It’s funny. I’d read Nicholas Kristof’s review of “White Man’s Burden” in October and this paragraph didn’t effect me as much then. I read it today (thanks Steve) and it really … well … made me livid. So excuse me, while I whip this out.
You visit an AIDS clinic there [in Africa], and see the efforts to save babies by using cheap medicines like Nevirapine to block mother-to-child transmission of HIV during pregnancy. Then the clinic gives the women infant formula to take home, so that they don’t infect the babies with HIV during breastfeeding. A hundred yards down the road, you see piles of abandoned formula, where the women have dumped it. Any woman feeding her baby formula, rather than nursing directly, is presumed to have tested positive for HIV, and no woman wants that stigma.
It really made me think of why businesses are so different from non-profits. I’m just going to put it out there how I imagine a business might deal with this issue.
So, if you know that your customer has to make to choice between a rapid social death followed by natural death if they use your product vs. plain old natural death if they don’t, there are a few things that you might do to appease your customers fears. From the customer’s perspective, her and her kids’ chances of survival are greater if they do not become social pariahs. Despite her tainted milk, her newborn may still have a shot, but if her status becomes widely known, they are both goners.
Knowing this, the effective entrepreneur might make the packaging as discreet as possible, make it easy to hide/dispose of the formula, offer tips on how to keep your HIV status a “private matter”, offer things to say to divert suspicion (like my baby is failing to thrive on my breastmilk alone), etc. etc. If a business fails to address these dire privacy concerns of its customers, it is highly likely to go out of business and thankfully make room for someone else who will do a better job. This is not the case for non-profits. That Darwinian principle of survival of the fittest is not as good at culling that herd. Okay that was a bit snippy and to be fair, I have no idea what is currently being done to address this and similar issues in health and development. It just struck me that the business approach to development where the recipients of aid are viewed as customers is not common. Otherwise folks wouldn’t get massive praise for being innovative whenever ever they do the least thing that is culturally competent. It’s so depressing that common sense business practice is seen as innovative in this field. Okay rant over.
Keeping on the business tip though, there is a great article from Slate called The Other Trojan War. It talks about why the Trojan condom brand became the leading seller of condoms in America and what “a canny Presbyterian from upstate New York” did to overcome everything from the Comstock Law, which banned the use of birth control, to the reticence of pharmacists to even stock the product. I think it is an excellent example of the type of ingenuity and understanding of the market that is often lacking in the implementation of development projects.