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For what it’s worth, GiveWell recommends the Against Malaria Foundation:
People who donate to domestic charities when AMF and the malaria consortium are saving lives for $5 a net are immoral or naive.
I'm a big fan of the Effective Altruism (EA) movement. If you also are interested in making the world a better place, it's worth spending time learning how to communicate better.
Even when you say something that is true, the way you say it matters. As sympathetic as I am to the view that people ought to do the most good, I find your phrasing of this sentiment hard to endorse.
Your goal is probably to encourage more people to give to AMF. You may have better success at expressing how much good AMF does with the money given, and that you would love to see more people considering donating to AMF.
Example: "Donating to AMF and the Malaria Consortium is a very effective way to help people. For $5 you provide a net that protects people from malaria for 3-4 years. This is a very cost-effective way to help others!"
EA is a shrinking movement because it is not effective at utilizing the strongest card philanthropy has. Shame. Donating to domestic charities is shameful, just like hoarding billions of dollars is shameful. Telling people AMF is effective isn't enough, we need everyone to know that other charities are not, otherwise they'll go on immorally donating to causes they care about or people that look like them.
That's not a very charitable view. Some people want to help solve problems that are local to them or have personally affected them. There's nothing wrong with that.
Caring about certain groups of people more than others is clearly immoral. When your resources can be used much more effectively wasting them is immoral. We all make immoral decisions everyday though, so I wouldn't say there's anything wrong with that.
Do you have a source on this 3000 kids a day? That's over 1M children a year. Assuming most of those are in Africa, you're claiming something like a 2% childhood mortality from malaria alone. The all-cause childhood mortality in Africa is considered astronomical at 7.8%. The WHO (UNICEF) says the death rate of malaria in Africa is more like 1 every 2 minutes, which comes out to 720 a day.
One dead child is too many and I worry that number inflation only makes the fight harder.
Got that stat from UNICEF: https://www.unicef.org/media/files/MALARIAFACTSHEETAFRICA.pd...
That documents lacks a date, but it seems to be old information. Based on [1] and [2] it seems that the numbers given in that document are from around 2005 or before, but there has been a lot of progress since then.
[1]: https://www.unicef.org/media/files/MalariaFactSheet.pdf
[2]: https://endmalaria.org/sites/default/files/RBM Annual Report 2018_EN.pdf (page 6)
The numbers are a bit weird:
> Malaria kills one child every 30 seconds, about 3000 children every day. > Over one million people die from malaria each year
3000 deaths per day * 365 days in a year = 1 095 000 deaths per year
So basically no adults die from malaria?
Most malaria victims are children, 57% of deaths are children under 5 years old https://ourworldindata.org/malaria
UNICEF seems to contradict themselves here then https://data.unicef.org/topic/child-health/malaria/
Those stats are for children under 5. So the total for children more broadly defined is likely to be higher.
WHO says ~1100 deaths/day, well below 3000
https://www.who.int/news-room/feature-stories/detail/world-m...
The stats for malaria is insane - Nature wrote an article that said malaria could have killed half of all humans who have ever died.
The discussion around malaria is always really strange to me, because it's so close to home and yet so far away at the same time.
At this point I've frankly lost count of the number of times I've contracted malaria, but I'm willing to bet it's well over fifty. I understand, theoretically, that it kills an obscene amount of people a year, but it doesn't really sink in that it's actually a deadly disease. I've never felt fear for my life while sick with it.
I wonder how much simply having access to the bare minimum of standard healthcare would reduce the number of fatalities per year.
About for how long do you stay ill each time? How does it feel? I'd suppose you're away from work the?
I you compare with having the flu? (usually takes one or two weeks before I'm ok again)
50 times sounds like a lot to me. The illness seems to come back again and again more often than what I could have guessed.
50 times does sound like a lot, but if you're in your mid twenties that only comes out to twice a year. Considering the frequency in my childhood, I think it's honestly closer to seventy or eighty. To be clear, I'm counting cases where I developed symptoms and had to be treated - you do build a tolerance to it over time, to the point that many people get infected with the malarial parasite but don't notice any symptoms (it's not really understood how or why that acquired immunity works, but it does seem to pass from mother to child and persist until the child is about four or so months old).
It starts out with a persistent headache, sometimes a cough (but with no congestion - this is critical for figuring out early enough that it's not just a cold). The most obvious tell though is that some of my muscles start feeling sore and I start feeling inexplicably tired. At this point I would start preparing for a possible full-on case; basically making sure that I have a proper stock of NSAIDs, easy-to-eat foods, multivitamin and mineral syrup, and oral rehydration solution (I measure and make mine with regular sugar and salt) - malaria tends to completely suppress your appetite, and it's vital to keep your blood sugar and iron up even if you can't eat at all.
Sometimes the illness just subsides, but if I find myself developing a fever (usually a day or so after the headache starts) then I immediately make time to go and get tested. The whole process including getting results takes about an hour or two (mostly spent getting to a health care centre). If I'm malaria positive then I get prescribed an artemisinin-based combination therapy and sent home - the test and the full course of therapy are free under most health insurance plans, and cost about $6 to $15 out-of-pocket depending on the brand and hospital (an afterthought for someone in my position, but prohibitively expensive for millions of people who live on $2 a day or less).
The medication course is three days long, and very strict about the dosage - two doses taken eight hours apart, and then four taken every twelve hours afterwards. It's fast-acting enough that most people feel a lot better after the first day of treatment, but you have to complete the course and make sure you're getting excess nutrition even though you feel "fine". If I pick up on things and start the ACT early enough, the fever doesn't have time to develop; sometimes it hits hard/seemingly out of the blue, though, in which case I'd get increasing muscle aches and shivering chills even though the body temperature is climbing and climbing (the chills are extremely deceptive - I've seen people beg for sweaters and blankets while running a fever of over a hundred degrees). I take NSAIDs (usually ibuprofen) to manage the fever, along with warm green or ginger tea to help with the shivering. Once I start sweating, the worst of it is over - it's a sign of the fever breaking.
I usually take time off for the length of the ACT, and I'm generally okay to work by the time I'm done with it. It might take up to a week afterwards for the fatigue and lowered appetite to completely lift though. All in all, it's rather like the flu in that the vast majority of otherwise healthy people just manage it at home, but different in that there's a known, effective treatment for malaria so you can avoid most of the suffering altogether if you can afford to be responsible with your health.
Interesting to read, thanks for writing. I'm getting the impression you know okay much about health care -- for example I had to lookup NSAIDs to know it means "Non-steroidal anti-inflammatory drugs". I wonder if that makes the illness less dangerous to you, and (like you wrote elsewhere) indeed indicates how important a generally good health care system is, to handle malaria. I actually didn't know there's a treatment nowadays.
Interesting to hear about how it feels, physically / health-wise, with chills and muscle aches.
Looking at statistics, apparently most people who die, are children, whilst for the flu, it's old people. That's a pretty big difference I think -- imagine one is 40 years old, and one of one's say, 70 years old parents, or one's 10 years old child, dies.
Malaria is probably going to be one of the hardest maladies to overcome. There was some promise with a vaccine, but it looks like that was fairly disappointing. The selective pressure is so high with malaria that sickle cell anaemia is a fairly common congenital disease that if one is homozygous for can be lethal in early age; conventional medicine has significantly increased life expectancy, but it's still fairly poor. Hopefully, it will be to the point where it can be controlled because the African continent has had its economies ravaged by it.
> A comparison of average per capita GDP in 1995, adjusted for parity of purchasing power, between countries with malaria and countries without malaria gives a fivefold difference (US$1,526 versus US$8,268). In the period 1965 to 1990, countries where malaria was common had an average per capita GDP that increased only 0.4% per year, compared to 2.4% per year in other countries.
That seems like a really egregious case of conflating correlation with causation.
But I wonder how much effort is being put into it though.
Take the Sars outbreak. They tried developing a vaccine, and failed. Everybody just assumed it was impossible to create a vaccine for a coronavirus, as we never had one anyway.
Now with Covid-19, we have multiple vaccines in the third, and final, stage of testing. And we also have a controversial vaccine that has been approved in Russia. All within a couple of months. Why that hasn't been achieved with Sars?
SARS fizzled out, so we lost interest and funding was cut.
SARS died down before they could develop a vaccine. After that it's kinda hard to do human trials without deliberately infecting someone.
Serious question - Why can't we put our minds to it and kill them all?
Why can't we banish this mass killer and cause of immense suffering to humans and animals alike.
I haven't seen any compelling evidence that they form any vital component of ecosystems apart from obviously spreading disease and applying some adapation pressure - which we could eliminate like we have done with lots of other killers.
>I haven't seen any compelling evidence that they form any vital component of ecosystems
https://mosquitoreviews.com/learn/mosquitoes-purpose
>As part of their useful role, the larvae of mosquitoes live in water and provide food for fish and other wildlife, including larger larvae of other species such as dragonflies. The larvae themselves eat microscopic organic matter in the water, helping to recycle it. Adult mosquitoes make up part of the diet of some insect-eating animals, such as birds, bats, adult dragonflies and spiders. They also help pollinate some flowers, when they consume nectar.
AFAICT, the more serious proposals to eliminate mosquitoes target the individual mosquito species that spread disease in areas where there are several other mosquito species that would quickly expand to fill the ecological gap.
Yeah, that's the difficulty. In fits of scratching and waving my arms on camping trips of yore I too have felt the urge to just pour a trillion liters of pesticide over the world and kill all of the little flying bastards in one fell swoop (har har). Problem is, it's actually really difficult to imagine such a plentiful and prodigious species _not_ playing a major food chain role. They're everywhere, and things that eat bugs are everywhere; it would be really hard to imagine their absence not collapsing some part of the food chain.
The only thing that would make sense to me would be to introduce some "invasive species" that eats the mosquitoes, doesn't spread the malaria, and can still be eaten by most of the things that eat the mosquitoes. Still, introducing any invasive species is playing with fire; it's literally impossible to know all the consequences in advance.
>part of the diet
>help polinate
It all seems optional to me.
I am somewhat uncomfortable with the tech for eradicating a species (genetic bombs etc). It feels like a Pandora’s box.
I get similar vibes to nuclear weapons, like, should we be on this path at all? Does an ethical person walk that path, even for “righteous” ends, or is the ethical move just to sit down in place and make someone else drag you down it.
BUT, letting so many people die when you could help is also unethical. That’s very different from an atom numb... bombs don’t save lives.
Still, the idea of weapons that are sexually transmitted and eradicate branches of the tree of life is just a bone chilling concept.
You might be interested in GEM Mosquito Control [0], environment friendly and effective.
That is, indeed, very interesting ... it reminds me of the "pot in pot" method of refrigeration:
Killing a whole species without damaging the ecosystem? How could we kill all mosquitos without killing all other insects?
There are options to target them specifically.
For example we could progressively make them sterile.
But things eat mosquitos. I’m not sure where I stand on this issue but the targeted sterilization isn’t really addressing the concern.
> How could we kill all mosquitos without killing all other insects?
Narrowly tailored insecticides are actually quite feasible. They are just quite a bit more expensive to develop than the indiscriminate kind so we rarely do so.
The key for a narrowly tailored insecticide is to base it on the hormones that regulate the insect's behavior. Insects are in many ways like little biological robots with a bunch of preprogrammed subroutines built in, with hormones triggering calls to those subroutines.
Say you have an insect that on the first summer evening above some certain threshold temperatures forms swarms two meters above patches of blue flowers next to ponds, where it mates, then the females lay eggs and die.
All those steps will be triggered by hormones. If you can identify the hormone that is released by the summer evening hitting the temperature threshold and synthesize that, then you might be able to spray an area with that hormone during the spring. That can then trigger the whole sequence of swarming, mating, egg laying, and dying to start early--before the weather is warm enough for the eggs to by viable, or even before the insects of reached sexual maturity so that the mating does not even produce fertilized eggs.
There are at least two very good things about this approach.
1. The insects do not evolve immunity.
2. The hormones for one insect are generally not harmful to things that eat those insects. Since those hormones already occur naturally in the insect, their predators are already exposed to them. All we are doing is messing with the timing.
These are expensive to develop because you have to really know the target insect. You need people to study its lifecycle in detail to identify what subroutines it has in its little insect behavior library. You need to identify the hormone triggers that affect the behaviors that you might want to use.
You probably also should verify that you have right insect. There was a case where an invasive species of moths (I think) was devastating crops in one state. In the state the moths were native to they were naturally kept under control by a parasitic wasp species that was also native there. An attempt was made to import the parasitic wasps (this was deemed low risk because the wasps could not survive without the moths, so once the invasive moths were gone the wasps would die too).
It was a good plan, and it would have worked except for one little detail. It turned out that there were actually two species of parasitic wasps that were almost indistinguishable. Only one of the two was a parasite for the invasive moth species. The other was a parasite for a different moth.
It wasn't until after the imported wasps failed to do anything about the moths that entomologists took a closer look and realized there were two species, and all the wasps that had been trapped for export to fight the moths had been collected in a place that had the wrong species.
Anyway, the bottom line is that you have to know your target really well to do the hormone based approach. And because it is so effective you can easily end up with an insecticide that will wipe out most of the target in a region, so you don't get repeat customers until maybe years later when the insect starts to make a comeback.
So you end up with an insecticide that was expensive to develop, might have a highly variable market, targets just one species, and most of the R&D for it does not really help with the next one you develop for the next species. That's just not economically worth it in most cases for most insecticide companies.
It might be worth it in this one case, though, perhaps as a publicly funded project. A lot would depend on how many different species of mosquitoes are involved. If only one or two are responsible for most malaria spread, it could be worth it. If there are dozens that are significant spreaders it might not be feasible.
Mosquitoes are not the killer. The might be the messenger but they are not the killer.
Being peaceful by nature, but also highly allergic to mosquitos, I'm cool with completely eradicating these little flying vampires and the ecological collapse that would ensue. Or not as the case may be https://www.nature.com/news/2010/100721/full/466432a.html
Only 200 out of 5,000 known species of mosquitoes feed on mammalian blood. If we could only target those 200, we could remove a great source of misery from the planet.
In fact, only 8 species carry disease, e.g. zika, malaria.
That said, mosquitoes have been around for 100 million years and it seems unlikely we can wipe them out without some scary technology.
Probably for the foreseeable future we're going to have to settle for managing the problem, draining malarial swamps and encouraging predator species like dragonflies for example.
> draining swamps
How does that work? I moved to a civilised place in Italy, where the swamps have been drained centuries ago etc etc; there is no malaria anymore.
Yet, nowadays there are tons of mosquitos, I have nets on all my windows and doors and yet I have to occasionally kill them either mechanically (I'm getting good at it but still) or using poisons.
My <1y child has huge reactions when bit; I tend to stay inside because it's so annoying to get bit all the time; sprays work but not 100%, as if those mosquitos are adapting against the poisons we throw at them.
Are these non malaria-carrying mosquites more adapted to breed with less water? Did we stop doing a good job draining the swamps?
Different species have different attributes. The tiger mosquito (Aedes albopictus) from SE Asia is invasive in the Americas and carries nasty diseases -- yellow fever, dengue, zika, chikungunya. It's a highly aggressive biter, highly adapted to marginal environments, and can breed in a tiny pool of water the size of a bottle cap. It tends to be active in human-settled areas. If ever a mosquito deserved to be wiped out, it's this one.
I'm not sure about Italy; I imagine you have plenty of species migrating up from Africa. If you have a lot of mosquitoes, probably there is a water source they're breeding in -- a pool, an old tire, a nearby pond? If you can find a breeding source, dump a mosquito puck in it -- a safe algae that kills mosquito larvae.
There was an attempt to control the population of Zika-carrying mosquitoes in Brazil by introducing supposedly sterile GM mosquitoes. The GM mosquitoes ended up breeding [0]. I'm all for killing them all, but it doesn't seem easy.
[0] https://www.dw.com/en/genetically-modified-mosquitoes-breed-...
They're more like flying hypodermic needles.
We already have a surefire low tech mosquito killer - mosquito bats or zappers. They work well, no chemicals just electricity and batteries.
We however don't have sharp eyes to track the movement of the stealth suckers. Nor the reflexes to position the bat at the right time while pressing the buzzer.
Blow up the size of the mosquito bat to foldable 6ft x 4ft mosquito killer and let probability do its work.
The humans in the room are all the attractant this mosquito killer from hell would need.
It's not widely known but Bill Gates is heavily invested in the fight against Malaria for a long time now. Billions of investment.
He's responsible for saving millions of lives.
https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundat...
It's pretty widely known, tbh.
Perhaps not as widely as his involvement in 5G and vaccinations, however (jk)
Perhaps in the tech bubble it might by common knowledge. Out of it most people don't know.
I wonder if Jobs was nearly as charitable... edit, google says nope:
> He bought an Alfa Romeo car for one of his girlfriends, Tina, and paid off Laurene's student loans. He also kept two cars- a Porsche and a large silver Mercedes-- for himself.
Which is just sad. What a waste.