Elizabeth Pisani, author of The Wisdom of Whores, writes about HIV from various perspectives: social, scientific, and political. In a recent article she notes how personal incentives are enough to overcome the stigma of HIV-infection.
Malawi is suspending its payments to HIV-infected civil servants because so many uninfected people are trying to cash in. A third of Malawi’s 120,000 civil servants have registered as HIV positive. That puts HIV prevalence among government workers at twice the national rate of 14 percent.
It reminds me of stories that surfaced in China when the government started providing free schooling for the kids of people with HIV. China being China, it wasn’t long before there was a secondary market in HIV-infected blood.
Stigma exists because we allow it to, because we reinforce it by tiptoeing around it. The bulldozer of personal incentives can break through stigma in exactly the same way as it can break through corruption, poor productivity and other areas of human endeavour. If we have to bribe our way into greater openness about HIV, why not?
via Chris Blattman