kenya, lacking mineral or oil resources, is an agricultural economy. Specifically, they are really good at growing tea, and, to a lesser extent, coffee. This helps explain why Kenya’s developmental trajectory has been far more successful than that of other economies. Tea production is labor intensive and often depends on small and mid-sized farms which employ lots of people. Instead of money flowing in the pockets of the corrupt, who often squirrel it away in overseas accounts, money goes directly in the pockets of growers.

Kenya is the UK’s biggest tea supplier, but Egypt buys more tea by volume from Kenya than any other country. A piece in Think Africa Press today wrote on the dual problem of falling demand for tea from Egypt due to prolonged unrest, and that of falling commodity prices worldwide.

The cause of the farmers’ problems lies far to the north of the cool, tea-covered slopes of the Aberdares, in the heat of Cairo and the continuing fallout from the Arab Spring. In 2010, the last year before the uprising in Egypt, Kenya supplied the tea-obsessed UK with around half of its tea, but Egypt was the the single largest destination for Kenyan tea exports, buying nearly a fifth of what the factories around Nyeri produce. With the overthrow of President Mohammed Morsi in July 2013 and the ongoing campaign against the Muslim Brotherhood causing continued political instability, demand has plummeted and prices have gone with them.

“It’s a supply and demand issue,” says Chai Kiarie, Field Services Manager at Gitugi Tea Factory. “We produced more tea this year, but we still made nearly $2 million less than we did last year. With these problems abroad, the demand just isn’t there.”

This isn’t an isolated problem. Coffee prices, once riding high on a boom in commodity prices have been steadily falling since the financial collapse. The commodity boom was a winning sitaution for African economies and helped drive much of the rapid growth seen throughout the 00′s. Regulation has started curbing speculative practices that drove the increases, removing a source of destructive volatility which drove up food prices in developing countries, but has also decreased badly needed foreign exchange revenues.

I visited a few farms the last time I was in Kenya. Farmers aren’t waiting around for subsidies to help pull them out of a potential mess. All of the farmers I spoke with are looking for new ways to diversify their operations and meet potentially lucrative world wide demand for competitive products. All of them wanted to think of ways to increase productivity while decreasing the cost of inputs. The pressures from falling tea demand could help push them to find ways to innovate and increase both revenues and stability.

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