Charting a Tragedy

Last week I spent some time collecting some data from various sources that summarise the differences and relationships between various crude measures of national performance, mostly for an introductory class on regression (which according to Rafe is the most fun that you can have with your pants on!). The chart below is the scatterplot of a tragedy and doesn’t require any sophisticated Bayesian modelling or even standard errors to appreciate. It shows the relationship between life-span and GDP across 160 countries. (If you cannot see it properly, the data and the graphic are in the Excel file HERE and you can follow the links to check the exact variable definitions. The file also has some other variables such as the freedom index that you might find interesting.)

There is Ireland, newly joined the leading pack, the reasons for which we may have cause to debate. But they do not live as long as we do (Australia is in red). While there is a fairly strong trend (r-squared about 57%) the effect of higher GDP on life span really tails off after about k\$20. If life span is a surrogate for general well being then we would expect a similar graph for well being. So it is probably no surprise that the various non-GDP well being indices show modest improvements in the recent past for effluent countries as they slowly increase their GDP from already high levels.

But what stands out more obviously in this plot is the huge variation in mean life spans at low GDP. There is a bunch of countries that visually seem to be following a quite different trend to the rest. Here is a list of the countries on this plot that have life-spans that fall at least 10 years below the mean for countries at that level of GDP (using log-GDP as predictor of life-span).

 Country Deviation from GDP trend Population (1000’s) Botswana* -32.9 1464 Namibia* -26.3 1648 Swaziland* -25.7 985 South Africa* -22.9 43426 Angola* -22.3 11178 Zimbabwe* -21.2 11163 Mozambique* -17.5 19124 Gabon -17.1 1226 Rwanda -16.0 8155 Zambia* -13.8 9664 Uganda -13.1 22805 Guinea -11.3 7539 Malawi* -10.9 10000 Cote d’Ivoire -10.6 15818 Lesotho* -10.1 2129

All are in Africa and ten (asterisked) are in southern Africa. It doesn’t take a genius to guess what the common feature is. AIDS. There are over 160 million people in the region and the the loss in potential life is truly staggering Great Leap Forward level staggering. I searched the web but could not find a list of country specific infection or prevalence rates though someone with more time could collate the information at UNAIDS. The ever helpful Wiki has the graphic below and points out that in Southern Africa only Angola has a prevalence rate of less than 10%. Of course this is a superficial analysis which doesn’t take account of other possibly confounding factors.

I do not know much about the politics of AIDS except to say that I am confident it was not a CIA plot to kill off black people. Nor is it a beat up by the drug companies to sell Africa expensive drugs they do not need, as Thabo Mbeki once thought. I do know that the epidemic was completely avoidable because we, and other western countries, avoided it after a significant initial infection. After all. We all know how it is mainly spread. It would only have taken a few billion dollars and a change of heart from the soon to be canonised John Paul 2 who died without giving his papal blessing to the condom.

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23 Responses to Charting a Tragedy

1. whyisitso says:

“We all know how it is mainly spread”

I assume you’re referring to sexual intercourse without protection, Chris. Interesting people, African Catholics. I mean completely disregarding the church’s strict teaching against extra-marital sex but religiously obeying the Church’s injunctions against artificial birth control.

2. michael says:

Most of these countries have HIV rates well above 15% – Cote d’Ivoire and Gabon less so, Angola I think has had very little surveillance – ever.

The reasons? A deadly cocktail – untreated STDs, uncircumsised men, multiple concurrent sexual partners (because transmission is relatively ineffective – viz. a 1 in 300 to 500 chance per unprotected sex, concurrent regular partnerships are a lot more likely to fuel the epidemic than countless one night stands, or serial monogamy), hardly any condom promotion on a massive scale, little access to testing or to antiretrovirals (so no reductions in viral load for those who are infected, so no ‘prevention benefit’ of the meds). In southern Africa all these elements come together in a ‘perfect storm’.

All can be addressed – but only on a massive scale which can only be led by the governments of the region. Sadly the most significant bit of news from the recent international AIDS conference in Toronto was the signs of HIV rates creeping up again in parts of Uganda – which was practically the only success story in the developing world. The perverse outcome of Uganda’s success was that it was flooded with money and US evangelists touting abstinence, which fed the most ossifying tendencies of a tired government and the real strengths of a home grown response have been lost.

3. Ken Parish says:

whyisitso

You must have led a very sheltered life indeed if you’ve failed to notice that Catholics in Australia are just as prone to extra-marital sex. It’s a fair guess that the difference is almost entirely due to Africans failing to use condoms, which in turn flows from a combination of poverty and ignorance/lack of education, as well as the cultural factor that in many such societies heterosexual anal intercourse between husband and wife around ovulation time each month has always been a traditional method of birth control. Thus the situation doesn’t have much at all to do with being Catholic as such, I suspect (not that I’m trying to absolve JPII by any means). Nor am I sure to what extent these high HIV infection African countries are predominantly Catholic anyway, or to what extent HIV infection rates within them correlate to catholicism.

4. whyisitso says:

You’ve (deliberately?) missed my point entirely, Ken.

5. Chris Lloyd says:

I take it whyisitso that your are saying that the quick spread of African AIDS is due to their promiscuity. In this case, condoms are the central issue though I concede that the Pope could not have stopped the spread. His blessing the condom might have merely saved a mere 100,000

6. James Farrell says:

If the Church teaches (1) don’t have sex with anyone other than your wife, and (2) don’t use condoms even you disregard (1); it’s hard to predict whether the net effect will be conducive to the spread of HIV. We need to know how what proportion of subscribers disregard (1) but still abide by (2). It’s obviously inconsistent, but maybe some men use religous doctrine as an excuse when it suits them.

Actually, I can’t see too many Catholic countries below the regression line – no Latin American ones, for example – although that doesn’t mean they necessarily have a low HIV incidence.

In any case, (1) is useful advice, and (2) is patently irrational. So, since they are not logically contingent on each other, the Church doesn’t escape criticism even if its net consequence is beneficial: it could do much more good if it used its resources and general influence to preach the reverse of (2).

By the way, there’s a heap of useful data and graphs in this World Bank report, Chris.

7. whyisitso says:

“though I concede that the Pope could not have stopped the spread”. Good to see you resiling from your ridiculous blaming of the Pope in the last paragraph of your post, Chris. But your 100,000 figure is of course just pluck-a-duck as you well know. It’s bizarre to suggest that men who go a-rootin’ then refuse to wear condoms because “it’s a sin”. They don’t wear condoms (if they could get them) because it diminishes their pleasure.

8. taust says:

On the first graph it seems remarkable by how much GDP has to increase to add one more year to the average life span.

9. Geoff Honnor says:

I’m not sure what – if anything much – Catholicism has to do with the sub-Saharan HIV epidemic. Most of the countries involved are ex British colonies so Protestantism (albeit pretty nominal I suspect) would be more likely to be competing with animist and cultural tradition in relation to sex practice.

But it’s worth pointing out that Catholics in Australia, almost universally, disregard Church teachings in respect of contraception so its hardly surprising that Catholics elsewhere might similarly adapt church teachings.

Catholic HIV aid agencies certainly operate in the region but as in PNG (where nuns wil frequently leave condoms in at risk settings, without fanfare) most of the workers I’ve come across think that Cardinal Trujillo’s detection of latex porosity in respect of HIV is laughable.

BTW, women represent the bulk of the infected population in Africa and women have much less sexual, reproductive and infection prophylaxis choice. Men generally decide when condoms will be used – not women – and men are much less likely to opt for condoms. We’re also far more efficient at transmitting HIV than women.

10. whyisitso says:

Quite so, Geoff. This blaming of the Pope for AIDS in Africa has little to do with empathy for the victims and everything to do with bigoted anti-Catholic attitudes.

11. DQ says:

“Quite so, Geoff. This blaming of the Pope for AIDS in Africa has little to do with empathy for the victims and everything to do with bigoted anti-Catholic attitudes.”

Wowsers – all this talk of “bigoted anti-Catholic attitudes” and I thought we were talking about your bigoted perspective on those promiscuous Africans seeking to avoid the diminishment of their pleasure by catching aids. Hell’s bells, the topics sure can get muddled at times.

Suffice to say, whether one person listens to you or a million, if you tell people not to wear condoms, knowing full well that their usage can prevent disease, then you’re most certainly a jackass.

12. Chris Lloyd says:

Boy. I didn’t think there would be people going in to bat for the Pope! If anyone were going to take offence at the remark (which really was there just as a conversation starter). I would have expected them to point out that the influence of other charismatic US religions in tying US foreign aid to abstinence programs is more of a problem. But then nobody claims they are saints.

WIIS’s argument about promiscuous men not caring about papal views is partly correct. But they might use a condom when they get back to their wife. In any case, the church could have used their money, power and influence to raise public awareness of the combination of promiscuity AND unprotected sex (if they weren’t hung up on rubbers). There is so much good that Catholics could do if they were not so contrained by the bastards who speak for them. Such awareness programs were successful here even though few of us are practising Catholics.

BTW: My wife and kids are Catholic. Anyway, it is not bigoted to take a shot at the disgusting pyramidal governance structure of that church and the intrusive sexual restrictions imposed by a bunch of bitter old men who have never got a root. I would stand by my claim that many, many, many people would have been spared if the church had encouraged condom use as a defence against the epidemic (take any small percentage of m24.5 you like). I wish I had the power to do so much good in my life!

13. whyisitso says:

“Boy. I didn’t think there would be people going in to bat for the Pope!”

I don’t give a shit for the Pope. But the argument that the Church’s teaching about contraception forces promiscuous men in Africa to kill multiple thousands of others is so illogical I have to oppose it.

“My wife and kids are Catholic.”

Ah this explains so much. I’m the product of what used to be called a mixed marriage, and my mother (the protestant) also grew embittered about the Catholic Church, not so much because she opposed its teachings, but because my old man was a hard drinking Irishman with a vile temper. I never became a religious person but because I was a reasonably compliant kid I took in and learnt a bit about Catholic doctrine. I call myself a former catholic (as opposed to lapsed). I reject a lot of its teaching but I also agree with a lot of it.

There’s usually a personal experience behing most bigotry.

14. whyisitso says:

“bunch of bitter old men who have never got a root.”

This is nothing but a low, nasty bigoted cheap shot. It suggests that these men are so unattractive to the opposite sex that they take a vow of chastity because it’s costing them nothing! Priests cover the full range of humanity. My experience of them is that the vast majority are sincere idealists. Your next remark will predictably be to call them all paedophiles, such is your love for unwarranted generalisations.

15. I know Chris and he’s not a bigot. Not a bigoted bone in his body.

16. Geoff Honnor says:

This is the curse of blogging. You do an interesting post on AIDS and everyone ends up stoushing about catholics.

FWIW, the Vatican’s absurd position on condoms has certainly been unhelpful but it’s not the major obstacle to effective AIDS prevention in sub-Saharan Africa where, for the most part, condoms have been recognised as the effective prevention agents they are. That doesn’t, of course, mean that the use of condoms has been anywhere near universal but there’s lots of other reasons for that.

Mbeki and his nutjob Health Minister have inflicted immeasurably more damage on South Africans living with HIV than did JPII and the ludicrous insistence on “abstinence-based” prevention programs as a precursor to US international AIDS assistance has been equally criminal. Bill and Melinda Gates got deserved praise for slamming the US administration on that score at the recent World AIDS Conference in Toronto. That and the fact that they’ve provided about 15 billion bucks in AIDS prevention program funding.

17. whyisitso says:

The subject of Catholics was initiated by Chris in the last sentence of his post. It didn’t just arise in the comments.

18. Geoff Honnor says:

Yep. An incidental point in the last sentence. And it became the whole basis of the discussion.

19. Chris Lloyd says:

The crack about not getting a root refers to the absurd requirement of celibacy for each and every member of the church governance structure and I was suggesting that it is responsible for their distorted views on sex. I was not suggesting they are ugly!? I reckon if you take 30 seconds to think before hitting the submit button you will get my meaning a bit better.

Calm down WIIS! You win the point that JP2 is not mainly responsible. Got it? You win. It was a cheap shot. Have you never taken a cheap shot before at…say socialists? Cause they have done damage in other domains? And let’s not forget that JP2 is up for sainthood which makes him fair game in my book.

I think if there was a theme I would like to draw out of both the discussion and my limited reading, it is that ideological bias has derailed serious analysis and prevented appropriate response to what was a preventable disaster.

20. whyisitso says:

OK Chris and Geoff. I don’t know you very well Chris, but I respect Geoff a hell of a lot, so I’ll back off.

21. whyisitso says:

But more because I’m feeling rather mellow from a glass or three of the NZ sauvignon blanc I had with dinner. Night, folks. Blog lesson – never comment after sauv anything!

22. Geoff R says:

What are the notable low-income long life countries? Cuba might be one but there seem to be many others.

23. Chris Lloyd says:

Here they are:

Counrty