Archive | November 2012

Uganda Drops Death Penalty for Homosexuals

uganda-5The Times reported this morning that the Ungandan lawmaker who originally introduced the now famous bill recommending the death penalty for homosexuals, has drop that particular portion. Instead, he favors imprisonment for homosexuals and people who advocate of behalf of them.

There’s no doubt that Sub-Saharan African countries have become a battleground for the debates of the United States, much as the DRC and Angola were de facto theaters of war for the US and the Soviet Union. However, as complicit as we are, the elephant in the room is that Uganda should spend more of its time figuring out how to lift its numerous poor out of poverty and how to protect the health of its children.

Worse yet, the sill hypocrisy is evident. Anti-Gay proponents claim that homosexuality in Africa will undermine African family values. As near as I can tell, poverty, HIV and massive gender inequality have done more than their fair share of damage to African family values. Like the US, conservative voices are remarkably silent on these issues.

Politicians love to pick on the defenseless, particularly when they are in small numbers and especially when they can’t vote. David Bahati, the bigot (and member of the fundamentalist US Christian group The Family) who introduced the bill, no doubt receives political concessions and maybe even financial contributions from abroad.

Even if the bill does pass, enforcement will be laughable. Police in any Sub-Saharan country are noticeably absent, particularly in the rural areas. The trouble is that, where police are not present, mob violence is. In Kenya, a petty thief at a rural market can expect to be horribly beaten and publicly burned to death without trial. The Ugandan Parliament merely fans the flames of this type of sickening violence by codifying hatred into law.

In Defense of Palestinian Pseudo-Statehood

The UN is set to decide on whether to give Palestine non-member observer status at the UN and it looks like the request will be approved. This is a far cry from full blown statehood, but a step in the right direction.

The US, Britain and Israel, of course, oppose the measure. The United States plays a difficult balancing game with Israel, one of the US’s largest investors, and certainly, convinced it knows best, enjoys guiding the conversation. However, the strategy of bullish America unilaterally providing solutions to the world’s problems is becoming ever more difficult to implement.

Recognition by the UN for Palestinian sovereignty would be vastly beneficial to both the United States and Israel and here’s why:

1. Israel’s repressive system of apartheid presents a deep moral challenge for democratic bastions like the United States (not that we haven’t had apartheid). Though the Americans happily bury their head in the sand when it comes to this reality, it is deeply difficult to have conversations on global human rights, when Gazan kids are deprived of a future. Palestinian statehood, even if only recognized symbolically, would at least begin to soften this deep moral dilemma.

2. Israel suffers as a result of Palestine’s continued marginalization. It may be difficult for them to admit, but it’s true. Like South Africa’s apartheid government, Israel stands to lose a lot through the continued repression of the Palestinian people. It spends vast sums of money and energy repressing Palestine that could be better used for economic development and wild things like schools and health care. Partnerships can be mutually beneficial. Worse yet, Israel suffers as a religious state. Judaism was not built on the violent suppression of enemies.

3. Equals can have conversations based on mutual respect. Equals have the ability to compromise. Though, Palestine and the Israel/British/US alliance will hardly ever be equals on the strict sense of the word, a recognition of Palestinian independence by the other countries in the UN would put the full force of nearly 90% of humanity behind them. Palestine is a tiny swath of land with a tiny population, but with the world behind them, they are the most populace place on the planet. If strength comes in numbers, then the powers that be will have little choice but to listen.

4. Strong adversaries sometimes become great friends. Nowhere is this more apparent than in China/US relations. Though the two powers have deep differences, the truth is that they have much to offer one another, and much to lose if things go wrong. This was the rationale in building up former enemies such as Japan and Germany post World War II.

The Americans should know that the balance of power and the guarantee of the a political voice are stabilizing factors. In fact, they should know this better than anyone. The empowerment of the weak is a key tenet of the American Constitution. No where is this more apparent than the First Amendment, which guaranteed a political voice, and the Second Amendment of the Constitution, which sought to take away the state’s monopoly on violence by guaranteeing citizens the right to fight back, if necessary.** Notice that India and Pakistan, being able to obliterate each other, are much more likely to work out their differences than before they had nuclear weapons (though I’m not recommending increased nuclear proliferation).

5. The arguments for even small steps toward Palestinian statehood are even more apparent when one notes the long impasse between the US and weak and marginalized states like North Korea and Iran. Suppressing these states does the world no favors. Unfortunately, like Gaza, the only bargaining chip these states have is the potential to commit random and unpredictable violence. Fully engaging with them might temper the necessity for killing people.

In short, granting Palestinian pseudo-statehood in the UN is a step in the right direction, no matter how small. I have the feeling that some within the US Government, and even Israel, might agree. A full return to the 1967 borders with a shared Jerusalem and freedom of movement would, or course, be preferable, but we’ll take what we can get, a little bit at a time.

** Of course, the founding fathers had no appreciation for how far and how fast military technology would grow, nor of the US’s impending social problems. For the record, I am pro tight regulations on weapons, but this essential philosophy behind the Second Amendment as a guarantee of democratic principles can’t be ignored. Liberals, of course, never get this. I’m no conservative, but I do understand their rationale, sometimes.

The balance of power and insured peace through the mutual and equal potential to hurt one another is, of course, the root of libertarian arguments for increased gun ownership. It’s interesting that we don’t apply the same principles when talking about poor countries.

Russell Allen 1962-2012: Mississippi’s First Punk Rocker

Russell (photo by Ed Inman)

I just heard the awful news that Russell Allen, a friend of mine from Jackson, Mississippi, has passed. I hadn’t kept up with Russell much since I left Mississippi, but never forgot him.

Russell was one of Jackson, Mississippi’s first punk rockers. He would enthusiastically show up to just about any show and tell you about it. It was absolutely true. Being a punk in Mississippi can be a lonely affair but Russell pulled it off, mostly because he never considered that it might be a bad idea. Russell was never afraid of anything. He had a suit of armor forged of smiles and laughter.

Sometimes Russell would show up to our band practice space. We would be trying to write lyrics and Russell would come up with lines that would have us rolling on the ground in laughter. I think that he was completely serious, but it was hard to tell. He would deliver his lines in typical Mississippi fashion, totally serious with complete conviction, dressed up in his ultra thick and authentic outer-Jackson drawl:

“Electric energy, unseen force, thrash into oblivion on a pale white horse”

In retrospect, we should have fired our singer and hired Russell. I’m not sure why it didn’t occur to us at the time.

Once Russell led us into the practice space of the WindBreakers, a local band which had achieved some success at the time. I never could figure out if he had the key or he broke in, but we got in, fired up their gear and started jamming out. Russell would again spit off these lyrics that would have you laughing to hard to worry about playing. Eventually, Tim Lee and the WindBreakers showed up with their mouths agape.

You couldn’t really be angry at Russell. He was just too much of a nice guy. Whatever infraction he might have committed was done only in the interest of fun and good times. I never, ever saw Russell say a bad word about anyone at all.

Russell eventually put on a suit and got a job as a jeweler at a mall store. He never ever stopped being Russell, however. Later, after we were somewhat in touch, he sent out a couple emails to me to say “I HOPE YOU’RE HAVING A ROCKIN DAY!!!!!” and really not much more. That was Russell.

Now, I’m kicking myself for not having gone to see him when I was in Jackson last year. Too busy, can always meet him later…. but later will never happen now.

Russell, take it easy, man. You were loved.

Thoughts on WalMart, America’s Ectoparasite

An ectoparasite is an organism which lives on the exterior of a host’s body, completely dependent up the host for nourishment. WalMart (like corn) is such an organism.

WalMart is one of the world’s most profitable companies. It sells household goods at competitively low prices, while at the same time doling out 20% of its massive earnings to stockholders. It is able to do this by 1) offering bottom of the barrel wages for workers 2) outsourcing manufacturing to China, for basement level prices and 3) lobbying to manipulate government programs and the tax code to enable its business model.

As discussions of walkouts and strikes by WalMart workers rages, WalMart’s stock is doing better than ever.

WalMart’s low wages are, of course, part of it’s business model. Customers go to WalMart to buy goods at low prices. WalMart employees are poorly paid and recieve 10% off of purchases at WalMart, meaning that their wages are simply fed back into the company, creating an awful vicious cycle that cripples local economies.

WalMart depresses wages. Opening a single WalMart can depress the average wage in a county by up to 1%. This effect, of course, is additive. According to a U Berkeley study in 2000:

With an average of 50 Wal-Mart stores per state, the average wages for retail workers were 10 percent lower, and their job-based health coverage rate was 5 percentage points less than they would have been without Wal-Mart’s presence.

Wages in 2012 are even lower. If we repeated the study, we might find that the situation now is even worse.

Besides the more than $1 billion in real tax subsidies that support the opening of new WalMart stores, the federal government picks up the tab for benefits in the form of EBT payments and Medicaid.

One oft repeated right wing mantra is that WalMart workers choose to work there. What happens to them is their own fault. As the entry of WalMart devastates the local business community in rural areas, there really aren’t many jobs to “choose” from anymore. I’ve been through plenty of rural towns where the only employer is WalMart.

The opening of a WalMart has also been shown to increase poverty. Increases in poverty are, in the end, merely shifts of capital, which could go to education or small business ventures, from the group of the bottom to the top.

WalMart bleeds communities dry through schemes that minimize its property tax burden:

This first-ever investigation of Wal-Mart’s local property tax records finds that the retail giant systematically seeks to minimize its payment of taxes that support public schools and other vital local government services. Online appendices with lists of stores and distribution centers examined.

The moral of the story is that local businesses can’t compete, potential entrepreneurs lack capital to start businesses and localities are bled dry of resources to support community investment.

After reading this post, I found that I didn’t develop the idea of WalMart as blood sucking parasite very well, but it’s there anyway.

Wal Mart Stock, Nov 25, 2012

British Man Faces Prison For Staging Theater Play on Homosexuality

While public acceptance of homosexuality and gay rights is rapidly improving in the United States, the debate rages in Sub-Saharan Africa.

Uganda is now famous for the introduction of a bill which sought to criminalize homosexuality. Some offenders would be punished with death. Though the Amendment never got passed, American Evangelistic Christians were implicated in inspiring the bill, presumably feeling that the damage they do domestically isn’t enough.

Now, David Cecil, a UK born theater producer living in Kampala faces a two year prison sentence for the awful crime of putting on a play dealing with homosexual themes.

From Xindex:

On 13 September, he was arrested in Kampala and held in detention for three days. Eventually released on bail, he now faces two years in jail or deportation on a charge of “disobeying lawful orders” after refusing to let the authorities suspend and review his play the River and the Mountain.

The play, which tells the story of a successful gay businessman who is murdered by his employees when he comes out, was always likely to cause controversy in Uganda.

Issues of homosexuality in Sub-Saharan Africa are as fascinating as they are repulsive. From the story of Tiwonge Chimbalanga and Steven Monjeza, the two men who attempted to marry in Malawi and were sentenced to 14 years in prison (they were later freed) to the horrible death of David Kato, a Ugandan gay rights activist who was publicly outed and bludgeoned to death in his home, the debate over gay rights in Africa as as contentious as it is dangerous.

Nearly all SSA countries have some law criminalizing homosexuality. Many of these laws are left over from the old colonial governments. The Brits have moved on, but have left their an awful, awful legacy. Now, ironically, the debate centers around what some people see as a heavy handed attempt by western countries to impose a dangerous morality.

Of course, I am always shocked to hear people rage about the damage homosexuality causes in SSA, while the HIV epidemic, fueled by heterosexual sex devastates the continent. Politicians, of course, have little to lose by alienating a small and defenseless population. Screaming about condom use, concurrent sexual relationships and prostitution might cost votes.

Malaria in the News: 1858-Present

Malaria in the South 1925-1935

A subscription to the New York Times gives one access to articles from 1851 onward.

A search for all articles with “malaria” in the text yields an amazing 33,800 results. Browsing through the headlines is like reading a brief history of the disease as seen through an American lens.

The oldest article is from 1889, a report on a malaria outbreak on the upper Hudson in New York: “An epidemic of a malarial nature is reported from towns along the upper Hudson, one physician in Newburg reporting more than seventy cases under his care. Newburg is famous for its breakneck streets.”

The article is notable because in 1889, very little was known about the disease. Of course, in 2012, we know much, much more, but the challenges (problems in diagnosis, complex and often contradictory observations on ecological factors and socio-economic infection gradients) are the same now as they were then.

From 1925:

30 INSANE PARETICS CURED BY MALARIA; Long Island College Hospital Reports Marked Success With New Treatment. Thirty patients regarded as hopelessly insane are back at work and leading normal lives after being artificially inoculated with malaria, allowed to suffer chills and fever for two weeks or so and then treated with drugs, according to an announcement yesterday by the Long Island College Hospital.”

I don’t think that anyone really knew what the “paretics” were suffering from, but it was likely syphilis. Malaria was used briefly to treat a variety of neurological disorders caused by infectious agents, with varying degrees of success and failure.

There are a few other shockers. Prisoners were used to test malaria drugs until halted in 1974, a practice that no IRB would ever approve now.

Vaccines have long been “just around the corner,” only to die in sad failure. The most overly optimistic claim came in 1984 from then head of USAID, M. Peter McPherson (who later became President of Michigan State University):

M. Peter McPherson, administrator of the Agency for International Development, said he expected that a vaccine would be ready for trial in humans within 12 to 18 months and widely available throughout the world within five years. ”We think this is a practical schedule,” he told a news conference at the State Department today.

A classic case of overstatement, I’m sure that he regrets this event to this day. No wonder scientists have to be wishy washy with their predictions. Statement like this live in sad perpetuity. We still don’t have a vaccine, and the outlook for having one any time soon hasn’t gotten much better now than in 1984.

Selected highlights:

1889 North River Malaria
1943 Malaria Problem; Our Knowledge Is Still in an Unsatisfactory State
1945 New Drugs to Combat Malaria Are Tested in Prisons for Army
1951 Army Tests Drug as Malaria Cure; Doses Given Troops
1957 World-Wide Battle On Malaria Mapped
1961 New Malaria Threat Is Studied At Infectious Diseases Center
1966 Leprosy Drug Reduces Malaria Among gi’s
1970 Malaria Up Sharply in Nation; Most Cases Traced to Vietnam
1971 Drug Users Spur Malaria Revival
1974 Prison Official in Illinois Halts Malaria Research on Inmates
1977 Malaria Spreading in Central America as Resistance to Sprays Grows
1987 Drug Combinations Offer New Hope in Fighting Malaria
1988 Scientists Report Advances In Vaccine Against Malaria
1991 Outwitted by Malaria, Desperate Doctors Seek New Remedies
1991 Hope of Human Malaria Vaccine Is Offered
1993 Mefloquine Is Found Best Against Malaria
1994 Vaccine Cuts Malaria Cases In Africa Test
1995 Vaccine for Malaria Failed in New Test

1996 Tests of Malaria Drug From China Bring Hope and Cautionary Tales

Household Debt is Down, but What Does That Mean?

Household debt to GDP

Household debt is down. Way down. After steadily increasing from 2000 until the end of 2009 (during the freewheeling economic bubble), American households are down to approximately owing 83% of GDP. The good news is the number is continuing to shrink.

Not only that, according to the Washington Post (“Five economic trends to be thankful for”), the cost of servicing that debt is also down. Previously, American households were spending more than 14% of their disposable income on debt repayments. Now, they only spend 10%.

This is great news. Households, rather than chaining themselves into stagnation through crippling interest repayments (which don’t help American workers at all), are able to spend that money doing things that give regular people paychecks.

This plot (from the Calculated Risk blog), though, makes the picture a bit more nuanced, however.

Nearly all the reductions in debt are due to declines in the amount of money owed on mortgages. Student loan debt, however is increasing. This is partly good. People are likely living in houses more inline with market prices and what they can afford. At the same time, unemployment is sending more and more people back to school.

While I’m all about people getting educated, I can’t help but think our phenomenon of skyrocketing tuition is merely shifting the debt from one sector to another.

James Bond and Economics: Shaken and Stirred

James Bond, closet Keynsian

Over my nearly 40 years of watching James Bond movies, it wasn’t until recently that I picked up on what it all meant.

James Bond, a talented 00 agent in MI6, gets sent the world over to thwart the nefarious plans of mad geniuses hell bent on world domination, all the while bagging beautiful women and downing martini after martini. That much is clear.

What was not clear to me, was the deep economic and political significance of the series. The Economist recently ran a blog post on 2006’s Casino Royale as an allegory for the financial meltdown, despite the fact that it appeared two years before.

Le Chiffre, a opportunistic genius who finances international terrorism for profit comes up with an infallible plan to short sell rapidly rising stocks in a airline company, destroy a highly anticipated prototype, then profit off the subsequent crash in stock prices. He does this by investing money that is not his own. The plan, of course, fails, and the “genius” plans to win it all back through a poker game.

This could have been pulled from the playbook of every alcoholic and gambling addict out there. Genius, indeed, but little different from the irresponsible and desperate behavior of market players as the American economic bubble was crashing.

Interestingly, Bond himself, through a couple of poorly planned strategies loses everything and appeals to the Treasury of the United Kingdom (taxpayers) to bail him out. The Treasury rightly refuses, unlike the Government of the United States. Instead of saying no, the US bailed out some of the worst offenders in the banking crisis, effectively rewarding them for gambling stupidly.

Of course, Bond has little to fear. The $50 million dollars that Bond needs is secretly offered up by the Americans as long as they are able to take the credit for the win. This exchange underlines the complex relationship between the UK and the US. Britain, once the largest power in the world, now relies on bailouts from the former colony when it makes stupid mistakes. Amazing.

The villains of the bond world distinguish themselves by not being power-hungry-insecure-would-be-despots (such as the Asgardian Loki in the recent movie the Avengers), but rather as shrewd financial schemers, who wish to manipulate the market to securely enrich themselves.

In this manner, they are no different than food speculators on Wall Street (the gold manipulation scheme in Goldfinger), and not out of step with the ever more obvious trend of the mass privatization of that which should be a public good (see the water scheme in Quantum of Solace).

Of course, not all of these villains are supply siders like the plan to control the worlds solar energy in The Man with the Golden Gun (of course, this ignores the possibility someone else might redevelop the technology and enter the market). Dr. Kananga in Live and Let Die sought to create market demand for his product by getting restaurant patrons hooked on heroin.

The economic depth of 007 was certainly lost of me until I started digging. Truthfully, I really didn’t know what a stock short sale was, but now I do. Perhaps instead of reading wordy economic tomes, we might just make students rewatch Bond movies? It would certainly be more entertaining.

Sometimes, when Good Ideas Die, Kids Die (from Malaria)

The Affordable Medicines Facility – Malaria (AMFm), an innovative subsidy program designed to increase access to life saving malaria medications in poor countries, died last week.

I would argue that malaria is the most important health issue in the world. This ancient disease kills the young, debilitates the living, and universally strikes the weakest of the weak and the poorest of the poor. Malaria’s complex biology doesn’t lend itself to the easy creation of vaccines, and its deep relationship with poverty makes it nearly impossible to eradicate. The only way to successfully eradicate malaria will be to eradicate poverty itself, not an easy task.

We have been able to create drugs which successfully treat malaria, but the parasite quickly finds and exploits weaknesses in the drugs. After time, the drugs become utterly useless. Right now, our last hope is medical cocktail based on artemisinin, a ancient plant grown in China, Artemisinin Combination Therapies (ACTs). The drugs are effective, and the cocktail based nature of the drug means that the parasite has difficulty developing a resistance to it.

Despite ACTs being effective, most people in parts of the world where malaria is most common have no access to it. ACTs are expensive, delivery difficult and developing country health systems poor and ineffective. In the public sector, stockouts are common making them an unreliable source. Distance from facilities is also a barrier. In Sub-Saharan Africa, for example, most people (often the poorest) live too far away from a facility to justify the trip.

This is where the AMFm comes in. The AMFm takes money from the Global Fund to Fight TB, Malaria and HIV and pays it directly to manufacturers for ACTs. Private wholesalers in participating countries are then able to procure ACTs at low prices. Wholesalers then pass this discount on to small private drug retailers, who are able to sell ACTs at a price equivalent to less effective (and cheap) anti-malarial medications. As private drug retailers exist just about everywhere, cheap ACTs become widely available to the poorest and most remote of populations at a price they can afford. The private sector, with profit as a motivator will maintain consistent stocks and older, ineffective medications are crowded out of the market.

At least, this was the hope. A meeting of the Global Fund last week effectively killed the AMFm.

The program was first proposed in 2002, has been piloted in 8 countries (7 in Africa and 1 in South East Asia), and has been under review for the past few years. Full disclosure, I was a part of a review of the AMFm as part of a a group affiliated with the UM Business School.

We found that under the AMFm, availability of ACTs increased, stocks were more consistent and prices fell. Our results agreed with other evaluations. Granted, problems in equity of access still existed, but, given the challenges of drug delivery in Sub-Saharan African countries, the AMFm was a rounding success, and potentially a more effective method of increasing access to meds than strategies which exclusively rely on the public sector.

The AMFm, despite all the indications that the program was going to bring (and has brought) life saving meds to populations that would normally go without, faced intense criticism. The critics most notably came from within the United States. The Presidents Malaria Initiative (PMI), a program started under George W. Bush to fight malaria was the most vocal. Some critics worried about diversion to non-AMFm countries. The same critic, with almost no data, (right wingers) even claimed that the AMFm supported organized crime.

PMI claims that the AMFm haphazardly doled out ACTs to people who did not need them, wasting resources and potentially inducing parasite resistance to the drug, rendering it ineffective. They claim that the AMFm undermined the public sector’s ability to provide services. They claim that ACTs under the AMFm disproportionately went to areas which had low levels of malaria transmission, such as the nearly malaria-free island of Zanzibar. The problem isn’t that these claims are false. They are all based on an independent evaluation of the AMFm sponsored by the Global Fund. The problem is in how the results were spun.

The reality, that PMI (and others) seem to ignore, is that nothing is perfect in Sub-Saharan African countries. In a world where the extent of poverty and human suffering is so great, a less than perfect result might be better than anything that was there before. Even if people are being misdiagnosed, the truth is that a number of people who do have the disease and did not have access before, now have access to drugs. Even if the public sector is being crowded out, the truth is that public sector health delivery in SSA is frought with problems. In survey after survey, people state that the private sector is their first choice for medical treatment. Bolstering health delivery through the private sector is an obvious solution.

In the end, the AMFm was held to a standard that was impossible to reach. I can think of no program in the past decade which has been held to this level of scrutiny. The AMFm, in this regard, was doomed to fail from the start.

Malaria metrics are often elusive. Information on malaria mortality exists, but only for people who show up and die at a formal facility. Estimates of infection prevalence exist, but asymptomatic cases and the difficulty of reaching remote and very poor populations reduces confidence. We know that malaria cases are down everywhere, but determining the exact causes of this decline are difficult. it is admittedly difficult to know how many kids the AFMm saved. We do know, however, that untreated symptomatic malaria in children is dangerous and that drugs are hard to get.

The odd thing to me, is that PMI, being a American group started by a free-market Republican would disparage an effort to bolster private sector health delivery. In essence, PMI is suggesting that a top down, government centered form of health delivery is optimal, which is entirely backwards from the stated philosophy of the Republican Party. Domestically, we know the attitude to be quite different. Personally, I think this smacks of paternalism. Private sector health care in the US is lauded, but Africans can’t be trusted with the same models.

I admit, before I became involved with this project, I was also skeptical of private health care delivery in developing countries. While regulation and certification programs are key to optimizing efficiency and insuring that standards of effective delivery are met, the results of the AMFm evaluations indicate that the private sector can be very effective. Really, it took me going to these areas and visiting these shops to realize how effective it can be. I wonder if the administrators of PMI ever took the time to visit.

Improving access to medications saves lives. Now that the AMFm is dead, I worry that kids will die, simply because a few people didn’t take the time to put their feet on the ground.

Happy Thanksgiving: Don’t Forget the Blood

This clip just never gets old. It is, of course, best watched together with friends and family.

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