To see what other people thought of various poverty-related issues, our team created a blog (in essence an online journal that allows users to comment on the entries) at http://adollaraday.blogspot.com. On this site, we have collected several of the best blog entries and comments, and placed them in various sections. In these blog sections, posts refers to original blog entries, while comments refer to user comments to these entries.

This blog section containst two posts, about the relationship between AIDS, overall health, and poverty.

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The Post (October 19, 2005):
HIV and AIDS play a unique role in poverty. Not only do highly impoverished areas have an increased risk of HIV/AIDS, HIV/AIDS causes increase in poverty wherever it takes hold. Sub-Saharan Africa is a prime example of this - AIDS caught on in already malnourished and poor areas, and now these areas face even MORE poverty. Read More...

AIDS can cause high increases in poverty for several reasons. For one thing, it greatly decreases the workforce, and increases the cost of labor. Much of Africa's economy is based off of agriculture, and more than seven million agricultural workers have died of AIDS so far. By 2010, the United Nations estimates that 25% of the workforce will have died off as a result of AIDS. This situation is exacerbated further because many African farms are small, family-run enterprises. When one family member dies, especially if it is the head of the family, everyone suffers. In Zimbabwe, one worker's death in a small-time farm can decrease production of a crop such as maize by 61%.

The the appearance of AIDS in an economically productive familyu member can soon result in other problems for a family. In Cote d'Ivoire, families with people sick from HIV or AIDS spent twice as much on health care as other families. These extra health costs, as well as the loss of income, can drive a family into poverty because they have no financial 'safety net' when a health crises strikes. When a family member dies, even MORE money must be spent - on funeral costs and other health costs (in Tanzania, families with AIDS deaths spent 8% of income on funerals and health care, in families without these deaths, it was only 0.8%).

AIDS also increases poverty by striking at the education system. In many African countries, children are pulled from school to help deal with financial setbacks due to AIDS. Also, AIDS takes a heavy toll on teachers and professors - both of which are in short supply. Zambia, for example, is a particularly extreme case. Each day, five teachers die from AIDS. In Congo, nine college professors of medicine died in three years from AIDS. While this might not seem like much, it is very tough on a country where only '1 in 10,000' become professors.

Clearly, AIDS is doing more than just wreaking havoc on health in sub-Saharan Africa - it is drastically increasing poverty through economic and educational losses. Collapse...

Comment #1: (Respondent #1)
AIDS is a terrible instance, but only one of many, of the greater property that is emblematic of poverty - life on the edge. Read More... Poverty is a state of precarious and unstable equilibrium, of living on the brink. The slightest perturbation in can send you crashing into the precipice from which there is no return.

Consider any mishap in the life of a family living day to day. It does not have to be AIDS. Any sickness will do. Or an accident or a drought or a flood or a theft or robbery and everything that the family had carefully built up over years of labor is gone.

In ancient Hindu culture, the cow slowly became deified, because it was the last reservoir of wealth and hope for a family. If during hard times, a family succumbed to the temptation of slaughtering its cows (or selling them), the following year, they wouldn't be able to till the soil and they'd be doomed without ever the hope of recovery. The cow became holy to save the family from its own desperation. For losing the cow meant plunging down the precipice.

In many third world countries, families take on debt that they do not know how to manage, often mortgaging their meager land holdings to get past a small calamity. But poverty puts them behind the eight-ball and they can never get out. Slowly and inexorably, their debt compounds until they lose their land and join the ranks of the landless. And then there is nothing to do but to migrate to the cities and look for unskilled day work. And if another disaster strikes in the form of sickness or such, it is all over.

AIDS is so terrible because it is so relentless and despite fundamentalist propaganda, so indiscriminate about who it destroys. It started slowly but like classic 'unstable equilibrium' in physics, the effects accelerate and soon there is nothing left but devastation. And yet, AIDS, while not entirely curable, is most certainly controllable! Those with sufficient resources have learnt to live with AIDS to the point where they are almost too complacent about its devastating potential.

A point to ponder: should AIDS drugs be patentable? Should any life saving technology be patentable. Is it fair to say that even if you can save a person's life by using a pill (or pills) that cost a dime to make, you can't do so unless you pay me a dollar for it since I invented it? Is it fair to say to someone that we do not care how much time and effort you devoted towards creating this cure - we can't afford to pay you so we'll just take it? What is the moral safe ground? Collapse...

Comment #2: (Respondent #2)
Does poverty lead to poor health or does poor health lead to poverty? ...[Y]our post cites strong evidence that the latter relationship holds true in parts of Africa. Read More... Of course, we all know that the converse often holds true as well. And in both cases, you wind up in the same place: with a lot of very poor people who are also very sick. Then the question becomes, What do you do to help them?

Too often the answer is not enough. An article about AIDS orphans in the November 3rd issue of the New York Review of Books starts by recalling President Bush's 2003 pledge to spend $15 billion on international AIDS programs.

The article goes on: "At least 60 percent of US foreign funding never leaves the US, but is instead spent on office overhead, travel, procurement of American-made cars, computers, and other equipment, as well as salary and benefit packages so generous that just one of them would be enough to feed, clothe, and educate hundreds of African children for years."

The author, Helen Epstein, a visiting scholar at Princeton, notes that while some U.S. dollars are being well spent to combat AIDS in Africa, other money is being wasted. As an example, she cites one proposal "to spend $600,000 to hire three consultants to 'mentor' South African health workers--an amount that could have been spent on antiretroviral drug treatment for some five hundred poor South Africans."

Surely we can do better than this. Collapse...

Comment #3: (Respondent #1)
The issue of self serving and wasteful "aid" is the dirty secret of the international aid community. Read More... Like Bush's 'grant' to fight AIDS in Africa which must be spent paying FULL retail prices for US sourced drugs when alternative generic drugs are available at a fraction of the cost, more often than not, a shamefully disproportionate amount is earmarked to for constituencies in the donor nation.

This summer, on our way to Dhaka we were switching planes in Frankfurt where we ran into Dr. Z, the founder and leader of a highly effective Bangladeshi aid/self-help organization. We have have several projects in the works with Dr. Z and I enquired about what brought him to Germany.

"I was here to negotiate a $5 million grant from a German foundation" he told me.

"That's great!" I exclaimed.

"Not really" said Dr. Z "the grant has to be used to hire German consultants for the project."

"That's not entirely bad, is it?" I asked.

"No, not entirely" agreed Dr. Z. "Although the consultants are a complete waste since none of them speak much English, we get to use 10% of the grant freely. And I can get a lot done for $500,000"!

Sadly, this is all too typical. Collapse...

Comment #4: (Respondent #4)
UNICEF just started a new global campaign called 'Unite for Children, Unite against AIDS.' Read More...

UNICEF Executive Director Ann M. Veneman and UNAIDS Executive Director Peter Piot noted that every minute:

"A child dies of an AIDS-related illness, a child becomes infected with HIV, [and] four young people aged 15-24 become infected with HIV."

Prevention agains AIDS has to be improved much more if we want to try and stop this terrible disease. Collapse...

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The Post (November 16, 2005):
It is well known that poverty affects health, and vice-versa. Read More...

For example, according to the CIA World Factbook, the 20 countries with the lowest GDP per capita are: Zambia, Niger, Mali, Liberia, Afghanistan, Congo, Republic of the, Kiribati, Ethiopia, Madagascar, Yemen , Eritrea, Congo, Democratic Republic of the, Guinea-Bissau, Tanzania, Comoros, Burundi, Somalia, Tokelau, Sierra Leone, Malawi, and East Timor

Of these 20 countries, seven are in the 20 countries with the highest HIV/AIDS Rate. 14 are within the top 50, and there is no information on three countries.

Of these 20 countries, eight are in the bottom twenty for life expectancy at birth. All except East Timor and Tokelau (No Information) are within the bottom 50 countries.

It is clear that poor countries have poor health conditions.

Does poverty have an adverse affect on health? Or, on the other hand, does poor health help create poverty? Collapse...

Comment #1: (Respondent #1)
Poverty is a risk factor for poor health, and poor health can be a risk factor for poverty. How you define the problem will influence how you propose to resolve it. Read More...

In the U.S., for example, poor women who otherwise wouldn't receive Medicaid often quality for prenatal care under this insurance program once they become pregnant. The reason is simple: we recognize that poor women won't receive prenatal care if they can't afford it, and we want them to receive it because it helps preserve the health of the mother and child and avoids costly expenditures for emergency and acute care. This is a case of intervening with a high risk group in order to prevent problems before they arise.

In other cases, poor health can lead to impoverishment. In the U.S., this sometimes happens as one grows old and age-related diseases take their toll. It used to be that nursing home care would often bankrupt not only residents themselves but also their spouses. Then Congress enacted laws that allow residents to quality for long-term-care benefits under Medicaid while their spouses retain certain assets and income. The intent here is to provide a safety net that helps break a fall after a problem arises. Collapse...

Comment #2: (Respondent #2)
I believe that it is a vicious cycle - a family above the poverty line might experience a disease such as AIDS, and be driven below the line after paying for medication. Read More... Devoid of funds, another disease such as malaria might go untreated, affecting the family's productivity and driving them deeper into poverty, and decreasing health at the same time. Eventually, the family will be forced to live unhealthily, just because they cannot afford proper nutrition/medication.

In this example, while the initial case of AIDS may have created the poverty, the poverty has started to decrease health even further - showing that both health and poverty and deeply entwined. Collapse...

Comment #3: (Respondent #3)
Health care is too expensive to be affordable by the people living [below the] poverty line. Read More... That's why a "prevention is better than cure" policy should be emphasised as a long-term policy. [The] importance of the practice of [a] safe and healthy lifestyle in all respect[s] should be emphasised as a part of basic education for maintaining good mental and physical health. Collapse...

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