Teaching and Researching AIDS in Economics: Strengths and Limits of
‘building block’ approaches.
Nicoli Nattrass
30 September 2008
This talk arises out of discussions with people in my dept (especially Beatrice Conradie) and others in the
Commerce Faculty and university about how we teach economics. While it is broadly accepted that
students graduating with an honours or masters degree in economics need to be equipped with a range
of technical skills, there is a growing sense that theory and technique may be:

crowding out more applied forms of economics; and that

courses which require more analytical and reading and writing skills are being crowded off the
curriculum.
This was brought home to us very starkly this year when the School of Economics cancelled our honours
course in African Economic Problems. The justification was that we did not have the resources – which
of course is a silly argument because we all should have been able to teach such a course. Rather, it
reflected the general lack of prioritisation of courses which are applied, which span disciplines and
which rely on the development of analytical skills – especially reading and writing.
Students, however, thought differently and Tessa Minter asked us to reconsider (pointing out gently
that not only was there a demand for it, but Africa is a strategic priority for UCT). We hastily put a teamtaught course together and obliged. We now have more than 20 students taking the class.
Why do we need these sorts of ‘topic-driven’ courses – like Africa, or AIDS? Could we not simply rely on
lecturers ensuring that more ‘applications’ are inserted into predominantly theoretical courses? Thus
rather than discussing Zimbabwe in a course about Africa, we could include the Zimbabwean example in
a macro course as a salutary lesson in how not to manage a macro-economy. A good lecturer could and
should do this. Beatrice, for example, runs an excellent third year course combining microeconomic
theory and applications with regard to water management. Students have responded really well,
writing excellent papers which have appeared in conferences (under Beatrice’s watchful eye) and have
even been published! So, there is potentially space for senior undergrad courses for this kind of
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integrated approach – but the success depends entirely on the dedication of the teacher – and not all
people are equally dedicated.
But while there is some room in the optional courses for applications, less room is available in the core
curriculum. Our undergraduate text-books tend to focus on advanced capitalist economy examples, and
the lecturers who do most of our undergraduate teaching are relatively junior and do not have a stock of
relevant examples to draw on. Worst still, even if they had, there is not much space in the core
curriculum for exploring case studies.
I discovered this last year when offered to give some lectures on the South African economy as part of
the second year macroeconomic syllabus. I used to teach and manage that course five years ago and
thought that I could do a two week slot on macroeconomic applications to South Africa. However, the
convenor told me rather shame-facedly that there was no longer room in the syllabus for this because
we had added more theory, and crowed out the applications – including the substantial focus which
used to be placed on South Africa. I was shocked, and instantly withdrew my offer to teach. The
thought of teaching theory and never contextualising it properly in our own economy was just too
dreadful to contemplate. So, not only have we ended up with a course which does not focus on South
Africa in any substantial sense, but we have a course which no one but the most dedicated
undergraduate teacher wants to go near. This cannot be a good outcome. A good course is one that
challenges both students and teachers – and the best way to challenge teachers at undergrad level is to
ensure that theories are applied to current issues and cases.
Which brings me to the issue of building ‘block approaches’. Economics at UCT is taught very much as a
set of theoretical building blocks; you have to do micro before you do macro, and as you ascend through
the years through undergrad, to honours and then masters, the models get ever more complex. It is a
bit like building a pyramid out of children’s building blocks – the layers are arranged in a clear hierarchy
with the entire design oriented towards creating a very narrow, beautiful pinnacle on the top. The
design is pre-arranged and each layer is set in concrete. Only those who get to the top and admire the
beautiful view ever truly understand what the whole painful building-by-numbers process was for.
We take all this for granted – as if this approach to teaching economics is a fact of life, a nasty, but
necessary, way of learning the trade. But it is not an inevitable or necessary model. I teach regularly at
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Yale, and have also taught at Oxford, and in both places Economics is NOT taught as building blocks in
the undergraduate curriculum. Students at Yale and Oxford can take different economics courses, in
different orders and it is very rare to see prerequisites attached to even senior undergraduate courses.
Indeed, the elite courses at both institutions (the PPE at Oxford and the EPE at Yale) have very few ‘core’
courses. Macroeconomics, for example, is an option at Yale – something which I found rather weird, I
must say….
The result of this is that students at Oxford and Yale learn a wider range of skills in their undergraduate
curriculum and have greater freedom to explore their interests and different ways of learning about the
world. Most notably, they are a lot more literate and informed than our students by the time they
graduate. We, however, have used the excuse of having large classes and being in a developing country,
to opt for an incredibly narrow building block approach. An alternative approach, of course, would be to
have smaller classes, more streams and more flexibility. And if our students were encouraged to take
more courses in other departments, we would be able to make the change without having to expand
our staff massively to cope with the smaller classes. We really need to start thinking better and more
creatively in this respect.
What has been the cost of our approach? Well, for starters, students taking the B.Com find themselves
having to absorb more and more theory, and with increasing mathematical complexity and fewer and
fewer applications, and end up leaving economics (with great relief, I am sure) at the end of second year
with an ugly truncated part of the pyramid, and with very little view of what economics was for. I
believe that these students are being failed badly – and that we should re-look at what sort of
economics we should be offering them. This issue is now a matter for debate in our department – next
Saturday we will be meeting to discuss this and other matters. I will be joining those who argue that we
should actually be offering a more applied stream for B.Com students who only want two years of
Economics and that we should be teaching it with more of a focus on the ‘real world’. We should be
giving these students a more ‘rounded’ education…..
What about those students taking economics as a major, and even going on to do post-graduate
economics? For those students continuing with economics, the view gets better the higher up – and by
the time they reach the high point, they are very skilled and do well in graduate courses abroad. My
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department is justifiably proud of this achievement. For me the important question is whether this has
been achieved at too high a cost – or perhaps at unnecessary cost.
What has been the cost of our building block approach? Well, for those students picking up Economics
and other social science subjects, the cost is probably fairly minimal because they are probably picking
up analytical and writing skills elsewhere. But very few students are in this position. Most of our
continuing students do economics as part of a Commerce program. The cost for them is that for their
overall education, Economics has merely added to the suite of technical and professional courses –
rather than expanding their skills as a social science would.
Is this a problem? Not necessarily from the perspective of a person who just wants to go into finance.
(But given the current meltdown in the financial world, this may not be a great choice right now…). It is
probably not a problem for those who want to do banking. Though, again, given the huge backlash
currently in America against bankers, a few courses in political science may be a good idea…. But for
those who want to go into business, management, or into journalism or research – I am increasingly of
the opinion that we are letting these students down. Not only are our programs not exposing them to
enough social science courses, but the kind of economic logic we teach them in Economics, is not always
a helpful way of looking at social problems (to put it mildly….).
Which brings me to the AIDS issue….
I teach a Master’s class in AIDS. It is a very rewarding class to teach because the students (especially this
year) really get into the subject matter and do the reading…. All but one of my 10 students this year are
economics students. In this regard, I benefitted from the building block approach because I could
assume that they had basic econometric skills and hence were comfortable reading technical
econometric papers on the relationship between poverty and HIV (for example). They were also unbothered by the demographic modelling we did. But this is really where the benefits ended.
Two things shocked me about the class. The first was that the macroeconomics they had studied for the
past four years went straight out the window when we explored debates about the pros and cons of
large flows of Aid earmarked for AIDS. For example, I gave them a really bad paper (written by an activist
who blames everything on the IMF). The paper argued that there were no adverse macroeconomic
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consequences of large flows of Aid into a country and that it was the duty of the West to increase
dramatically Aid flows for health and human resources (including paying the public sector wage bill). I
thought that the students would tear it apart. They certainly should have! The paper had technical
errors you could drive a truck through. But no, all except one really liked it! I had to force them to
consider issues like ‘Dutch disease’ (where a large inflow of foreign exchange appreciates your exchange
rate and kills your manufacturing sector). This is undergrad macro – yet it was not a tool they were
using. Instead, they went along with the moral force of the argument and tossed their economics out of
the window.
Maybe that is youth – and I know that AIDS causes strong emotions, and that these push our thinking in
certain directions. This has certainly been the case for me. But still, I think something more was going
on. I think that for my students, economic theory is taught in such an overwhelmingly theoretical frame
that they think it is a logical game – to be played on a black board, not applied to real issues. I got the
strong sense that they simply were not used to thinking in an economic way about current issues. The
minute they got engaged by a subject, they failed to make use of the tools we had so painstakingly given
them. In my view we had failed to give them a tool which they could recognise as being a tool. And that
is a terrible cost of a program that prioritises theory over applications and case studies.
But it gets worse. When my students did use economic logic to think about current issues in AIDS
research, the results were not always good! This is because the core logic of economics is one of
methodological individualism. We teach students to look for incentives facing individuals, and to pose
the behavioural problem as one of rationally maximising utility and minimising costs. This is not a bad
place to start thinking about a micro issue. In fact it is a very good place to start. But it is only a start,
and having dived off the starting blocks armed with methodological individualism, my economics
students often flounder in the waters of analysing real world problems which require a broader
analytical frame.
Take the issue of condom use – a big topic in AIDS. The typical economist starts off by looking at costs
and benefits, and the results are absurd. The literature abounds with arguments going something like
this:

Less educated and poorer men do not use condoms because their expected life-term earnings
are low (so the costs of an early death are low) relative to the benefits of unsafe sex;
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
Women want to use condoms (because they are less concerned with immediate benefits) but
cannot do so because they lack the economic muscle to force men to take their views into
consideration, or because they take advantage of men’s desire for unsafe sex by charging more
for it.
These arguments sound plausible – they are certainly in line with what microeconomics would tell us to
consider. My students either agreed with this literature or second-guessed it because it flows so
obviously from our standard microeconomic approach. But these are inferences about the real world
that are theory-driven, not problem-driven. Rather than starting from the problem: ‘why is condom use
low’, the analysis takes an economic frame and imposes it on an issue.
Is this a problem? Yes, indeed. And in this regard, we can learn a lot from anthropologists and
sociologists whose starting point is not theory, but speaking to people. And they come up with much
more interesting and better arguments. Consider condom use among young people. There is a
wonderful piece of anthropology conducted amongst African teenagers and young adults showing that
the key issue is not individual maximisation of utility – but rather a relational problem involving trust,
status and competition. The anthropologist points out that in a culture where it is known (and largely
accepted) that men have multiple partners, condom use becomes an important signal of the value of a
relationship. More specifically, the accepted norm is not to use condoms with your main partner (the
‘one you love’), and to use condoms with your other partners (known as ‘spares’). This is a fairly
widespread rule – those who practice open marriages almost certainly have the same rule – i.e if you are
going to have extra marital partners, make sure you use a condom. OK. So how does this explain low
condom use amongst the young? Well, according to the anthropologist, most girls want to be the main
partner, not the ‘spare’. And given that condom use symbolises exactly which category you are, the girls
push to get rid of the condoms. There is thus huge pressure coming from competition between the
women on the men to tell all the girls that they are main partners…. The result is less condom use
overall. Make sense? Indeed. But you wouldn’t have got there through applying methodological
individualism to the topic! You had to get out there, start asking questions, and thinking more broadly.
Similarly, applying a more socially rooted analysis to the issue of transactional sex also results in greater
insight than the risk/price framework imposed by microeconomists. Sociologists working in Malawi
have demonstrated that the exchange of sex for gifts is best understood as part of the broader patron
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client system which Africans rely on in times of economic insecurity. They came to this realisation after
hearing men saying that they were ‘forced’ to have multiple partners. The sociologists said initially they
laughed, but then after probing the issue in more depth, realised that there were indeed huge social
pressures on richer men to redistribute income – and doing so through girlfriends and even giving them
houses etc, was an expected part of their social contribution. They conclude that until other social
means of redistribution and social status emerged, transactional sex and multiple partnering would
remain a feature of the landscape. This has new and important implications for policy….
It is amazing what you can learn when you start with the problem, not a theoretical straight-jacked –
and when you value talking to people as a key research activity. When my Economics masters students
read these anthropological and sociological papers, it is as if a light goes on. They suddenly realise that
there are many ways of approaching a subject and that methodological individualism is only one of a
suite of analytical skills. They also learn that you can arrive at better answers to specific problems
through an open-ended approach which may or may not be suitable for economic modelling. They learn
that speaking to people and asking them questions - and situating their answers within a broader social
frame which is being contested and challenged all the time – can result in new and surprising answers.
And I am constantly surprised at what a revelation this is to them.
But very quickly, I move from surprise to anger about our curriculum. We should not be waiting until
Masters to teach them this – and in an optional course besides…..
What are the lessons here for the way we produce economists?
 We should reconsider the building block approach which channels students down a very narrow,
overly technical curriculum which just prioritises one way of seeing the world. This is bad for
their intellectual development and blinds them to important insights. This, for me, is the key
reason why more space needs to be made within our academic programs for students to take
more social science courses.
 We need to have more applied examples and case study discussions in class. I have already
argued that this should be the case for students doing economics as part of a professional
degree (e.g. the B.Com). But the principle also applies to those in continuing streams. Having
more room for applications in the core economics curriculum will make this more rewarding for
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both students and teachers (and so senior staff wont run screaming from the undergrad
curriculum). Yes, they will learn fewer theories – and perhaps with less intensity. But the
benefits are huge, and the costs (in my view) low because sophisticated theoretical
development can be prioritised in post-graduate courses.
 Carefully considered use of case studies and applications can help illustrate the use of
theoretical tools and show the value of problem driven approaches. Beatrice, for example, has
done work in the Bee industry. Actually asking bee keepers about their decisions revealed
some fascinating things – such as that many bee keepers love their bees, and for them, happy
bees are more important than profits. Her work shows the value of economic analysis and
insight – but also the importance of talking to people and finding out what makes them tick.
We need to keep injecting this kind of material into our curriculum in order to keep students
alert to different ways of seeing the world – and which will make them better thinkers, and
better economists, in the end…
 We should accept that post-grad economics will be much more theoretical - but we should still
craft alternative paths through the post-grad curriculum where students can choose to do
more or less theory. Not everyone does post grad economics to become ‘an economist’ at the
top of the pinnacle. For some, reaching the higher levels is just fine. Our department is
increasingly catering for different categories of students at post grad level – which is a good
thing.
 For me, the challenge is to make the undergrad learning experience better, and more applied. In
this sense Beatrice has pioneered a useful path with her work. For this reason, and not only
because she is a friend, I am very sorry to see her go. For those of you who don’t know,
Beatrice has resigned and will be pursuing a career at Saarsveld College. We are all losing a
valued colleague and one of the few who value the undergrad experience. I hope that we will
be able to build on her efforts.
I would like to end my talk at this point. Let’s have a discussion about some of the issues I have raised,
but also take some time at the end to say goodbye to Beatrice and to express our appreciation of her
efforts as an educator and a friend to us all.
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