Tuesday, April 2, 2013

Truly remarkable numbers from Rwanda

it is an increasingly well known fact that Rwanda today has the highest proportion of female civil servants in the world. 

Life expectancy climbed from 28 years in 1994 to 56 years in 2012.
In June 2012, 108 113 people with advanced HIV disease in Rwanda were receiving antiretroviral therapy, making Rwanda (along with much richer Botswana) one of only two countries in sub-Saharan Africa to achieve the United Nations goal of universal access to antiretroviral therapy.
As of June 2012, 90.6% of the population was enrolled, while another 7% are covered by civil service, military, or private insurance plans.
Rwanda was among the first countries to integrate the rotavirus, pneumococcal, and human papillomavirus (HPV) vaccines into its national immunisation system, achieving greater than 93% coverage for each of nine vaccines (rotavirus data are not yet available). This includes 93.2% coverage for all three doses of the HPV vaccine among eligible girls in 2011; by contrast, less than a quarter of eligible girls in the United States have received a complete series.
Mortality associated with HIV disease fell by 78.4% (the greatest reduction in the world during that timeframe) and mortality from tuberculosis by 77.1% (the greatest decline in Africa). From 2005 to 2011, deaths from malaria dropped by 87.3%. Between 2000 and 2010 the country’s maternal mortality ratio fell by 59.5%. The probability that a child dies by the age of 5 years decreased by 70.4% between 2000 and 2011—falling below half of the regional average and approaching the global mean (fig 2).
Life expectancy (had) remained the lowest in the world from 1989 to 1997. 
The authors credit the central government and the Ministry of Health with much of this success.  I think this is right.  Rwanda serves as a strong counterpoint to those who would argue that socioeconomic factors affect governance and not vice versa.  The causality runs both ways.

It is also interesting to note the association between that first fact (Rwanda's high proportion of female civil servants) and Rwanda's highly effective and honest civil service.

Monday, April 1, 2013

Approaches to political reform

Daniel Triesman, on the three main approaches to political reform used in 1990s Russia:
The first approach might be called the cavalry charge. Plunging headlong at the enemy, the reformers sought a breakthrough by force of will, speed, and concentration. Such tactics worked wonders in postwar Japan, where General MacArthur, U.S. troops at his back, broke up the business empires of the prewar zaibatsu and imposed a democratic constitution. With similar cavalry attacks, Ataturk carved a modern Turkish state out of the Ottoman ruins, closing religious schools, suppressing opposition parties, and imposing European legal codes. General Pinochet crushed the Chilean labor unions to impose macroeconomic stability. Cavalry charges make for rousing theater and— sometimes— stunning victories. They make less sense when the valley one must charge down is surrounded by cannons. 
The second approach— the war of attrition— involves neither speed nor surprise, nor overwhelming force, just a patient search for incremental gains. What victories occur result from painstaking preparation and periodic probing of the opposition’s defenses. Reformers exploit moments when the opponent is distracted to make technocratic advances, which add up over time to more substantial change. In such a war, persistence is key. “Many of our decrees were overturned three or four times,” Chubais later recalled of 1993, “but we would remake them phrased slightly differently.” The war of attrition can work well when time is on the reformers’ side. Often it is not. 
Finally, reformers may seek progress through creative recombination— dividing and conquering their opponents, coopting some by designing reforms in ways that benefit them, while isolating others, who can then be crushed or ignored. Reformers help potential beneficiaries to organize, building a support coalition. Victories, in this approach, are always relative and costly, and to keep reforms moving the reformers must be ready to make sudden turns, striking out against their erstwhile allies. The timing of such reversals can be crucial. Too soon, and the first reform crumbles; too late, and the reformers end up hostage to their creations.
That's from The Return, his terrific, narrative-busting book on Russian politics of the past 30 years.

Sunday, March 31, 2013

On free will

This sums up the argument against free will quite nicely:

The problem of free will, of course, is that we understand that we are physical entities: specifically, the brain is the physical basis of mind, and the brain, as a physical system, is not exempt from the physical laws that determine everything else that goes on in the universe; neither are our thoughts and actions exempt. So the problem of free will is simply this: how do we reconcile our conscious experience of freedom of the will with the sheer and simple fact that we are physical entities existing in a universe that consists of particles acting in fields of force?

The rest of the article is interesting as well.