WoW, part 1
Yesterday, today, and tomorrow are all about shopping and doing chores for mom (getting a new hard drive and keyboard for her computer, setting up electronic bill pay for her electricity, cutting kindling and stacking firewood, hanging a heavy framed print my sister bought for her). In lieu of anything interesting to report, I’ll share an excerpt from a book I read on the way to the U.S.: The Wisdom of Whores. It’s about how politics and ideology get in the way of effective public health programming.
The book is by epidemiologist Elizabeth Pisani, who focuses on HIV prevention. One of her themes is that politicians are more comfortable saying the spread of HIV is tied to poverty, therefore we'll spend money on education and youth programs and micro loans. Because buying condoms for prostitutes and needles for junkies is a harder sell. But actually makes a difference in preventing HIV, while development aid does not.
Here’s an excerpt:
"At the top of the development food chain is the US government, which gives away $23 billion of its taxpayer money every year for all manner of development projects. Some of that goes to the UN or the Global Fund and they give it to governments. But most gets earmarked for projects decided in Washington in consultation with US embassies around the world. Each proposed project gets posted publicly and anyone who can figure out the positively byzantine US government tender systems can bid to take the money and run the project.
"Most of the bidders are beltway bandits—organizations that squat around the Washington DC ring road never far from the comforting nipple of the USAID. When the government announces a new contract the bandits leap into activity writing proposals that show how clearly they will spend the money, or rather what’s left of the money. The bandits slice between 15% and 30% off the top before they ever pass it on to the country office."
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