Contenu du sommaire : Health and Development

In the decade 2000-2010, development policy has given health care higher priority, which has translated as a sharp global increase in health expenditure. This increase can only effectively help reduce poverty if the expenditure is efficient and if access to health services becomes more equitable. This paper contributes to the study of health equity in developing countries, focusing specifically on child and mother health care services. Our research highlights that increased public health expenditure is directed more towards the poor than the rich, but that health equity is only marginally improved. We also find that access to health services is significantly dependent on household socioeconomics, including the mother's level of education. A policy targeting better schooling for girls would therefore significantly improve access to health services among poor populations. Finally, we identify several dimensions of governance that could help significantly close the health equity gap.JEL Classification: I1, I3.

This paper decomposes the impact of the determinants of the evolution of HIV/AIDS pandemic in sub-Saharan Africa from 1997 to 2005. We classify our set of determinants into socioeconomic, epidemiological, sociologic and cultural and we try to assess the importance of each group of determinants in the spread of the epidemic across the continent. Using a panel data of 42 African countries from the 1997-2005 period, we examine the link between the three categories of determinants and HIV/AIDS epidemic. After a logit transformation of HIV prevalence rate among adult population (15-49), we estimate our equation with the random effects model and we include a regional dummy in order to capture sub-regional differences in the spread of the epidemic. Then we estimate the same equation using prevalence rate among young population (15-24). Finally, we estimate the same equation with the generalized method of moments (GMM) to accounts for dynamic effects in our model. Our results are robust and our analysis shows that epidemiological and sociocultural variables have a greater impact than socioeconomic ones. More important, within the group of socioeconomic variables, education and women's economic independence and income inequality appear very important in determining the spread of the pandemic.JEL Classification: I10, I19, 015.

The paper argues that the United States has unwittingly created a new global “entitlement” to US-funded AIDS treatment that currently costs about $2 billion per year and could grow to as much as $12 billion a year by 2016 – more than half of what the United States spent on total overseas development assistance in 2006. And the AIDS treatment entitlement would continue to grow, squeezing out spending on HIV prevention measures or on other critical development needs, all of which would be considered “discretionary” by comparison.JEL Classification: I12, I18, O15.

The sectors of coffee and cocoa in Côte d'Ivoire represented, before the political crisis, approximately 15% of the GDP and 40% of exports. The production zone of these two crops is the forest, which is a malaria endemic area. The cultivation of these crops is less constraining than that of the food crops such as rice or yam, which need to be replanted each year. However, the maintenance of the ground and trees and pest management are major tasks contributing to high yields. But, by increasing the work time in fields, they also expose farmers to mosquito bites and, as a consequence, to the risk of malaria. Farmers in this area also grow food crops, and more specifically rice, as rain cultivation crops, but some also cultivate these crops in irrigated lowland. The aim of this paper is twofold: first of all, to evaluate the role of malaria in coffee and cocoa production; secondly, to assess the role of the rice production scheme on malaria transmission. Three functions are therefore estimated: the production of coffee, the production of cocoa, and the production of health. Data were collected during a survey carried out on 750 households (21 villages) in the forest area. The main results show that malaria has no effect on coffee and cocoa production and that lowland irrigated rice cultivation does not constitute a risk factor for malaria transmission.JEL Classification: I12, O13.

This paper explores the link between P. falciparum malaria – the causative agent of most malaria-related morbidity and mortality – and primary education in terms of school performances at macroeconomic level. Cross-country regression analysis shows that the relationship between school results (measured by repetition and completion rates) and the P. falciparum malaria index is strong. The results imply that the achievement of the educational Millennium Development Goals will require more than just focusing on expenditure in primary education. This does not mean that resources allied to education are unnecessary, but simply that increasing resources in education and improving education resources management alone are unlikely to be sufficient. This paper suggests that health conditions, especially diseases such as malaria that could alter children's cognitive capacities, should be taken into account much more seriously. We also see the need to place emphasis on research that will improve the quality of interventions to prevent malaria. Specific education expenditure combined with health policies should be investigated further as a means of tackling malaria.JEL Classification: O15, I10, I20.