Esther Duflo speaking at Pop!Tech in 2009. Photo: kk + (flickr)

Ever wonder why some development projects succeed while others fail?

Esther Duflo and her colleagues at MIT’s Poverty Action Lab are working on the answer. Duflo is one of the newest recipients of the MacArthur Genius Grant because of her commitment to investigating what causes poverty to persist in some developing countries and what works to alleviate it.

She does this by setting up controlled field experiments in some of the poorest countries in Africa and South Asia. These experiments set out to prove how social and economic forces fuel the cycle of poverty in these areas. They also test how effective foreign aid projects are at lifting people out of poverty.

Duflo conducts her experiments using a method that mimics how drug companies conduct randomized medical trials. One group participates in a development project while the other does not. The differences between them are then measured to see if the project worked, and exactly how well.

Some of Duflo’s best known work is on HIV prevention in Kenya. Her research shows it’s more effective to teach girls specific ways to reduce their risk — like avoiding sexual relations with older men — than teaching basic medical facts about HIV and emphasizing abstinence as the best method of prevention. As she explains in her recent article for VoxEU.org, girls who were given risk-reduction information now use condoms more often, stay in school longer, and become pregnant less often.

“Economics is about the best way to allocate resources, and finding out what works is important to understanding how to allocate these resources,” Duflo told Philanthropy Action. Too few development strategies are vigorously tested. Proving what works can help.

(For more information on the Poverty Action Lab, check out Sarah Standish’s post "Researching Better Ways to End Poverty.")

Antiretroviral drugs. Photo: shortie 66 (flickr)

An enormous barrier in the fight against HIV/AIDS in developing nations has started to crumble.

Last month, the international drug purchaser and WHO-partner organization UNITAID announced plans to form a patent pool to lower the cost of some of the most expensive medications used to treat HIV, reports the Guardian. The agreement is a blessing for the estimated 14 million people who do not have access to affordable treatment — most of whom live in developing nations, says UNAIDS, a branch of the UN that deals specifically with HIV/AIDS.

The patent pool will allow generic pharmaceutical companies to develop medications that are still protected under patent laws in exchange for royalties. Consequently, the competition between generic manufacturers lowers the overall price of the drug. By UNITAID's estimate, the cost of some drugs will fall from $1,000 a year to as little as $100.

Not only will more people have access to these new drugs, the drugs themselves will become better. Fixed-dose combination medications (FDCs), formed from different compounds that work well when used together but are often developed by competing pharmaceutical companies, have been hard to create under old patent laws, reports UNITAID. In contrast, the pool gives manufacturers access to a variety of different compounds to make more effective and easier-to-use FDCs.

So far, UNITAID has identified 19 drugs from nine different pharmaceutical companies to bring into the pool. Although there has been resistance by a few of the companies — who are in no way obligated to enter the pool — many like Merck and Gilead have already pledged to put some of their top medications into the pool. “Today is a good day for people living with HIV/AIDS in developing countries,” noted one UNITAID official.

An HIV positive woman marches in Cape Town, South Africa. Photo: Trevor Samson/World Bank Photo Collection (Flickr)

Earlier today, South Africa's President Jacob Zuma announced an ambitious plan to combat HIV/AIDS. Zuma called for more HIV testing centers, better treatment facilities and emphasized the need to identify and treat HIV-positive children younger than one year old, CNN reports.

Zuma's plan ends a decade of neglect imposed by his predecessor Thabo Mbeki. The former president adamantly refused to recognize that the HIV virus led to AIDS and blocked necessary medication from entering his country. A study mentioned in Forbes Magazine suggests Mbeki's policies lead to the deaths of more than 350,000 South African adults and 35,000 babies.

The speech was welcomed by the international community. Without skipping a beat, the United States pledged $120 million to supplement President Zuma’s new policies.

Photo: Common Threadz (flickr)

An estimated 12 percent of children in sub-Saharan Africa are homeless. If we're going to make a dent in this problem, we need more people like Anna and Phina Mojapelo.

For these South African sisters, giving homeless children a safe place to live just seemed like the right thing to do. In 2000 they opened up a small orphanage in Midrand, South Africa, called "New Jerusalem." Nearly 100 children under the age of 16 now live at the orphanage. Some of the children are AIDS orphans, some came from abusive homes and some were abandoned by their parents.

The sisters are working to give them an education. The Christian Science Monitor recently profiled the sister's efforts to build a Montessori-style preschool with the help of the Dutch charity, Orange Babies. Forty of the young orphans and 40 children from community attend the school.

Although this project seems small, I am impressed both by the vision and compassion that New Jerusalem was founded upon, as well as the potential it encompasses. Powered by Midrand locals, this orphanage is successfully providing kids with a safe home and an early education — both of which give them a better chance of overcoming poverty. As Adrienne Feldner-Busztin — a New Jerusalem volunteer — says, "If you look at the size of the problem, you can feel hopeless, but we don't feel hopeless at all. When you are impacting 96 little lives, you can't feel hopeless."

A new mobile technology is helping battle HIV in Biwindi, Uganda where most people walked days through the tough terrain to get medical care. Photo: youngrobv (Rob & Ale)

Could you imagine having to walk a full day to get medical care, and then wait weeks to learn your test results? Well, that was the reality for people in Biwindi, Uganda until just a few months ago, the BBC reported earlier this month. Now, new technology is bringing medical testing to people living in the middle of Uganda's forests.

This new technology is called the PointCare NOW machine. It's a portable blood-testing device that analyzes what's wrong with you within 10 minutes. It's also the first portable machine that can diagnose HIV within minutes. Developed by PointCare, a U.S.-based company specializing in diagnostic equipment for developing countries, the machine easily fits in the trunk of most vehicles.

PointCare's founders Petra Krauledat and Peter Hansen came up with the idea for a portable, durable HIV-testing device on a trip to southern Africa a few years ago. Krauledat and Hansen say the battery-powered machine has a 180,000-day lifetime.

PointCare is piloting the technology in rural Uganda, where the need for fast and comprehensive medical care is obvious. One in 20 Ugandans is infected with HIV, according to Avert, an international AIDS charity. One in 12,500 people in Uganda is a doctor. And 70 percent of the population lives in rural areas.

Dr. Williams, a physician from England that opened a small hospital in Uganda, sings the praises of the PointCare NOW machine. He tells the BBC:

"I started a testing centre in the hospital, then the mobile testing services, and then, once we had access to drugs, developed a treatment program. Now our death rates from HIV are very low. We're able to diagnose it early, manage it early and keep people living with HIV fit and well. Over a reasonably short period of time, we've been able to change HIV from being a death sentence into something that people can live with and lead productive lives."

This pharmacy at the Evangel Hospital in Jos, Nigeria could be one of the beneficiaries of cheaper drugs and better facilities from GSK. Photo: MikeBlyth (flickr)

Pharmaceutical companies are often seen as villains for making life-saving drugs so expensive the poor can't afford them. But what if a new CEO was making drugs more affordable and sharing secrets that would lower profits but result in more cures?

Andrew Witty is the new chief executive of GlaxoSmithKline (GSK) — the second largest drug company in the world. Witty recently outlined his plan to radically shift GSK policy to make four major changes that will help the developing world:

1. Slash drug prices to 25 percent (or lower) of their current U.S. and UK levels in the world's 50 poorest nations, and make drugs more affordable in middle-income countries like Brazil.

2. Reinvest 20 percent of drug profits made in developing countries to support health clinics and pay medical workers in those same countries.

3. Place their research on neglected diseases (with the exception of HIV) into a patent pool to share with other scientists to dramatically speed up medical breakthroughs.

4. Invite researchers from other governments, companies, and NGOs to participate in their research on tropical diseases at their institute at Tres Cantos in Spain.

So why would GSK do this? Witty told the Guardian he was so tired of hearing speeches about how terrible it is that there has been no progress in tuberculosis research or treatments for other diseases that he decided to do something about it.

We work like crazy to come up with the next great medicine, knowing that it's likely to get used an awful lot in developed countries, but we could do something for developing countries. Are we working as hard on that? I want to be able to say yes we are, and that's what this is all about – trying to make sure we are even-handed in terms of our efforts to find solutions not just for developed but for developing countries.

Lowering drug prices will help — but without adequate health care infrastructure, even cheaper drugs might not be accessible. That's what makes reinvesting profits to support clinics and pay medical workers' salaries so important, because it will increase access to these drugs.

But the most important change Witty has proposed is sharing GSK's research. By placing their research into patent pools, GSK will dramatically increase the speed of early-stage R&D activities and the likelihood of finding cures to neglected diseases.

"This is a gutsy move in a commercial world" said Mike French, World Vision's director of advocacy. "Witty has demonstrated a willingness to make saving lives a business goal along with making money."

Global Citizen Corps leaders host a fundraiser for World AIDS Day. Photo: jessicaphansen (flickr)

On last year's World AIDS Day, Sam held an afterschool open-mic event to raise awareness of HIV/AIDS. Rachel got 200 people to sign a letter asking for more government attention on AIDS — and sent it to Barack Obama. Lily had a candlelight ceremony in memory of those who have died from the disease.

So who are these youth?

They're all members of the Global Citizen Corps leadership program — a national network of high school students that are committed to ending global poverty.

Global Citizen Corps leaders build awareness in their communities by organizing informative events at their schools that focus on issues like climate change, HIV/AIDS, world hunger, and access to education.

Dozens of teens are making a difference. Jaime wrote an article her high-school newspaper to raise awareness about global poverty. Kate hosted a "blackout" at her school, cutting off the water to show students how climate change can impact people's lives.

Global Citizen Corps is looking for more dedicated and compassionate youth to join the program. Students gain access to Mercy Corps resources and agree to host informative events at their school or in the community. Leaders will also have the opportunity to lobby for access to education in Washington D.C. and participate in the annual leadership summit in New York City.

The 2009-2010 High School Leadership Program is now accepting applications. The deadline is April 15, so apply today.

Photo: woodleywonderworks (flickr)

Sure, your cell phone can take pictures and send text messages, but can it detect malaria?

UCLA scientists have found a way to bring medical diagnostic tests to resource-poor areas by transforming cell phones into cheap, portable gadgets that can monitor and detect diseases like malaria and HIV.

As Wired explains:

UCLA researcher Dr. Aydogan Ozcan images thousands of blood cells instantly by placing them on an off-the-shelf camera sensor and lighting them with a filtered-light source (coherent light, for you science buffs). The filtered light exposes distinctive qualities of the cells, which are then interpreted by Ozcan's custom software. By analyzing the cell types present in a much larger sample, a more accurate diagnosis can be made in a matter of minutes.

Currently, the software to analyze these images runs on a desktop computer, but Ozcan’s team is working to create software that runs on the cell phone device itself.

This technology is still in developmental stages, and skeptics are already lighting up online discussion boards. But the promise of quick, accurate and low-cost blood testing in the world's most remote areas is definitely exciting. And if this idea does become a widespread reality, here’s hoping that effective treatment for those diagnosed follows quickly on its heels.

A Congolese woman recovers at a hospital in Goma, DRC. Photo: Endre Vestvik (flickr)

Congo has the world's biggest deposits of gold, copper, diamonds, and tin. Its dramatic mountain landscapes once inspired Humphrey Bogart and Katherine Hepburn’s romantic saga in The African Queen.

But that was before Congo’s internal conflicts drove foreign investors and tourists out of the region, dramatically reducing economic output and government revenue.

In the last decade, more people have died in the DRC than in Iraq, Afghanistan and Darfur combined. Political initiatives by Africa, the West and the UN — including the deployment of more UN peacekeeping troops than any other nation in the world — has failed to stop the fighting and protect the lives of Congolese civilians.

If there's a bright spot, it's that humanitarians are highlighting what UN officials call the "worst sexual violence in the world."

In the last ten years, hundreds of thousands of women have been raped. But it received little recognition from the government and there were few prosecutions. Now, European aid agencies and the UN are spending millions of dollars building courthouses and prisons to punish rapists. Mobile courts are holding rape trials in the hard-to-reach villages. And the government is paying for Congolese investigators to travel to Europe to learn "CSI"-style forensic techniques.

The results are seen in towns like Bunia, where rape prosecutions have increased 600 percent in five years. There are organizations like Women for Women, which teaches rape survivors how to read and write, cook, make soap and other skills that could empower them to be financially independent. Grassroots campaigns are encouraging rape victims to speak out in open forums.

These signs provide some hope that amid Congo's chaos, there's at least a chance for positive change.

Photo: whiteafrican (flickr)

Each day, one million South Africans get a text message that reads something like this:

Frequently sick, tired, losing weight and scared that you might be HIV positive? Please call AIDS Helpline 0800012322.

It's part of Project Masiluleke — which means “hope” and “warm counsel” in Zulu — a plan to use mobile phones to encourage South Africans to test for HIV. It is believed to be the largest mobile communication campaign for health promotion ever attempted.

South Africa has an estimated six million people infected with HIV, according to the United Nations. And almost 90 percent of South Africans have mobile phones with plans that include free “please call me” text messages.

Encouraging people to get tested is a challenge in a country where stigma and shame accompanies a positive diagnosis. Project Masiluleke will offer South Africans discretion and privacy to get tested, treatment options and counseling.

Initial results have been encouraging. During three weeks of usability testing in October, Project Masiluleke helped increase daily call volume to the National AIDS Helpline in Johannesburg by nearly 200 percent, according to National Geographic.

As CNET reports, "This isn't the first time cell phones have been employed in the battle against AIDS. In August, a catchy 'condom, condom' ringtone made its debut as part of a three-year ad campaign aimed at making condom use more socially acceptable in India."

Project Masiluleke is another good demonstration of how mobile phones can be used for the public good. Let's hope it encourages South Africans to take control of their health and pursue the care they need.

Condoms prevent transmissions of disease, and could be key to population control. Photo: Rampant Gian (flickr)

CIA director Michael Hayden recently identified one of the biggest threats facing the U.S., something that occurs over 215 million times a day — sex.

“Population is the essential multiplier for any number of human ills," Hayden said recently. He said overpopulation in the poorest parts of the world is causing global political instability and extremism, climate change, and the food and fuel crises.

In the 1970s, environmentalists frequently discussed the problems of overpopulation, but in the last 30 years, rigid population control has been condemned.

Robert Engleman, vice-president at the Worldwatch Institute and author of the new book More: Population, Nature and What Women Want, says that after China's controversial one-child policy, "Environmentalists came to realize how complicated and sensitive this issue was.”

As food and fuel prices rise, so do concerns that the planet’s limits are finite. Population growth has slowed in developed countries, but is still rising in much of the developing world. With climate change forcing a fresh look at overpopulation, Engleman’s new book argues that “the key to limiting population growth is to give control over procreation to women.”

What Engleman is suggesting is not feminism, it’s just common sense. He says that even in societies with traditionally large families, when women gain control over family sizes with contraception access, birth rates shrink.

Fifty-year-old Linganni, who earns $2.50 a week sweeping streets in Burkina Faso, would certainly agree that too many children and not enough food is a problem. In an article that discusses how the food crisis is hitting women the hardest, The Washington Post describes how her 25 children share one meal a day. And Linganni always eats last.

In his recent article "What Condoms Have To Do With Climate Change", Time's Bryan Walsh suggests the best policy for the U.S. would be “vigorous foreign aid that helps make contraception safe, reliable and accessible in every country — too often women in the developing world who want to use contraception, can't get it.”

Contraceptive aid from the U.S. may be a difficult sell, considering that Americans are still obsessing over abstinence-only sex education and holding father-daughter purity balls. And around the world, contraception is often taboo, and the decision whether to use it is up to the man.

One solution is to support forms of contraception that give women control and are invisible to men, like the Pill or IUDs. But whatever the approach, women need to have control over the number of kids they have. Population control will only happen, Engleman reminds us, when "women are in charge."

Photo: youngrobv (flickr)

A bike can change a life.

The benefits of a bike can range from awakening your inner child to being an eco-friendly commuter. In a developing country, however, the simple bike becomes a locally sustainable method of alleviating poverty and building healthy communities.

The bicycle means greater access to educational and economic opportunities. (Cool fact: A bike can go three or four times faster than the pedestrian and uses five times less energy.) But in communities where people make only a few hundred dollars a year, a bicycle that costs an average of $100 is financially out of reach.

To help bridge the gap, various organizations have sprung up as bicycle distributors for developing communities mostly in Africa.

World Bicycle Relief, an organization fighting the HIV/AIDS crisis in Zambia, describes the power of bicycles in its mission statement:

Simple, sustainable transportation is an essential element in disaster assistance and poverty relief. Bicycles fulfill basic needs by providing access to healthcare, education and economic development. Bicycles empower individuals, their families, and their communities. Our mission is to provide access to independence and livelihood through The Power of Bicycles.

Organizations like this depend on donated bikes, which they then ship to community-based organizations that employ and train locals as bike mechanics. In Namibia, the Bicycling Empowerment Network has bicycle workshops (called Bicycle Empowerment Centres) stocked with tools and bicycle parts that act as the hub for bike distribution and repairs.

Even grassroots groups in the U.S. have joined the cause. Bikes to Rwanda, a project supported by Stumptown Coffee in Portland, Ore., ships cargo bicycles to farmers in a Rwandan coffee cooperative.

With today’s gas prices, cycling is a more attractive alternative for residents of places from Amsterdam to Zambia. But bikes aren't limited to transport anymore. They can be modified to sharpen knives, double as an ambulance, and even filter and store water — all innovative adaptations geared towards positive social change.

We buy cheap bootleg DVDs and fake Coach purses from random street vendors with little hesitation. But what about buying your daily medication from them, too?

This is a common practice in the developing world. In Zimbabwe, for example, street vendors offer the poverty-stricken populace medicine for a price five to eight times less than a legitimate pharmacy.

The trouble with these cheap meds is that they're often not the real thing. One study cited by the World Health Organization says the counterfeit medication industry could reach $75 billion by 2010. Although the industry's reach is worldwide, it's more prevalent in developing countries. The WHO says "many countries in Africa and parts of Asia and Latin America have areas where more that 30% of the medicines on sale can be counterfeit."

Though buying counterfeit medications can save a lot of money, it is also very risky. In 1995, 89 Haitian children died from taking counterfeit cough syrup that contained the active ingredient in antifreeze instead of the real medication. Governments in the developing world often lack the resources to track and prosecute these illegal manufacturers and sellers. The Internet is only making the fight harder.

Major pharmaceutical companies are protecting their products from counterfeiters using different methods. Today, companies like GlaxoSmithKline use holographic labels or stickers to make their product more distinguishable from fakes. Recently, counterfeit drugmakers have, however, been able to convincingly duplicate many of these stickers and packaging. For example, one study revealed that about half of Southeast Asia's supply of the anti-malarial drug Artesunate was counterfeit despite holographic packaging.

The easiest and fastest way to decrease the market for these fake drugs is for consumers to increase their own awareness. Many news organizations have begun to help. In this video, Al-Jazeera reports on counterfeit drugs in Mauritania.

Community Health Workers in Haiti have had one of the most astounding responses to the HIV/AIDS epidemic in industrialized or developing countries worldwide. When the epidemic first came to Haiti’s shores, many world leaders thought the country was too poor and underdeveloped to make intervention worthwhile. In the decades since, they have been proven wrong. The World Security Institute writes that "Twenty-five years after the AIDS epidemic was given a name, it is a plague with tangled ties between the wealthiest and the poorest countries in the hemisphere. With HIV rates second only to those of sub-Saharan Africa, Caribbean islands that conjure visions of sun, sand, and tourism now highlight the interplay between poverty and the epidemic in this hemisphere."

This short film, In Focus - Haiti's Hope by the Pulitzer Center, showcases what health clinics in rural and urban Haiti are doing, in order to create a sustainable approach to treating disease – and help the Haitian people move out of the world’s most dire poverty level at the same time.

Want to know the hot gossip in a small Rwandan village? It's not the latest developments in AIDS treatments. Instead, it's the recent $2000 foreign order for coasters and place mats.

Read The New York Times' guest columnist Josh Ruxin's great article about the importance of supporting business opportunities to combat AIDS and other health problems in Africa.