Abuse of programs in Malawi

On October 14, 2008, in Uncategorized, by Karen Grepin

Chris Blattman covered a news item today that is related to something that I have been thinking about a lot lately. In Malawi, the government had been providing $35 a month to HIV infected civil servants to help improve their nutrition. Not terribly surprisingly, a remarkable share of people in the civil came forward claiming to be infected in order to benefit from the supplement. Due to the abuse, the program was suspended.

Numerous national HIV/AIDS programs have begun to include certain benefits or entitlements for HIV positive individuals, such as additional allowances for food, vouchers to send their kids to school, and other items intended to improve the welfare of these disadvantaged people. While the intention is certainly good, and potentially it helps to reduce stigma, it does create somewhat perverse incentives.

I attended a lecture by Vinh-Kim Nguyen last fall who presented some of his anthropological work in Cote D’Ivoire that discussed how the entire identities of people were now being shaped by their association with AIDS programs.

I was actually thinking about it this morning on my drive back from the Korle-Bu medical area in Accra. In Accra there are literally hundreds of people with very obvious handicaps in the downtown area on the streets begging. These people get nothing or very little from the government or the ministry, despite being so terribly disadvantaged.

When will they figure out that they too may benefit if they could associate with the HIV/AIDS programs? Terrible thing to think, but I am sure many of them have thought about it as well. Membership has its privileges.

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