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Markets in everything: reverse prostitution edition
Thousands of people in Africa will be paid to avoid unsafe sex, under a groundbreaking World Bank-backed experiment aimed at halting the spread of Aids.
The $1.8m trial – to be launched this year – will counsel 3,000 men and women aged 15-30 in southern rural Tanzania over three years, paying them on condition that periodic laboratory test results prove they have not contracted sexually transmitted infections.
The proposed payments of $45 equate to a quarter of annual income for some participants.
Here is the full story. It is a joint private sector, public sector initiative, in case you were wondering. I thank Johannes for the pointer.
Posted by Tyler Cowen on April 28, 2008 at 01:08 PM in Economics | Permalink
Comments
How much money is spent today on HIV/Aids - including research, prevention, treatment etc. (Is there actually a way to find out how much it is?)
Now add the economic losses due to HIV/Aids.
Is that really so much cheaper than paying every person in a high risk group in developing countries those 45 dollars and controlling (in some effective way I haven't made up yet) them?
I'm asking only about the money, not about morals, discrimination and this kind of stuff. And I know that it's not actually a good idea to stop Anti-Aids-Research for whatever reason.
Posted by: Finja at Apr 28, 2008 1:56:24 PM
Not to be too cold hearted, but why do we care so much?
If, after being told about STDs, there effects and the likely hood of getting one, people still chose to have risky sex (aka all sex), why would we want to stop them? Seems like this project destroys utils (the people choosing not the have sex are presumably better off, but not $45 better off, and those making the donation are $45 worse off (plus admin cost).
There is probably an argument to be made that the fewer cases of AID in the world the less likely I am to get it. True, but why start in Southern Tanzania, I’m, and I think most people giving the money are not likely to be there any time soon. I know the after life holds nothing good for me.
Posted by: Mason at Apr 28, 2008 2:03:47 PM
$1.8M spent on 3,000 people is $600/person. Tanzania's GDP is $316/person. If they were to just give the Tanzanians the money, instead of giving them only 8% of it and spending the remaining 92% on first-world researchers, they would tripple the Tanzanians' income. That kind of increase in standard of living would be certain to induce more health-conscious behavior.
Posted by: David Wright at Apr 28, 2008 2:56:15 PM
@mason
the basic argument for this is we live in a global economy. Africa´s current struggles make a us markedly poorer. HIV is a bomb. It´s explosion causes civil and economic unrest. If we can find ways to mitigate this unrest the one time static lose probably is overwhelmed by the continual gains from increased ability to participate in the positive sum trade gains. As is much of the continent is languishing under the pressures of this (amongst many other) diseases. Alleviation is in everyones benefit.
Posted by: Mdesus at Apr 28, 2008 2:59:09 PM
Isn't this a bit wacky? If getting AIDS isn't enough incentive to avoid unsafe sex, wouldn't we be shocked if a few bucks made the difference?
Posted by: Wilson at Apr 28, 2008 3:13:36 PM
The problems in Africa are complex, but I suspect that female rights are part of the problem. The female has very little bargaining position in a country like Africa. With concurrent sexual pairings common, how can a female protect herself? By asking her husband to wear a condom? She may as well be asking him to beat her, since in so doing she's accusing him of unfaithfulness. This at least makes safesex in the best interest of poor men, and therefore helps realign incentives of men with the incentives of women. Plus, $1.8 million for such a project seems like cheap compared to many other kinds of aid sent to Africa. Can't wait to see what we learn from this. It reminds me of Roland Fryer's project in NYT on paying students to achieve. I'm all for becoming more experimental and creative on these projects, recognizing that incentives matter, and that cash transfers are the most efficient ways to change behavior.
Posted by: jason voorhees at Apr 28, 2008 3:24:04 PM
Why not just focus on the education part? I find it hard to believe that paying them $45 each to practive safe sex will serve as a greater incentive than the threat of living with a drawn-out and deadly disease. That is unless your goal is to boost wealth there in the process.
Posted by: Gabe at Apr 28, 2008 3:30:40 PM
If people are starving and their children are starving, and prostitution involving unsafe sex provides food for them and their children, why wouldn't they do it?
How many commenters have even spoken to someone who has been to Africa since the Rwandan genocide, never miind been there themselves?
Posted by: caveat bettor at Apr 28, 2008 3:53:32 PM
Where is the "markets in anything" component? Here's where:
If I have AIDS, I'm already out of the running for this money, but I still want to capitalize on the experiment. If you don't have AIDS, I know you will have $45 extra dollars at the end of the experiment. You will be willing to part with, say, $20 today to me and my local gang to avoid rape. The trade is beneficial-- I get $20, you get $25 and avoid AIDS. However, and I'm not sure how this would go down, but if the majority of people 15-30 already have AIDS, then the ones who are AIDS-free will soon be targeted for extortion by more than just one gang. You will soon be out of $20 more dollars.
Posted by: mpkomara at Apr 28, 2008 4:07:03 PM
My question is what happens if it works (as I suspect it will)? Does the program roll out to the entire country? Region?
Posted by: E at Apr 28, 2008 4:07:55 PM
Gabe - This isn't being proposed to substitute for education, but in conjunction with it. The program has an education component, after all.
Also, one reason to think this would be effective is because in poor countries, the presently discounted cost of the disease is low if mortality is already high, or if they are poor. Oster discusses this here. A payment of four months wages today would seem to be much more effective deterrent.
Posted by: jason voorhees at Apr 28, 2008 4:08:08 PM
"...in a country like Africa..."
Speechless.
Posted by: bartman at Apr 28, 2008 8:18:02 PM
"Speechless."
Your PCness getting in the way?
Posted by: Tom at Apr 29, 2008 8:21:47 AM
"...in a country like Africa..."
Speechless.
Eeks! Substitute "continent" for country. I swear I know the difference!
Posted by: jason voorhees at Apr 29, 2008 11:58:32 AM
I remember, maybe wrongly, that years back a nordic country declared three-strikers mentally unfit and therefore eligible for a pension.
Posted by: Hans Suter at Apr 30, 2008 10:38:22 AM
I am an African (albeit a white 'un) and I grew up in a rural and traditional area now thought to have the highest rates of HIV infection in the world - South Africa's Eastern Cape (formerly the Transkei) and I have an idea for you researchers for your next piece of research:
Instead of paying individuals, pay the local traditional healer ('mganga' or witch doctor). Incentive payments could be based on a variety of formulas: for example deductions from a lump sum for everyone testing HIV positive within their 'parish'.
I am genuinely serious when I say this: I have no idea why HIV experts have not sought to co-opt traditional healers. They have the ear of the people (a damn sight better than western doctors and educationalists) and they are extremely open to profit-making opportunities.
Just ask the witch-doctor my girlfriend recently had me visit, who had a very good cure for "male importance" [sic].
Posted by: Mark at Apr 30, 2008 1:48:42 PM
