A column in The Economist on learning languages that I’ve been enjoying this week…maybe not in his exact experience and words, but in the joy and inevitable amusement, the intense thrills and frustrations of trying to conquer a love, navigating the twists of subtle desires….

I’ll be home in 2 months. ACK.

More later….

As a recent new “lender” who is pretty inspired by the process of micro-lending, I agree with the author that there are real benefits to this process, not to mention the satisfaction of seeing a “donation” be paid back (a fairly strong sign of efficacy, as measures of aid go). Applying this model to appropriately lend to larger small businesses could lead to increased employment and might provide another avenue for economic growth… I wonder if it might not be worth it to explore how those small-to-medium businesses got to where they are, be it from a small individual-owned business that attracted enough support to grow or not, and to focus on that bridge a bit more.

http://www.newyorker.com/talk/financial/2008/03/17/080317ta_talk_surowiecki/?yrail

(2) I wrote a post a few years ago talking about a program in Brazil intended to incentivize keeping children in school and out of the labor force. A fellow Fogarty scholar emailed out a comment from The Lancet (a medical journal) discussing this type of program, Conditional Cash Transfers (CCT), which is described as:

During the past decade, countries with transitional and middle-income economies have introduced programmes that transfer money to poor households on the condition that they comply with a set of requirements, including attendance for health care, food and nutritional supplementation, and enrolment of children in school. Conditional cash transfer (CCT), a type of social contract, is both an alternative to more traditional social assistance with handouts and a complementary strategy to the provision of health and education services.1 Because poor families usually face the greatest barriers to health interventions, CCT helps to redistribute resources and thus reduces health inequities.2 For very poor families, cash provides emergency assistance, while the conditions promote longer-term investments in human capital.

The author goes on to discuss the numerous known benefits of programs such as this one, including evidence from a “systematic review of six CCT programmes in Latin America and Africa showed a fairly consistent picture of the effects of such programmes on the use of health-care and education programmes and, to some extent, growth and health outcomes for children early in life, despite some methodological concerns.”

The accompanying concerns are not too surprising, dealing with a need for a better understanding of which aspects of programs such as these (eg, health interventions, food supplements, and cash transfer) truly affect health-outcomes and the expense of programs such as these– particularly with regards to low-income countries for whom the program may not be cost-effective, let alone feasible without appropriate health and education services.

Conditional cash transfer: a magic bullet for health?
The Lancet 2008; 371:789-791
Kenji Shibuya

…and, um, how exciting that my (Pennsylvania-based) vote matters?!

From the WHO News Release:

Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report published today. The report presents findings from the largest survey to date on the scale of drug resistance in tuberculosis.

The report also points to some successes. Thirteen years ago, Estonia and Latvia were singled out by WHO as drug-resistant TB “hotspots”. Following a substantial investment and a sustained assault on MDR-TB, rates in these two Baltic countries are today stabilizing and TB case notification rates are falling.

The true scale of the problem also remains unknown in some pockets of the world. Only six countries in Africa - the region with the highest incidence of TB in the world - were able to provide drug resistance data. Other countries in the region could not conduct surveys because they lack the equipment and trained personnel needed to identify drug-resistant TB. “Without these data, it is difficult to estimate the true burden and trends of MDR-TB and XDR-TB in the region. It is likely there are outbreaks of drug resistance going unnoticed and undetected,” said WHO TB expert Abigail Wright, the principal author of the report.

WHO estimates that US$ 4.8 billion is needed for overall TB control in low- and middle-income countries in 2008, with US$ 1 billion for MDR-TB and XDR-TB. But there is a total finance gap of US$ 2.5 billion, including a US$ 500 million gap for MDR-TB and XDR-TB.

From the report:

Data from nine sites in India show that drug resistance among new cases is relatively low;
however, new data from Gujarat indicate that 17.2% MDR among retreatment cases is higher
than previously anticipated and it is estimated that 110,132 (79,975-142,386) MDR-TB cases
emerged in India in 2006, representing over 20% of the global burden. Although plans have been
developed for management of 5000 MDR-TB cases annually by 2010, insufficient laboratory
capacity is seen as the primary limitation in implementation of these plans.

Coulombe also wanted to make sure his employees were paid fairly, instituting a policy in the 1960s that full-time employees had to make at least the median household income for their communities—an average of $7,000 a year at the time, $48,000 today. Store captains, almost all of whom are promoted from within, can make six figures annually. Trader Joe’s also allows part-timers to earn health-care benefits, a feature that makes the store a haven for artists, musicians, and other creative types who wouldn’t normally seek supermarket jobs.

In line with my perpetual [informed, I'd like to think] idealism, I thought it worthwhile to point out this policy. As much as I believe in universal healthcare and consider it the main solution to the country’s current horrendous state for all of the economic reasons, there is always a place for straight-up social responsibility, unmandated and out of the simple sense of doing the right thing.

scary.

Tonight, the members of my research group presented the findings from two studies looking at STI/VIH prevalences and related behaviors in urban areas and in indigenous communities along the Amazon. If you’re interested in the studies, I’d be happy to discuss some of the findings, but otherwise enjoy the photos!

‘night!