172 CHAPTER 10


tance altogether, are needed to reach hard-to-reach children, such as street children and those in child-headed households. Fourth, all of the alternative targeting methods, from proxy means tests to community-based methods, carry risks of missing certain kinds of households and individuals, for exam- ple, remote households living in difficult terrain, migrants, and people who self-exclude or face discrimination by other community members due to race, ethnicity, caste, disability, HIV/AIDS status, or other factors. Ways to reach these groups, through eligibility criteria and targeting methods, should be carefully designed into the process. Fifth, given the impacts of HIV and AIDS, the human costs of errors of exclusion are graver than the financial costs of inclusion errors, assuming that the latter are not so high as to make the pro- gram nonviable. It is worth allowing some inclusion errors in order to reduce exclusions.


Conditionality


This monograph has focused heavily on the implications of cash transfers for protecting human capital because of the threats that HIV and AIDS pose to the human capital of families, including the health, nutrition, and education of children. These threats result from a vicious downward spiral involving ill- ness, loss of income and assets, decreased food security, the need for chil- dren to care for the ill or otherwise work, inability to afford healthcare and school expenses, and stigma and emotional distress that reduce children’s participation or performance in school. A concern over the ability of cash transfers to affect human capital is also driven by the evidence on the inter- actions among early childhood nutrition, health, and education and the effect of these interactions on long-term income-earning potential and thus long- term intergenerational transmission of poverty or emergence from it. In other words, many children who are not protected from the effects of HIV and AIDS on their families now will never recover. For these reasons, we examine not only UCTs in southern and eastern


Africa but also CCTs in Asia and Latin America, which are designed primarily to strengthen nutrition, health, and education and may thus provide lessons for progressing toward these goals in Africa. CCTs have shown much promise globally but also raise many concerns as they are introduced in new contexts— and heavily AIDS-affected contexts are certainly one such type. This mono- graph has reviewed the debates around conditionality and the key issues that policymakers should weigh in considering them. For Sub-Saharan African countries concerned with mitigating the impacts of AIDS, these include, first, the importance of designing them to carefully address priority issues rather than adopting a blueprint from Latin America. For example, if in South Africa AIDS risk is reduced specifically where girls graduate from high school, CCTs


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