Recently in BoP Category

Awethu: Imported to Detroit?

As anyone reading this space knows (anyone? anyone? I can read your comments if you click the "(No) Comments" link above, you know), I've been thinking a lot about Detroit. And I think it's fair to say that, once foreign cars began to arrive in the United States, and then gain wide acceptance for being affordable, high quality vehicles, Detroit was in trouble. Imports have not been kind to Detroit.

But here's one that could be.

I met Yusuf Randera-Rees several weeks ago at the Skoll World Forum and talked to him on the phone a few days ago.  His organization, the Awethu Project, is creating vibrant businesses where they rarely exist: South Africa's townships, or what we would call slums.

The Awethu Project conducts brief trainings for those in the townships on how to create a business and then tells them to think up a business idea and put it into practice in their community. A month later, those who have created the most profit (with records to back up their claims) begin a more extended period of training. They receive support both for personal development and formalizing their business ideas, being taught "hard" topics like time budgeting and record keeping as well as "softer" topics including personal discipline. Those who excel become part of Awethu's business accelerator, where Awethu helps move them from being small, isolated business towards becoming what Awethu really expects of them: to become business that are as good as the top businesses in the world and to link up, as appropriate, with that business ecosystem. Awethu also invests in these businesses, so their success benefits Awethu, further reinforcing the relationship and Awethu's desire to see them excel.

The idea behind Awethu is simple: identify gifted entrepreneurs in under-resourced communities, and provide them with the training and resources needed to compete with the world's best. The underlying premises, of course, is that there is a latent pool of such individuals everywhere who lack the opportunity, but not the inherent skills, to launch world-class businesses.

And if those potential world-beaters are everywhere, then they are certainly in the poorer parts of Detroit.

Yusuf is well educated, optimistic, and idealistic. And his efforts produce: he has developed a model of business talent identification in the township of Alexandra that has been noticed by the South African national government, which is now funding the project. In the coming year, Awethu will identify and put through its business accelerator program 1,000 entrepreneurs with world-class talent. As Awethu expands, Yusuf expects to take this idea across the country and then across the African continent.  

You've heard Chrysler's new slogan: Imported from Detroit. This is an idea Detroit (and the US) need to import themselves. Now.

Enhanced by Zemanta

Juhudi Kilimo

Two key questions about microfinane and then an amazing model for extending credit to poor, rural African farmers:  

1. Does microfinance reduce poverty?

A recent CGAP study reviewed the evidence from field experiments.  Recently published randomized control studies of microcredit variously found: 
  • business creation as well as increases in non-business (i.e., "consumption") spending (India); 
  • improvements for farmers but not others; and business owners increasing savings but non-owners increasing only their consumption (Morocco); 
  • increases in income and food consumption in general (South Africa); 
  • a decrease in business activity and employment (Philippines).

Ambiguity, at least surprise, also surrounds experiments that explore non-credit applications of microfinance, including savings, technical support, and insurance.  For instance, 
  • providing advice to business owners to keep their  personal accounts separate from their business accounts helped them more than when they got more detailed accounting advice;  
  • farmers recognize that droughts are the most significant risk they fact, but they are very reluctant to purchase insurance, even when they receive information explaining how it works and its benefits.

Three other randomized studies focusing on the design of microfinance products showed that 
  • allowing a grace period before a borrower's first loan payment is due helps some but hurts others; 
  • borrowers with individual versus group liability were just as likely to repay;  
  • fingerprinting borrowers caused borrowers with marginal credit worthiness to take smaller loans and be more likely to repay them.

To summarize: we don't know enough to generalize about what works and in what circumstances.  And, although we are far from certain about what design features are likely to "take," design considerations seem to matter.

If the situation is not uncertain enough, let's also ask ...

2. Should microcredit be for business-building loans only?

There is ample reason to believe that the poor need credit to help them through the unpredictable, uneven (and, of course, low-income) financial lives they lead to make their lives manageable.  Still, from the perspective of alleviating poverty, are loans for businesses most important?  The very framing of the question seeks opinions, not facts; and there is no consensus here.

The relatively recent trajectory of extending credit seems to be away from business-only loans, as even Grameen II now permits borrowing for reasons other than starting or expanding a business.  In many respects, this may reflect the reality that, after someone receives a loan, how do you prevent them from doing what they want with it?  

Yet fears about poor people becoming over-indebted remain prevalent and valid.  And the arguments that rising out of poverty comes from building (a business, your home), rather than consuming, has much resonance.  

My microfinance class was lucky enough to hear from Nat Robinson,  CEO of Juhudi Kilimo the past week.  The microfinance organization's lending model is no less a revolution than being able to have a real-time, interactive conversation with Nat, at his office in Kenya, as my class and I did with him over Skype video.  Juhudi's model directly addresses the issues of using microfinance to lift people out of poverty, ensuring that loans go towards business rather than consumption, and preventing over-indebtedness.  All are baked into the design of its microfinance products.

Juhudi Kilimo (Effort in Agriculture, in Swahili) provides loans in the form of durable assets to rural Kenyans.  For instance, smallholder farmers may receive a milk cow, instead of cash.  Farmers can then immediately begin to improve their income.  To make this loan most productive, Juhudi provides technical training and ongoing support.  By making loans in-kind, a struggling farmer has a real asset that can be sold (with Juhudi's help) if he can't repay his loan, and Juhudi also insures the cow against theft or death to provide further protection against over-indebtedness.

Juhudi Kilimo began in 2004 as a non-profit initiative after observing the low productivity of Kenyan farmers.  Five years later, after proving its model, it became a for-profit organization in an effort to serve as many clients as possible.  As it has grown, it has added supporting technology to improve efficiency.  It uses Kenya's wildly popular M-PESA system to collect payments, and is beginning to use an open source application on Android phones to replace  cumbersome, manual record keeping in the field.  

By raising capital, including grants and quasi-equity, within three years, Juhudi Kilimo expects to become sustainable and help lift 100,000 farmers and others with small agri-businesses out of poverty.

Enhanced by Zemanta

Who's going to save the world -- Wal-Mart or the social entrepreneur toiling away with little fanfare?

Let's consider:

Wal-Mart, the world's largest company, sells slightly more than $400 billion a year.  The poorest two-thirds of the planet -- people living $4 a day or less -- spend about ten times that amount.

Each year, Wal-Mart serves 100-200 million customers.  At most, that's less than 3% of the world's population.

Wal-Mart's recent shift from focusing exclusively on everyday low prices to finding profit in acting in pro-social ways has been commendable.  It has committed to creating zero waste and obtaining all its energy from renewable sources.  It announced this week that it will open 300 stores to bring fresh food to inner-city "food deserts" in the next five years (on top of the more than 200 it already operates).  It has entered the low-income banking business in Latin America and, in the U.S., where it can't officially run a bank, it works through partners to offer unbanked Americans low-cost money orders, check cashing, and overseas remittances.

Despite Wal-Mart's heft and new found focus on creating business opportunities from addressing societal ills, it can't meet many of the most basic requirements of the needy. 

In the developing world, access to clean water is arguably the most fundamental need of the poor.  Protection against preventable diseases, including malaria and diarrhea, is close behind.  These are beyond the ambit of Wal-Mart's merchandising. 

Even Hindustan Unilever, with its more targeted efforts to address the needs of the poor, has been unable to respond effectively enough to these needs.  With revenue one percent of Wal-Mart's, Hindustan Unilever does reach deep into Indian rural life through efforts such as its Project Shakti, which creates door-to-door selling opportunities for poor, rural women. (Have you heard of Avon Ladies?)  It recently announced an altruistic effort to study the under-supply of water, and has made previous efforts to help renovate village ponds, manage watersheds, and promote improved water harvesting.  Despite these efforts, clean water remains in short supply, with more than 750,000 deaths occurring each year in India alone from water contamination.   

In the United States, basic needs are under-served, too.  Despite (or motivating) Wal-Mart's food efforts, food deserts exists throughout the country.  (See the USDA's interactive map.)  The consequences?  Poor people eating less nutritious, usually fattening food, or inconvenient and costly (in time and money) travel to obtain food of higher quality.  Likely, too: a higher incidence of serious illnesses and premature death.

Nor is the financial services picture rosy for the U.S. poor.  The FDIC estimates that over one-fourth of all households, accounting for 60 million adults, are unbanked or underbanked.  For blacks and Hispanics, the proportion is approximately 50 percent.  The alternative financial services that these un- and underbanked use -- non-bank money orders and check cashing, payday loans, pawn shops, and others -- are necessary, but costly, ways to live without formal banking.

So, where do social entrepreneurs come in?

Social entrepreneurs provide services where companies are absent, where they don't sell the right products, or where they sell products that are simply too expensive.

Social entrepreneurs (or non-profits) together with companies form a co-adaptive ecosystem.  What companies leave unattended -- in their "background" -- creates the foreground environment for social enterprises, shaping their opportunities .  In turn, social enterprises can serve as a type of free, and early, testing ground for companies.  The success of non-profit microfinance institutions in providing banking services for the poor, for instance, caught the notice of larger, for-profit banks, spurring their entry into the same market.

social entrepreneurs prove successful in reaching their constituents, for-profit companies take notice.  And, as companies change their focus, they affect social entrepreneurs.  This interplay has led nonprofit microfinance institutions to serve poorer, more rural customers as larger, for-profit providers use capital markets to offer more, and larger, loans to wealthier segments of the poor.

Today, we are seeing examples overseas of early-market activity among social enterprises in the field of water:  Naandi (water purification and delivery), Wello (water transport and business opportunity), and Sarvajal (a filtration and franchising model). 

In the U.S., healthful food is offered to the poor through a variety different kinds of social enterprises.  D.C. Central is a community kitchen that not only "recovers" and delivers good food headed for waste, but trains low-income individuals for jobs in the food services industry.   Peaches and Greens, a mobile produce market, makes scheduled delivery stops and home-deliveries in inner-city Detroit three seasons a year.  And even urban farming is proving viable, as organizations such as Growing Power, headquartered in Milwaukee, are proving. 

It waits to be seen whether such efforts in water and healthful food will one day be viewed as attractive opportunities for many large companies.


So, who's going to save the world -- mega-corporations like Wal-Mart with their size, reach, and efficiency; or social entrepreneurs, who can attack deeply entrenched problems without a slavish focus on bottom-line results?

My answer: both -- by acting and adapting in response to each other even as they continue to do what they do best.

Enhanced by Zemanta

Be Encouraged

It's easy to be discouraged, even cynical, these days. 

We're inching towards defaulting on our national debt.  China is worried we're acting like a third world country playing financial chicken. 

As our government sputters over issues of consequence, the House did just muster the "courage" to pass one bill to prevent the Environmental Protection Agency from enforcing the Clean Water Act and another to prevent the Energy Department from enforcing higher energy standards for light bulbs.

(Why was I surprised that I saw a car on the highway today with a bumper sticker that read, "I support global warming"?)

We are starting to get used to our middle of the international pack stature in education.  U.S. 15 year-olds scored below the developed world (OECD) average on mathematical literacy (and well behind China and Singapore).  In science literacy we did better: about average. (Want your kid to be better in math?  You could send them to Korea, Finland, Iceland, Slovenia, or the Slovak Republic.)

Other statistics reveal that health care in Cuba is better than ...

... no:  Let's look at why we should be hopeful!

I'm writing a book to support social entrepreneurship.  Tentatively titled What I Wish I Knew Then: Becoming a Social Entrepreneur, the book  uncovers and addresses the questions and issues holding back early stage social social entrepreneurs.

In the course of researching the book, I've been talking to social entrepreneurs from around the world (including my co-author, Cynthia Koenig, founder of Wello), who are working on problems spanning the spectrum of societal ills.  Here are very brief profiles of two of them.

Derek Stafford never intended to start a social enterprise.  He started two.  Stafford is a political scientist with expertise in the mathematical properties of social networks (stuff like how many links to Kevin Bacon, which truly is important in studying power and influence).  La Unión, Honduras, provided the perfect spot for his research, its geographical isolation and rich tapestry of personal connections creating a social network with just the properties he wished to explore.

Stafford and team did extensive research on the ground, mapping relationships among people who had long histories with others in the community, even if they typically only knew them by their first names.  To compensate them for their time, Stafford wanted to provide something of value to La Unión -- but what?

The region produces outstanding coffee, but most residents, working for much wealthier coffee growers, earn subsistence incomes.  Stafford launched Unión MicroFinanza to provide microloans (in the form of fertilizers and coffee inputs) to small farmers, extended them credit, and purchased their coffee through his second social enterprise Microloan Coffee.  He also banded farmers together into a coop and encouraged them to use the coop's market power to improve their bargaining power with him.   He is looking at the role of crop insurance and price guarantees to further support small coffee farmers in La Unión.

Maria Springer's route to social entrepreneurship was also serendipitous, but perhaps less surprising.  She was about to join the Peace Corps after receiving a bachelor's degree in Political Science and International Relations when she received a phone call from her cousin asking if she'd like to be part of a local solution to local problems in Kenya.  The call changed her life.

At the age of 22 she founded Kito International along with Wiclif Otieno.  The organization trains Kenyan "street youth" and employs them as as salespeople through Kito's companion organization iSmart.  The street youth, who formerly endured all the hardships that confront the homeless everywhere, now earn steady salaries. 

Through its deeds and relationship building, iSmart has gained the support of suppliers who provide products such as solar lights and LED lamps on credit.  The Kito-trained sales force provides "last mile" sales and distribution, benefiting themselves, suppliers, and the slum residents who can't easily obtain the kinds of beneficial products that the former street youth sell.

Derek and Maria both excelled in school, have palpable drive and energy, and have countless opportunities they could pursue.  And they are working to make a true difference in the lives of those who are eking out a living.  Their work reflects the their humanity, commitment, and integrity.

There are more Dereks and Marias today than ever before.  Perhaps all the things that make it tough to get a foothold in today's ultra-competitive job market are tipping people (and not just young people) towards social entrepreneurship. 

But I think it's more than that.  In a world where traveling and living internationally are more and more common; where communicating with one (or thousands!) of people is just as easy if they are half-way around the world or next door; and where there is more opportunity than ever to receive support for an idea that can change the world -- in that world, our world, we are seeing an awakening to a life of purpose. 

That world is a world that should encourage us all.

Postscript:  As this blog entry marinated in my drafts folder, Google just announced the winners of its first ever science fair.  The winner, a 17 year old girl, discovered how a cellular energy protein might help a cancer drug become more effective.  The winners in the 15-16 and 13-14 age groups, also girls, studied the effects of air quality on lungs and how to control the carcinogens produced by grilling meat, respectively.

Those of us who seek societal change have to think about how we can create impact. As an educator, I have the opportunity to share my ideas with students, who can think about them, modify them to suit their needs, and apply them to problems they are attacking. That source of impact is my privilege.

Erica Anzalone-Newman was student in a course I teach on "Solving 
Society's Problems through Innovation and Enterprise." In the essay 
that follows, she beautifully illustrates key themes from the my book, Design Your Life, Change the World: Your Path as a Social Entrepreneur. These themes are:

  • Big Picture Design. First, design everything:make sure that you consider everything in your design thinking, not just the central product or service you're providing. Among other features, these would likely include how you distribute your product, gain acceptance for it, and make it affordable. And second, steal shamelessly: attempt to identify ideas with proven merit and use them for the problem you're addressing.
  • Make It Appropriate. Ensure that your product or service not only is relevant -- but is also perceived as being relevant -- to the context in which you are working.

  • Make It Stick. Make sure that you have the means to successfully introduce a product or service to a new region and that you can "embed" it so that it gains long-term acceptance.
  • Make It Bigger. Find ways to spread you product or service to other regions so that it benefits more people. Also, you can increase awareness of your ideas or recruit others to join you so that your idea is taken up and spread.

Learning from Brazil's Assault on HIV/AIDS: Applications in US Urban Communities

by Erica Anzalone-Newman

Examples of transplanting modified, developed-world innovations to the developing world are rampant. Yet there is much to be gained by organizations serving US populations adopting and adapting business and service delivery models developed in developing countries. More specifically, Brazilian groups have developed and executed one of the most successful responses to HIV and AIDS in the developing world, if not the world at large. The Brazilian response to HIV/AIDS is based on component elements that might be modified for implementation in US urban centers, including Newark, NJ.

Before I explain how that can occur, I present a brief history of the spread of HIV/AIDS in both 
locales. HIV/AIDS in Newark, NJ: History and Context Newark has a long history of a high incidence of HIV/AIDS cases, wrought by the virus essentially since its first detection in 1981. The context for Newark's AIDS crisis began with the infamous race riots of 1967, after which the population declined significantly and many businesses left the city. Employment rates plunged, and the poverty rate soared. By the late 1980s, one-third of the residents lived below the poverty line, and homelessness was three times that in New York City [1].

As the city lost the vast majority of its middle-class, an "underground" economy began to thrive [2], and Newark became plagued by political corruption, insidious crime and, importantly, pervasive drug use. According to a New York Times article written at the height of the AIDS epidemic, "[New Jersey] stands apart as the first state in which intravenous drug abusers, rather than homosexuals, make up the largest group of victims." [3]

This was especially true in Newark, New Jersey's largest city. Indirect effects of intravenous drug use were that women, with virtually no job prospects, turned to prostitution to support addictions, increasing exposure to and the spread of HIV [4]. Drug-addicted men, as well as those engaging in sex with prostitutes, were similarly exposed; in turn, they began to infect non-drug using wives and other sexual partners, who were often unaware that they were infected until their newborns were found to be HIV-positive at birth. According to one Coordinator from the U.S. Centers for Disease Control, "'In cities like Newark, AIDS [had quickly] become a disease of the family" [5]. By early 1989, there were nearly 1,200 cases of AIDS in Newark, of which more than half resulted in death [6]. Clinical research was fairly prominent in Newark; however, community-based efforts, such as outreach, prevention, treatment and care were minimal [7]. 

HIV/AIDS in Brazil: History and Context The first case of AIDS in Brazil was recorded in 1982 [8]. In the early years of the epidemic, the majority of HIV carriers and AIDS victims were men who have sex with men in large urban centers. Other populations initially affected in disproportionate numbers included intravenous drug users and individuals requiring blood transfusions [9]. However, since 1993, heterosexual transmission has been most prominent [10]. During the early- to mid-1980s, as Brazil was realizing true democracy for the first time, NGOs were instrumental change agents within Brazilian society. These groups were vocal proponents of government intervention on a variety of fronts, including HIV/AIDS prevention and treatment. They were also instrumental in encouraging "a climate of social solidarity, allowing open and frank debate about HIV and AIDS." [11]. The responsiveness of the government, inspired by the pressure imposed and partnerships formed by NGOs, has been central in stemming the spread of HIV/AIDS in Brazil. 

A Critical Look at the Brazilian Approach to Combating HIV/AIDS

  • Big Picture Design and Making It Bigger

Based on the spread of HIV in Brazil through the early 1990s, World Bank estimates indicated that 1.2 million Brazilians would carry HIV by 2000; instead, the true figure was only six hundred thousand, and HIV growth since 2000 has been slower than in many other nations, as well [12]. 

It seems that adherence to the tenets of Big Picture Design and emphasis on growing efforts to scale have been central to this relative success story. Certainly there were numerous elements of the Brazilian approach that were grassroots in nature (i.e. not developed as part of a master "Big Picture Design" plan); still, the approach is impressively comprehensive in terms of the demographic and geographic segments it covers; the attentiveness to all aspects of product and information dissemination - including the underlying tone or message accompanying each individual initiative; the combination of top-down and bottom-up 
initiatives; and the efforts aimed at both prevention and treatment. 

NGOs started the conversation about HIV in Brazil, but quickly sought government involvement to set the tone for addressing the virus nationwide. The government first undertook distribution of information, to raise awareness and educate on prevention, with a focus on the highest-risk groups within the population [13].

In 1988, the country's new constitution included legal protection against discrimination for people living with HIV, as well as free access to healthcare for all Brazilians. Healthcare for all included the provision of free antiretroviral drugs (ARVs) to people living with HIV; by 2007, 80% of those requiring ARVs were receiving them [14]. Availability of ARVs drastically improved AIDS-related mortality rates and also reduced the number of mother-to-child transmissions.

The government has also promoted growth within the Brazilian pharmaceutical industry, which is now equipped to produce 40% of AIDS drugs domestically; this increases the long-term viability of free distribution to citizens, as it enables the government to purchase ARVs at lower prices those drugs that must be produced internationally, the government has put significant pressure on foreign pharmaceutical firms, threatening the issuance of "compulsory licenses" to elicit lower prices. "Compulsory licenses allow countries to override patent laws and produce their own generic (copied) versions of company-owned drugs, and can be issued when the government of a developing country deems it to be a public health emergency." [17]

In 2007, the Brazilian government actually issued a compulsory license for an AIDS drug produced by Merck. This action has had an impact beyond lower ARV prices; it demonstrates the government's willingness to provide bold support for HIV/AIDS initiatives even in the face of harsh criticism. 

These are just a few examples that illustrate the collaborative "passing of the baton" back and forth, between the Brazilian government (top-down) and NGOs (bottom-up), which has contributed to Big Picture Design in that the Brazilian approach has the necessary scope and scale to be effective.

These examples also illustrate the notion of "designing everything." For instance, it is not enough to make HIV testing available; you must also provide resources, so that people are not deterred by their inabilities to respond to the test results, financially or otherwise. Finally, these examples speak to the complementarity between prevention and treatment efforts, which could only be discovered through careful analysis of the "Big Picture": the virus's entire life cycle.

  • Making It Appropriate

The Brazilian approach involves a supreme focus on being relevant and perceived as relevant. For example, media campaigns for testing have featured celebrity advocates, who tend to be especially influential among youth, and prevention campaigns use all types of media, including TV, newspapers, billboards, bus shelters, and others [18]. Much HIV-prevention work is based on condom distribution, with particular emphasis on settings and geographies in which condoms are most absent. For example, during the 2009 carnival season, 65 million condoms were distributed - an increase of 45% over the usual number distributed in an average month - because carnival season tends to be correlated with increased sexual activity in Brazil [19]. Condom distribution and other forms of grassroots education and support have also been especially prominent for sex workers, as prostitution is legal in Brazil, and sex workers are at high risk for both contracting and transmitting HIV [20]. 

There are other examples of "making it appropriate," too. There is an emphasis on preventing HIV-positive mothers from breastfeeding, by providing both education and breast milk alternatives. Additionally, rapid HIV tests are widely available in maternity wards. Needle exchange programs for intravenous drug users are widespread, as is counseling and access to treatment targeted at this group. In "shanty towns," NGOs have fostered peer-to-peer education networks by training youth representatives [21].

The Brazilian approach involves being present at absolutely every touch point in an individual's life when HIV could potentially be transmitted, and providing information and products through channels that are familiar and disarming.

  • Making It Stick

The paramount explanation for why the fight against HIV/AIDS is so embedded in communities within Brazil is the work that has been done to de-stigmatize and de-politicize the virus. From the outset, NGOs pushed the government to approach the need for HIV/AIDS prevention and treatment as a human rights issue, not a moral or religious issue, or one that impacts only certain minority groups withinthe country [22]. "The Brazilian response has... pushed for everyone - from the President to prostitutes - to practice safe sex. Public health experts say Brazil's approach works because it doesn't discriminate" - just like the virus [23]. Brazil's fight against stigma, as well as its "tolerant, non-judgmental approach to HIV prevention," are considered unique differentiators in the fight against AIDS [24].

Potential Applications in Newark, NJ

It is reasonable and realistic to acknowledge that certain Brazilian programs, particularly some of the governmental programs, are not precisely replicable in the US due to fairly different social mores; some Americans may raise moral objections to some of the Brazilian methodologies. Ultimately, however, Brazil's success vis-à-vis the de-politicization of responding to HIV/AIDS, is too great to ignore. (Recall: Big Picture Design advocates "stealing shamelessly.") Perhaps the only way to respond to HIV/AIDS so comprehensively within the US is to shift the majority of the load to private organizations, rather than relying on government intervention to the degree that Brazilians did. (Making ItAppropriate means seeking relevance through flexibility, not rigidly applying an approach that will be unwelcome and rejected.)

One opportunity area involves modifying the Brazilian model for partnering with sex workers, to partner with intravenous drug users in Newark instead. These two populations are approximately the same in their respective locales in terms of bearing disproportionate risk of carrying and transmitting HIV. There have been some recent needle exchange efforts in Newark, but there is also a long history of NJ state government opposition to such programs. Needle exchanges have consistently correlated with reduced spread of HIV in pilot areas, and given the direct and indirect contact that drug users have with other segments of the Newark community, this would seem to be a worthwhile early investment.

Perhaps a new enterprise is needed for this to be feasible: a syringe manufacturer that sells syringes to local doctors' offices, hospitals, and clinics in order to subsidize the costs associated with needle exchange programs. This enterprise could even arise as a subsidiary of one of NJ's many pharmaceutical and medical supply producers. To be most relevant, needle exchanges would need to be most prominent around the first of each month, when welfare checks are distributed and spending on drugs is highest in Newark.

Another opportunity area involves replicating Brazil's myriad campaigns to reduce the stigma associated with HIV/AIDS,as this has historically been a severe problem within the predominantlyblack and Latino communities in Newark. The subject matter of the campaigns could run the gamut from human rights-themed messages, to celebrity (local or national) endorsements of HIV testing, to educational public health messages that inform/remind people about how HIV is transmitted.

While there are surely a number of other specific applications of the Brazilian strategy for Newark, generally speaking, Newark should focus on a few thematic lessons from the Brazilian case: First, Newark organizations should learn from the Brazilian concentration on being relevant and relentless at every touch point in individuals' lives at which they might be exposed to HIV; action at manyof the aforementioned touch points in the Brazilian context would be directly transferrable to the Newark context. Second, Newark organizations should recognize the importance of making AIDS a sustained, public conversation about a public health issue - whether that is done with or without the government's assistance. Finally, Newark health organizations (e.g. hospitals and clinics) and/or the local government should focus on identifying incentives for private sector producers of products that are needed for prevention and treatment efforts, in order to procure these products at manageable prices. 

[1] Williams, L. (1989, February 2). Inner city under siege: fighting AIDS in Newark. The New York Times. Retrieved 13 Nov, 2010, from

[2] Tierney, J. (1990, December 16). Urban Epidemic: addicts and AIDS - A Special Report: in Newark, a spiral of drugs and AIDS. The New York Times. Retrieved 13 Nov, 2010, from 

[3] Narvaez, A. A. (1987, July 21). Newark hospitals seek unit for AIDS treatment. The New York Times. Retrieved 13 Nov, 2010, from

[4] Tierney, J.

[5] Williams, L. 

[6] House of Representatives Committee on Governmental Operations. (1990). "The AIDS Epidemic in Newark and Detroit." Washington, DC: U. S. 

Government Printing Office. Page 50.

[7] Ibid, page 35.

[8] Accessed 14 Nov. 2010.

[9] Ibid.

[10] Bacon, Pecoraro, et al. "HIV/AIDS in Brazil." UCSF Country AIDS Policy Analysis Project. San Francisco (2004): 9.

[11] Accessed 14 Nov. 2010.

[12] The Economist. (10 May 2007). "Brazil's AIDS Programme: A Conflict of Goals." Sao Paolo. Retrieved 13 Nov, 2010, from

[13] Accessed 14 Nov. 2010.
14 Ibid.

[15] Public Radio International. (11 Jan 2010). "Brazil's Effective HIV Prev

ention Strategies." Accessed 13 Nov, 2010, from

[16] Accessed 14 Nov. 2010.

[17] Ibid.

[18] Ibid.

[19] Ibid.
 20 Ibid.

[21] Ibid.

[22] Ibid.

[23] Public Radio International. (11 Jan 2010). "Brazil's Effective HIV Prevention Strategies." Accessed 13 Nov, 2010, from

[24] Accessed 14 Nov. 2010

About this Archive

This page is an archive of recent entries in the BoP category.

Books is the previous category.

Economy is the next category.

Find recent content on the main index or look in the archives to find all content.