We Can Eradicate Malaria Within a Generation

http://www.gatesnotes.com/Health/Eradicating-Malaria-in-a-Generation

by dsr12 • 12 years ago

183 102 12 years ago

x0x02• 12 years ago

Eliminating malaria may or may not be possible. If you look at the work that Jimmy Carter and others have done to eradicate Guinea Worm -- reaching a low of 148 people infected in 2013, down from 3.5e6 in 2013 -- it is now primarily a political problem. The last infections are in south Sudan.

If Gates can accomplish this, eradicating malaria is a worthy coda of a life.

cma2• 12 years ago

And on the other side, the fake vaccine drive used to locate Osama bin Laden (or at least the leaking of it) might turn out to dwarf the September 11th attacks--it may keep polio from being eradicated. Hopefully it just delays the eradication.

Back on topic: how does Gates want to address animal vectors for malaria? Nothing in the blog post.

x0x02• 12 years ago

It's one of the things that makes me wonder what useless worthless fuckwit thought that was possibly okay to do. We have enough -- and often for good reason! -- problems getting vaccines to certain countries; indisputable evidence the cia was testing identities subverts all the trust people have worked to build.

rmc3• 12 years ago

I don't think it was a fake vaccination, they just got some extra blood. However it does prove that "it's all a CIA plot" is an actual possibility.

Some charities (like MSF) are incredibly anti-political for exactly this reason. Some charities (like US AID) are not/

thaumaturgy3• 12 years ago

Back on topic: how does Gates want to address animal vectors for malaria? Nothing in the blog post.

This is only a guess, but Gates has been funding several different efforts to combat the mosquitoes themselves. One of them was something the HN crowd might appreciate: a "laser fence", an automated sentry that was remarkably able to detect mosquitoes in the air and cook them to death.

tim3334• 12 years ago

Should be 3.5e6 cases in 1986

ggreer2• 12 years ago

Before the Gates Foundation and The Giving Pledge, billionaires usually did three things:

1. Buy fancy yachts.

2. Continue running the business that made them rich.

3. Spend a token amount on a feel-good charity. The Foundation to Prevent Euthanasia of Cute Puppies or Whatever.

Gates has managed to convince them of another option:

4. Spend wealth to alleviate large causes of suffering that few/no groups are working on.

More than 3.3 million people who would have died of malaria are alive today.

I realize he can't take full responsibility for that, but considering all he's done, Bill Gates is a living saint.

res0nat0r• 12 years ago

Rockefeller and Carnegie were donating vast sums of money to many different charities long ago. I wouldn't call either of their donation efforts "feel good".

ggreer2• 12 years ago

I'm aware of both. I said, "usually" and I was talking about contemporary billionaires.

Both Carnegie and Rockefeller had a sense of effective philanthropy. I find it very impressive that Carnegie managed to spend 90% of his assets before he died.

hellodevnull• 12 years ago

More than 3.3 million people who would have died of malaria are alive today.

This does make him sound like a saint, but is number of lives saved really a good metric? I mean, what's the quality of life like for these three million people, what's their life expectancy?

I know this makes me sound like a horrible person but I think keeping extremely poor people barely alive looks good as a statistic and there's more worthy causes to spend our efforts on in those areas where malaria is prevalent.

adamnemecek• 12 years ago

This does make him sound like a saint, but is number of lives saved really a good metric? I mean, what's the quality of life like for these three million people, what's their life expectancy?

You can't really be improving living conditions of people who are dead can you. So it's a first step.

rmc3• 12 years ago

What if some of the poverty in these countries is because people die young/unexpectedly? Lots of people dying can't be good for the economy. What if curing the deaths helps the quality of life?

thaumaturgy3• 12 years ago

Heh. I predicted a comment like this would be here before I even opened the comments page. "Getting rid of malaria is nice and all, but those people will still be poor." (I also expected, "Are we really sure that saving the lives of so many people is a good idea?", but fortunately that comment isn't here yet.)

It's difficult to have much empathy for people whose lives are so far removed from our own. For most of us, cancer is the boogeyman: most of the people here have had at least one friend or relative affected by it. What would you say to someone that suggested that saving the lives of cancer victims wasn't a worthy cause?

...there's more worthy causes to spend our efforts on in those areas where malaria is prevalent.

You are welcome to spend your efforts wherever you like. Gates has decided to spend his efforts on malaria. There is no room for an "our" there, unless you are a significant part of the Gates Foundation. I'm grateful that the mob doesn't get to decide how Gates spends his resources.

lukevdp• 12 years ago

Say that to someone whose life has been saved! You don't need to be rich to be happy. Who are you to judge the value of someone else's life?

zentropia• 12 years ago

If less children die of sickness people have less children and can feed them better.

netcan• 12 years ago

I think this might be a moot point.

Malaria doesn't just kill. It maims. It scars families and communities. It impairs people's ability to earn. Childhood sickness inhibits the development all sorts of robustness later in life from physical strength to intellectual development. It makes certain areas underserved by public services and for profit services. It closes the doors to industries like tourism. etc. etc.

These measures aren't just extending life at the expense of quality. That's more of an advanced medicine concern.

__Joker• 12 years ago

Yes, Gates believes that philanthropy can be part of solutions to alleviate social problems[1]. While most people don't agree to that, at least he is doing something one way or the other.

[1] http://www.gatesnotes.com/Books/Why-Inequality-Matters-Capit...

andreasvc• 12 years ago

I don't think most people have any opinion whatsoever about how social problems can be alleviated. What makes you think they would not not believe in philantropy's effectiveness? I have never heard such a claim.

ekianjo3• 12 years ago

Bill Gates is a living saint.

Maybe he just feels he has a lot to give back after what he did in the business world ?

skrebbel2• 12 years ago

    1. Earn shitloads by monopolistically holding 
       back a decade of innovation in the rich west.
    2. Give all of it to the poor.

If anything, that sounds like Robin Hood to me, more than anything else.

masklinn• 12 years ago

Your descriptions are utterly out of whack with objective reality, and Gates's philantropy is very much in-line with Gilded Age philantropists like Rockfeller, Carnegie, Eastman or Rosenwald. Hell, Rockfeller very specifically championed and helped lead efforts against malaria (amongst many other causes).

kopparam• 12 years ago

sees author's name -> rubs eyes vigorously -> confirms that it was written by Bill Gates

sameerismail• 12 years ago

"gatesnotes.com"

Why are you surprised?

ceejayoz• 12 years ago

Have you been asleep the last 15 years or so?

http://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundati...

CmonDev2• 12 years ago

Is his call for donation directed at specific people? I would gladly donate once I am in his position - own a house, have retirement funds etc. Which will probably take me another 30 years.

philh• 12 years ago

No, I think it's directed at anyone who can afford to donate, which probably includes you even though you don't own a house.

GFK_of_xmaspast2• 12 years ago

Are you seriously telling me that your life is so hardscrabble it'll take you 30 years to scrape up a spare hundred bucks or so to toss into the pot.

CmonDev2• 12 years ago

I am already involuntarily contributing by paying 40% tax.

deanclatworthy2• 12 years ago

Armed with this 50-cent test, community health workers with little training can determine in minutes with 99 percent accuracy whether someone has malaria or not. Last year, we deployed 200 million of them in Africa alone.

I found this statement incredible. My perspective is from someone who had a Malaria scare after coming back from Asia this summer and passing through Krakow, Poland.

I had numerous blood tests to determine whether I had malaria or not, taking hours to get the results, and even then an expert from the hospital told me they could not be sure and would need to take further tests when my fever shoots up to determine if the spores are actually there.

If we have a 50c test that has been rolled out 200 million times to Africa, I find it astonishing that a modern medical center in Poland would not have access to them.

gambiting• 12 years ago

How long ago were you in Krakow?

deanclatworthy2• 12 years ago

2 months.

piokoch• 12 years ago

Probably this is because tropical diseases are rather rare in Poland (not a big surprise). As far as I know the only place in Poland where you can find someone with practice and expertiese is Gdansk (big port in Poland) - they need to treat sailors occasionally.

tim3334• 12 years ago

It wouldn't surprise me if it is because it had not tested and licensed for EU regulations yet. Bureaucracy seems to trump common sense on these things.

icegreentea• 12 years ago

From poking around reading CDC and WHO websites on malaria RDTs, they stress that since RDTs have a higher limit of detection than blood microscopy tests (which are apparently the gold standard), and also can only detect 4 common strains of malaria (at least two strains are not covered by RDTs), then negative results should (when possible) be verified by a microscopy test either way.

Given your situation then, it doesn't actually make sense to use a RDT on you. Basically, if you have what the medical infrastructure and low enough rates of malaria, you may as we just do the microscopy test all the time to ensure that you do the right treatment.

In your specific case, if they were having troubles detecting the parasite in a microscopy test, then likely they would have trouble detecting it with RDTs as well given its high limit of detection.

chrisBob• 12 years ago

As someone in the US, I didn't know a whole lot about malaria, but I have read about it a little over the past few years. It isn't much of an issue here, but historically it is huge. By some estimates, half of the people who have ever died were killed by malaria. Ever.[1]

http://ngm.nationalgeographic.com/ngm/0707/feature1/text3.ht...

toolslive• 12 years ago

It's not that difficult. There are historical examples of freeing specific locations from malaria. I remember being told about Brijuni. http://en.wikipedia.org/wiki/Veliki_Brijun

nolok3• 12 years ago

You have to respect the man's dedication.

He wanted his OS on every desktop computer and he may have played loose with the rules but he got his wish.

Now he wants this terrible disease to be destroyed, and there are a lot of obstacles in his way (and after all, destroying a well entrenched virus is a feat that humanity reached only once before), but still in my heart I feel like I wouldn't bet on the virus on that one.

With the money, prestige, experience and pull that he has he could be anything he wanted, and I for one am glad what he wants is to move humanity forward. Some say his time as CEO is done and now he is only playing the philanthropy game, but when you see talks from B.Gates on the matter it is clear that he is just as driven to that goal as he was during his CEO time, if not more. I think he likes the challenges, it drives him and he is one of the few who can tackle it head on, which ultimately will benefit everyone.

Cowicide9• 12 years ago

he may have played loose with the rules ... he is one of the few who can tackle it head on, which ultimately will benefit everyone.

He --may-- have? Let's not whitewash history. He not only very much played loose with the rules, he outright broke the rules and trampled upon laws that caused far-reaching net damage to society in the process.

Like yourself and most others, I'm certainly pleased that Gates has decided to give back a small portion of his overall plunder from society, but it also shouldn't act as a public relations whitewash that erases his past history. His charity doesn't simply erase his overall negative impacts upon society that runs easily into the trillions and also took away from charity by proxy and directly in the process as well for decades.

We should teach future generations to give to charity, but in the process we shouldn't also instruct future generations that the way Gates amassed his ridiculous amount of money and power was acceptable and good for society overall.

Despite what they and their lackeys would have many of us believe, society prospers without megalomaniacal billionaires. Billionaires reach that ridiculous, megalomaniacal status by pushing the externalities produced via their business growth upon the rest of society instead of paying it themselves.

Once externalities are accounted for, there are very few organic, ethical ways to acquire and hoard that kind of wealth without stunting the rest of society in insidious ways. And, by the time one "gives it away", all the greater damage has already been done in the meantime.

We don't need them. For example, the overwhelming majority of charity comes from small businesses and lower income individuals. The same individuals and small businesses that are drastically hurt and destroyed by the business practices of people like Gates and other billionaires.

Keep in mind, large corporations and people like Bill Gates give only a tiny percentage of overall charity, but they (and their lackeys) spend vastly more on telling everyone about it through various public relations channels, etc. and that's why it distorts public perception on who really gives the lion's share to charity overall.

Again, I'm very happy Gates is giving to charity, but let's not whitewash his overall net impact against society in the process. He accomplished some great good for society with his business and now his charity as well. But, for us to ignore all the harm he's caused with his past business practices over those decades isn't fair to society and it's a horrible lesson for future generations that may think they should emulate the methodologies billionaires like him use to acquire and hoard enough wealth to reach that "status".

There's much more to the story of Bill Gates and his dire issues with externalities (and charity issues as well) that we shouldn't ignore in our haste to worship him and/or as someone else in this thread did... apply some sort of sainthood.

edits: spelling/grammar

tim3334• 12 years ago

doesn't simply erase his overall negative impacts upon society that runs easily into the trillions

Any source on that? I rather enjoyed using his products.

linker3000• 12 years ago

"We should teach future generations to give to charity"

We should encourage future generations to develop an alternative to the financial system that in many respects creates barriers to equality and progress in so many fields. It's tragic that eradicating a disease requires us to contribute 'tokens' to facilitate action - and if we don't contribute enough we will penalise sections of our population.

/That's my fill of financial philosophy for the week. //Time to track down that flying pig.

freehunter2• 12 years ago

"He may have played loose with the rules" does not mean "I don't know if he played loose with the rules". It means "Yes, he played loose with the rules, but on the other hand..."

nolok3• 12 years ago

First, you don't understand what the sentence you quote means. For one, it doesn't mean "maybe".

Second, if you read my message thinking I was worshiping him or applying some sort of sainthood, then it is your opinion that is pre-conceived, blurred and wrong, not mine. I'm explicitly saying the man does not do it out of niceness, but because he likes (and need) to tackle a challenge and we're lucky this time he picked one that would benefit us, especially since he's one of the few than can win that one.

Third, you're greatly exaggerating the wrongs he did as CEO. Not that he did not do any or that it wasn't so bad, but he isn't the second coming of the devil either.

Take a breath.

tptacek2• 12 years ago

"A small portion of his plunder"? The most charitable interpretation of this phrase is that you're playing a little loose with that possessive pronoun.

jnbiche• 12 years ago

Now he wants this terrible disease to be destroyed, and there are a lot of obstacles in his way (and after all, destroying a well entrenched virus is a feat that humanity reached only once before), but still in my heart I feel like I wouldn't bet on the virus on that one.

Correction: malaria is not a virus. It is one of 4 different species of protozoa (type of single-celled organism).

nolok3• 12 years ago

Thanks, I know very little about it and always assumed it was a virus.

spikels• 12 years ago

Slight clarification: there are 4 COMMON species of the malaria parasite that are known infect HUMANS. Also known are around 10 rarer species that also infect humans and a few hundreds that infect other animals.

melling5• 12 years ago

Why not advance medicine in general, moving civilization quicker up the technology curve? Won't more people benefit in the long run? Medicine doesn't advance at an exponential rate, but progress can be made more quickly.

chm3• 12 years ago

I think what he wants to do is bring the afflicted regions up to par with what one expects from life in the western world, in terms of health. That's very important.

ethbro• 12 years ago

What I think Gates is rightly targeting with his organization in a broader sense is that no matter how high the technology curve extends on the ceiling side the floor remains unaffected.

Or, to put it another way, third world countries are too poor to buy newer medical technology, and relatively few people are financially-interested in making older medical technology cheaper.

Iow, the faster/cheaper options on what to do with semiconductor process improvements.

Additionally in this case, eradication does provide a number of benefits to the global community. Even in countries with top-tier health care systems.

Letting an effective virus / bacteria / micro-organism fester in any human population isn't that different than playing Russian roulette. You may get lucky, but far better to scrub that genetic code off the face of the planet and reset the clock back to the beginning of its evolution.

ggchappell2• 12 years ago

Why not advance medicine in general ....

I think big, specific challenges are often the best way to move useful knowledge forward. They can be enormously motivating, and they very often have positive side effects in seemingly unrelated areas.

For example, consider the Manhattan Project and the U.S. efforts to get people to the Moon. Both of these were highly focused projects. But they resulted in advancements in computing, materials science (e.g., plastics), fail-safe engineering, etc.

Or consider all the money poured into AIDS research in the past couple of decades. Results have been somewhat disappointing, but OTOH we now know a lot now about the human immune system, etc.

I would expect that a global effort to eradicate malaria would have similar wide-ranging benefits.

acinonys• 12 years ago

Does anybody know, how Malario No More compares to for example Against Malaria Foundation, which was recommended as a top charity by GiveWell for a long time ( http://www.givewell.org/international/top-charities/AMF ), in terms of cost-effectiveness?

smartpants• 12 years ago

Complete Prevention means reducing opportunities for mosquitoes to pass the parasite on to humans, and preventing the emergence of strains that resist drugs and insecticides. We’ll need next-generation vaccines that block transmission for six months to a year, so that once an area is cleared of the parasite, it stays clear. We’ll also need new insecticides to offset the widespread emergence of mosquito resistance to the chemical compounds we use most frequently today. We may even need cutting-edge approaches, like introducing special fungi into mosquito populations to kill them off or introducing modified genes that can stop mosquitoes from reproducing.

there is actually a better solution, they just have to figure out the delivery mechanism.

http://www.iflscience.com/health-and-medicine/gm-mosquitos-c...

qj4714• 12 years ago

This is a commendable goal, but I feel like it is all too tempting to focus narrowly on one disease and ignore a more holistic approach towards addressing the underlying problems. I have travelled to many countries in Africa and the big difference between countries that are sucessful in addressing malaria and others that are not are having better health systems and trained health workers. Giving out bed nets and spraying has limita. There are a lot of interesting techologies that may one eradicate malaria such as a vaccine or genetically modifying the mosquitos, but it is too short sighted when looking at the problem holistically.

Too often donors are tempted to focus on a single disease because it is much easier to measure progress and it is easier to "sell" to the public. But when you dedicate so much resources towards a single disease you're distorting the health system, and it becomes more susceptible to shocks like Ebola.

drzaiusapelord• 12 years ago

I was thinking something similar. Addressing just the disease is fine and good, but the terrible sanitation and lack of medical access issues are still there. Are those who normally going to die of malaria now going to die of something else due to environmental and social economic conditions. I guess this is how progress works. You take out the big baddies first and work your way down. The smaller baddies might also have an easier and cheaper treatment plan.

JoeAltmaier• 12 years ago

Malaria isn't a small one. Its a corrosive disease that not only reduces the ability to work, it makes you a burden on your family/community. Solve that one, there's loads more energy left to solve the others, locally.

blackoil• 12 years ago

Problems of a poor country are in vicious circle. Poverty, poor health, poor education, poor governance, ignorance all feed on each other. Of these investing in health and education give most long term benefits, of which health is most easily accepted (a dying person is more prone to accept support of strangers). Also investment in malaria, have a halo effect including awareness of hygiene, basic training for health workers.

StavrosK2• 12 years ago

Is there any way to eradicate mosquitoes completely? Are they useful for anything? They're just a huge nuisance and carriers of disease, why haven't we managed to get rid of them by now?

We're apparently pretty great at making species go extinct, just not the ones we want.

chm3• 12 years ago

    And so, while humans inadvertently drive beneficial
    species, from tuna to corals, to the edge of
    extinction, their best efforts can't seriously threaten
    an insect with few redeeming features. "They don't
    occupy an unassailable niche in the environment," says
    entomologist Joe Conlon, of the American Mosquito
    Control Association in Jacksonville, Florida. "If we
    eradicated them tomorrow, the ecosystems where they are
    active will hiccup and then get on with life. Something
    better or worse would take over."[1]

[1]: http://www.nature.com/news/2010/100721/full/466432a.html

sadkingbilly• 12 years ago

Mosquitoes are a food source for many animals, including: fish, birds, spiders, and bats.

Maybe those animals could find something else to eat, but there sure are a lot of mosquitoes - imagine how many get eaten.

StavrosK2• 12 years ago

Are you sure? An article I read said that mosquitoes are so lean that they aren't even worth the energy expenditure of hunting them.

davesque• 12 years ago

Bill's my favorite tech entrepreneur.

shostack• 12 years ago

This may be a dumb question, but are there any downsides to eradicating malaria?

While there is obviously a huge immediate benefit for humanity in doing so, is there any impact on the ecosystem, or other factors that this could upset the balance of?

Again, not saying we shouldn't eradicate it, just curious if there are any potential negative consequences.

wmil• 12 years ago

My understanding was that it was impossible to eradicate Malaria in Africa because great apes could also be carriers, and treating every wild ape wasn't remotely practical.

Is that not the case?

Actually the only effective means of eradication I've ever been able to think up is an engineered virus... As it parasite it should be vulnerable to a viral weapon, and you could leave chickens with the virus in their bloodstream in Malaria infected areas.

But that could be my inner mad scientist trying to get out again.

We Can Eradicate Malaria Within a Generation

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