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Someone watched the Politician
Please don't post unsubstantive comments here.
15 or so years ago I was in a remote African town and a local business had a picture of Gerald Ford up. Perplexed I asked why. The United States, I presume while Ford was president, had sent aid to build a bridge, some irrigation canals, and eradicated what he described as a worm that you pull out of your skin by wrapping it around a pencil and turning, an inch an hour. I guess it would have been this worm or something similar.

Not a big deal for us, I'm sure hardly anyone outside the area heard of it. But for the locals it changed their lives, the food they could eat, the quality of life they could live. I'd say that I wish we did more stuff like this instead of the geopolitical games, but on another trip I found out that the majority of the Kenyan governments entire budget is foreign aid. Didn't seem to be doing much. But I knew some people from the USA who existed on donations that ran a free school for children, with meals out of a slum. They were poor in the US, but doing so much good. While the official NGO staff drove around in $50,000 SUVs to do surveys.

Doing good is hard. Throwing money at something is not enough. It takes thoughtful, wise people and hard work. But there have been so many people pulled out of really bad conditions over the last few generations. Many many unsung heros.

Is it possible that the picture was Jimmy Carter? As the article mentions, the Carter Center has been leading this effort and Carter hopes to outlive the last guinea worm (though this timeline would make it difficult given he just turned 95 today).

But perhaps both presidents have worked on it, just curious.

reduced the number of new infections from 3.5 million per year in 1986 to just 28 in 2018

Jesus! They need to stop being so hard on themselves. That remarkable progress!

Yea, I sort of wonder how important it is to actually eradicate it. Like, how much would it cost to achieve eradication (given the new knowledge of dog transmission) vs. maintaining the current extraordinarily low infection rate indefinitely? Is the latter (on-going) cost cheaper than the interest on the former (one-time) cost? I'm sure this econ analysis has been done, but articles like these rarely mention it.
Eradication of Guinea Worm means no more Guinea Worm. Zero ongoing cost for all subsequent time.

This is actually more substantive than for Smallpox because Smallpox is deliberately stored in a lab in case it is interesting (supposedly for defensive research, in practice for weaponisation) and so invariably every decade or four it'll leak. Guinea Worm isn't suitable for that, when they eradicate it that's the end of the parasite forever.

This is an infinite benefit. So to model that without getting nonsense out you have to use a discounting model where you arbitrarily consider infinite future value to not be worth more than, say, 10 billion dollars, and there's your answer. But that's a paper exercise, why bother? You could choose values that say a trillion dollars or $9.99.

> This is an infinite benefit. So to model that without getting nonsense out you have to use a discounting model where you arbitrarily consider infinite future value to not be worth more than, say, 10 billion dollars, and there's your answer. But that's a paper exercise, why bother? You could choose values that say a trillion dollars or $9.99.

It's really not that arbitrary. There are many ways of valuing this, sure. Here's a fairly straightforward one:

Say it costs you A per year to maintain current levels, and the yearly cost of capital to eradicate is X amount of capital * y% yearly cost per year (e.g. if you borrow X at y% interest, or if you have X but sacrifice y% returns by spending the money instead of investing it), and the lowest viable cost to save at least as many lives as the infection currently claims is B, then it's a question of whether A+B or X*y% is lower. Whichever is lower will allow you to divert more funds to other targets, and so save more lives (or do something else). Of course there are risks here, in that any of the variables can change, so if they're close it may be worth it to eradicate simply to eliminate the risks that the alternatives get more expensive going forwards.

But this is not a very hard thing to model. The reason we don't do that more often is that often there are many other factors involved, such as politics and emotions and who fights hardest to get funded.

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... only it doesn't work.

Those models work very well on a short-term timescale. We have major upheavals every few hundred years. At that point, the fiat money in the bank account disappears. Once eradicated, the worm doesn't come back.

You seem distracted by the use of the word “dollars”. No need to be so literal, they’re just using them as an abstract unit of value. It can be replaced with milligrams of gold or Satoshis without loss of meaning.
It can. And that gold sits around until the Germanic tribes invade Rome and take it all. Major upheavals affect all systems.
Well, yeah. Don't eradicate it. How will the CIA find new and interesting ways of torture without buddies like this?
So, I get why you're saying this, but it's actually a very well studied problem in business. Basically, let's imagine you're the Carter Foundation and you have found a way to treat the 30 cases a year exhaustively and prevent any meaningful spread for 2M$/year, and it's expected to stay flat over the rest of the future. Let's say you have a one time cost to get rid of the remaining worms of 10M$. Well, it's almost certainly a good idea to get rid of the worm's then, it costs 20% as much to treat next years infections as it does to eradicate them eternally!

Instead consider if it would cost 1B$ to eradicate them. Still a good thing to do... but the interest from 1B$/year is about 50M$ (order of magnitude). You could keep guinea worms completely eradicated and give away 48M$ to other things indefinitely.

(This is effectively the same calculation and efficient business should make for most any decision. Is the internal rate of return on this decision good enough to earn the money to do it.)

Exactly. Looking at other things to invest in the opportunity cost right now might already be higher.

Say you could have a slightly higher number of Guinea worms but stable for 1M a year. The 1M you save might save many more lives if used for something else with a higher impact.

At 28 infections per year it's almost guaranteed there's something else that's already much more efficient at preventing deaths.

A podcast, think it was Stuff to Blow Your Mind, did a podcast on the Guinea Worm and talked about this at length. The worm is wildly infectious. Every incident requires immediate deployment of teams of people to control it or it explodes with re-infections. There are wild populations of the worm still, which are the main source of ongoing infections.

The 28 cases doesn't indicate low importance, it indicates those are enough to re-seed the worm if huge areas if not vigorously acted on, every time they see a new case.

I'm surely getting some details wrong, but it sounds like zero for several years has to be the goal, or it'll rebound swiftly.

Thing is, there's a big difference between eradicated and almost eradicated / controlled - it's that when for whatever reasons the control measures break down (e.g. civil war or natural catastrophes) then whatever is almost eradicated will come back with a vengeance (especially if a generation has passed and e.g. people aren't vaccinated anymore if vaccines apply), but whatever has been actually eradicated won't.

There's also an ongoing health cost - for example, if vaccines apply (not in this particular case but in others) then if it's controlled by herd immunity, then you have to keep vaccinating and suffer any risks and sideeffects while doing so - but if it's eradicated, then you can stop doing so and there's some health benefit in being able to skip unneeded vaccines.

There is also the not-insignificant cost of simply rebuilding the specialized health care infrastructure to manage the new outbreak. Particularly difficult if the area of concern is already challenged by remoteness, poverty, conflict, etc. See: resurgence of polio.
Lucky they have 100's of millions of militant people working to stop the mild discomfort from global warming in 60 years time.

Youtube of Guinea worm, like many of these things stopping productivity and schooling can cause a cyclic issue -

https://www.youtube.com/watch?v=oCB1A2gFvuU (2013)

Quotes from the article:

A few years ago, it looked like humanity was about to wipe a debilitating parasitic disease off the face of the Earth. But the long road to eradicating Guinea worm just got a whole lot longer. Faced with evidence of previously unknown routes of transmission, the World Health Organization (WHO) has quietly pushed back the target date for stamping out the disease from 2020 to 2030.

---

The number of new Guinea-worm infections in people has remained relatively constant in Chad, at about a dozen per year since 2010. (This year is an exception, with 24 cases — half of which came from a village where people drank from a contaminated pond.) Yet the number of new cases in dogs has climbed from hundreds in the early 2010s to more than 1,500 so far this year. “In Chad, it is clear that dogs are driving transmission and humans are ancillary,” Eberhard says. “If we control it in dogs, human cases might go away.”

---

The eradication programme is offering a US$20 reward to anyone in Chad who reports a case of Guinea-worm disease in dogs.

---

Plot twist: People are infecting dogs on purpose to earn 20$. Might be a profitable business.

As a counterpoint, it must be said that more than half of the life beings in the planet are parasites of other species. Wiping all of them would be a disaster for biodiversity conservation and a direct danger for humans.

First, would make the populations of all agricultural plagues explode, populations of rats would increase also even more (but rodents would be much safer for humans). That would lead to choose between famine or free buffet of pesticides for all of us: breakfast, lunch and dinner. Second would have a profound impact on the development of our inmune system leading to people suffering a cascade of nasty autoinmune diseases.

Parasites can have other benefits. Some clean the body of the host storing its heavy metals; other enter in open wounds and then feed on bacteria, releasing painkillers and substances that arre known to accelerate the healing of wounds. This avoid innecessary mutilations. The fine microsurgery made by some flies has been still not achieved by modern medicine and has saved lots of human lifes in the past wars.

The reason for the disparition of many cases of guinea worm is wiping entire freshwater ecosystems

I thought the official definition of a parasite was an organism that benefits itself at the expense of the host? If the host gains from the relationship it would be called something else entirely. In that case, I think your statement that half of life on the planet are parasites is not really accurate...
The real number is unknown, because parasites are shared often among different hosts, but could be much higher in fact.

Each species of free living animal known have at least one parasite, hosting 20 different species is not uncommon. Humans have several thousands just in the Platyhelminths group. Each plant known have at least two or three parasitic fungus. All known viruses except virulent bacteriophages are parasites, and is expected that most unknown viruses will be parasites also (we only had studied a small percentage of the extant viruses and there are serious estimates that calculate over 100 millions). Many bacterias also are parasites. Lots of fungus are parasites of animals also. And parasites have its own parasites.

Can you post sources for parasites 'cleaning the body of heavy metals, releasing painkillers and doing micro surgery'?

Thank you in advance

Surgeon, anesthetist, pharmacist (antibiotic developper), crime fighter and murder solver:

https://en.wikipedia.org/wiki/Lucilia_sericata

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An interesting experience from this history is showing how parasites jump in zero seconds to a handful of other species when its main host is unavoidable.

We were repeatedly guaranteed for years than Guinea worms were exclusive from humans. Thus wiping it would not affect any other species, and could be protected only if some humans would agree to suffer the parasite in their bodies, that is a gross price. Now we know that this was incorrect. Plain false, and nobody see it.

The species is linked with other mammals, could be saved from extinction and is not different to a hundred thousand species of other parasites in the planet.

To decide to wipe an animal just because is ugly and unsentient is a deeply wrong path and a pandora box. Treating the drinking water would suffice to prevent most cases in human patients.

A similar problem could easily happen if we mess with mosquitoes without a full, extensive, complete, knowledge of what we are doing and asuming the consequences of it.

I find this incomprehensible. It's a disease. What does it matter if it is bacteria, eukaryote or virus? Medicine involves killing things that interfere with us and hopefully eradicating them completely.

The whole "mosquito extinction" fears are really overblown. Nobody is proposing to eradicate all species of mosquito - only the ones that carry malaria. And the normal system of eradication (removing standing water) is much more invasive than the proposed method of genetic engineering.

Not, is not a disease, is an animal.

An animal that can cause a non lethal and treatable disease in part of its life cicle, and is linked with copepods, frogs and fishes, dogs, baboons and humans.

There is a simple solution in two steps to avoid being infected with guinea worms:

1) don't drink copepods. Provide african people living in the same distribution area as this animal with a modern system of water purification; or teach them to boil the water before drink it, so they will not eat alive water fleas that carry the larvae. Simply filter the water trough a cloth before drinking would be enough to protect you from this parasite (but will not protect against other problems so boiled water technique is much more safe). If not, use chemicals to treat drinking water.

and 2) people infected by the parasite should avoid to bath in drinking water or put their wounded feet in drinking water.

Life cycle stopped and end of the problem in the same year with the magic of parasitology

Why we sould not run to extinct entire species?

We don't know where hides the next cure for cancer, the next cool matherial for engineery or the next modern generations of painkillers. Parasites had helped in the past with some of our problems and could hold the key to a treasure of solutions to our present and future problems.

Even if not, to randomly remove pieces of a machine could lead to unexpected consequences. This animal is the result of million years of evolution and when is gone, is gone forever. If we find in the future that some of those consequences are undesirable, the machine is beyond repair.

It's as easy as those two steps, but in most of Africa those two steps are not easy. Read the article: for the people in Africa affected by the worm the disease is so debilitating they are unable to grow food or continue their education. This parasite ruins lives.

>Why we sould not run to extinct entire species? We don't know where hides the next cure for cancer,

This is like trying to argue against abortion because any given baby could be the next Einstein. Sure, but any given baby could also be the next Hitler... and both statements aren't even wrong (https://en.wikipedia.org/wiki/Not_even_wrong).

Whatever ill effects of the guinea worm's extinction can be overcome. If they can't, we were all probably going to die anyway.

I'm reasonably sure that we will not find a tiny hitler inside the packets of 6 guinea worms, but if is really there, we could choose just not follow it

The "not even wrong" argument is incorrectly applied here. We are not talking of filosophy, this is biology so the idea that parasites can be useful is perfectly falsifiable. We can just do more research and find if something in this animal is useful (nothing prevent us to do this because, well... is not extinct).

We have many examples of parasites doing useful things before and the "99%" of species are still really poorly known, so that wouldn't be an impossible scenery.

Here is another humble and useless roundworm that fortunately nobody decided to extinct before 1960's:

https://en.wikipedia.org/wiki/Caenorhabditis_elegans

From living in mudville streets to became a space survivor and genetic rockstar. Not bad

http://news.bbc.co.uk/2/hi/science/nature/2992123.stm

Look: Your ideas are misguided and dangerous. Read the article to see the effects of the guinea worm. The parasite ruins lives.

The "not even wrong" was applied appropriately as the statement "there is some good to be had from keeping the guinea worm" is potentially true but practically unverifiable and is part of an argument whose goalposts can be moved easily and indefinitely, and are already so far away as to be unassailable.

There is some value to biodiversity and its study and there are likely parasites that are beneath our radar but that this specific one can be isolated and studied and has recorded negative effects on humanity is enough to destroy it.

>I'm reasonably sure that we will not find a tiny hitler inside the packets of 6 guinea worms, but if is really there, we could choose just not follow it

Maybe studying the DNA of the guinea worm leads researchers to a breakthrough in targeting retroviruses at vulnerable human subpopulations and genocide is committed because we didn't exterminate it!

See? You don't know that won't happen!

> Your ideas are misguided and dangerous.

Torches and pitchforks at this hour of the nigth? ok I'll start running.

Well... Or maybe yours are wrong. At least you grant that biodiversity has "some" value. If we start wipping species just by caprice, there will be easier to extinguish the next. Is a slippery slope, and we will shoot ourselves in the face at some point with some serious and totally unexpected cascade of consequences. It has happened before. It happens all the time.

> the parasite ruins lives

For a year or less. Is a nuissance, for sure, but people can fully recover from it to enjoy the rest of their lives. Can be easily avoided with just a bucket and a piece of cloth and there is not any reason to let the people with the parasite walk for the water when a bucket is enough to alleviate their feet.

Poliomyelitis ruin lifes, this... hem, not normally.

Alright, we've gone full circle. You're just repeating how super simple it is to avoid infection (it's not, otherwise no one would have guinea worm and it'd already be extinct!) and minimizing the impact this has on people's lives without actually addressing anything I've brought up.
Wouldn't be my intention to minimize the impact it has currently over the lifes of 30 people each year in the entire planet, but you must admit that among 7700000000 humans (0.0000000039 % of humanity affected by Guinea worm) is not a high number.

With zero people dead by this animal in the last years, does not feel like its extinction would be an urgent problem to adress.

If we wipe it, what would prevent somebody tomorrow to ask for the extinction of the much more dangerous sharks?, or tigers, polar bears, scary spiders, and dogs of course (dogs kill lots of people each year, maybe we should wipe them), or pretty much anything alive that could cause allergies to some people, or that could be seen by somebody as disgusting or ugly.

Economic resources are limited and we have worse problems that are not being adressed.

We as a species cause the extinction of other species at such a rate that we’re considered on par with geologic processes (https://en.m.wikipedia.org/wiki/Holocene_extinction). I’m not here to argue that this is a good thing, but instead that, hell, let’s at least turn this terrible ability towards some good. Guinea worms and a. gambiae suck. The former causes pain and suffering without any detectable benefit. The latter is probably the biggest killer of humans, and there’s plenty of other stuff its predators can eat. Screw them.
Thank you. We drive species extinct left and right with hardly a thought. Now we need to be really careful about two that attack us directly and effectively?
Good luck getting most of the crowd here to understand this perspective. I applaud your attempt at encouraging people to stop and think about things, but most people here seem to have grown up well protected from difficult things and think that if they try hard enough all pain and struggle can be removed from the path of humans through time.

I just finished my chicken slaughter for the season; it being fall up in the Northern Hemisphere. I did my best to make sure the chickens didn't suffer too much, but killing is not a perfect science. I do know that they were really well taken care of compared to the wild birds around us for the last three months.

I would never wish Guinea worm on anyone. I have first-hand experience with worm-based parisites and the pain/suffering they bring. It's awful. But life is a cycle, and belief in eradication of anything as a solution to suffering is, I believe, evil in it's truest sense.