That's a non solution. Giving them nets and fishing nets will only make then sell the fishing nets and using the mosquito nets for their fishing needs.
One solution is to look for another solution. Like a genetically modified mosquito that is inhospitable to malaria and outcompetes regular mosquito.
The people who are currently giving starving people mosquito nets, and expressing surprise that they use them to get food, probably shouldn't try to stabilize the region economically, politically, or, heaven forbid, militarily.
Giving out proper fishing nets would also enable over-fishing, but this could be the lesser of two evils. It reminds me of the calculus around giving addicts clean needles: it feels wrong to enable a destructive and illegal behavior, but the alternative is a net net worse outcome. (Pun intended.)
Over-fishing using nets is done on an industrial scale backed by capital from wealthy industrial and post-industrial economies. The family that fishes in the swamp is not the critical actor.
The proper fishing nets won't have nearly the amount of bycatch as the malaria net used for fishing. The holes in the malaria net are small enough that mosquitos can't make it through. Holes in a fishing net are far larger, so will let very small fish or other creatures through.
I beg to differ. The economic principles underlying both are the same — technology pushed the supply curve too far to the left, past the critical regeneration threshold (which must exist for any self-renewing resource).
The concern here isn't so much about fishing (though it may be a problem) as much as it is what the nets are treated with, which might affect fish populations, other species, and the very humans they're intended to protect. The article explicitly states that permethrin is highly toxic to cold-blooded animals, fish in particular, and could over-stress local populations. If the fish they don't catch die from exposure to insecticides, the situation is liable to get much worse.
I understand why the nets were treated with insecticide, but it seems a bit foolhardy to have done so when there was a possibility the nets might not be used for their intended purpose. Although I suspect no one involved considered such a possibility, or if they did that it wouldn't be nearly as wide spread.
I think this represents one of the major problems with our current means of providing foreign aid. Although well-meaning, providing mosquito nets to people in effort to protect them from a disease that is likely to kill them versus starving to death (which definitely will kill them), the people are going to address their immediate concerns first. I don't know what the solution is, but it seems that just attacking one particular problem at a time isn't working. I agree with other comments here that eliminating malaria probably means dealing with food stability and access to clean water first and foremost, then addressing malaria (in parallel, possibly). I respect the organizations that are trying to help, but the solutions don't come easily.
But then you also have the other problem that these are impoverished, sometimes war-torn areas that have threats even beyond the scope of access to food and water...
When people don't fall sick again and again in his beds by malaria, they can work more days and have more resources to spend in the food market. This should be understood as an economy improvement for the family. Same as to have a roof.
Overfishing and the extinction of both fishes and the professional fishers is a big problem for all the community.
Oh, I agree. I just think the problem in this case is that it's difficult for us (being well fed and well educated) to fully appreciate the immediacy of starvation.
The solution is to make nets weaker so they break if used for fishing. You do not need a strong net for mosquitoes but you do need one for fishing. Also, maybe if there is real hunger provide food relief as well.
Welcome to the wealthy nation's interactions with Africa. To think "we" can tell people what problem they should solve (Malaria) when not even their food supply is secured, that's just hubris.
Knowing Maslow's hierarchy of needs, it's Physiological needs (food) vs Safety needs (Malaria protection). And the former are more basic, so expecting anything else shows little foresight (easy to say in hindsight, I know).
Yes, but you couldn't eat the vaccinations. This particular problem is caused by the safety solution also, accidentally, doubling as a means to procure food.
We need to work on both simultaneously, if only for our own safety. The eradication of smallpox was a major success in the 20th century and treating it in Africa was instrumental. It does no good to try and eliminate dangerous diseases if we leave reservoirs, just because those populations are not food secure.
Obviously malaria has its own transmission dynamic that doesn't directly apply here, but for infectious disease generally (eg. ebola) African safety needs are an important part of our own safety.
From the article: "experts say that the vast majority of mosquito nets are used exactly the way they were intended". There's also good evidence that they work: http://www.givewell.org/international/technical/programs/ins.... If you don't buy that, then GiveWell's #2 charity just hands out cash to poor people in Africa. Those guys know what they're doing.
As per my comment on another post I do not fall into your idea of "we". I've spent all of my life in Africa. Much of it under mosquito nets.
Much like other posters here you're approaching this from an academic point of view (maslow etc). The truth is very different. Eg did you know that DDT is still (officially) being used to combat malaria? As in they spray that stuff on houses (it's compulsory for some areas). Enjoy the birthdefects. Another poster here reckoned my pessimism is unwarranted. What does it take for it to be warranted?
This is not true and this type of fatalism is just not warranted. Malaria deaths have actually been decreasing the last 20 years or so. And that is impressive because population has been increasing.
The ecology of a country is a very complex system and becomes even more complex if you throw humans into it. So any significant aid is bound to have unintended side effects. Thus, any aid must be accompanied by close monitoring and modified when necessary. This particular problem, for example, can be easily solved by making nets weaker so they break during fishing.
But one should not take any side effect as an excuse to stop aid. Unless of course one is looking for any excuse to stop aid.
>This is not true and this type of fatalism is just not warranted.
No? I bet I've spent more years in Africa than you have (my entire life). Also spent thousands of nights under mosquito nets. Ever seen someone fish with a mosquito net? I have.
"ecology of a country"? Spare me the armchair commander BS.
"Western" people mostly miss the plot. Eg vaccination. Massive freaking supply chain operation to get the stuff to Africa (great success) ... Mobile LPG powered refrigeration etc. High Five. Local witchdoctor says these things are evil - entire shipping of mission critical vaccines expire on site. (true story)
>No? I bet I've spent more years in Africa than you have
This sound like an appeal to non-authority. How does seeing someone fishing with a mosquito net discount the fact that malaria deaths have been decreasing for 20 years? (a point you chose to ignore, by the way).
Africa is not a monolith: it's 54-countries strong with a multitude of cultures (I'd bet you'd be hard-pressed to find a "local witch doctor" in Tunis).
You are entitled to your opinion, just because you live there doesn't automatically make you an expert. I too have spent my entire life in (southern) Africa.
I've heard public health people talk about the problem of giving away nets for free before, and that charging some amount of money seems to improve usage. It may be more than just the decision between starving and malaria, but also some psychology involved with getting free things.
and then they have more people and need more food, need more support for their ecosystem because of the exploding population is destroying it, and now you have uneducated people so they need education assistance, schools etc, etc etc. it seems like it would never end
Any truly sustainable solution must address all these issues.
You've hit on the fundamental challenge of complex systems — it's the interactions between components that determines the behavior, not the components themselves. I would strongly recommend the video I linked elsewhere in this thread, if only as a "crash course" in systems thinking.
That turns out to be surprisingly hard to do as well. You can't just ship free food in, strongmen will capture it and put it to their own use. Nets, being less fungible in their value, are ultimately less likely to be misused.
We need easy solutions because hard solutions won't scale. We can't create modern economies in places that don't have the infrastructure. We tried doing that once, it's called colonialism and it generally sucked. Your "sustainable food system" is something we can't give to people.
I'm having trouble understanding what you're hoping to bring to the conversation. The basic problem is this. There are a great deal of resources that can be brought to bear on solving problems in the world. There are lots of philanthropists in the world, with lots of money.
The problem is picking the right problem. There are big problems, like hunger. No matter how many resources you have, you're never going to make a dent in world hunger.
There are smaller problems, like dam building. One could, conceivably, build all the dams in the world that need to be built. But just like the big problems, there's never going to be any shortage of these smaller problems to solve, and each effort needs to be managed and championed.
So you can't just solve all of them. You have to pick one at a time and throw everything you have at it. The problem is not resources, but ideas. We need really good ideas for how best to go about making the world a better place. A good idea needs to be simple, because it has to be scaled.
HN is a forum where one good idea could inspire someone to make a Kickstarter campaign, that could attract the attention of someone like Bill Gates, and could improve the lives of potentially millions of people. I wish more people took that seriously.
Malaria nets have their problems. But they've also helped eradicate malaria in many places. People look at stories like this and they think, "aww that was a stupid idea anyway! Silly billionaires." It's not a stupid idea. It's a great one that we need more of.
Sorry if I was unclear. I'm not blaming the billionaires or the users of the nets.
You seem to be viewing the less-industrialized world as a philanthropic playground for the rich. Naomi Klein's comments about Richard Branson's climate prize seem especially pertinent here. https://www.youtube.com/watch?v=Jdaxehd0cF0#t=2m44s
> viewing the less-industrialized world as a philanthropic playground for the rich
So, you have nothing to bring to the discussion other than some silly moralizing.
If Richard Branson could fix global warming while keeping a silly grin on his face, tossing around a beach ball, would you pat him on the back like he's expecting you to do and tell him how great he is, or would you rather he just sit down and shut his stupid face because obviously global warming won't respond to such a simplistic approach? Even if it does?
Morality does play a part here, but what you took for "moralizing" is me pointing out how the framing of the question constrains the answer. Specifically this passage:
>>>The basic problem is this. There are a great deal of resources that can be brought to bear on solving problems in the world. There are lots of philanthropists in the world, with lots of money.
Yes, those things are true. There are also people over there, and their participation matters at least as much as (and I would argue much more than) that of the wealthy elite.
In the case of the "carbon-sucking gizmo", the cure is worse than the disease. Even Branson-level cash can't change thermodynamics and evolution.
The Virgin Challenge finalists are conspicuously absent in their energy and land use analyses. I expect they suffer from the same problems as previous CCS "solutions" — energetically they can't compete with simply shutting down a coal plant, and in land use they can't compete with reseeding farmland to forest. So when you understand why those simpler methods aren't done, you'll understand the finalist's actual scaling problem.
It all washes out in the lifecycle analysis. Anything else is feel-good.
There's another side to that, which is that charging a tiny amount has a disproportionate effect on usage (e.g. $0.00 to $0.01 has a bigger effect than $0.01 to $1.00). This shows that charging a fee has the negative impact of preventing people from buying them, even though the benefit outwieghs the cost.
"It is often argued that cost-sharing—charging a subsidized, positive price—for a health product is necessary to avoid wasting resources on those who will not use or do not need the product. We explore this argument through a field experiment in Kenya, in which we randomized the price at which prenatal clinics could sell long-lasting antimalarial insecticide-treated bed nets (ITNs) to pregnant women. We find no evidence that cost-sharing reduces wastage on those who will not use the product: women who received free ITNs are not less likely to use them than those who paid subsidized positive prices. We also find no evidence that costsharing induces selection of women who need the net more: those who pay higher prices appear no sicker than the average prenatal client in the area in terms of measured anemia (an important indicator of malaria). Cost-sharing does, however, considerably dampen demand. We find that uptake drops by sixty percentage points when the price of ITNs increases from zero to $0.60 (i.e., from 100% to 90% subsidy), a price still $0.15 below the price at which ITNs are currently sold to pregnant women in Kenya. We combine our estimates in a cost-effectiveness analysis of the impact of ITN prices on child mortality that incorporates both private and social returns to ITN usage. Overall, our results suggest that free distribution of ITNs could save many more lives than cost-sharing programs have achieved so far, and, given the large positive externality associated with widespread usage of ITNs, would likely do so at a lesser cost per life saved."
"The third finding from recent pricing studies is
that people need not have paid for something to
value it. Households are as likely to use their
bednet when they get it for free as when they
have to pay for it (4, 7–9). People are as likely to
use their water filter if they paid a lower price
for it (2). This is surprising for two reasons. First,
standard economic theory suggests that charging
nontrivial user fees should help target products to
those who need them the most—and thus those
most likely to put them to appropriate use. But
this reasoning breaks down when people face
credit constraints and their ability to pay is lower
than their willingness to pay. When those who
could use a product the most are too poor to pay
cash for it, higher prices screen out the poor, not
just those with lower health returns from using
the product (9). Second, it is often thought that
the act of paying itself makes people value a
product or service more; the feeling of “guilt”
from having spent money on something that is
left unused would make people more diligent
users. However, experimental studies designed
to test the importance of this psychological
phenomenon suggest that this consideration
is not important when it comes to essential
health (2, 7, 10). The cost of poor health seems
a good enough incentive to put products to
good use."
It seems like there is an opportunity here for a mosquito net that won't work as a fishing net. Could a finer mesh be air-permeable enough but not water-permeable? Or a fabric which degrades in strength when saturated with water?
That's one way to look at it, I suppose, although what first occurred to me is that it seems like there is an opportunity here for purpose-built fishing nets, or another way to starving people to feed themselves.
How dare our charity be used for practicalities! We must over-engineer harder! Only our brilliance can save poor, poor Africa!
Same nonsense I've been reading about since the 1800s. The Africans figured out how to deal with public health a long, long time ago: spread your villages and use air and time to isolate outbreaks. This has worked for longer than human history has been recorded. And this technique has survived countless imperial collapses as well.
We simply wish to mold Africa into an urban scheme because we don't know how to bring "progress" without packing millions of people into city blocks. That causes disease spreading, which puts diminishing returns on the urban scheme. There's one city in Africa who loses about 1% GDP from city-based malaria alone.
If you want to over architect something, the net isn't the problem. Learn to engage in feel-good progressivism without the dependency of industrial organization models. Billions of dollars to whoever figures it out first.
As many problems as this particular net situation brings, it would be foolish to step back and blame first world efforts. Further education is sorely needed. As education seeps into these system, corruption and foolish decisions are eventually called to account.
Africa is not a monolithic problem with identical inputs and outputs everywhere. Assistance from first-world countries does actually make a difference, and comes in many, many forms, from medical care to microloans to security assistance and psychological trauma support.
Sometimes I feel that the western fascination with Malaria is a little misplaced. Actual Africans speak about Malaria like we speak about Influenza: a treatable illness that only kills the very old and very young.
Actually Flu and Malaria kill roughly about the same number of people globally each year. Imagine if African billionaires showed up on our shores one day and started handing out respirators and face masks to Americans. "Just everyone wear these all winter and you won't catch the flu! So many lives would be saved!" We might use them to go fishing as well.
As someone who is an American-born-Nigerian and my wife, born and raised in Nigeria, I can confirm this.
My wife got malaria all the time in Nigeria, it was like a really bad cold or a flu in America. You get over it and move on. Only if your immune system is already compromised in some other way like old age or whatever malaria isn't really that big a deal among those who were strong and healthy before getting it. Instead of trying to stop malaria, focus on how they can get food. If they're well fed and strong/healthy, the malaria won't kill 'em just like it didn't kill my wife or any of her 5 siblings, or her university classmates, or my parents, or their siblings, etc. Now, there are those in Africa who don't have plenty to eat and/or have stressful daily lives that prevent getting a couple of days of rest. That is what allows malaria to kill so many. Just like the flu in America would kill a whole lot more often if there was a lack of food or inability to get consecutive days of rest.
Yeah, my brother in law got Malaria in another tropical country, like a bad flu, recovered pretty quick. Certainly not as scary as people make it out to be (unless you're already in bad shape).
One also has to remember the epidemic flu viruses that killed millions in the west in past centuries, yet now we barely care enough to get flu shots.
I think medical care is the missing part of the equation in your anecdote (and gp's). If you get malaria and medical attention, you'll have a lousy time, but probably be fine.
However, for people with limited access to medical care (too remote or too impoverished), preventing Malaria altogether is the best bet, hence mosquito nets.
It was in a 3rd world country with 3rd world access to medical care (and he lives there)...
Anyhow, health and other factors matter more than mosquito nets... Malaria isn't too different than the flu, and the flu has killed millions in the past.
According to the WHO, malaria kills almost 500,000 children under 5 each year globally, though the vast majority (~90%) of these deaths are in Africa. [1]
In the US, 3,000-49,000 people die each year from the flu.[2]
Not to mention, we can eliminate an extreme majority of malaria deaths, and we can do so at a relatively low cost per person. Something the parent is ignoring entirely.
"Influenza occurs globally with an annual attack rate estimated at 5%–10% in adults and 20%–30% in children. Illnesses can result in hospitalization and death mainly among high-risk groups (the very young, elderly or chronically ill). Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 250 000 to 500 000 deaths."
I think you're orders of magnitude off on your annual deaths[1]. It seems that most recorded influenza deaths are from pneumonia, and aside from the very rare and deadly influenza strains, far more people have died from malaria than any other disease in the 20th century - perhaps aside from only smallpox.
Malaria is believed to kill on the order of a half million or more a year. There are other infectious diseases that kill millions of people - such as the many illnesses that cause diarrhea - and these are also prevalent in Africa, and related to health care.
Ultimately improving health care has cumulative effects. A society that does not need to worry about malaria (or influenza, for that matter) can begin to work on other issues. When so many children die every year from a random illness, adults cannot plan families, governments cannot address other issues.
It's vital that malaria be cured because it is necessary to solve many other issues. Improving health care, period, would reduce the population growth rate and allow more resources to be dedicated to education, infrastructure, and yes, further improving health care.
It's only in places like the United States, where the leading causes of death are from ourselves (car crashes), from disease associated with old age (cancer, heart disease), and our mistakes (medical mistakes), that we can be a society that looks so far forward.
It's difficult for someone in the 21st to realize that our treatment of influenza and other diseases has prepared us to be a super power. Diseases just don't kill people very often in the US, and allowing young children and their parents to not worry has drastically changed our society.
Sure, but you also have to remember malaria is much more localized than influenza. The same region of the world that has to deal with regular outbreaks of influenza also has some of the only areas with malaria. (South America and India also have malaria, but I don't know mortality rates.)
People in Europe don't die of malaria. It just doesn't happen. People in Europe do die of influenza, and that is a global problem, but this is a localized disease that kills a half million people a year. Now, this might be just a case of me coincidentally finding stats to back up my argument, but I searched for "malaria deaths africa" and found this graphic:
It looks like Sub-Saharan Africa has about 71% of the worldwide cases and 86% of the worldwide deaths. Concentrated in a population of comparable to the US or the EU - not the world. If these statistics are accurate, the death rate is so much higher it's not comparable to influenza. The top 4 countries, Nigeria, DRC, Uganda and Ethiopia have a higher population than the US, but they also apparently account for half of the malaria deaths.
So it's not like the flu, for the countries with prevalent malaria, it's many, many times worse.
I'm guessing that flu is much more global than malaria as well meaning that out of the number of people that could possibly be infected malaria is much more common.
I studied health economics a bit, and the article does a really good job of covering all the bases. This really isn't a question that can be answered with grand theories e.g. "Just give them money", "Africa needs low tech solutions" or "White people always create more problems" (actually the first theory might be true, I just haven't seen much specific evidence regarding malaria).
A summary of the background facts are
- Malaria is a big problem.
- Mosquito nets prevent malaria
- It's hard to get people to use mosquito nets.
I think the key takeaways from the article are that (1) the proponents of mosquito nets aren't convinced that the scale of this problem is big enough to offset the overall positive effect of free mosquito nets. But (2) critics of mosquito nets suspect that proponents have too much psychologically (and financially?) invested in the mosquito net solution to consider alternatives. E.g. this interesting quote:
>Dr. Lehman, the American physician on Lake Tanganyika, wonders if there might be better malaria solutions for waterside communities. Specially treated wall coverings? Custom-fit window screens? “Why is this question not being asked?” she said, a bit exasperated. “Is it that we don’t really want to know the answer?”
"The leading mosquito net manufacturers insist that their products are not dangerous. Still, many nets are labeled: 'Do not wash in a lake or a river.'"
I'm interested to know what language this label was written in. Bemba? Nyanja? Moreover, where did the manufacturers intend for Zambians to wash the nets?
Generally nets are not supposed to be washed with untreated water (doing so will wash away the infused chemicals). If you are going to wash the net, you are supposed to wash it in a bucket or any small container with treated water to maintain potency.
I have travelled throughout Africa and looked at malaria activities and based on my experience using malaria nets for fishing is purely anecdotal. It is obviously not a good thing, but it is not a pervasive thing.
Of interest, people also use malaria nets for gardening. They are used as a means to keeps bugs out of crops.
The more complicated issue is whether people are using the nets properly. It takes discipline to correctly put the net over your body the entire night and sleep under it.
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[ 1.3 ms ] story [ 168 ms ] threadOne solution is to look for another solution. Like a genetically modified mosquito that is inhospitable to malaria and outcompetes regular mosquito.
Other is to try stabilizing the region.
https://www.youtube.com/watch?v=HMmChiLZZHg#t=27m53s
I understand why the nets were treated with insecticide, but it seems a bit foolhardy to have done so when there was a possibility the nets might not be used for their intended purpose. Although I suspect no one involved considered such a possibility, or if they did that it wouldn't be nearly as wide spread.
I think this represents one of the major problems with our current means of providing foreign aid. Although well-meaning, providing mosquito nets to people in effort to protect them from a disease that is likely to kill them versus starving to death (which definitely will kill them), the people are going to address their immediate concerns first. I don't know what the solution is, but it seems that just attacking one particular problem at a time isn't working. I agree with other comments here that eliminating malaria probably means dealing with food stability and access to clean water first and foremost, then addressing malaria (in parallel, possibly). I respect the organizations that are trying to help, but the solutions don't come easily.
But then you also have the other problem that these are impoverished, sometimes war-torn areas that have threats even beyond the scope of access to food and water...
Overfishing and the extinction of both fishes and the professional fishers is a big problem for all the community.
So what happens to the mosquitoes when the fish population drops?
Knowing Maslow's hierarchy of needs, it's Physiological needs (food) vs Safety needs (Malaria protection). And the former are more basic, so expecting anything else shows little foresight (easy to say in hindsight, I know).
Obviously malaria has its own transmission dynamic that doesn't directly apply here, but for infectious disease generally (eg. ebola) African safety needs are an important part of our own safety.
As per my comment on another post I do not fall into your idea of "we". I've spent all of my life in Africa. Much of it under mosquito nets.
Much like other posters here you're approaching this from an academic point of view (maslow etc). The truth is very different. Eg did you know that DDT is still (officially) being used to combat malaria? As in they spray that stuff on houses (it's compulsory for some areas). Enjoy the birthdefects. Another poster here reckoned my pessimism is unwarranted. What does it take for it to be warranted?
Africa... One step forward two steps back.
http://www.who.int/gho/malaria/epidemic/deaths/en/
The ecology of a country is a very complex system and becomes even more complex if you throw humans into it. So any significant aid is bound to have unintended side effects. Thus, any aid must be accompanied by close monitoring and modified when necessary. This particular problem, for example, can be easily solved by making nets weaker so they break during fishing.
But one should not take any side effect as an excuse to stop aid. Unless of course one is looking for any excuse to stop aid.
No? I bet I've spent more years in Africa than you have (my entire life). Also spent thousands of nights under mosquito nets. Ever seen someone fish with a mosquito net? I have.
"ecology of a country"? Spare me the armchair commander BS.
"Western" people mostly miss the plot. Eg vaccination. Massive freaking supply chain operation to get the stuff to Africa (great success) ... Mobile LPG powered refrigeration etc. High Five. Local witchdoctor says these things are evil - entire shipping of mission critical vaccines expire on site. (true story)
One step forward two steps back. ..
Africa is not a monolith: it's 54-countries strong with a multitude of cultures (I'd bet you'd be hard-pressed to find a "local witch doctor" in Tunis).
You are entitled to your opinion, just because you live there doesn't automatically make you an expert. I too have spent my entire life in (southern) Africa.
Couldn't giving them out for free increase coverage even if the average usage is lower?
The symptom is that people are misusing nets. The problem is that they have no sustainable food system.
You've hit on the fundamental challenge of complex systems — it's the interactions between components that determines the behavior, not the components themselves. I would strongly recommend the video I linked elsewhere in this thread, if only as a "crash course" in systems thinking.
https://www.youtube.com/watch?v=HMmChiLZZHg#t=27m53s
Agreed, that doesn't qualify as a sustainable food system.
No argument there. They need their own sustainable food system.
We all do, if humanity is to continue (which is all "sustainable" means — able to continue).
How could humanity possibly continue without a sustainable food system? Am I missing something? This seems pretty uncontroversial.
The problem is picking the right problem. There are big problems, like hunger. No matter how many resources you have, you're never going to make a dent in world hunger.
There are smaller problems, like dam building. One could, conceivably, build all the dams in the world that need to be built. But just like the big problems, there's never going to be any shortage of these smaller problems to solve, and each effort needs to be managed and championed.
So you can't just solve all of them. You have to pick one at a time and throw everything you have at it. The problem is not resources, but ideas. We need really good ideas for how best to go about making the world a better place. A good idea needs to be simple, because it has to be scaled.
HN is a forum where one good idea could inspire someone to make a Kickstarter campaign, that could attract the attention of someone like Bill Gates, and could improve the lives of potentially millions of people. I wish more people took that seriously.
Malaria nets have their problems. But they've also helped eradicate malaria in many places. People look at stories like this and they think, "aww that was a stupid idea anyway! Silly billionaires." It's not a stupid idea. It's a great one that we need more of.
You seem to be viewing the less-industrialized world as a philanthropic playground for the rich. Naomi Klein's comments about Richard Branson's climate prize seem especially pertinent here. https://www.youtube.com/watch?v=Jdaxehd0cF0#t=2m44s
So, you have nothing to bring to the discussion other than some silly moralizing.
If Richard Branson could fix global warming while keeping a silly grin on his face, tossing around a beach ball, would you pat him on the back like he's expecting you to do and tell him how great he is, or would you rather he just sit down and shut his stupid face because obviously global warming won't respond to such a simplistic approach? Even if it does?
>>>The basic problem is this. There are a great deal of resources that can be brought to bear on solving problems in the world. There are lots of philanthropists in the world, with lots of money.
Yes, those things are true. There are also people over there, and their participation matters at least as much as (and I would argue much more than) that of the wealthy elite.
In the case of the "carbon-sucking gizmo", the cure is worse than the disease. Even Branson-level cash can't change thermodynamics and evolution.
The Virgin Challenge finalists are conspicuously absent in their energy and land use analyses. I expect they suffer from the same problems as previous CCS "solutions" — energetically they can't compete with simply shutting down a coal plant, and in land use they can't compete with reseeding farmland to forest. So when you understand why those simpler methods aren't done, you'll understand the finalist's actual scaling problem.
It all washes out in the lifecycle analysis. Anything else is feel-good.
"It is often argued that cost-sharing—charging a subsidized, positive price—for a health product is necessary to avoid wasting resources on those who will not use or do not need the product. We explore this argument through a field experiment in Kenya, in which we randomized the price at which prenatal clinics could sell long-lasting antimalarial insecticide-treated bed nets (ITNs) to pregnant women. We find no evidence that cost-sharing reduces wastage on those who will not use the product: women who received free ITNs are not less likely to use them than those who paid subsidized positive prices. We also find no evidence that costsharing induces selection of women who need the net more: those who pay higher prices appear no sicker than the average prenatal client in the area in terms of measured anemia (an important indicator of malaria). Cost-sharing does, however, considerably dampen demand. We find that uptake drops by sixty percentage points when the price of ITNs increases from zero to $0.60 (i.e., from 100% to 90% subsidy), a price still $0.15 below the price at which ITNs are currently sold to pregnant women in Kenya. We combine our estimates in a cost-effectiveness analysis of the impact of ITN prices on child mortality that incorporates both private and social returns to ITN usage. Overall, our results suggest that free distribution of ITNs could save many more lives than cost-sharing programs have achieved so far, and, given the large positive externality associated with widespread usage of ITNs, would likely do so at a lesser cost per life saved."
Jessica Cohen & Pascaline Dupas, "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment", 2010 http://www.stanford.edu/~pdupas/CohenDupas.pdf
"The third finding from recent pricing studies is that people need not have paid for something to value it. Households are as likely to use their bednet when they get it for free as when they have to pay for it (4, 7–9). People are as likely to use their water filter if they paid a lower price for it (2). This is surprising for two reasons. First, standard economic theory suggests that charging nontrivial user fees should help target products to those who need them the most—and thus those most likely to put them to appropriate use. But this reasoning breaks down when people face credit constraints and their ability to pay is lower than their willingness to pay. When those who could use a product the most are too poor to pay cash for it, higher prices screen out the poor, not just those with lower health returns from using the product (9). Second, it is often thought that the act of paying itself makes people value a product or service more; the feeling of “guilt” from having spent money on something that is left unused would make people more diligent users. However, experimental studies designed to test the importance of this psychological phenomenon suggest that this consideration is not important when it comes to essential health (2, 7, 10). The cost of poor health seems a good enough incentive to put products to good use."
Pascaline Dupas, "Getting essential health products to their end users: Subsidize, but how much?" Science 345:1279-1281, 2014. http://www.sciencemag.org/content/345/6202/1279.full.pdf?key...
Of course the problems first has to be acknowledged.
How dare our charity be used for practicalities! We must over-engineer harder! Only our brilliance can save poor, poor Africa!
Same nonsense I've been reading about since the 1800s. The Africans figured out how to deal with public health a long, long time ago: spread your villages and use air and time to isolate outbreaks. This has worked for longer than human history has been recorded. And this technique has survived countless imperial collapses as well.
We simply wish to mold Africa into an urban scheme because we don't know how to bring "progress" without packing millions of people into city blocks. That causes disease spreading, which puts diminishing returns on the urban scheme. There's one city in Africa who loses about 1% GDP from city-based malaria alone.
If you want to over architect something, the net isn't the problem. Learn to engage in feel-good progressivism without the dependency of industrial organization models. Billions of dollars to whoever figures it out first.
Africa is not a monolithic problem with identical inputs and outputs everywhere. Assistance from first-world countries does actually make a difference, and comes in many, many forms, from medical care to microloans to security assistance and psychological trauma support.
Actually Flu and Malaria kill roughly about the same number of people globally each year. Imagine if African billionaires showed up on our shores one day and started handing out respirators and face masks to Americans. "Just everyone wear these all winter and you won't catch the flu! So many lives would be saved!" We might use them to go fishing as well.
My wife got malaria all the time in Nigeria, it was like a really bad cold or a flu in America. You get over it and move on. Only if your immune system is already compromised in some other way like old age or whatever malaria isn't really that big a deal among those who were strong and healthy before getting it. Instead of trying to stop malaria, focus on how they can get food. If they're well fed and strong/healthy, the malaria won't kill 'em just like it didn't kill my wife or any of her 5 siblings, or her university classmates, or my parents, or their siblings, etc. Now, there are those in Africa who don't have plenty to eat and/or have stressful daily lives that prevent getting a couple of days of rest. That is what allows malaria to kill so many. Just like the flu in America would kill a whole lot more often if there was a lack of food or inability to get consecutive days of rest.
One also has to remember the epidemic flu viruses that killed millions in the west in past centuries, yet now we barely care enough to get flu shots.
However, for people with limited access to medical care (too remote or too impoverished), preventing Malaria altogether is the best bet, hence mosquito nets.
Anyhow, health and other factors matter more than mosquito nets... Malaria isn't too different than the flu, and the flu has killed millions in the past.
In the US, 3,000-49,000 people die each year from the flu.[2]
Clearly, the scales are not comparable.
[1] http://www.who.int/malaria/media/world_malaria_report_2013/e...
[2] http://www.cdc.gov/flu/about/qa/disease.htm#deaths
vs.
> in the US
Speaking of incomparable scales...
627,000 malaria deaths * 90% in sub-Saharan Africa[1] = 564,000 malaria deaths in sub-Saharan Africa.
564,000 deaths / population of Africa (~815 million) = 69.2 African malaria deaths per 100,000 people.
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About 32,743 U.S. flu deaths per year, recently.[2]
32,742 deaths / population of U.S. (~316 million) = 10.4 U.S. flu deaths per 100,000 people.
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It looks like, by these numbers, that malaria in Africa is about 6.7 times as deadly as the flu in America.
[1] http://www.who.int/malaria/media/world_malaria_report_2013/e...
[2] http://www.npr.org/blogs/health/2010/08/26/129456941/annual-...
http://www.who.int/mediacentre/factsheets/fs211/en/
The flu? That's a completely different story..
Malaria is believed to kill on the order of a half million or more a year. There are other infectious diseases that kill millions of people - such as the many illnesses that cause diarrhea - and these are also prevalent in Africa, and related to health care.
Ultimately improving health care has cumulative effects. A society that does not need to worry about malaria (or influenza, for that matter) can begin to work on other issues. When so many children die every year from a random illness, adults cannot plan families, governments cannot address other issues.
It's vital that malaria be cured because it is necessary to solve many other issues. Improving health care, period, would reduce the population growth rate and allow more resources to be dedicated to education, infrastructure, and yes, further improving health care.
It's only in places like the United States, where the leading causes of death are from ourselves (car crashes), from disease associated with old age (cancer, heart disease), and our mistakes (medical mistakes), that we can be a society that looks so far forward.
It's difficult for someone in the 21st to realize that our treatment of influenza and other diseases has prepared us to be a super power. Diseases just don't kill people very often in the US, and allowing young children and their parents to not worry has drastically changed our society.
[1] http://www.huffingtonpost.ca/lawrence-solomon/death-by-influ...
People in Europe don't die of malaria. It just doesn't happen. People in Europe do die of influenza, and that is a global problem, but this is a localized disease that kills a half million people a year. Now, this might be just a case of me coincidentally finding stats to back up my argument, but I searched for "malaria deaths africa" and found this graphic:
http://www.rbm.who.int/gmap/3-2.html
It looks like Sub-Saharan Africa has about 71% of the worldwide cases and 86% of the worldwide deaths. Concentrated in a population of comparable to the US or the EU - not the world. If these statistics are accurate, the death rate is so much higher it's not comparable to influenza. The top 4 countries, Nigeria, DRC, Uganda and Ethiopia have a higher population than the US, but they also apparently account for half of the malaria deaths.
So it's not like the flu, for the countries with prevalent malaria, it's many, many times worse.
http://www.who.int/mediacentre/factsheets/fs211/en/
Malaria kills about 650,000 people each year. The low estimate is 473,000 and the high estimate is 789,000
So, if by "roughly the same" you mean "more" then yes, they are roughly the same.
And people do take flu immunisation if they are in a vulnerable group.
A summary of the background facts are
- Malaria is a big problem. - Mosquito nets prevent malaria - It's hard to get people to use mosquito nets.
I think the key takeaways from the article are that (1) the proponents of mosquito nets aren't convinced that the scale of this problem is big enough to offset the overall positive effect of free mosquito nets. But (2) critics of mosquito nets suspect that proponents have too much psychologically (and financially?) invested in the mosquito net solution to consider alternatives. E.g. this interesting quote:
>Dr. Lehman, the American physician on Lake Tanganyika, wonders if there might be better malaria solutions for waterside communities. Specially treated wall coverings? Custom-fit window screens? “Why is this question not being asked?” she said, a bit exasperated. “Is it that we don’t really want to know the answer?”
I'm interested to know what language this label was written in. Bemba? Nyanja? Moreover, where did the manufacturers intend for Zambians to wash the nets?
Of interest, people also use malaria nets for gardening. They are used as a means to keeps bugs out of crops.
The more complicated issue is whether people are using the nets properly. It takes discipline to correctly put the net over your body the entire night and sleep under it.