How did Sierra Leone beat river blindness?

This is from The Economist:

…. Sierra Leone is doing better at beating back neglected tropical diseases (NTDs) than almost anywhere else in Africa. Fifteen years ago as much as half the population was infected with the worm that causes onchocerciasis, or river blindness. Many villagers in the south-east used to think it was perfectly normal for people to go blind after 30, says Mary Hodges, from Helen Keller International, a charity that works on blindness and malnutrition. Yet by 2017 only 2% of people carried the worm, and there had been no new cases recorded of people going blind from onchocerciasis in a decade. Elimination is expected by about 2022.

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What is Sierra Leone’s secret? Apparently, it’s because a high initial disease burden made inaction not an option:

Paradoxically, one is the extraordinarily high prevalence of NTDs. Because the entire population was exposed to at least one NTD, the government made it a priority early on, says Dr Joseph Koroma, who managed its programme. And instead of dealing with these diseases separately, Sierra Leone tackles them all at once.

This is a big win for global public health and the Carter Center.

Here is a great read on how the Guinea worm was eliminated in Burkina Faso.

However, despite success stories like Sierra Leone, it is worth noting that the global fight against river blindness is being made harder by the fact that dogs are becoming the new carriers of Guinea worms.

Why is Madagascar the only non-conflict country to have grown poorer since independence?

FT’s David Pilling asks this question in a great piece interrogating Madagascar’s decline:

Screen Shot 2018-06-19 at 11.24.33 AMPresident Hery Rajaonarimampianina is weathering the latest in a series of political crises that have debilitated his nation since independence in 1960. In that period, Madagascar is the world’s only non-conflict country to have become poorer, according to the World Bank. Its income per head has nearly halved, to about $400 [see image with the sobering trend data from the World Bank].

A leading candidate for explaining the decline is that the Malagasy state does very little:

“Madagascar is the world’s forgotten island,” said Patrick Imam, the IMF’s representative to the country, who argues the west should pay more attention. “This is probably one of the few countries in the world where the IMF cautions the government: ‘You are not spending enough money,’” he says, referring to the limited presence of the state outside Antananarivo.

According to World Bank data, since the mid-1960s government expenditure in Madagascar has consistently been below the regional average:

Screen Shot 2018-06-19 at 11.13.34 AMRead the whole thing here.

A somewhat speculative explanation might be the abolition of the Merina monarchy in the late 19th century by the French. For much of its post-colonial history Madagascar has been racked by one episode of elite political instability after another. A stable monarchy might have provided a nucleus around which to construct elite consensus on legitimate means of organizing the country’s political economy.


Colonial education, social status, and social mobility in Uganda

This is from an exciting paper by zu Selhausen et al. in Economic History Review:

This article uses Anglican marriage registers from colonial and post‐colonial Uganda to investigate long‐term trends and determinants of intergenerational social mobility and colonial elite formation among Christian African men. It shows that the colonial era opened up new labour opportunities for these African converts, enabling them to take large steps up the social ladder regardless of their social origin. Contrary to the widespread belief that British indirect rule perpetuated the power of African political elites (chiefs), this article shows that a remarkably fluid colonial labour economy actually undermined their social advantages.

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conditional probability of entering Class I (Kampala)

Sons of chiefs gradually lost their high social‐status monopoly to a new, commercially orientated, and well‐educated class of Anglican Ugandans, who mostly came from non‐elite and sometimes even lower‐class backgrounds. The study also documents that the colonial administration and the Anglican mission functioned as key steps on the ladder to upward mobility. Mission education helped provide the skills and social reference needed to climb the ladder in exchange for compliance with the laws of the Anglican Church. These social mobility patterns persisted throughout the post‐colonial era, despite rising levels of informal labour during Idi Amin’s dictatorship.

Status inversion/disruption during colonialism is significantly under-appreciated as a cause of elite political instability in post-colonial Africa (paper on this coming soon). Ghana, Nigeria, and Uganda are paradigmatic examples of this phenomenon of educated “commoners” butting heads with established pre-colonial ruling elites following independence. 

The authors also call for a more nuanced understanding of political power under British indirect rule:

Although many Ugandan chiefs were appointed as administrative officials under indirect colonial rule and in this way exercised both political and economic power over the local population, our micro‐evidence portrays a society in which access to secondary education and a labour market seemingly based on meritocratic criteria caused chiefs’ colonial power gradually to disappear. This shift, which was helped by colonial land reforms and increased African access to Kampala’s formal labour market, challenges the perception of British indirect rule as ‘decentralised despotism’. It also illustrates how mission education did more to foster social mobility among our sampled grooms than to entrench the traditional privileged classes.

Read the whole paper here (gated).



David Ndii on the Kenyatta-Odinga “Handshake” and what it means for Kenyan politics going forward

Ndii contends that “whatever comes out this [Kenyatta-Odinga handshake] … will not be transformational.” It is merely a “containment.”

Ndii also concedes that it’s impossible to work around ethnicity as the primary basis of organizing Kenyan politics.

The whole thing is worth watching:

North Korea is now a globally recognized nuclear power

That is the conclusion of Narang and Panda in the Times:

North Korea has arrived as a nuclear power, and there is no going back. Once the reality-show theatrics of the Singapore summit meeting subside, we are left with the reality that North Korea was just recognized as a de facto nuclear weapons power.

…. Didn’t he just agree to “work towards complete denuclearization of the Korean Peninsula”? He did. Just like his grandfather’s deputies did in 1993. That phrase — “denuclearization of the Korean Peninsula” — is a term of art that the United States and North Korea can interpret to suit their interests.

More on this here.

Any normalization of relations or easing of sanctions with North Korea will have implications for a number of African states (see here and here) that have enjoyed lucrative economic ties with Pyongyang (mostly through the import of arms and statues).

The consequences of the vanilla boom: Madagascar Edition

Vanilla is currently rivaling the value of silver, per unit weight.

That has come with consequences for Madagascar, which accounts for 80 percent of the global production of natural vanilla. According to FT:

Madagascar, which supplies 80 per cent of the world’s natural vanilla, is in the grip of a vanilla boom. “People are saying, ‘I don’t care about growing food to feed myself. I only want to grow vanilla’,” says Eugenia Lopez, an agricultural expert with Swiss development agency Helvetas. Girls are dropping out of school to marry “vanilla barons”, and sales of televisions, alcohol and other luxuries are high. “People are buying cars and motorbikes that they won’t even be able to fill with petrol when the price of vanilla crashes,” says Ms Lopez.Screen Shot 2018-06-05 at 10.03.27 AM.png

Not all the value is trickling to farmers. And the sector remains highly volatile, but with minimal options for smoothing consumption among affected farmers.

While the likes of Coca-Cola, Unilever, the British-Dutch consumer goods group, or Danone, the French food company, are forced to pay inflated prices, farmers receive only 5 to 10 per cent of the value of their crop [!!!!], according to industry observers.Worse, they say, if farmers switch to lucrative vanilla and abandon food crops such as rice and manioc, they could be left in desperate straits when the vanilla market crashes, as it inevitably will. Vanilla has been through violent booms and busts before. Only five years ago, it was trading at $20 a kilogramme against some $515 now, down from a recent peak of $600 and compared to a silver price of $528/kg.

More on this here.

Meanwhile, Madagascar is in the midsts of a political crisis ahead of elections scheduled later this year.

… a dispute over electoral minutiae had spiralled into a full-blown political crisis. A month on, the situation seems intractable.

The original rally centred on some controversial laws that would have made certain opposition candidates ineligible for elections scheduled for November. Most notably, the changes would have barred both Marc Ravalomanana, president from 2002 until he was removed in a coup in 2009, and Andry Rajoelina, the coup leader who took over as president until 2013, from running.

….. On 3 May, the High Constitutional Court (HCC) rejected a number of clauses in the new laws as unconstitutional. This included those provisions that would have prevented Ravalomanana and Rajoelina from running.

According to Malagasy law, the next step should have been for the executive to send the legislation back to parliament for review. But instead, the president unilaterally amended the laws and published them on 11 May.

The military has threatened to intervene, again, if the politicians fail to resolve their differences.

H/T Pavel

Religious offerings as insurance?

This is from Auriol et al.

This paper presents experimental evidence exploring how insurance might be a motive for religious donations by members of a Pentecostal church in Ghana. We randomize enrollment into a commercially available funeral insurance policy and let church members allocate money between themselves and a set of religious goods in a series of dictator games with significant stakes. Members enrolled in insurance give significantly less money to their own churches. At the same time, enrollment in insurance reduces giving towards other spiritual goods. We set up a model exploring different channels of religious based insurance. The implications of the model and the results of the dictator games suggest that adherents perceive the church as a source of insurance and that this insurance is derived from beliefs in an interventionist God. Survey results suggest that community-based material insurance is also important and we hypothesize that these two insurance channels exist in parallel.

…. Our findings add to the literature on the economic functions of religious organisations by providing experimental evidence that a religious institution can be used as a substitute for a formal financial service in an environment where obstacles to the functioning of the formal market are high. Furthermore, the experimental findings add nuance to the literature on religious institutions as coordinating platforms by demonstrating that adherents might care as much about spiritual insurance (affecting outcomes through signalling to an interventionist God) as they do about material insurance (accessing transfers of goods and services from other church members).

The paper, of course, provides micro evidence of wider country-level correlations between income (which maps onto financial access) and religiosity.



Are Africa’s political and economic elites the most complacent class in the world?

This is speculative.

Africa’s elites are arguably the most complacent in the world. They engage in almost no innovation — whether in the fields of governance, technology, religion, philosophy, or science. This is not to say that there is not any innovation in these fields on the Continent.

Far from it. A lot of innovation is happening on the Continent. The problem is that innovation tends to be purview of individuals who are part of the economic and political underclasses, many of whom lack the power to mainstream their innovations.

Consider the case of which global elites attend the best universities in the world. If you did a survey you would find that political and economic elites from almost all parts of the world are represented in these institutions through their offspring. Africa, on the other hand, tends to be represented by smart but politically and economically disempowered students.

Some of these students are wealthy, but the vast majority are complete political and economic outsiders in their home countries. Many get absorbed into the middle and upper-middle classes of their adopted countries. The offspring of elites from other regions of the world go back home and work to mainstream the ideas learned abroad.

Meanwhile, the offspring of Africa’s political and economic elites largely attend mediocre academic institutions. Many never learn much, including the basics of economic and political management. It is therefore not surprising that many live and aspire to reproduce their parents’ complacency and mediocrity.

Am I painting here with a very broad brush? Perhaps. But show me a prominent African political leader and I will show you an offspring with mediocre grades and limited ambition.

Sierra Leone is the roundest country in the world (Zimbabwe is third)


H/T Felix Salmon

This reminded me of this paper by Laitin, Moortgat, Robinson:

….. For each country, we measure the degree to which its axes run across ecological biomes relative to within them. This measure takes the form of the ratio of the average length of the north-south axis relative to the average length of the east-west axis. To the extent that the ratio is greater, we ask whether there has been greater persistence of cultural diversity within the boundaries of that state. Diamond’s theory would expect linguistic diversity to erode naturally with east-west migrations. The combining of societies relying on similar technologies would amalgamate those societies into wider speech communities. The theory would then predict the concomitant loss in viability of either the languages of the migrants or those of societies indigenous to the lands that had been populated by those migrants. Meanwhile, the theory would not expect such erosion with north-south migrations, as in this case even small speech communities would survive culturally intact, relying on their special skills related to conditions in climate zones different from where the migrants left.

We find suggestive evidence that the more exogenous a state’s borders are, the greater the impact of geographic orientation on the persistence of cultural diversity. Next, we evaluate the impact of axis ratio on the persistence of diversity among artificial geographic units comprised of contiguous neighbors, and again find a positive relationship. All of these results provide consistent evidence that the degree to which a geographic unit is oriented more north-south than east-west is related to the persistence of cultural diversity within that unit.

Here are the three least round countries:

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More on this here.

It pays to go to school

This is from The Economist:

WHICH has provided a better return in recent decades: America’s stockmarket or education? The latter, according to a research review by George Psacharopoulos and Harry Patrinos for the World Bank. The two economists looked at 1,120 studies, across 139 countries, and came up with an annual average “rate of return”—actually a pay premium, the increase in hourly earnings from an extra year of schooling—of 8.8%. The analogy is inexact, but for comparison America’s stockmarket returned an annual 5.6% over the past 50 years.

Their figure excludes social gains, such as lower mortality rates associated with greater education. The premium is higher for girls and for primary education. It is also higher in poor countries, presumably because the smaller the share of educated people, the higher the pay they can command. The same reasoning suggests that the return should have dwindled as educational attainment rose. Instead, it has stayed strong, especially for higher education.

More on this here.

Screen Shot 2018-05-05 at 5.45.31 PM.pngEducation attainment appears to be trending in the right direction across the globe (see image). However, the rate of improvement over the last three decades has been higher in some regions than in others. For example, while in 1992 Africa and South Asia had 42% and 38% of the out-of-school children of primary age, respectively, by 2014 the comparable figures were 57% and 19%. Clearly, African states need to do more.

The Bill & Melinda Gates Foundation has recently announced its foray into education. If done well, the Foundation’s involvement in the education secctor has the potential to nudge policy makers in the right direction, while also generating valuable data for cross-country comparisons.

Unrecognized States in Africa

Post-war juridical sovereignty has been hell of a drug. For a region with a lot of weak states and so-called “artificial borders” Africa has seen almost no substantial revision of state boundaries or the creation of new states (and not for lack of irredentist and secession movements…)


Only South Sudan and Eritrea have managed to successfully secede and gain international recognition. Somaliland comes close. And while the Sahrawi Republic is recognized by the African Union, it still lacks robust international recognition. Apartheid South Africa stands out as the only state to voluntarily reorder its geographical integrity by creating new vassal statelets within its domain for its own racist ends.

H/T Paul D. Williams

The Scramble for Somalia


The Journal has a great piece on the new scramble for Somalia among regional and global powers:

The maneuvering for territory has drawn a motley crew of actors, including U.A.E. state-owned shipping giant DP World; a Turkish conglomerate owned by the family of President Recep Tayyip Erdogan’s son-in-law; and Navy-SEAL-turned-businessman Erik Prince, who wants to develop a port south of the capital Mogadishu. France and Japan have military bases, and Russian entities are scouting for deals.

Since 2011, a number of regional powers have been in a scramble for political and economic influence in (Southern) Somalia. Many of these foreign engagements have come with serious threats to Somalia’s territorial integrity and the capacity of the Federal Government to effectively influence regional governments.

Kenya has strong relations with Jubaland, and prefers a weak federated Somalia. Ethiopia and the United Arab Emirates (UAE) are keen on working with the breakaway region of Somaliland. Somaliland, of course, is thriving as a free electoral democracy with functional institutions.

Turkey and Qatar are focused on supporting the Federal Government and investing in Mogadishu and its environs. And Qatar’s Gulf rival, the UAE, is interested in working with the semi-autonomous region of Puntland, against the wishes of the Federal Government.

It is fair to say that the conflicting interests and goals of Somalia’s friends are not helping the wider stabilization effort under AMISOM.

So far Turkey is miles ahead of every other regional powers in terms of economic influence in Mogadishu. This reality is causing a lot of angst among Gulf states eager to cut Qatar, an ally of Turkey, to size.

Turkey and Qatar will likely win this race.

Turkey invested in Somalia early (since 2011) and in a diversified fashion:

Turkish money and aid – delivered directly to key stakeholders in the Somali Federal Government – ingratiated Turkey with local power brokers and provided Ankara with access and power in Mogadishu. What soon followed is Turkish control and management of Somalia’s most lucrative assets, the airport and seaport.

Parallel to these were unilateral rebuilding efforts, offers of scholarships, renovations of hospitals, and the hosting of international conferences about Somalia. These have largely contributed positively to Somalia’s development and yielded the international acclaim and diplomatic clout craved by President Recep Tayyip Erdoğan and his coterie.


Can African states eliminate malaria?

Southern Africa has an ambitious plan to eliminate malaria by 2030. According to the FT:

Under the Elimination8 plan, the idea is to end malaria by 2020 in four so-called frontline states where transmission levels are already low — below 10 per 1,000. These are Botswana, Namibia, South Africa and Swaziland. Four higher-transmission, “second line” countries — Angola, Mozambique, Zambia and Zimbabwe, where transmission rates can climb as high as 400 per thousand — have until 2030 to get the job done.

Kenya presents a less sanguine but still somewhat positive story. The country reported 8.3 million cases of malaria in 2018, a decline of 12% from 2012. And out of these cases, 16,000 fatalities were reported. Contrast this with China which in 2017 reported a grand total of 2,672 malaria cases, all of which were due to infections while abroad. China’s population is 1.4 billion. Kenya’s population is 49 million. 40 years ago China reported more than 24 million malaria cases annually.

So how did China do it?

Screen Shot 2018-04-24 at 9.08.41 PM.pngThrough a combination of vector control, human behavioral change (including use of treated bed nets), and treatment. All three approaches are important. For instance, while the malaria mortality rate of 0.09% in Kenya is not super high (thanks to treatment), it still means that each year millions of work hours are lost due to illness. It is also a significant drain on the healthcare system. In addition, while treated bed nets have been shown to save lots of lives, we should still work towards complete elimination of the disease.

And that will require an aggressive form of vector control, something that is glaringly missing from most malaria programs on the Continent.

Interestingly, the international community used to take vector control seriously, which resulted in some significant results (see map):

 In 1955, the UN committed to ending the scourge of malaria. It was optimistic because it thought there were effective tools. The pesticide DDT had been found to kill the mosquitoes that were spreading the disease in US army camps in the Pacific during the second world war. Widespread use of DDT and the drug chloroquine drove malaria out of many countries in the Americas, Europe and parts of Asia.

But it all fell apart. There was no real attempt to tackle malaria in sub-Saharan Africa because it was thought to be too difficult. Elsewhere, elimination fell foul of the problem that has bedevilled all malaria control efforts: resistance of the malaria parasite to drugs and of the mosquitoes to pesticides. Then in 1962, Rachel Carson’s blockbuster Silent Spring was published, alerting the world to the environmental devastation wreaked by DDT. The UN’s malaria eradication plan was officially scrapped in 1969.

The over-correction arising from Carson’s paradigm-shifting findings meant that much of the world was willing to sit on their hands as more than 400,000 people died each year of malaria. The WHO only dabbles in vector control through treated bed nets. Sadly, resistance to its choice of insecticides stood at 81% in 2016.

That translates to over 200 million people infected each year, over 400,000 of whom die.

Even Bill Gates agrees that complete eradication of malaria is the most sustainable solution:

“Eradication is the only sustainable solution to malaria,” Bill Gates said on the release of the report his foundation produced with the UN last September. “The alternative would be endless investment in the development of new drugs and insecticides just to stay one step ahead of resistance. The world can’t afford that approach.”

Is anyone out there investing in research on environmentally-safe insecticides?



Africa does not need your used shoes

This is from a yoga studio in Cambridge, MA:



More broadly, it is worth remembering that aid in kind is almost always a waste of everyone’s time and money. Send cash instead. In the specific case of shoes, TOMS did a study that found zero impact of their shoe donation program:

According to the Economist (in 2016):

The first of two studies found that TOMS was not wrecking local markets. On average, for every 20 pairs of shoes donated, people bought just one fewer pair locally—a statistically insignificant effect. The second study also found that the children liked the shoes. Some boys complained they were for “pregnant women” and some mothers griped that they didn’t have laces. But more than 90% of the children wore them.

Unfortunately, the academics failed to find much other good news. They found handing out the free shoes had no effect on overall shoelessness, shoe ownership (older shoes were presumably thrown away), general health, foot health or self-esteem. “We thought we might find at least something,” laments Bruce Wydick, one of the academics. “They were a welcome gift to the children…but they were not transformative.”

More worrying, whereas 66% of the children who were not given the shoes agreed that “others should provide for the needs of my family”, among those who were given the shoes the proportion rose to 79%. “It’s easier to stomach aid-dependency when it comes with tangible impacts,” says Mr Wydick.