Passing Trade

A new paper, from Emily Oster, looks at the impact of trade on HIV infection rates.

Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa by Emily Oster 
I generate new data on HIV incidence and prevalence in Africa based on inference from mortality rates.  I use these data to relate economic activity (specifically, exports) to new HIV infections in Africa and argue there is a significant and large positive relationship between the two:  a doubling of exports leads to as much as a quadrupling in new HIV infections.  This relationship is consistent with a model of the epidemic in which truckers and other migrants have higher rates of risky behavior, and their numbers increase in periods with greater exports.  I present evidence suggesting that the relationship between exports and HIV is causal and works, at least in part, through increased transit.  The result has important policy implications, suggesting (for example) that there is significant value in prevention focused on these transit oriented groups.  I apply this result to study the case of Uganda, and argue that a decline in exports in the early 1990s in that country appears to explain between 30% and 60% of the decline in HIV infections.  This suggests that the success of the Ugandan anti-HIV education campaign, which encouraged changes in sexual behavior, has been overstated.

I’ve always been of the view that trade was good, and circumcision was unnecessary. But from the standpoint of AIDS, both those views seem rather shaky.

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4 Responses to Passing Trade

  1. Sinclair Davidson says:

    Trade remains good, and HIV rates do not rise in other parts of the world where trucking good occurs. One of the issues is a resistance to the use of condoms (unrelated to Catholicism before anyone gets excited). This reflects poorly on the civil institutions of society where societal and cultural leadership is unable to get people to modify their risky behaviour. The other problem, in parts of Africa, is that circumcision is done in tradational ritual to adult (or older youths) in conditions that cannot be described as being sanitary.

  2. harry clarke says:

    This is a common idea with many things – not just HIV. Having increased trade in services (tourism) probably increases the spread of infectious diseases while trade in biomass probably helps spread disease of weeds etc in agriculture.

    In most cases I think a policy of free trade coupled with policies tackling the specific problem outperforms restrictions on trade. The policies can recognise the trade dimension – e.g. GPs in Australia when confronted with an infection should routinely ask ‘have you travelled recently’.

  3. Kevin Cox says:

    All trade and all trading has other effects than just the transfer of goods and services. We normally want to have as much trade as is practical the difficulty arises in handling the externalities.

    We know for example that the “trade” of purchasing energy from sources that produce greenhouse gases has undesirable side effects whose cost is unknown but significant. Why not put in extra constraints and suggestions on such trades. For example we could have planet health warnings on all petrol bowsers or a requirement that to buy petrol you also must invest some money in ways to reduce the demand or substitute petrol. That is, put the way of helping “solve” the externalities of a trade with the trade itself. We are already doing it in many cases why not extend its use.

    With respect to truck driver’s it seems a small constraint that truck drivers in Africa must be circumcised in order to participate:)

  4. Patrick says:

    For example we could have planet health warnings on all petrol bowsers

    Best.Environmental.Policy.Ever. Never again will I miss the chance to savour my weekly moment of gaia-beating!

    With respect to truck driver’s it seems a small constraint that truck drivers in Africa must be circumcised in order to participate:)

    Er, easy said from here?

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