PSD Blog - The World Bank Group

Involving the public in public private partnerships

Call them taxpayers, citizens, or just simply the public—they are the reason why public private partnerships (PPPs) are created. They are the users and the ultimate financiers, whether by paying taxes or tolls, and they want to have a bigger role in decisions about what infrastructure shall be built and how. It’s no surprise that public opinion is the ultimate judge of the success of PPP projects.

And this ultimate judge is not always just; it does not always have the right information at the right time. It’s up to fallible public sector officials to ensure that proper information and reporting is available to the public and that proper stakeholder consultations take place prior to key decisions regarding the project.

Development 2.0: The power of conversations

Any social media evangelist surely knows the objection all too well: you try to make the case for Web 2.0 and the power of conversations that it enables when someone inevitably comes up with "conversations are all very well, but what about real work? And real impacts?"

So it’s nice to see an example of social innovation out of the UK that is based, quite simply, on enabling conversations. Patient Opinion is a website founded by Paul Hodgkin, a general practitioner "who wanted to find a way to make the wisdom of patients available to the National Health System (NHS)." Acting as an independent broker, the site enables conversations between patients and health care providers that help identify concrete opportunities to improve health service at the local level. Apparently, the model has proven successful enough to attract funds for an extension, this time focusing on mental health.

The civil war of the self

I recently blogged about a website that allows people to bet with themselves on whether they will achieve certain weight loss goals. The smart minds behind the website, Dean Karlan and Jonathan Zinman, have provided an answer to the question I posed at the end of that post - are there any better uses to which we could put these kinds of commitment devices?

In turns out, they have already worked quite well in helping people quit smoking in a developing country context. The researchers carried out a randomized control trial wherein participants deposited money into a savings account and forfeited this money at the end of six months if they failed a nicotine test. (Surprise test visits followed at a later date.) Here's what they found:

Could access to finance help reduce risky sexual behaviors?

If access to savings accounts helps the poor manage risk better, the answer may very well be "yes". A new working paper on Transactional sex as a response to risk in western Kenya reports that sex workers engage in better compensated but riskier sex acts following unexpected health shocks. From the abstract:

Bill Gates, prankster

Bill Gates thought it would be a good idea to release mosquitoes on a crowd at the TED2009 conference to make a point about malaria. He was quoted as saying, "Not only poor people should experience this." That seems to be the theme lately at elite gatherings.  

Health vs. wealth

The Economist reports this week on new research on the relationship between Health and Wealth. The long and the short of it is that improvements in health don't necessarily lead to higher incomes, as counterintuitive as that sounds at first. (As always, the causation may be running the opposite direction - higher incomes lead to better health.) In one of the papers, researchers from MIT looked at the impact of medical advancements like penicillin that improved health in developing countries but clearly were not the result of improved incomes in developing countries. They found that income per head dropped despite improvements in life expectancy.

According to the Economist, the researchers offered this explanation:

The reason was that increased life expectancy led to a higher population using a limited stock of things like land and capital, thus depressing income per person. Over time, reduced fertility, more investment and the entrepreneurial benefits of having more people could reverse some of this, but the data suggested that reductions in fertility in particular took a long time.

Measuring human opportunity

The World Bank yesterday released its new Human Opportunity Index report. This first round focused on Latin America because of the extremes of inequality presented by the region; however, future rounds will be extended to other parts of the world. According to the press release:

The study also finds that between one fourth (Colombia) and one half (Guatemala) of income inequality among Latin American adults is due to circumstances outside of their control, faced in the beginning of their lives. Race is a key factor to explain income differentials, especially for the most disadvantaged groups.

As longitudinal data develops over the next few years, it will be interesting to see how inequality of opportunity and attitudes to the private sector relate. My guess? High levels of inequality will be highly correlated with negative attitudes, regardless of the role that the private sector can play in expanding opportunity. 

Cell phone vs. HIV

While telemedicine is nothing new, improvements in telecommunications are creating the possibility of previously unthinkable innovations. The text message, as I've commented before, is becoming widely available in the developing world, and many organizations have taken note. A non-profit called One World launched a help service for questions on HIV in Kenya a few years ago. But researchers at the University of California - Los Angeles are proposing a truly heroic advance in the use of cell phones. The UCLA researchers propose using cell phones to diagnose diseases like HIV through a novel imaging technique (Hat tip: Giulio Quaggiotto). According to the article:

Ozcan envisions people one day being able to draw a blood sample into a chip the size of a quarter, which could then be inserted into a LUCAS-equipped cell phone that would quickly identify and count the cells within the sample. The read-out could be sent wirelessly to a hospital for further analysis.

No word, unfortunately, on the possible price tag for the proposed cell phone.

Alphabet soup - AED, AAP, PDA

Perhaps in contrast to my post on the digital war on poverty, I just noticed an interesting article on the website of AED - the Academy for Educational Development. They are using a technology called the African Access Point (AAP) in combination with personal digital assistants (PDAs). From the article:

...to increase connectivity, AED is employing a new technology, called the African Access Point, or AAP. This technology links inexpensive PDAs to a computer hundreds or even thousands of miles away using an existing wireless telecommunications network.

The digital war on poverty

Jeffrey Sachs, ever the optimist, has announced victory - or something very near it - in the digital war on poverty. Writing yesterday in the Guardian, Sachs had this to say:

Extreme poverty is almost synonymous with extreme isolation, especially rural isolation. But mobile phones and wireless internet end isolation, and will therefore prove to be the most transformative technology of economic development of our time...There are now more than 3.3 billion subscribers in the world, roughly one for every two people on the planet.

Perhaps I am a Luddite, but Sach's article brings to mind Rousseau's Discourse on the Moral Effects of the Arts and Sciences (available in English translation here). Rousseau expresses a certain skepticism about the benefits of technology that has been echoed repeatedly since. Here is one interesting passage: