Lessons We Can Learn From Fighting HIV

In the outskirts of an African capital, a young woman living in a makeshift hut gets sick. It’s probably just the flu, say the relatives. A traditional healer prescribes herbs and an amulet.  Instead of improving, she gets thinner. A local druggist gives her antibiotics, the only drug he can think of. But she is so weak, she cannot even tolerate it. Her funeral takes place a few months later, one more statistic in the AIDS epidemic.

In the same neighborhood, an illiterate young girl hears that a new school has opened and requires no tuition, so she enrolls. A textbook is distributed to all that have beautiful pictures and interesting stories from the very start. Mysteriously she does not even learn letters from it. She sees some squiggles on the blackboard and repeats meaningless phrases, but cannot relate the two. Nor could she make any sense of the language even if she did. She starts attending less and less often. A few months later, the list of students sent to the Ministry of Education omits her name. Her life story as a student ends there.

Prescriptions for illiteracy: beginning pages of the French, English, and Portuguese grade 1 textbooks. Huge chunks of information, knowledge particles appropriate for well- trained middle class kids

“Missing tiny chunks of knowledge”

For now there is no cure for AIDS, and illiteracy might seem a much more preferable fate. But illiteracy may actually shorten lives. People need information to make good decisions quickly, and these often come in written form. Those who cannot process the information may endanger themselves and their children. So in some respects illiteracy is like HIV: its effects incubate for years. They become obvious when a functionally illiterate person signs papers for a high-interest loan that will prove disastrous for their livelihood, or when ignorance damages children, from infant mortality to early marriage, disease, or maternal mortality.

Just like HIV which sometimes has mild symptoms which can go unnoticed, ineffective reading instruction is hard to detect. Many of us donor staff may visit schools that are breeding grounds of illiteracy, but our personal experiences of schooling get in the way of seeing. Many of us did not have illiterate classmates, so we expect normal children somehow to progress to literacy.

The cause of HIV and AIDS is a virus; an evanescent organism that is barely a chunk of DNA. It was discovered in 1981 after much research among rival medical teams. Billions have since been spent on antivirals that keep people alive and relatively healthy. In a rough analogy, the cause of illiteracy is missing tiny chunks of knowledge.

Increasing the efficiency of instruction

We learn skills by chunking tiny particles of information into bigger chunks, such as letters to words, or single digits into calculations. Middle class kids get these opportunities starting at birth. By the time they enter school, they deal quickly with entire words and meaningful texts right from the start. And they have enough working memory left over to appreciate the pictures of the books. But poor people have fewer chances of developing some neural circuits that facilitate performance. They must start from the features of single letters. These are infinitesimally small and invisible pieces, like viruses. Students need targeted training, feedback, appropriate books, and practice to chunk the tiny particles into bigger pieces. And they must do this without home help. However, the methods they get were made for the knowledgeable middle class. Look below at the visual and linguistic complexity of African textbooks. Unless the poor are inordinately intelligent, they drop out illiterate.

Large chunks in a Chichewa textbook

The cause of AIDS is no longer a mystery. By contrast, the causes of learning failure are unclear to most donor and government staff. Cognitive neuroscientists research the above topics, but education colleges rarely teach cognitive neuroscience, and when they do, it is aimed at the students of high-income countries. So unlike the AIDS agenda, no money is being spent to study how the brains of children who grow up without exposure to reading process information and identify the unseen obstacles. Instead, billions are currently being spent to educate them through methods that work for very few, just as if Ministries of Health gave out herbs and antibiotics for AIDS.

An illiteracy vaccine

Scientists verified the existence of the virus in samples dated from the 1950s. It was in the 1950s also that cognitive research clarified the rules of chunking and automaticity in the human brain. This research points to efficient and specific solutions. It suggests that there is an illiteracy vaccine available – something that does not yet exist for AIDS. The vaccine is automaticity, the ability to read 45-60 words per minute across languages and scripts. Once children can read fluently, they may retain the ability to read even if they see print rarely.

Just like antiretroviral drugs, treatment needs to be precise. But literacy instruction is not needed for the rest of one’s life. In almost all languages (except for English, French, Chinese, maybe Khmer) the basics can be taught in about 100 days. Then more opportunities to read, such as books available in local languages, will stabilize automaticity. Pilots in the Gambia and in Cambodia have shown that the treatment works.

Gambian grade 1 textbook: small information chunks and change patterns

However, the road to treat AIDS has followed a faster path. HIV/AIDS activists created the “ACT UP” movement and dogged officials with demonstrations, demanding faster and better treatments. Common teaching practices (PDF) may work at best for 15-20% of poor populations in some countries but thus far no illiterates have taken to the streets demanding appropriate instruction. Thus the many concerns about fixing the learning crisis have not focused on the cause.

The donor community is making huge fundraising efforts to benefit primary education for the poor.

To use the money wisely and teach nearly all students, the AIDS campaigns have several lessons to offer. Governments and donor agencies should insist on simple and effective literacy instruction in consistently-spelled languages. And millions of supplementary books should be made available to ensure automaticity and comprehension. This way, the beneficiaries will be able to get the needed information from print and make decisions to benefit their families. They could even be saved from AIDS itself.

With our current knowledge we are in a position to beat illiteracy before the medical researchers beat AIDS.

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