By the author of unsongbook.com

Slow But Steady

I saw this on Giving What We Can and was so delighted I wanted to repost it here. Source is The effect of malaria control on plasmodium falciparum in Africa between 2000 and 2015 in Nature:

GWWC comments:

The reduction in malaria has been caused — in large part — by people sleeping under bednets…Long lasting insecticide-treated bednets are a powerful weapon against malaria, not only because they’re a physical barrier between mosquitoes and sleeping children — the insecticide coating kills mosquitoes, so they don’t infect other members of the family (and the village) who don’t have mosquito nets…

In other words, this paper tells us about the bigger picture, showing that bednets are incredibly effective, not just at the level of individual villages, but at the level of whole populations. Essentially, the case that we should be distributing bednets just got even stronger.

The research suggests that anti-malarial interventions have prevented about 663 million malarial fevers. Long-lasting insecticide treated bed nets stand out as being particularly effective — being responsible for around 68% of the malaria reduction. This means that bednets have prevented around 450 million cases of malaria! And globally, 6.2 million fewer people died of malaria over the last 15 years because of malaria interventions…

Malaria is an immense economic burden on health systems and people: since 2000, malaria treatment in sub-Saharan Africa has cost almost $300 million. We can see the flip side of this in places in the United States, Brazil and Uganda — children born after malaria was eradicated or heavily controlled and so were not exposed to malaria during pregnancy, had substantially higher income later in life.

We urgently need to keep funding the distribution of bednets, because bednet distributions are one of the most cost-effective ways of preventing disease and death. Since 2000, one billion bednets have been distributed (costing around 5 dollars each), and have averted 450 million cases of malaria — this suggests that, on average, one episode of clinical malaria can be prevented for about $11 (malarial fevers can be very painful). One recent study suggests that in Kenya, bednet distributions between 2003 and 2008 have prevented a death of a child for about $1,011 on average

Humanity seems to be very visibly winning the war against malaria. I just donated a thousand more bednets; now I feel like a part of it and one day I can tell my kids that I helped. If you’re interested, you can donate to Against Malaria Foundation here.

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236 Responses to Slow But Steady

  1. Allan53 says:

    This makes me so happy to see. I haven’t donated as much as you have – in part due to my lower income, mostly due to I’ve only really gotten into EA in the last few months – so I don’t get the “I helped that” feeling, but it still makes me really happy to see actual progress being made 🙂

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    • chaosmage says:

      I’m astonished it feels this amazing. Nobody told me it would.

      If all or most EA people get this proud happy feeling of having been on the winning side, GivingWhatWeCan needs to get started advertising it.

      Data point: I only donated a two-digit number of nets and get that feeling anyway.

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  2. Leo says:

    This is P. falciparum; any data on P. vivax?

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    • gwern says:

      “The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015”, Bhatt et al 2015 https://www.dropbox.com/s/kfhra18sxwt461o/2015-bhatt.pdf ; abstract:

      Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015, and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542–753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.

      Doesn’t mention vivax other than a citation to “Global database of matched Plasmodium falciparum and P. vivax incidence and prevalence records from 1985–2013”, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540003/

      Whilst approximations of ‘non-P. falciparum’ malaria exist, the burden of Plasmodium vivax malaria is considered to be largely unknown8–10.

      The graph of vivax incidence they manage to produce from existing data does not show much vivax: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540003/figure/f2/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540003/figure/f3/

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  3. keranih says:

    I am delighted to hear of this reduction in misery. The people doing this should feel proud of their accomplishment.

    However, I find this disturbing:

    Long lasting insecticide-treated bednets are a powerful weapon against malaria, not only because they’re a physical barrier between mosquitoes and sleeping children — the insecticide coating kills mosquitoes, so they don’t infect other members of the family (and the village) who don’t have mosquito nets…

    So this is a non-discriminate control that encourages insect resistance to the insecticide. (Which the abstract notes is an issue of concern.) I don’t have access the whole article – how has the resistance pattern changed since 2002?

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      • keranih says:

        Thank you!

        From that page – resistance is expected to eventually rise, people distributing bednets think that the actions of agriculture is a larger contributor than their own actions, and we don’t have enough information, which the GW funded groups would like to gather more of. Which is fair enough – I would like to see more work done now on this effect, rather than later. (But the suggestion to start rotating insecticides is just wrong all around.)

        Again, thanks for that page. I am heartened to see that the problem is at least acknowledged.

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        • Deiseach says:

          This is good news, so I will not be a bitch about it 🙂

          Re: agriculture, I did some Googling a little while ago about rice cultivation because I was assuming (as per the Maremma) that increase in cases of malaria after reduction/extirpation could be due to the stagnant water in the fields that rice cultivation involves, but apparently this is not the case in Africa, at least.

          Or rather, it depends on the species of mosquito, the country in question, and the date of the study.

          Mali – is responsible for increase in mosquito population (2007)

          Central Kenya – reduces mosquito populations (2008)

          So the answer, like so much else in life, about “is agriculture a greater contributor than insecticide resistance due to bednets” is “It’s complicated and it depends”.

          Still, ad multos annos to Giving What We Can!

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          • Deiseach says:

            More “malaria and rice cultivation” articles (because it tends to trigger the spam filter if I have more than two links in a post):

            Big Business Health Site – Yes it does which is why we need to educate our workers (2012)

            Agricultural and land use practices that increase malaria transmission

            Malaria is a parasitic disease that is transmitted through the bite of an infected female anopheles mosquito. Generally mosquitoes breed favorably in areas with high temperature, high rainfall and poor environmental sanitation. Some agricultural practices and land use patterns can predispose farmers and their households to malaria infection. These include:

            Irrigation agriculture: Irrigation agriculture is used to water crops mainly in semi-arid or arid regions to compensate for variable or low rainfall in such areas. It is used extensively in the cultivation of rice paddies, wheat and in sugarcane fields. Many of the irrigation systems lack efficient drainage, facilitating water accumulation which provides a breeding ground for mosquitoes. Irrigation agriculture can render areas with both seasonal and year-round malaria transmission vulnerable to high malaria incidence, especially among children under five and pregnant women.
            Deforestation: Deforestation is the clearing of forests to make way for road construction, logging or new farms. This practice contributes to alterations in the local ecosystem (temperature, sunlight, humidity and vegetation). Cross-continental studies illustrate that a change in ecosystem can cause changes in mosquitoes’ breeding behavior. In particular, deforestation offers non-forest anopheles species a new breeding territory, which increases malaria transmission in that region.
            Farming highland regions: Most tropical highland areas tend to have seasonal malaria transmission. The expansion of farming activities such as upland rice cultivation in India and Thailand or tea and coffee cultivation in the Western highlands of Kenya may increase malaria incidence in these areas for two reasons. First, upland farming activities alter the ecosystem causing changes in rainfall patterns, temperature and vegetation. Like deforestation, these changes can produce optimal breeding environments for mosquitoes. Second, farm workers from lowland malaria-endemic areas migrate to work in the highland areas, bringing malaria with them.

            Côte d’Ivoire – No it doesn’t make it worse than usual (2013)

            Ah, if only life were simple and there were One Big Easy Answer, eh?

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          • keranih says:

            Maybe I’m entirely missing it, but aren’t those links talking about skeeter prevalence/spreading malaria, and not skeeter resistance to the insecticide? (I was more concerned about the insecticide resistance, as that’s a problem that’s only going to get worse.)

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          • The most interesting thing I read about mosquitoes developing resistance to bed nets was that, instead of becoming resistant to the insecticide, the mosquitoes are feeding at hours when people are more likely to be awake.

            However, it looks like bed nets are still getting head of malaria.

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          • Douglas Knight says:

            Nancy, where did you read that? Givewell claims that behavioral resistance moves much slower than chemical resistance, so slowly that they don’t bother to talk about it.

            But behavioral resistance is good, because we’re fighting malaria, not mosquitoes.

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          • Loquat says:

            @Douglas Knight –

            I thought we were fighting mosquitoes as a proxy for malaria since the mosquito bite is what transmits the disease – are daytime mosquito bites somehow less likely to transmit malaria than nighttime bites?

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          • Douglas Knight says:

            Night vs day, no. In bed vs out of bed, yes, for several reasons, one of which I gave here. Inside vs outside and village vs fields have similar reasons

            One might hope to apply selection not only on mosquitoes, but also on malaria. If people who are incapacitated by disease are isolated from passing it on, there will be pressure for the disease not to incapacitate.

            I get these examples from Paul Ewald, who points to geographic differences in virulence of cholera as the result of selection in historic time.

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          • I’m not sure where I saw it, but here’s a link.

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          • Douglas Knight says:

            Thanks, Nancy.

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    • Murphy says:

      I wouldn’t go so far as to call it “non-discriminate” since only insects which attempt to approach sleeping humans get poisoned. Also any chemical form of control will cause an increase in resistance over long time periods. I’m willing to trust in our ability to come up with new poisons every few decades.

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      • Douglas Knight says:

        since only insects which attempt to approach sleeping humans get poisoned

        That is very important. Behavioral resistance is a good thing. It doesn’t protect humans from mosquitoes, but mosquitoes aren’t the problem. Malaria is the problem and humans get malaria from mosquitoes, but also mosquitoes get malaria from humans. People suffering a current bout of malaria are much more likely to be in bed. If the mosquitoes are kept away from bed, they are less likely to get malaria and thus less like to spread it.

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    • keranih says:

      Thanks for the replies and additional links – I am still disquieted by the lack of understanding we have of the impact of the distributed bednets on chemical resistence of local mosquito populations. (To be clear, I don’t oppose bednet distro on that ground, I oppose distro without accompanying measurement of resistance impact. Which sounds like a need to donate to the testing/monitoring groups.)

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  4. DanielLC says:

    Is it bad that I’m annoyed that someone else is picking all the low-hanging fruit, and when I get a job I won’t be able to donate it as efficiently?

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    • zz says:

      It’s entirely possible that Open Philanthropy, once they start really producing results (rather than building capacity, which is mostly what they seem to be doing up until now), will be recommending charities with cumulative funding gaps unfillable by even Good Ventures that are better opportunities than their currently-recommended charities; “proven, cost-effective, scalable” turns out to be a fairly narrow restriction that, while allowing GiveWell to figure things out, doesn’t necessarily contain the best giving opportunities.

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  5. Michelle Taylor says:

    I don’t want to discourage people from giving bednets – quite the reverse – but I’ve always found it fascinating what alternate purposes people have managed to put them to. There’s a very educational series of Google Street View which starts in the Sundarban in Bangladesh which has a lot of odd blue fencing and housing repairs…

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  6. Steve Sailer says:

    That’s great news. This particular kind of malaria is probably the single biggest disease in the world. Sickle cell anemia is a side effect of evolution coming up with a crude response to this type of malaria, so you can see how bad it has to be that sickle cell anemia would be acceptable blowback from a natural selection standpoint.

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  7. For those who want to pluck some perennially low hanging fruit, you can always donate to Heifer International. They cover the less polluting cooking and access to quality protein end, and there’s always a need for those things.

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      • Deiseach says:

        As noted above in another comment, GiveWell’s criteria are not the be-all and end-all. The Irish equivalent of Heifer International is Bóthar and I think urban middle-class dwellers tend to discount, where they are not ignorant altogether, of the knock-on effects of having a milk cow in calf, or bees, or a goat, or the other activities that Bóthar is involved in (I think Ireland, having a strong rural background that up to quite recently was quasi-tribal peasant understands similar cultures in a way that is all nuance and indirection*).

        Every family and community receiving animals also receives training in environmentally sound, sustainable agriculture. Recipient families pass on the gift by sharing one or more of their animals’ offspring with other struggling families.

        Giving people money so they can, for instance, buy infant formula if they so choose is fine. But having a goat you can milk to feed your child may have other benefits, e.g. goat’s milk is recommended for children with eczema, or those not able to tolerate cow’s milk, though that’s more in a folkloric or ‘alternative medicine’ way that may not meet the high standards of rationalism here 🙂

        *I don’t think GiveWell, for all their fine qualities, would quite get the joke behind this poem (here in translation by James Clarence Mangan) but I’m fairly sure an African small rural village would:

        Your neighbour’s poor, and you it seems are big with vain ideas,
        Because, inagh! you’ve got three cows, one more, I see, than she has.
        That tongue of yours wags more at times than Charity allows,
        But, if you are strong, be merciful, great Woman of Three Cows!

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        • Michelle Taylor says:

          Giving money allows people to buy cows if that is their top priority (and quite a few people in Give Directly’s catchment do buy livestock); but if they’re more in need of a tin roof, or a dowry, or a motorbike, then they can get one of those instead – and more of them can get whatever their cow-equivalent is because you haven’t spent a bunch of the money on procuring cows and providing advice.

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          • Tibor says:

            Giving people money also allows them to buy bednets if they find them more useful than other things they could afford for that money…which makes me a bit suspicious about giving out bednets being better than giving out cash. True, the mechanism is a bit different, you give a relatively large amount of cash to one household – about 1000 USD or a yearly earning of a household in that area. Then you not how they use the money and what effect it has on them and based on that and some other data you select the next “most efficient” recipients of that cash transfer. So maybe it is so that malaria nets can improve a life of many many people a bit whereas the cash transfers improve a life of a relatively few people by a lot (plus there is the secondary effect of those people really being on their feet, being able to start a business with that money or something and pull others a little bit up with themselves…sort of like the secondary effect of impregnated bednets which kill mosquitos)

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          • Deiseach says:

            Nobody seems to be taking into account that you don’t just dump a cow on a family, give them a quick rudimentary course on caring for it, and that’s it. People owning livestock has a knock-on effect on those around them. Suppose you sell the milk from your cow? That has an effect on food sources for the locality, and the money you make you spend in the market in town, which indirectly benefits other small traders. This is why people made farmhouse butter and cheese for sale at markets, you know!

            The GiveWell link on cash donation is so festooned with qualifications, I don’t think it really proves “giving money directly is better”:

            This trial indicated that unconditional cash grants lead to large increases in recipients’ consumption, assets, business investment, and revenue, but did not observe a short-term increase in profits.

            They say other studies show better long-term outcomes. So how about measuring long-term outcomes of “giving money versus giving an animal”, rather than jumping straight to “giving money is definitely better”?

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          • Alex Richard says:

            We can say with a fair degree of confidence that most people given cash wouldn’t buy bednets: observational studies find that a 15% increase in income only leads to a 5% increased likelihood of buying bednets. There’s three standard explanations for why people’s purchasing priorities are wrong.

            1: The effects of malaria fall almost entirely on infants, who aren’t making purchasing decisions. (For example, if you look at Givewell’s cost effectiveness estimates for bednets, you see that their estimate of bednet effectiveness assumes that malaria’s only impact is killing people aged 0-5.)

            2: Bednets have strong positive externalities. There are a number of studies cited here. See also row 27 of the Givewell speadsheet cited above, in which Givewell estimates that 50% of the impact of bednets comes from community level effects.

            3: People don’t have good access to the information supporting the effectiveness of bednets. This is partially because the evidence is large-scale studies; however, it’s also in part because they simply lack direct experience with bednets, and there are enough snake-oil salesmen/people selling alternative medicine or whatever that people are rationally skeptical of claims of effectiveness. Seeing the results of bednets being used significantly increases people’s willingness to buy bednets.

            4: Due to economies of scale and the fact that it’s a nonprofit, AMF is able to distribute bednets cheaper than they are available for sale. This is a minor point, as the different is likely not very large. (Market prices seem to be 6-8$; AMF has an average cost of around 5.15$.)

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          • Richard says:

            @Tibor:

            Alex Richard covers a lot of the key points. A couple of other reasons why people don’t always buy bednets with cash, from this comment:
            – People expect nets to be made freely available later, due to past distributions, and therefore won’t spend scarce money on them now. This philanthropic “lock-in” means past actions of philanthropists have committed future philanthropists to continue their work, because it changes the expectations and behavior of recipients. This concept of philanthropic lock-in has other implications (it gives us reason to hesitate before starting a new intervention at large enough scale to change recipient expectations if we think we may not follow through with it later), but now that we are committed, continuing to donate seems like the right decision.
            – (Anecdotal evidence only) The type of bednets AMF distributes may simply not be available in local markets. GiveWell staff recall being told this on a site visit.

            Edited to add: also found this GiveWell blog post, which talks about this at a bit more length.

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          • Tibor says:

            Richard: Hmm, I find the “people get used to getting things for free so you have to keep giving it to them for free” quite disturbing. This seems similar to me like the effects of giving out other free stuff like food – it damages the local businesses or prevents them from coming into existence. Now, manufacturing a insecticide-treated bednet is more hi-tech than farming (well, some kind of farming anyway), so maybe you would not be able to expect a local manufacturer to start making them. However import should still be a viable option, if you can get mobile phones to Africa, you can get bednets there as well. So maybe a cash transfers plus an information campaign about bednets which demonstrates their effectiveness?

            Also, 5% increase in bednets bought at a 15% increase of income is relatively high, especially when people can reasonably expect that they will later get a bednet for free. While all the arguments listed for why people are not buying bednets could be true, they do not really dismiss the possibility that people are not buying bednets simply because they have some better things (from their standpoint) to spend money on. To check how big a problem is that people simply expect they will be given bednets later for free it would make sense to stop giving out bednets in an area and give cash there instead and observe the results.

            As for people not trusting bednets to be better than other snakeoil…apparently they are widespread enough so that people have seen their effect first-hand and there is not much they have to believe. Of course, if you’ve never heard of insecticides you might not believe that the net kills the mosquitos (although the neighbours who have them can probably tell you that there are now dead mosquitos around the bednets) but you can see that it is something a mosquito does not come through, I also assume that people know there that malaria is spread by mosquitos.

            So my expectation would be that people do not buy the bednets mainly because of a combination of them being given out for free and because they actually have better things to buy first.

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          • Matt M says:

            “and because they actually have better things to buy first.”

            This is probably a nice place to start. It’s easy for white Americans to run all the numbers and say that bednets are the most effective, on net, use of money to save lives in Africa.

            But for any individual poor African, a bednet is something resembling insurance. It doesn’t immediately *improve* your life, rather it helps prevent a hypothetical future state that would be even more devastating.

            If your children are starving right now and you get some money, you’re going to buy food – not a bednet, and FOR YOU that probably is the correct decision, even if it isn’t the correct decision for the “average” African or whatever.

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          • Alex Richard says:

            > People expect nets to be made freely available later, due to past distributions, and therefore won’t spend scarce money on them now.

            The claim that free bednet distributions make people less likely to purchase bednets in the future is empirically wrong. See the Dupas study I cited; the opposite is true.

            > Also, 5% increase in bednets bought at a 15% increase of income is relatively high, especially when people can reasonably expect that they will later get a bednet for free.

            No it’s not. A bednet for an infant probably increases its lifetime earnings by >15%.

            > As for people not trusting bednets to be better than other snakeoil…apparently they are widespread enough so that people have seen their effect first-hand and there is not much they have to believe. Of course, if you’ve never heard of insecticides you might not believe that the net kills the mosquitos (although the neighbours who have them can probably tell you that there are now dead mosquitos around the bednets) but you can see that it is something a mosquito does not come through, I also assume that people know there that malaria is spread by mosquitos.

            Again, it is just empirically true that giving people free bednets causes them and their neighbors to want to purchase more bednets; the explanation I’ve given is, so far as I’m aware, the mainstream one among economists, and in particular was in the paper cited. Unless you have some justification for the unsupported claim that “apparently they are widespread enough so that people have [sufficiently] seen their effect first-hand,” I’m going to go with the obvious explanation of the data as given by the economists conducting field work on this topic.

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          • Tibor says:

            @Alex Richard: Ok, fair points. I think I won’t switch my donations form GiveDirectly to bednets but I guess that you have good arguments and might as well be correct (I still prefer GiveDirectly for the chance that there is still something missing in the argument and direct cash transfers seem to be really the most stupid-proof charity I can think of and also I acknowledge that it is partly based on reasons other than the best efficiency).

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          • Alex Richard says:

            OK yeah, trying to stupid proof things sounds like a reasonable reason to favor GD.

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        • Cord Shirt says:

          I was once the Woman of Many Cantaloupe Plants Loaded with Blossoms. Then I became the Woman of One Cantaloupe and a Whole Lot of Powdery Mildew. 😉

          It was sad. Everyone had been looking forward to those cantaloupes. The neighbors, too. 😉

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    • Mason says:

      This American Life profiled Give Directly and Heifer International a couple of years ago (in a podcast titled ‘I Was Just Trying To Help’). I wasn’t impressed with Heifer.

      Excerpt from the transcript:
      =================

      Jacob Goldstein:
      We called up Heifer International to see what they thought of the idea. We talked to Elizabeth Bintliff, vice president of Heifer’s Africa programs.

      David Kestenbaum:
      How would you feel about a head-to-head trial where one village gets cash, the other village gets the same amount of money spent on cows and training, and we see which does better?

      Elizabeth Bintliff:
      [LAUGHS] Well, let me say this– I mean, as an African woman, that sounds to me like a terrible idea.

      David Kestenbaum:
      [LAUGHS]

      Elizabeth Bintliff:
      I mean, it sounds like an experiment, and we’re not about experiments. These are lives of real people and we have to do what we believe is correct. We can’t make experiments with people’s lives. They’re just– they’re people. It’s too important.

      David Kestenbaum:
      I think the GiveDirectly response to that would be, we have to do experiments, because that’s how we can figure out the very best way to help people.

      Elizabeth Bintliff:
      It’s just not that linear. It’s not an equation. It’s an ecosystem– that’s the only way I can describe it.

      David Kestenbaum:
      Is part of what you’re saying that you feel like there’s a limit to data?

      Elizabeth Bintliff:
      Well, data has its value but it cannot capture everything. There is a limit to it.

      David Kestenbaum:
      If you’re someone who got into the aid world to help people, the idea of dividing them off into two groups and tossing a coin to see who gets this and who gets that could just feel cold, especially if you’ve done this work for years and you’ve seen that you’re helping people.

      Elizabeth Bintliff:
      I was in Zambia in September of last year, and, I was with a woman whose name is Flora, who I will forever remember. And she had received a couple of draft animals from Heifer. And within two years– and she had really good records– within two years, she had more than tripled what she was getting out of that farm.

      And for her, it wasn’t just about the money. I talked to her about what the real value is and she said, I am a proud woman and I can stand up and I can talk and people listen to me and I have a voice. And you can’t measure that stuff. Sorry, I’m getting emotional. You just can’t measure that stuff.

      Jacob Goldstein:
      Elizabeth Bintliff told us Heifer does try to measure certain things about their programs. She said Heifer’s worked with independent researchers who study Heifer projects.

      Elizabeth Bintliff:
      The University of Western Michigan evaluates Heifer’s projects and has found that there is a very positive return to families in terms of income, nutrition, and other indicators– gender relations, children’s welfare, education, and so on.

      David Kestenbaum:
      Do you know what any of the numbers are from that study?

      Elizabeth Bintliff:
      I can send those to you, yes.

      Jacob Goldstein:
      But after we talked to Elizabeth, we got an email from Heifer. It said, thanks for your interest in those Western Michigan evaluations but, quote, “as the sources cited are unpublished, we’re not able to provide further information publicly at this time.”

      David Kestenbaum:
      So we asked Heifer for whatever they could show us about what their projects cost and what they achieve. They told us that, according to a progress report for the project we visited, families make about $950 a year off their cows. But they said that number, quote, “is not meant to be considered an analysis of the project. It is information collected at the project level by field staff.” And they wouldn’t show us the report.

      Jacob Goldstein:
      We also asked how much it cost to provide a family with a cow and training. Heifer told us it varies from family to family, and they couldn’t provide a number.

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      • Anon says:

        “I mean, it sounds like an experiment, and we’re not about experiments. These are lives of real people and we have to do what we believe is correct. We can’t make experiments with people’s lives. They’re just– they’re people. It’s too important.”

        Ah, the good old “How dare you ask us to experiment, these are peoples lives!”

        As if what we’re doing now isn’t also an experiment, just an uncontrolled one we can’t get any useful data out of. Some villages get cows from heifer, some get money from give directly. What’s wrong with comparing the two more formally?

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      • keranih says:

        To be fair to Heifer, they are hardly the first to be resistant to developing real metrics for their work.

        (It makes sense, in a way – these are long term problems that need people dedicated to fixing the problem – in other words, people who will structure their lives around struggling with that particular issue. Is it any wonder that people hesitate when invited to contemplate a situation where their life’s work no longer has meaning?)

        They should do better, true.

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        • They provide animal protein to women and children when most NGOs think it’s fine to eat that for themselves while dumping beans and “golden” rice on the local markets.

          Heifer International serves places where cash to buy something doesn’t mean as much since there may not be much of a cash economy. But there can be a building of strong relationships through provision of essential nutrition and wealth everyone can recognize as wealth. I think they do really well. The only serious criticism I’ve really seen from them, besides the red herring of “efficiency”, is complaints from white Western vegan types that they give poor people more access to animal products.

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          • Scott Alexander says:

            This is a pretty straightforward question about which method of giving charity most improves the lives of people in the Third World. You seem to be ignoring the points at issue and turning it into political point-scoring. It is neither kind nor necessary and probably not true. This is your final warning and further issues will result in a ban.

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          • RCF says:

            Wow, that sounds rather “If you continue making posts I disagree with, I’m going to ban you” adjacent.

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          • Elizabeth C says:

            Scott, this is your blog and you can ban whoever you want. But I truly don’t understand why this poster is being censured so strongly, and that makes me reluctant to post here.

            Especially since I can’t find any evidence that this poster has ever been a problem for you before. Maybe there is backstory I don’t know.

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          • Elissa says:

            I was also a bit surprised by how strong this reaction was, even though I completely agree with Scott and completely disagree with the commenter about the object-level point. Was it “white Western vegan types” that did it?

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          • Nornagest says:

            I’m pretty sure GiveWell is right and Heifer is wrong, but the post looked well within the bounds of etiquette to me. And I more than occasionally wish the reign of terror here was a bit more terrible, so this isn’t some kind of generalized permissiveness speaking.

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          • Vox Imperatoris says:

            @ Nornagest:

            Exactly.

            Maybe Scott accidentally responded to the wrong person? This is just weird.

            With all the blatant trolling and unsubtle racist >implying that goes on here sometimes, I find it hard to see how this comment was singled out. I mean, maybe this comment is trolling on some level, but it’s not obviously terrible.

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          • Daemon says:

            This comment seems reasonable to me. It made me rethink Elizabeth Bintliff a little, and consider the possibility she was trying to make a reasonable point and failing to state it properly, instead of dismissing her statements because, taken at face value, they clearly stated an invalid position.

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      • anon says:

        So, they think Heifer is bad because it’s an experiment to determine what the best approach is, but they also think Heifer is bad because it doesn’t produce one hundred percent accurate metrics.

        Is there some way to reconcile the two that I’m missing?

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  8. Steve Sailer says:

    I wonder if the success of the anti-malaria campaign is contributing to the unexpected growth in population in sub-Saharan Africa? The UN puts out new population forecasts every few years and they’ve been going up sharply, with the 2015 forecast for 2100 being 4 billion Africans. (The success of the fight against AIDS has been another cause.)

    http://www.unzcloud.com/wp-content/uploads/2015/09/Population-1950-2100-b.png

    The decline in malaria ought to make family planning more popular in Africa: now mothers don’t have to have five children if they want three to survive to adulthood.

    Good news leads to more good news.

    The rest of the world needs to step up and strongly encourage Africans to now bring their population growth in line with the rest of the world.

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    • mr roboto says:

      I’m pretty sure a big part of it was wider access to medication for gonorrhea and chlamydia. Pre-1990 going back to god knows when central Africa was this giant infertility belt. With parts having up to 40% of women being childless.

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    • keranih says:

      Do you have a place where you are finding changing predictions of population growth for Africa (or the world?) All the retro studies I’ve seen have (probably correctly) included wide confidence intervals that make the changes from predictions in, oh, 1970 to those now seem very small, but I remember much higher predicted global population peaks are in our current models.

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    • Wrong Species says:

      This is partly why I still haven’t donated to charity yet(other than selfishness of course). If malaria reduction leads to more people starving then I’m not sure that’s a good thing. Have EAs looked in to either buying products from African countries or investing there? A growing economy is the best way to raise living standards in the long run.

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      • No matter what we do, in the long run the Malthusian trap always looms.

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        • xtmar says:

          Empirically, this doesn’t seem true. Our ability to improve our extractive efficiency seems to have outpaced population growth, and furthermore the difference between carrying capacity and population needs seems to have increased with population. This suggests that an increasing population leads to more connections between engineers, innovators, inventors, and so on, which leads to even more innovation. If anything, at this point we should be more concerned about depopulation than an increasing population.

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          • We’ve been doing very well recently and I’m quite optimistic over the short and medium term. But there’s likely a limit to the number of people we can support with a given amount of material and even at the speed of light the material available only grows as time to the third power while population can expand exponentially. I think it’s fair to consider not hitting the Malthusian trap until we get to those circumstances to be as much a victory as we could hope for, though.

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          • xtmar says:

            @Andrew Clough

            I agree that over the very long term you hit the limits of the carrying capacity of the solar system in terms of energy available, and indeed I think we would hit practical limits far before that. If we had one person per square meter of land, even if we could somehow feed them and provide them basic sanitation, I don’t think most would think that would be a good situation. However, I think that where we are on the curve, and where we are likely to be on the curve over the next few generations, the improving standard of living from network effects is likely to outweigh resource limitations, as it has over the past few generations.

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          • baconbacon says:

            @ Andrew Clough

            How does population expand exponentially without extra resources? The Malthusian trap isn’t that population outpaces production, a bunch of people are born and then they all start starving. The trap is more about variance, population increases to its carrying capacity and then a bad harvest hits and you get starvation. Wealthy countries don’t face this issue in part because variance is naturally far lower for advanced economies. Combined with contraception it is highly unlikely that a Malthusian trap exists for a wealthy humanity in the future, even if we do approach some theoretical carrying capacity.

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          • Doctor Mist says:

            The last thousand years have been atypical. 🙂

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      • Allan53 says:

        I believe the idea is that by reducing malaria and worm loads and similar, we lessen the economic burden on the countries, as well as making people more able to build their own economy. That’s part of why I’m skeptical of Give Directly and similar – I don’t see how it helps build the economy in the long-term.

        That said, if there was a way to more directly assist economic development in the regions, I’d certainly be interested.

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      • Worrying about Malthus should make us be quicker to target debilitating diseases like Malaria over diseases that kill quickly. I don’t think this is something we should be worry about now but even if we were going after Malaria would be a good idea.

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        • Steve Sailer says:

          Falciparum malaria kills some, debilitates others. It’s a very, very bad disease and all progress against it is welcome.

          This evidence of progress against malaria should come as a reminder that it’s time to re-emphasize helping Africans make the demographic transition to modernity.

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    • Linch says:

      My impression is that fertility has been going down over time in the vast majority of countries, not just developed ones.

      http://data.worldbank.org/indicator/SP.DYN.TFRT.IN/countries?display=graph

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      • Steve Sailer says:

        The problem is that in the 21st Century, the evidence has mounted that fertility isn’t falling as fast in Africa as it was expected to. That’s why the UN World Population Prospects reports of 2012 and 2015 have made so much more sobering reading than the UN report back in 2004.

        Here’s a WSJ article on what the population explosion is like in one obscure city in Nigeria:

        http://www.unz.com/isteve/promise-of-youth-wsj-on-population-explosion-in-africa/

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        • anonymous says:

          Why care about the size of the African population? For resource use or environmental impact, what matters is not population per se but population times living standard-the total GDP. For national security, population is not the major concern either. It’s state capacity and ability to build nuclear weapons.

          Population size might matter to some extent but we should focus first on whatever the ultimate concern is

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          • houseboatonstyx says:

            @ anonymous
            Why care about the size of the African population? For resource use or environmental impact, what matters is not population per se but population times living standard-the total GDP.

            This is something to remember when it’s said that the Demographic Transition will lower the birth rate. The DT means more consumption per person, so there may be more environmental impact from X richer people than from 2X poor people.

            To dismiss this is to put a lot of faith in ‘more people to solve the problems’ — ie ‘one mouth two hands’, which may not work so well when the problems need adult educated brains (if solvable at all).

            Look, I’m not knocking EA’s accomplishment, or saying let people die of malaria. (Yay EA!) Just that if a region already has higher population than its resources can support, perhaps we had better offer them contraceptives along with the bed nets.

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    • Deiseach says:

      The rest of the world needs to step up and strongly encourage Africans to now bring their population growth in line with the rest of the world.

      “Way too many of you, just enough of us”.

      And why shouldn’t the descendants of Africa take over the underpopulated and depopulated nations of the West in centuries to come? That was pretty much the same justification for the colonisation of the United States: “All this empty land the natives are doing nothing with that we could turn to use!”

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      • C.S. says:

        And why shouldn’t the descendants of Africa take over the underpopulated and depopulated nations of the West in centuries to come?

        …we Europeans have seen what happens to major cities once they go black. Detroit, for example. Or St.Louis. Those places make Naples look good.

        No thanks!

        That was pretty much the same justification for the colonisation of the United States: “All this empty land the natives are doing nothing with that we could turn to use!”

        Even if half of all Europeans died right now, EU would still have about double the population density of the United States. Right now it has something like 3-4x.

        And a die-off is unlikely to continue long. Harsh times make apes have more children, it seems.

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        • Evan Þ says:

          …we Europeans have seen what happens to major cities once they go black. Detroit, for example. Or St.Louis. Those places make Naples look good.

          Those examples are from the African-American subculture, and confounded by all the issues peculiar to the US. Are there any examples in another country, or regarding more recent immigrants from Africa?

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          • Steve Sailer says:

            Cologne on a New Year’s Eve. Car-be-ques in the Paris suburbs. Murder in a kosher supermarket in Paris. Etcetera etcetera …

            The problem is that the downsides for Europe of the population explosion in Africa and the Middle East are so obvious that it has become a mark of respectability not to notice them right now. To worry about what the obvious implications of the UN World Population Prospects 2015 report is considered unthinkable if it could be mentally considered at all.

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          • Evan Þ says:

            North Africa and the Middle East definitely have problems, yes. But isn’t the rest of this discussion about Sub-Saharan Africa?

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          • Schmendrick says:

            Perhaps I’m wrong, but I had been under the impression that Boko Haram, the Rwandan genocide, the ongoing horrorshow in Congo, and the ethnic strife in South Africa (to say nothing of Mugabe’s innumerable cruelties) all were in sub-Saharan Africa.

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        • akarlin says:

          Moreover over the long term people with higher fertility preferences will be selected for in the absence of Malthusian constraints, making Europe’s current demographic problems self-correcting, not to mention that automation will likely make all of this moot sooner or later anyway.

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        • Lemminkainen says:

          Worth noting: Detroit and St Louis only became majority black because the major industries in those cities collapsed or left, and the cities’ white residents, who had more accumulated wealth (thanks to not being segregated into higher-rent areas and being eligible for FHA assistance) were much more able to leave than their black neighbors. (See Tom Sugrue’s “The Origins of the Urban Crisis” for more info.) I think that you have causation backwards here.

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      • Steve Sailer says:

        “And why shouldn’t the descendants of Africa take over …”

        And why should they?

        Does anybody really believe that a world of four billion in Africans in 2100 due to failure to assist Africans to make the demographic transition to family planning would be better than a world in 2100 in where there are 2 billion Africans due to the West facilitating African women choosing how many children to have?

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      • ad says:

        Well, that’s helped discourage me from donating.

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    • Scott Alexander says:

      I’ve never understood the claim that preventing early mortality leads to the demographic transition. I understood people as saying that you’ll have lower population growth rates because mothers won’t have to have 10 children just to get 2 who survive to adulthood? But if that’s true, shouldn’t you get the same number of surviving adult children in each case?

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      • CalmCanary says:

        If you have enough children that you expect two to survive and child mortality is high, there is a non-negligible probability that all of them will die and you’ll be left to starve in your old age. Thus, most people will aim for more than two expected adult children to reduce this risk. If childhood mortality is very low, you can have only two or three children and be almost guaranteed that enough will live to be adults.

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      • Steve Sailer says:

        The overpopulation comes when traditional expectations of childhood mortality are rendered out of date, but the fertility behavior based on these outdated expectations continues onward into the future. African needs campaigns to publicize this good news about declining mortality and explain how it rationally leads to more family planning.

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      • meyerkev says:

        A world in which women have 6 kids/woman (3 per parent) and population is stable is one in which 4 kids have to die before they get old enough to get classified as parents.

        So assuming 3 generations are alive at any given time and no adult mortality ever happens (and yes, this is hilariously over-simplified):

        6 Million kids – 2 Million parents – 2 Million grandparents = 10 Million total (Henceforth 6-2-2)

        Then you solve whatever problems were causing your 70% infant mortality rate, and…

        6-2-2
        18-6-2
        54-18-6 (78 Million!)

        At which point you either discover newer, sexier causes of infant mortality at a higher population level (aka a Malthusian Trap) OR you start having fewer kids because urbanity/crowding/????. Like so:

        6-2-2
        12-6-2 (TFR 4)
        12-12-6 (TFR 2)
        12-12-12 (TFR 2 steady state)

        So a country with 10 Million people in it becomes a country with 36 Million people in it over the course of about 3/4 century. Which… could be problematic. That’s the rough equivalent of the USA ending up with the population of China.

        But it sure beats having a population of 78 Million with a steady state if you stopped RIGHT NOW!!! of 162 Million.

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      • Think of it as a portfolio theory. If the average family aims to have a 95% chance of having 2 children survive to adulthood, and childhood mortality is 35%, they would need to have 7 children. Of those 7, 4.55 (7*.65) would survive to adulthood.

        If Childhood mortality improves to 20%, then they would only need 5 children for about a 95% chance of them reaching adulthood, of those, 4.5 (5*.8) would reach adulthood. So, assuming parents are maximizing the chances of having surviving children, the result is the lower the childhood mortality rate, the lower the population growth.

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      • baconbacon says:

        @ Scott

        “I understood people as saying that you’ll have lower population growth rates because mothers won’t have to have 10 children just to get 2 who survive to adulthood? But if that’s true, shouldn’t you get the same number of surviving adult children in each case?”

        The children that die early carry a large cost in pregnancy and early childhood. Having fewer children die makes families wealthier and allows them to have more surviving kids. Labor being a major resource these larger families get another boost (or a continual slow growth more likely) as those children become more productive over time.

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      • JuanPeron says:

        The justification I’ve always seen is that mortality declines are slow to impact the culture of parenting. It’s often non-obvious that they’re happening, and they don’t change the behavior of parents until after people start to see more children living to adulthood.

        As a result, the usual demographic model is a one-time population spike as 1-2 generations have kids at high-mortality rates, but those kids live at low-mortality rates. I’ve also seen some fairly credible people argue that this is one of the keys to industrialization – a massive, long-lasting increase in national labor force.

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      • Nornagest says:

        You’re assuming risk neutrality, but people are not risk-neutral, and that means that variance matters as well as expected value. If a child has a 50% chance of surviving to maturity and you want to have a 95% chance of having at least one descendent around in your old age, then you need to have five children (for a 1/32 chance that all of them will die) — but that gives you an expected two and a half surviving kids. If on the other hand each child has a 95% chance of surviving to adulthood, you only need to have one kid, for an expected 0.95 survivors. The difference comes out of the need to hedge your bets.

        The math scales up similarly if you want more than one surviving child, which is probably more true to life, but I can’t do the combinatorics for that in my head so I’ll leave it as an exercise.

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    • houseboatonstyx says:

      @ Steve Sailer
      The decline in malaria ought to make family planning more popular in Africa: now mothers don’t have to have five children if they want three to survive to adulthood.

      How immediate is this effect supposed to be? A prudent 1M2H* family would wait to see how many of the current children actually do survive to adulthood, before ceasing to start spares.

      * 1 Mouth 2 Hands

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      • Steve Sailer says:

        Publicity speeds things up.

        More and more people in Africa watch television or have smartphones. That makes it easier to communicate ideas to replace outmoded ones.

        But, Africa needs Western NGOs that are enthusiastic about limiting African population growth. The Gates Foundation, for example, does work on that problem but they maintain a pretty low profile. We need a revolution in attitudes in the West to make it respectable for Westerners to be enthusiastic again about helping African women have smaller families.

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        • houseboatonstyx says:

          @ Steve Sailer
          We need a revolution in attitudes in the West to make it respectable for Westerners to be enthusiastic again about helping African women have smaller families.

          I’m afraid anything on the line of ‘X society needs change of attitude’ sort of spreads out and soaks into the sand. Particularly, if it’s doubled: ‘Society A needs a change of attitude about changing the attitude of Society B.’

          [moved down] The Gates Foundation, for example, does work on that problem but they maintain a pretty low profile.

          A while ago Melinda Gates said that when she asked villagers what they wanted, a common request was ‘more of that stuff they used to give to keep me from getting pregnant’. She was starting her own project to develop new contraceptives that could be produced much nearer the village level, or by the women themselves.

          I was disappointed to hear no more about this. I hope the Gateses were just going low profile, instead of dropping the idea.

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          • Steve Sailer says:

            My vague impression that Bill Gates is an old-line WASP population controller in the mode of 1960s Rockefellers and Bushes, but that’s very out of fashion these days for racial reasons. The Gates Foundation does spend a fair amount of money on family planning, but they aren’t as enthusiastic about publicizing it as about most of their other enthusiasms.

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    • anonymous says:

      If the rest of the world has the will to do that, then should we also restart colonization in Africa?

      Israel is a kind of colonial-style project. It has a much higher GDP per capita than its neighbors. White South Africa apparently would be one of the richest countries in the world, if it were a country at all. Singapore seems like a colonial-type project, but Chinese people were the main group of colonists, although Britain enabled them. America is a colonial project…ok, enough. Point is, could new modern colonial (city?)states be built?

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      • Jiro says:

        You have to distinguish “rich because they’re better at earning and maintaining wealth” and “rich because they’re better at taking wealth from others”. In standard colonies and in white South Africa, there’s enough of the second that you won’t be able to measure the first.

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      • Troy says:

        White people, both those in Africa and the West, can help African development. But restoring colonialism is not the way to do it, if it were even possible, which it is not. People understandably want to be self-governed. What we should do is support moderate African governments that aren’t afraid to work closely with the West and with white-owned businesses. Botswana is a model.

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  9. Arceris says:

    Is may just be my eyes playing tricks, but it looks like, at about 2006-2008, while the overall picture was improving, the core areas got worse (the red-orange became deeper red while the light yellow faded to blue). After that you see the core drop off. I’m fully willing to accept it as a perceptual trick, but am curious if it was real, and what may have been the cause if it was.

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  10. Shmi Nux says:

    Are there models that predict the optimal number of bednets? I expect that we will not be eradicate malaria completely with just the bednets. At some point another marginal bednet will not produce a worthwhile reduction in malaria, compared with other interventions or causes. What is that number?

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  11. Linch says:

    This is really great news! I’ve read about general trends and I think I’ve actually seen the abstract of that article before, but it’s wonderful to see it described so clearly in a map like that. I linked this post to an essay I wrote about my personal experiences with the Bystander Effect, historical analogues, and how it is applicable today:

    https://medium.com/@draconlord/the-bystander-fcdf57545cbe#.nlc8ezg4n

    (Sorry for the shameless self-promotion, but this is the first “real” article I’ve written in years that’s not academic or humor and I’ll really appreciate comments, thoughts and possibly shares if you actually like it).

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    • Cord Shirt says:

      “What I really like about effective altruism is the full understanding that, to paraphrase a bumper sticker I saw about Christianity in the back of a van once, “[Effective altruism] is a hospital for sinners, not a country club for saints.””

      …so it really *is* a religious movement.

      …IMO it’s better for humanity if each of us works to build/maintain a functional community where we are. I prefer not to outsource my judgments of charities’ effectiveness.

      Maybe I’m just too old and cynical but

      CANDIDE
      You’ve been a fool
      And so have I,
      But come and be my wife.
      And let us try,
      Before we die,
      To make some sense of life….

      CUNEGONDE
      I thought the world
      Was sugar cake
      For so our master said.
      But, now I’ll teach
      My hands to bake
      Our loaf of daily bread….

      CANDIDE, CUNEGONDE, MAXIMILLIAN, PAQUETTE, OLD LADY, DR. PANGLOSS
      Let dreamers dream
      What worlds they please
      Those Edens can’t be found.
      The sweetest flowers,
      The fairest trees
      Are grown in solid ground.

      ENSEMBLE
      We’re neither pure, nor wise, nor good
      We’ll do the best we know.
      We’ll build our house and chop our wood
      And make our garden grow.

      EAs: Come home. Come to your own local communities, and live, and get your hands dirty, and see the results of your own actions with your own eyes. Come home.

      (Deiseach knows what I mean, I think.)

      …IOW, it’s well-written, which is why it sparked a response. OTOH, I do disagree with it…I’m not an EA.

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      • Anon says:

        You misread that quote in order to confirm your own biases. Don’t do that.

        All EAs have been told by people like you that we should focus on our own communities. You must know this. Do you understand the reasons why we don’t? If not, make the effort to understand before belaboring the point.

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        • Cord Shirt says:

          My point was that the fact that he’s attracted to the same language as is used by a religious movement is evidence that EA is serving the same psychological needs, making use of the same impulses, and likely subject to the same biases, as any [other] religious movement. Sorry that was unclear.

          (BTW, I also think that those emotional needs include “seeing the results of one’s charity with one’s own eyes,” and I think failing to meet that one encourages unhealthy scrupulosity.)

          “All EAs have been told by people like you that we should focus on our own communities.”

          Which people are you saying I’m like?

          “Do you understand the reasons why we don’t?”

          I have my own opinion of why you don’t, which may differ from yours. It underlies what I wrote there. I edited it before posting to try to make it politer than my original version.

          One factor IMO is that you think of people as…more like interchangeable units of economic production than I think is wise. Different people are different, and it’s human nature (IOW, another of those emotional needs) to put one’s own family and community above others. I think going out of one’s way to avoid that, as EAs do, is a bad idea in the long run…

          Even though I share the impulse. It does seem much more elegant and pure, doesn’t it? I share that attraction to the idea of abstracting away things like individual personality (what more emotional types might call, uh, “humanity” 😉 ). I just…think it turns out to be a bad idea in the end. (Maybe I’m overemphasizing the need to fight that impulse because I’m so used to it being important to fight. Bravery debates etc.)

          I still recommend /Candide/.

          I think that if everyone focuses on improving their own community, this will be more effective in moving toward a goal of everyone having the kind of community they want. I’m inclined to think that if we all sit in our own little microapartments while giving 10% of our incomes to faraway charities we have outsourced the judgement of…then everyone will *not* all wind up with the kind of community they want.

          Do you understand why Dickens considered Mrs. Jellyby a fit subject for caricature?

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          • Linch says:

            “My point was that the fact that he’s attracted to the same language as is used by a religious movement is evidence that EA is serving the same psychological needs, making use of the same impulses, and likely subject to the same biases, as any [other] religious movement.” TBH, that specific phrasing was used deliberately to draw in more (American) Christians by minimizing the apparent inferential gaps that normally exists between Christianity and EA.

            Don’t read too much into it.

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          • Anon says:

            “People like you” meaning only the many, many people who are of the opinion that charity which is not local is not worth doing, and tend to approach EAs with appeals to come home without really showing any evidence of understanding why we don’t.

            “you think of people as…more like interchangeable units of economic production than I think is wise” / “abstracting away things like individual personality” – what gives you the idea that we do this? Suppose we do not – how would our behavior differ? We are still left in the situation of trying to do good with limited resources, and still need some way to choose how. I’m also always skeptical of the argument from “human nature”; I’m a pretty weird person in general. Wasn’t it supposed to be human nature to want to settle down with a partner of the opposite sex? Be careful that you are not just describing your nature.

            I’ll check out Candide some day, but I don’t tend to find fiction all that persuasive. And you will need a very strong argument indeed to convince me that it is better that I act differently and more people suffer.

            “I’m inclined to think that if we all sit in our own little microapartments while giving 10% of our incomes to faraway charities we have outsourced the judgement of…then everyone will *not* all wind up with the kind of community they want.”

            See, this is the kind of comment which suggests to me that you are fighting against a theorized picture of what an EA would look like, not what actually happens. If anything, I’d guess EAs spend more time in the company of friends than similar people who are not EAs. And, well, it’s plausible that the world you describe would be, in many ways, suboptimal, but – first, we’re nowhere near the point at which “people spending too much of their lives helping other people they don’t know” has become an issue plaguing our communities, and it seems unlikely we’ll ever get there; and second, it is not obvious to me that the world you describe would not still be better than the one we’re currently in.

            Frankly, it seems to me that even if I could, by myself, transform my (~1000-person) local community into its best possible form, this would be an improvement to the world much lesser than that three children outside of it live, who would otherwise have died.

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      • JBeshir says:

        It looks like bednet distribution has saved approximately 4.2 million lives in the last 15 years. Do you think that money would have saved nearly as many people if distributed locally? This is the core EA objection to localism, so it’s the place to start if you want to make a case for it.

        Something being romantically appealing doesn’t mean there’s something to it, from an effective altruism perspective, so pointing that out isn’t highlighting any kind of contradiction. The ideas we find intuitively attractive, even altruistic, are picked out by unconscious processes which are more selfish, amoral, motivated and dishonest than we’d ever consciously endorse. I’d suggest they’re a big part of how simple, cynical following of incentives happens amongst humans.

        I don’t think it even means it’s effectively selfish; our intuitions are rigged to deal with tiny hunter gatherer communities, not dense modern human societies, and it’s pretty plausible that they weight cooperation too low to even be effectively selfish nowadays- notice how the people who push selfishness down, “resist temptation”, seem to keep winning on the personal level because they align with other cooperators, form little high-trust social groups, and their group as a whole just does so damned well?

        I think this probably does fit pretty closely with religious ideas of sin, or the “evil inside every person” that has to be pushed down; a tendency to be ‘selfish’ in a manner which is in conflict with what we describe to ourselves as our values, and is even self-destructive in the long run. While that certainly makes it easy to mock, it doesn’t make it wrong; it’s pretty plausible that the effect was real and merely misattributed.

        If there’s a good, solid case for how locally spending all this money would have an expected value of above 4.2 million lives, I’d like to hear it, but I’m not going to be swayed by an emotive case because an emotive case existing is entirely consistent with social intuitions just being persistently selfish, able to see how local charity’s benefits cycle around to me, and unable to follow how helping more of Africa transform into economic success stories would have benefits that cycle around to everyone.

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      • Deiseach says:

        Though I appreciate the name-check, I have to say I detest Bernstein’s “Candide” (I don’t like Bernstein’s music in general) so I have to disagree there; Candide and Cunegonde at the end have settled for a rational selfishness disguised as “sadder but wiser” and “older now so learned hard lessons”.

        They’re still seeking their own satisfaction, this time by living nice comfortable country lives. There’s nothing there to say they will have learned charity from their experiences and will help others in their neighbourhood; they’re going to concentrate on their own house and garden for their own idea of the good, temperate life for themselves.

        I have no objection to charity abroad as well as at home; my beef with the EA insistence on GiveWell as the prime example of the be-all and end-all is that measuring effectiveness is all very well and indeed necessary, but it’s possible to have different ideas of effectiveness. And bednet donation seems to be working very well, and that’s good, but as has been pointed out – after that, you need to keep the momentum up, and then comes development (which has been shrugged off to me as “not my business” by some) and other charities which don’t score as high on the “most bang for your buck” metrics of GiveWell and others, but which are also necessary and doing good work.

        I’m a little dubious about waiting to donate so you can give as much as possible; yes, that’s fine if we’re stacking dust specks, and certainly “If I wait thirty or forty years I can donate a whole pile of money at once which will do heaps and heaps of good!” does work.

        But it’s rather “Live horse and get grass” for the objects of the charitable donations. That’s my problem here: it’s more about making the donors feel good (by presenting it as “I am making the most rational choice to do the most good by the most sensible measurement”) just as much as any of the warm-fuzzy charities condemned as ineffective.

        What you are saying to the people who need help now is “Die if you must, I’m going to wait for future generations to be in misery so I can get the maximum gratification of my donation”.

        Someone whose house has burned down would appreciate some help right now, not “If you can wait ten years, I can give you ten times as much money”.

        But I am not mathematical and I’m sure there will be comments leaping to the defence of deferred giving with statistics and graphs galore to prove me wrong – and I am sure I am wrong about the effect of money, and it really is better to wait twenty years before giving so as to give the very most you can.

        I want to say, with all this, that charity is about people – the objects of your donations are real human beings, not points on a graph or targets.

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        • Anon says:

          For what it’s worth, there is not consensus among EAs about donating now vs later. There are strong arguments for and against

          That said, I think you’re wrong to present the argument as “Die if you must, I’m going to wait for future generations to be in misery so I can get the maximum gratification of my donation”. Instead, it is exactly the same argument as for donating to AMF instead of Make a Wish: “you’re suffering, and had I infinite power I would stop it, but since I do not I am going to use my limited power to do the most good I can” + some pretty persuasive arguments that the most good you can do is investing and donating later.

          I realize you’re cynical about people donating for “warm fuzzies” instead of for doing as much good as they can. But how would you tell them apart, here? How does “I have looked at the available data, and it seems to me that this is the best possible use of my efforts towards the goal of making the world better” look like evidence against the hypothesis that we are, in fact, sincerely trying to make the world better?

          In other words, yes, the objects of donation are people, but so are all of the people who we can’t donate to. Every choice has opportunity costs.

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        • One point I haven’t seen discussed here is the tradeoff between helping people by giving them stuff and helping people by spreading ideas that lead to them changing their institutions.

          Consider the contrast between India and China. For decades India was the target of lots of foreign aid money and well meaning advice. Most of the advice, unfortunately, supported the economic model the rulers of India liked, which was a dirigiste regime, creating a permit raj in which the people who were supposedly solving poverty did pretty well for themselves. I still remember my father’s comment on Indian exchange controls. The theory was that they were to keep Indians from wasting their scarce foreign reserves on luxuries–a theory put forth in conferences held in air conditioned hotels in New Delhi. India stayed poor. Things now seem to be improving a little, as that model is being very gradually dismantled.

          China, on the other hand, abandoned the Maoist model after Mao died, getting to something close to a conventional modern market society by a process largely of trial and error. From Mao’s death to 2010, per capita GNP went up twenty fold. Probably the fastest improvement in total human welfare in history, and surely much larger than all of the benefit received by people elsewhere in the world from charity over that period.

          More generally, if you look at the parts of the world where people no longer live in the sort of poverty that was the norm through most of history, it’s changes in institutions (and technological progress) that made the difference, not charity.

          The obvious conclusion is that, if you want to help poor people in poor countries, the most effective way is to spread ideas. Of course, that assumes you know what institutions are better–it describes what the people giving bad economic advice to India thought they were doing just as it describes what the people giving good advice elsewhere were.

          Over the past year, I have given talks in India, China, Indonesia and Brazil, largely arguing my (possibly mistaken) views about how society ought to be structured. If I am wrong, that did no good and perhaps some harm. If I am right, and if I succeeded in planting ideas that some of my listeners picked up, expanded on, spread, I did more good than all the bednets I could afford to buy.

          I realize, of course, that the same argument could be made by people arguing for very different views. That would include both socialists and Christian missionaries.

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          • Troy says:

            I realize, of course, that the same argument could be made by people arguing for very different views. That would include both socialists and Christian missionaries.

            A similar argument about the positive effects of missionary activity is made in this paper, which has gotten a lot of press in this last year: http://prec.com/PRECdocuments/missionaryrootsofliberaldemocracy.pdf

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          • onyomi says:

            I do think ideas and the institutions they shape are ultimately most important. But I think the question of how physical/material circumstances shape receptivity to ideas may be as important. Very broadly speaking, I think people in dire circumstances are more receptive to bad ideas and short-term thinking than people in relatively comfortable circumstances. Of course, if people are in quite comfortable circumstances that may in turn bias them toward the status quo as the impetus for change is lost.

            Nevertheless, I think the pattern of “government is just a chance for me and mine to get all we can while the getting is good for the short time we can manage to hold on to power” is much more likely to occur in places where material circumstances are dire. Witness third-world dictators hiding huge amounts of their countries’ wealth in foreign bank accounts. This attests to the fact that they are not just misguided by bad philosophies of governance but are perfectly aware of what they are doing and how it is likely to end up.

            I feel like teaching good economics and respect for property rights to people who are, by and large, suffering intensely, is sort of like trying to get someone who has been diagnosed with terminal cancer to increase his savings rate and learn about prudent, conservative retirement savings. Even if they have the presence of mind to see the general wisdom of your case for savings, it will feel irrelevant to their circumstances.

            Hence, I think alleviating the misery associated with problems like malaria does more than just, well, alleviate misery and free up the previously miserable to participate in economic and social life. It may also make them more receptive to the type of ideas which ultimately lead to better institutions.

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          • phantasmoon says:

            I have a problem with this argument, David, and it’s not about how it applies equally-well to fundamentalist religion or socialism. The idea that institutions can lead a country to economic and cultural development and if we can only export these institutions to underdeveloped countries they’ll do better ignores the fact that many (many) countries have tried to do just this and mostly failed.

            Consider Latin America. The region is almost entirely governed by democracies, yet the people of many of these countries elect, of their own free will, populist strongmen whose policies weaken democracy and undermine development. This seems to be a quasi-cyclical phenomenon, with countries like Argentina going from populist leftism to military dictatorship to “we’re really going to change this time and do things properly” democracy, only to start backsliding again.

            Every time the economics establishment identifies a recipe for success in a developed nation (e.g., independent and autonomous central banks with inflation targeting goals), underdeveloped nations find a way to subvert it (e.g., Argentina ensures that the central bank is only independent on paper and deliberately taints official inflation figures). No institution can protect people from their own bad choices.

            Rather, it’s people who protect institutions. Consider the Argentinean pension system, which was built to mimic Chile’s successful private pension plan. In time, the Argentinean government found that it could use the system as a captive buyer of government debt by forcing the pension funds to hold (increasing) amounts of government debts as a share of their portfolios. Later, in a naked money grab, the Kirchner administration nationalised and effectively stole private savings by making the extraordinary argument that the pension funds held so much public debt as a share of their assets that the Argentinean government was already paying a significant share of private pensions, and it may as well nationalize the whole thing. The Argentinean public allowed this to happen, and once again their pensions are at the mercy of a government that is known to be corrupt and profligate.

            While all people are vulnerable to populism to a greater or lesser degree, some countries consistently fall prey to it more than others. One could argue that this is because Argentineans do not have enough exposure to information that would allow them to understand how populism works and why a libertarian regime would be better than yet-another self-serving strongman, but Argentina is among the wealthiest Latin American countries today and could have been counted as a developed country at the start of the 20th century, judging by GDP. It always has been among the most educated countries in the region. The people are no strangers to free market arguments: they were exposed to them (and many of the benefits they brought in terms of freedom and prosperity) during the Menem administrations after their last hyper-inflation episode. How high do we have to set the education / information availability bar for the people of a country to stop choosing actively harmful leaders and policies? At what point should we entertain the idea that maybe they’re expressing a preference towards a paternalist state that shields them from global markets and competition?

            From where I’m standing, it looks like people who should know better choose not to protect the institutions that safeguard their liberty. I’m at a loss on how to fix that short of taking away their right of self-determination—which is how Chile managed it.

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          • @phantasmoon:

            You are treating my argument as if it were about imposing institutions. It isn’t. It’s about changing peoples’ view of the world–what I think of as the body of free information (true or false) that drives the choices of rationally ignorant voters.

            I can’t set up institutions. I can give talks which spread ideas.

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          • JBeshir says:

            I think this is a fair argument, and it fits very much in with the general criticism of EA as overlooking systemic change in general.

            If after factoring in any meta-level concerns about how much you should trust your judgement vs other people’s judgement, doubt about whether other people will do your ideas sufficiently right/with all prerequisites, question as to how much you can trust yourself not to be overly optimistic about a thing you want to be true, and remembering only to count your own marginal effect, not the whole outcome (e.g. advocacy for an inevitable thing only gets to count the value of the extent to which it expects to speed it up, you have to count any negative/backlash/counter-campaigning you might cause, etc), you still have a strong outside view position that doing advocacy has higher expected value than other things, doing this kind of thing makes sense.

            Whether we should encourage other people to try this is a different question- a question about what one thinks would happen from everyone else doing the above, rather than about what one thinks will happen from oneself doing it. Counterfactually, if everyone did this instead of bednets, it would have caused 4.2 million more people to die prematurely. Do we expect the net effect of everyone trying to advocate for what they think is politically good to do enough good to outweigh that?

            If so, EA as it is, is fundamentally misdirected, and the social justice activists calling for everyone to get politically active in fixing the world have the right idea- even if most people are wrong, the net effect would outweigh the stopping of anti-malaria efforts. Nobody Is Perfect, Everything Is Commensurable would be wrong in its suggestion that political activism was mostly less effective than bed nets.

            If not, if most people would get the meta-concerns wrong, and the few who get it right wouldn’t do enough good to substitute for the loss of anti-malaria efforts, we should still advocate for EA focused on directly evidenced or multiplied out interventions, award people kudos for ignoring their mostly-faulty intuitions and going “no, bed nets”, and just, if necessary, consider ourselves an exception to it.

            For myself, I’m in the camp which is not outside-view certain enough of any particular political goal’s effectiveness, let alone any means of trying to accomplish it, to expect political advocacy for what I think is wise to have high expected value, short of some very high utility * very low probability combinations which I throw out as Pascal Mugging. And I think other people who aren’t in that camp are almost always wrong not to be.

            But much more strongly I think that even if you don’t agree with that you should probably think that other people are flawed enough that EA should remain evidence or at least simple-reasoning-focused rather than being dismantled as the thing it is and refocused on personal intuitions of outcomes of political advocacy.

            (Related to all of this is Scott’s http://slatestarcodex.com/2015/09/22/beware-systemic-change/ which contains some of his take on it, with epistemic status updates on that take)

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          • @JBeshir:

            I think the answer to “what should everyone do” is usually “no.” Different people have different abilities, resources, interests, concerns. If what you feel strongly about is helping small children, finding a way of doing that is probably a better idea than looking for the charity with the highest payoff in quality adjusted years, if only because you are more likely to actually stick with it.

            Earlier today I did an online interview with a fellow libertarian whose basic question was “what should libertarians do to bring a freer society.” My response was that the answer is different for different libertarians.

            I think the answer I proposed above may well be correct for me and for some other people. Scott almost certainly does more to make the world a better place through this blog than through his charitable contributions. There are other answers for other people.

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          • JBeshir says:

            That makes sense. I think some kind of “do X if you’re good at X, otherwise do Y if you’re good at Y, otherwise…” thing *might* be generalisable.

            I don’t think I agree with the part about “doing what you like” being more likely to do good than doing things effectively in the general case. The difference in effectiveness between the median charity you might hear about and then donate to and a charity picked out for efficiency is easily 2-3 orders of magnitude, with the things people tend to like being at the worse end of that. You usually will end up spending millions per saved life instead of thousands if you stick inside health interventions, and doing even worse if you go outside them.

            And that’s total effectiveness of the entire charity- variation in marginal effect of additional donations is even worse, because a lot of charities don’t spend additional donations very well at all, and use them more as a “way to pay staff more while they live their dream of working on the cause” thing than a way to expand operations. If you don’t look at marginal effectiveness properly you are pretty likely to throw away your money or time for negligible outcome.

            Even if you only stick with the more effective thing for a year because it’s less appealing, you *still* probably did more good than if you’d spent your whole life sticking to the inefficient thing- probably by a order of magnitude or more.

            So I think in the mean case, “target efficiently, as directed by directish reasoning and evidence of effect, and give 10% of income or equivalent value in time” is just so absurdly better than the expected value of anything they are likely to be otherwise doing we should encourage it in general- if everyone did it, the world would be a much nicer place, and it probably has higher return per person when fewer are doing it so it’s even better to encourage while everyone isn’t doing it.

            But it makes some sense that carefully encouraging just the particularly thoughtful or high impact into fuzzier avenues of thought could do better. For an extreme example, if we had the opportunity to persuade a world leader to pursue a course of action to make the world better, and knew they would think well about what we said, “donate 10% of your income to efficient charity” would probably be a poor use of that opportunity.

            If we could advocate this in a way which didn’t remove all force from advocacy directed at the more typical case I think that might be worth doing, although I don’t think we can- it’s an attractive way to try to claim the kudos without having to actually do anything different, and vague enough that people will get away with doing that enough, incrementally, to degrade it into unfiltered “call yourself an advocate for sharing posts on Facebook and you’re just as applause-worthy as someone who buys thousands of bed nets a year”, and destroy the social incentive to say “No, bed nets” entirely.

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          • phantasmoon says:

            @ David:

            That is fair. I hope you’re wildly successful. 🙂

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        • Cord Shirt says:

          I’m actually not a fan of Bernstein’s Candide (as opposed to Voltaire’s) either…except that I do think this scene gets it right. I was also thinking of past discussion of Voltaire vs. Leibniz and the poem on the Lisbon earthquake:

          Think ye to cure our ills denying them?
          All peoples, trembling at the hand of God,
          Have sought the source of evil in the world.
          When the eternal law that all things moves
          Doth hurl the rock by impact of the winds,
          With, lightning rends and fires the sturdy oak,
          They have no feeling of the crashing blows;
          But I, I live and feel, my wounded heart
          Appeals for aid to him who fashioned it.

          (I’m more of a Leibniz than a Voltaire in temperament, but I can see both perspectives, and here, it’s Voltaire’s that tends to be overlooked.)

          Voltaire does at times resort to a form of epistemic learned helplessness. But I don’t think that’s his main point with “we must cultivate our garden.”

          I agree with the rest of your comment. Check out my other comment. 🙂

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      • Linch says:

        Hi Cord Shirt,

        Thank you for the kind words. Unlike the other commentators, I agree with you that EA shares many similarities with the things we in the West commonly associate with religion. Most of these similarities are superficial, but not all of them are.

        For example, EAs, like most religious communities, typically perceive something immensely wrong about the world (in some cases, far more so than mainline Christians do). Further, EAs seek to fix it. Some (not all) elements of EA form a very tight community across racial and geographic lines. There are focal points of “learning” (including this blog lol) and patterns of speech. There is often a odd dash of genuine humility mixed with perceived superiority. There are certain aspects of EA that could be perceived as virtue signaling (public pledges of donations, vegetarianism/veganism).

        I personally think EA is different enough from what we commonly associate with religions that I would not classify EA as a secular religion (unlike say Communism). There are several strikes against that classification in my view:

        1) Non-exclusivity with “other” religions.
        2) Intense doubt and self-skepticism.
        3) A tangible focus on visible outcomes (A common refrain of Maoist China is “When we reach Communism”, some Christians are more concerned with the after-life than today).
        4) Acceptance of moral relativism

        However, ultimately I don’t think the classification is very relevant. Taboo the word “religion,” list your genuine disagreements with EA, and then we can probably have a more informed discussion about whether you disagree with EA as a concept, as a community, or some combination of the above.
        ___

        As an aside, I read Candide (the book, not the play. Also not in French) in 12th grade. I hated that book and was furious with Candide. The idea that you should till your own garden instead of caring about actual people actually dying infuriated my 12th grade self immensely, and I wanted to hurl the book across the room. But it IS a pretty funny satire (though not as funny as Jonathan Swift in my view).

        And of course Voltaire didn’t exactly take his own advice and till his garden. Quite the opposite…

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        • Cord Shirt says:

          I read the book as a teenager too. I disagree with your interpretation of his point. Did you have a chance to discuss the book with anyone?

          IMO “Till your garden” doesn’t mean “care about no one but yourself.” It means, “Focus your charitable efforts where you can see their results.” This is so that you can know if/that they really are helping, and can adjust when the situation changes, and do not fall prey to the errors of (what Robin Hanson calls) “far-mode thinking” in evaluating this work.

          Voltaire very much did till his garden in this sense. He got himself into trouble with local powerful people who he thought were harming others, often to the point of even having to flee; he adopted a child; etc.

          In my comment to Deiseach I mentioned Voltaire’s poem on the Lisbon earthquake. Have you read that? It expresses some of what I’d like to.

          …I could say that the rationalist/EA community is generally suffering from a relative lack of high-verbal types, but that would be a bit boring.

          I have noticed the way this community tends to want to characterize mathematical ability as “the only *real* intelligence.” Sometimes people make an exception for our host. But they still often claim that in general, high-v just leads to “*political* skill. Not *real* intelligence.” To do this they overlook the degree to which many verbal measures (such as, even, Wordsum) correlate with g.

          My anecdotal experience of years interacting with my fellow subjects in a study of high-IQ kids (and their families, other families of similar kids in advocacy groups, etc.) has led me to believe that no matter which human “mental module” (math, natural language, visual, etc.) you are best at using, you can use it to perceive/understand/predict reality. Whatever you’re best at, it (not your weaknesses) is what determines your g; you can use it to compensate for any weaknesses in other mental modules…most of the time. Still a boring claim, I suppose.

          The areas where high-math and high-verbal agree are examples of this. Where two people (or groups of people) used different mental modules but came to the same conclusion, I’m encouraged to believe the conclusion is correct.

          But what about where they disagree?

          I see those areas as opportunities to discover where one or the other mental modules does fail. Where people are mistaking their own thinking habits, their own favorite mental module’s habits, their own abstractions and simplifications, for reality.

          ISTM that this community’s underrepresentation of verbal types means the “math module” failure mode is sometimes going undetected. When these conflicts occur, this community is too quick to declare the math mode’s conclusions always the right ones, the verbal mode’s disagreements always the failures. So they’re missing out on some aspects of reality. And when you do that…

          I think that’s often what people mean when they say that there are “not enough literature/philosopher types” or “EA is inhuman” or invoke Mrs. Jellyby as I did in my other comment (Mrs. Jellyby, after all, was Dickens’ expression of his perception of a similar problem in charitable efforts back then).

          …I don’t have as much time as I’d like to devote to putting this clearly into words, but one of my concerns about EA’s similarities to religion is that EA has not had the time to develop all the psychological safety mechanisms that organized religions have. For example, EA is not the psychological-needs-meeting organization 😉 that developed the idea of “scrupulosity.” Catholicism is. It’s encouraging that EA had the sense to adopt it. But there are other problems that *need* safety mechanisms that EA does not have. And Mrs. Jellyby-ism is a big one. And…when searching on “Mrs. Jellyby” I found this…I haven’t explored the rest of the website, but it looks like an Orthodox Christian attempt at a safety mechanism.

          I wish I had time to reply to other aspects of your comment too (and JBeshir’s comment), because this topic deserves more attention…maybe later.

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          • Linch says:

            “I read the book as a teenager too. I disagree with your interpretation of his point. Did you have a chance to discuss the book with anyone?” Yes, I read it for my AP Lit class. “til your garden” does not necessarily entail being selfish per se, but it does mean caring more about your own walled garden(in today’s terms, “monkeysphere”) than the outside world.

            I am unconvinced that Voltaire followed that. He was very widely travelled and cosmopolitan, and *by the standards of his time*, giving the communications and transportation technologies available to him, he was very globally minded.

            w/r/t your point about verbal ability, I think your argument is too high-level. I would point out that people with high verbal ability have a unfairly HUGE advantage in winning arguments since verbal ability is much more optimized for winning than in truthseeking. To the extent that “mathy” arguments actually “win” against them, this will be a strong indication that those arguments are closer to correctness/the truth, since people with lower verbal IQ are essentially playing with a handicap.

            While it is true that EAs currently have more mathy types than verbal types, quite a few of the more prominent people in EA are high verbal types (as you can sort of expect). For example, Will MacAskill and Peter Singer are both professional philosophers. In addition, our host here likely has (by his own admission) mathematical ability somewhere in the south of the 98th percentile, but his way with words is basically off the charts. So it’s kinda funny that you think high-verbal types will inevitably be against EA, considering that you’re typing this comment on *Scott Alexander’s* blog.

            Also, I’m not sure how to say this without coming across as really arrogant, but my verbal ability generally in the same range as my mathematical ability, so if you really think that agreement between high-verbal and high-mathematical ability is a reasonable barometer of correctness, then you should totally trust me as an authority. 😛

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  12. Elissa says:

    Why not link to GWWC?

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  13. Decius says:

    Seems like the numbers swap around from ‘cases of malaria prevented’ to ‘malaria deaths prevented’ to ‘cost to distribute a net’ and ‘cost to save one child’.

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    • Linch says:

      ? Can you explain?

      “This means that bednets have prevented around 450 million cases of malaria! And globally, 6.2 million fewer people died of malaria over the last 15 years because of malaria interventions…” This will be an odd substitution if true.

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  14. Albatross says:

    Wow. This restores much of my faith in humanity.

    6.2 million lives. What an amazing impact. Just wow.

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  15. modus remotius says:

    Look, you rationalists, if you help reduce infant mortality in Africa without at the same time pursuing some kind of game plan for family planning or any other means of reducing the insane population growth rates these countries already have, you might as well leave them to die here and now. “effective altruism” indeed.

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    • Linch says:

      3 points.

      1) The impact that “rationalists”, even if your expansive definition includes all of EA have on reducing infant mortality is pretty low right now, though hopefully this will increase in the coming years. GiveWell’s total money moved is something on the order of 100 million.

      The Gates Foundation alone spends many times that on Global Health per year (though not so many times that it’s impossible to envision a future where the totality of EA spends more).

      2) There’s a direct connection between reduced infant mortality and reduced fertility. https://en.wikipedia.org/wiki/Demographic_transition

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    • Fertility in the developing world has been declining faster than anyone dared hope in the 1970s.

      The developing world is, in fact, developing. Less mortality, less fertility, less hunger, greater literacy, etc., pretty much everywhere across the board. Poverty is shrinking worldwide, not growing.

      The notion that these are horrible intractable problems that can only be made worse by interventions is so dated, it’s almost quaint.

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      • Steve Sailer says:

        The looming problem of the African population explosion is by no means intractable. A sustained effort by the West to facilitate the demographic transition within Africa would likely be effective and much appreciated by African women.

        The problem is that we have to gear up for a big effort soon because “demographic momentum” is such an important phenomenon. And to do that, we Westerners have to get over concerns that there’s something racist about helping African women modernize.

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        • keranih says:

          we Westerners have to get over concerns that there’s something racist about helping African women modernize.

          err…I’m not sure that’s possible. I mean, I think there is, inherently, something racist/culturalist/bigoted about saying “your culture is wrong and the things you want are bad. You should set aside the things you like and take up the things which we say are better for you.”

          I think that if we step back and look at a variety of cultures and lifestyles – Catholic, Christian, American, liberal, Portlandian, WEIRD, whatever – there is an element of intellectual/behavioral coercion going on. “You are doing bad actions. Stop your bad actions, take up these better actions, and you and the world will be better off for it.” There’s a lot of “saving souls” and “enlightenment of barbarians” and “changing hearts and minds”, or whatever the phrase du jour is, but it generally comes down to ‘white man’s burden’ when it’s not straight up ‘kill the Indian to save the man’.

          I’m not saying that “helping African women modernize” is bad – what I’m saying is that yes, we’re trying to kill their culture, as it exists today, and maybe we should be honest that this is what we’re doing.

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          • Cliff says:

            The problem with your argument is that you completely mischaracterize what you are arguing against.

            We don’t have to tell anyone they are doing it “wrong” we just have to make sure they know infant mortality has been dramatically reduced and give them the means to choose the number of children they have.

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        • baconbacon says:

          Who helped British women modernize during and after the IR? Why would African women need outside help for something that appears to happen as a natural cause of growth?

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    • Anon says:

      The 19th century called, it wants its dismal science back.

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    • Matt M says:

      They (and their families) probably disagree.

      Someone who doesn’t want a bed net because they’d rather their child just go ahead and die now rather than potentially starve to death later is free not to take one.

      Surprisingly, that option doesn’t seem to be exceedingly popular.

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    • @modus:

      Are you familiar with the history of the “overpopulation is the cause of poverty” argument over the past fifty years? It was largely orthodoxy in the sixties. It led to predictions of the terrible things that would happen if nothing drastic was done to reduce population growth. Those predictions turned out to be not merely false, but the opposite of what actually happened. Calories per capita in the third world continued to trend up, percent of the world’s population in extreme poverty dropped to less than a third what it was.

      That might be a reason to be less confident of the same theory reapplied fifty years later.

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      • Matt M says:

        I don’t think I’ve seen anyone reference it yet, but “The Ultimate Resource” by Julian Simon is a great work in terms of this.

        The basic thesis, if I understand it correctly, is that the human brain’s ability to reason and adapt to circumstances is far more valuable than any individual resource we may be worried about right now – and that generally speaking, having more humans around tends to make places BETTER, not worse…

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  16. Helldalgo says:

    Donated 60, and set up a recurring donation. I have been meaning to do that, thanks for the reminder.

    The statistics are really uplifting.

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  17. jjbees says:

    Effective Altruism is strange in that it seems completely reasonable to save millions of lives buying bednets, but external costs related to social pathology via population movement into their own countries on the back end are completely ignored.

    I stopped going to Less Wrong meetups due to this kind of autistic thinking.

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    • Lemminkainen says:

      There’s a huge difference in the orders of magnitude between the millions of people saved by buying bednets and the number of deaths which could possibly be attributed to “pathological” populations moving into Western countries. Also, because refugees and immigrants tend to be escaping from violence and problems in their own countries (and are unlikely to bring a lot of those problems with them– a few thousand Syrian refugees aren’t going to somehow reproduce the Syrian civil war in a country with strong institutions), and sending home remittances which go a lot further in those countries than they do in the first world, the net utility/number of lives saved by immigration from poorer countries to richer ones is almost certainly positive. Nothing “autistic” about that judgment.

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    • Haltingthoughts says:

      I doubt these costs exist. Nearly all immigration is net good.

      Even if they do how are they anywhere close to the value of a life? Saving one life now is not going to cost anywhere near a life in social pathology (especially given discounting).

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      • jjbees says:

        “I doubt these costs exist. Nearly all immigration is net good.”

        Can I come live in your house then?

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        • Lemminkainen says:

          That’s a false equivalence. I can imagine a plausible good-faith case that immigration has a net negative effect, but this isn’t anything like it. Come back when you actually want to address your interlocutors’ arguments instead of just using flip, fallacious rhetorical tricks.

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          • Walked Away, Still Looking Back says:

            That’s a false equivalence.

            Looks real to me.

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          • Winter Shaker says:

            Looks real to me.

            “Can I come and live in your neighbourhood would be a better analogy.

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          • baconbacon says:

            @ Walked away

            That is because you confuse open borders with open movement. Open borders is simply allowing the question “can I come live in your house”, border restrictions are where the government prevents the question. Migration has been a net boom because of both sides to the question- the guy asking the question and the guy answering it, open borders does not imply that you HAVE to answer yes, only that you CAN if you choose.

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          • Cliff says:

            Your family controls who can enter your home. Your countrymen control who can enter your country. It is not unreasonable for either to be selective in who they let in.

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        • “Can I come live in your house then?”

          You are confusing free immigration with the abolition of property rights. You can come live in my house if you and I can agree on mutually satisfactory terms of rental. With open immigration, someone from Syria can come live in the United States if he can find someone willing to rent him housing, someone willing to employ him on terms that will let him pay for that housing (and food and …).

          Barriers to immigration don’t protect private property rights, they reduce them, since they forbid me from renting my house to, or employing, people I might want to rent to or employ.

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          • Jiro says:

            In the analogy, America is being analogized to the house. You own the house, and in the analogy, the citizens of America jointly own America. Since they own it, they should be able to keep people out of it just like you keep people out of your house. They could decide to let people in anyway, but they have no moral obligation to.

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          • nil says:

            Yeah, but it’s a mendacious analogy. It’s like “taxation is slavery.” Sure, to some degree taxation is unpaid labor, and that is a core component of the definition of slavery. But the purpose of the analogy is to grant to taxation some of the same moral disgust we ascribe to slavery–and the on the list of reasons we find slavery reprehensible, “slave masters didn’t pay their slaves” is relatively low for most people, coming after things like lack of protection from sexual/physical violence, lack of freedom of movement, inability to maintain an intact family, and overall dehumanization.

            Saying that open immigration is the same as having people move into your house is valid insofar as they both implicate a diminished ability to exclude people from the space you currently occupy, but the mental image of foreign strangers living in your home includes privacy, safety, and standard of living concerns that immigration only touches on indirectly, or not at all.

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          • Vox Imperatoris says:

            @ Jiro:

            The citizens of the United States do not “own” the country, in the sense that they have the right to do whatever they want with it.

            First of all, most of the land is private property anyway, and since I don’t think the opponents of immigration are willing to let immigrants in as long as they stay on privately-owned land, it’s a pointless argument.

            But even the public property does not sit at the whim of the majority to do with it as they wish. The only justification for there being public property (such as highways) is that it is ostensibly necessary for people to enjoy the free exercise of their rights. So they can’t use it in a way that harms people or deprives them of their rights, including the right to travel over it.

            For one thing, the when the government monopolizes things like roads, people have no alternatives, and if the government could restrict rights in this way, people would have no rights. “For reasons of the public interest, no conservatives or gun-owners will be allowed to drive on the roads.”

            Now natural rights don’t pertain to citizens; they pre-exist the state and therefore pertain to everyone. So the government has no legitimate power to stop peaceful people from entering. But supposing that you did take the “citizenist” approach, then the concerns of David Friedman come into play.

            I want to (let’s suppose) hire someone from Guatemala to clean my house. When the government prevents him from driving along the roads, it violates my freedom of association and freedom of contract, just as surely as it violates rights when it bans protests it doesn’t like on the grounds of “blocking traffic”.

            The majority, in its “ownership” of the roads, can’t violate minority rights by passing a law saying “no black people can drive on the streets”.

            If you deny that immigrants have a right to come here, or that I have a right to hire them or associate with them, fine. I disagree. But the public’s “ownership” of the country doesn’t come into it.

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          • anonymous says:

            It was a non sequitur since Haltingthoughts made a positive argument and jjbees deployed as a rejoinder a metaphor whose purpose is to convince that immigration isn’t a moral obligation.

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          • Vox Imperatoris says:

            @ anonymous:

            Yeah, and the purpose of Friedman’s comment was to show that this metaphor is completely inapplicable, since immigration has nothing to do with giving people the right to live in your house.

            You own your house. You do not own the country.

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          • Cliff says:

            Borders do protect property rights because they dictate who votes and therefore who sets the laws. If all of Latin America moves to the U.S., good luck with your property rights. When you are living under a Chavez or Castro-style socialism I guess you can comfort yourself with the idea that for a while there, industrial agricultural companies were free to employ Hondurans to pick fruit in their fields at low prices. Let freedom ring!

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          • Adam says:

            What on earth makes you so convinced that will happen? The closest analogies to anything that we’ve actually experienced is Cuban asylum-seekers and eastern Europeans post-Soviet fall flooding here and they’re both among the most anti-communist sub-populations we have in the United States. Almost all of our communists are white college professors. Venezuelans are not genetically destined to be red sympathizers.

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          • “Borders do protect property rights because they dictate who votes and therefore who sets the laws.”

            Except they don’t. There are lots of people living within the border of the U.S. who don’t get to vote.

            My standard proposal for open borders is that anyone can come, that there is a long delay before citizenship, and that non-citizens are not entitled to welfare benefits but also free from a share of taxes representing an estimate of the cost of the benefits in question. I see no reason to expect that the immigrants who came under those terms would, when they finally became citizens, be less friendly to property rights than the current residents, nor that their children would.

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          • Jiro says:

            @Adam: The people coming to the US from Communist countries were often fleeing Communism, and wouldn’t be expected to export it here. Even if not directly fleeing Communism, they had direct experience with it and the problems caused by it were obvious, even to people in their home country, never mind people immigrating to the US–almost nobody living in the Communist country believed that Communism worked.

            I highly doubt that Latin American immigrants have experience that voting away your rights doesn’t work in the same way that people from Cuba or Russia had experience that Communism doesn’t work.

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      • Alphaceph says:

        > I doubt these costs exist. Nearly all immigration is net good.

        we don’t really know that IMO. Left leaning media, academics and policians tend to supress any potential evidence of harms due to immigration. France AFAIK has a national policy to not collect statistics on race.

        Immigration of people from cultures which are hostile to western values poses black swan type risk. If muslim immigrants to Eurpoe set off a nuclear bomb in a European capital in the next decade, it would be plausible that they would wipe out all the gains from muslim immigrants over the past few decades. Or more likely: they use simpler tactics like the Paris attackers, but with a very high frequency, e.g. one machine gun attack/week on a major European city, killing tens of thousands of people per year and scaring businesses away from our major cities.

        Immigration of people from cultures which are hostile to western values also poses threshold based risks. Islamists have used the tactic of winning a democratic election to gain power from which they can dismantle democracy and impose the Islamic caliphate on a country, however this requires a certain percentage of Muslims to be successful.

        It is plausible to me that mass immigration of muslims into Europe is sowing the seeds of our destruction and cold blooded murder 30-50 years down the line. If that were to happen, any economic gains made due to a greater supply of low skilled labor now would be wiped out.

        Also, even if the above scenario is not particularly likely, we have to ask what % chance of slipping into an Islamic Caliphate it is worth bearing in order to reap the economic benefits of immigration. At a more advanced level of analysis, even this is actually wrong because it is a false choice: we can be selective about who we let in, study which groups/races/cultures integrate best with western society and only let those in. For example, high caste Indian immigration to the UK, asian Americans. We could probably have a greater benefit by making it easier for the “good” people to immigrate and avoid most of the downside risk by excluding most muslims and Africans and some other groups (certain parts of Eastern Europe plausibly?). Obviously policy experiments would be good here – allow immigration of selected groups to certain areas, keep them there and measure outcomes. Learn and iterate.

        But, because SJW values have become mainstream, we will continue what I would call the real “dumbest experiment in history”: fill Europe with muslims and hope we don’t turn into the middle east.

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        • “Left leaning media, academics and policians tend to supress any potential evidence of harms due to immigration. France AFAIK has a national policy to not collect statistics on race.”

          The latter has no connexion to the former (which is false: there is plenty of discussion about the problems of immigration in western media). France doesn’t collect ethnic statistics (not “racial”, the concept of race is not recognized in France) because of historical awareness, due to direct experience of Nazi military occupation, of what they can be used for.

          “Islamists have used the tactic of winning a democratic election to gain power from which they can dismantle democracy and impose the Islamic caliphate on a country”

          This has not actually happened anywhere; all the countries where Sharia law applies in full are either countries which have weak or no democratic tradition (the Islamic State, Saudi Arabia, Sudan, Yemen, Qatar, Sudan, Mauritania, Brunei) and/or where Sharia was implemented by design from the very beginning after a regime change, prior to any election (Iraq, Iran, Maldives, Afghanistan, Pakistan).

          The only democratically elected “islamist” parties that haven’t been quickly toppled after their elections (Enahda and the JDP) have not implemented Sharia law even in part.

          “f muslim immigrants to Eurpoe set off a nuclear bomb in a European capital in the next decade”

          Bad science fiction.

          “It is plausible to me that mass immigration of muslims into Europe is sowing the seeds of our destruction and cold blooded murder 30-50 years down the line.”

          If this is “plausible”, then severe recalibration is needed, unless “plausible” really means “not even wrong”.

          “Also, even if the above scenario is not particularly likely, we have to ask what % chance of slipping into an Islamic Caliphate it is worth bearing in order to reap the economic benefits of immigration.”

          The percentage is currently 0, and with the current trends, it will stay at 0 in the foreseeable future — if only because Islam is not a strong religion, but a religion in crisis; muslims are rapidly secularizing both in the western and islamic world, and for every muslim that joins the Islamic State, 100 are leaving Islam.

          “But, because SJW values have become mainstream”

          They haven’t.

          “fill Europe with muslims”

          This isn’t happening (for a non distorded definition of “fill”).

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          • Alphaceph says:

            > “muslim immigrants to Eurpoe set off a nuclear bomb in a European capital in the next decade – Bad science fiction.”

            Would the Paris attacks, 7/7, Madrid, Cologne rapes/mass sexual assualts, Rotherham Islamic paedo ring also have counted as bad science fiction before they actually happened? At some point you have to update your beliefs so that you are not continually surprised by bad news about muslim groups.

            To be fair, getting hold of a nuke is very hard and that scenario represents only a small risk IMO. A dirty bomb seems more likely, and conventional attacks at a greater frequency than we see today, and with greater effect, worry me more.

            Still, you have to put a number (probability) on it and, “oh that’s just bad science fiction” is not a number.

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          • Unless an actual and clear explanation of how, in ten years, the European situation is supposed to go from “sporadic low-level terrorism” (compared to Iraq, Pakistan, or even Lebanon, Europe doesn’t have a terrorism problem) to “immigrants detonate a nuclear bomb in a major city” is given, any probability of such a happening going over 0.0000015 (approximately the chance of Yellowstone undergoing a catastrophic caldera event or of a 1km large asteroid hitting Earth this year) is ludicrous.

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          • Alphaceph says:

            > actual and clear explanation

            1) Iran acquires (or already has) nukes. Therefore Saudi also gets nukes. Saudis (or elements in the Saudi regime) give nuke to IS to detonate against Assad because, due to Russian intervention, Assad is winning Syria. IS instead puts nuke in boat packed full of “refugees”, sails it into a coastal European city, dets at the docks. Attempts to intercept the boat or deal with it are thwarted because the relevant navy doesn’t want to look bad by shooting at refugees.

            Obviously I hope that these kind of scenarios don’t happen. But the probability of the union of all scenarios in which IS dets a nuke in Europe is greater than 0.0000015 in my opinion. 0.0001 seems reasonable to me, over the next 10 years, rising rapidly as nukes become more available.

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          • chaosmage says:

            > Islam is not a strong religion, but a religion in crisis; muslims are rapidly secularizing both in the western and islamic world, and for every muslim that joins the Islamic State, 100 are leaving Islam.

            Fascinating! And surprising. Source?

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          • Alphaceph > That seems like a very contrived scenario, to be charitable; that doesn’t seem to provide any reason to update the previous probality upward.

            There’s no positive evidence that Iran has the bomb or is trying to acquire it, multiple intelligence sources, both western and non western, both governemental and non governemental, concord on this point — the fear of the Iranian bomb is mostly spread by the same sources who spreaded the fear of the Iraqi bomb.

            Meanwhile, the Saudi have been trying to woo Pakistan to acquire the bomb for decades, so far without success. Pakistan has the bomb and didn’t let independent armed group get it, there’s little reason to think the Saudi would do so (ISIS has Saudi supports, but those are mostly rich, distant relative of the reigning family, far removed from the actual center of power, let alone military command).

            Europe has multiple security dispositives, both human and technological, to prevent the illicit circulation of radioactive material within its borders. If there was even suspicion that a boat poses a nuclear threat, that boat would be stopped before leaving its middle-east naval base.

            chaosmage > direct statistics on muslim apostasy do not exist, but as a good proxy, the Council of ex-Muslims of Britain claims to provide assistance to 350 people every year. Given how taboo apostasy is in Islam, it can be assumed that this is actually only a minority of the people who turn away.

            If we go beyond straight apostasy to secularised believers, in France, an inquirry reveals that only 36% of muslims describe themself as “observant believers” and only 20% claim to go to the mosque on every friday, although 70% observe ramadan. This thus leaves 30% of people with muslim background or culture who have little to no religious observance, which is more than a million French citizen.

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          • “Left leaning media, academics and policians tend to supress any potential evidence of harms due to immigration.”

            Of course free immigration has always been a project of left wingers. Like me, and Julian Simon, and Reason Magazine … .

            Machine Interface writes:
            “all the countries where Sharia law applies in full are either countries which have weak or no democratic tradition (the Islamic State, Saudi Arabia, Sudan, Yemen, Qatar, Sudan, Mauritania, Brunei) and/or where Sharia was implemented by design from the very beginning after a regime change, prior to any election (Iraq, Iran, Maldives, Afghanistan, Pakistan).”

            I think you are confusing fiqh, Islamic jurisprudence, based on the attempt of religious scholars to deduce the implications of sharia, roughly speaking law in the mind of God, about which scholars may and do disagree, with state run legal systems that borrow some of their rules from traditional Islamic law. One of the central tenets of Islamic legal theory is the separation of state and law. Saudi Arabia may arguably have more or less the traditional system, but I don’t think most of the rest of the states you describe come close.

            For more details on traditional Islamic law, a draft of the relevant chapter of the book I’m working on is webbed at:

            http://www.daviddfriedman.com/Academic/Course_Pages/Legal_Systems_Very_Different_13/Book_Draft/Systems/Islamic_Law_Chapter.htm

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          • “There’s no positive evidence that Iran has the bomb or is trying to acquire it”

            Do you have any explanation for Iran’s willingness to bear very large costs in order to develop a nuclear industry that could be used to produce a nuclear weapon other than their trying to do so? For their expanding that industry covertly until caught doing so? I don’t–and since it seems obviously sensible for Iran to get a bomb if they can, I find your “no positive evidence” unconvincing.

            It’s possible that the Iranians have decided that, at present, carrying through the project costs them more than it is worth. But the claim that it wasn’t their objective strikes me a wishful thinking.

            In an earlier post, you wrote:

            “and for every muslim that joins the Islamic State, 100 are leaving Islam.”

            Asked for a source, you engaged in some irrelevant hand waving. You don’t know what percentage of Muslims attended mosque ten years, or a hundred years, ago. You don’t know, or at least say, how many muslims join the Islamic state. You gave zero information on how many leave Islam.

            Unless you have an actual source, I will take this as evidence that you are willing to invent numbers in order to make your argument sound more persuasive, and discount your future claims accordingly. It’s too bad, since on the whole we are on the same side in this argument.

            A quick search for data on Muslim population growth found, from the Pew Research Center:

            “Meanwhile, religious switching, which is expected to hinder the growth of some other religious groups, is not expected to have a negative net impact on Muslims. By contrast, between 2010 and 2050, Christianity is projected to have a net loss of more than 60 million adherents worldwide through religious switching.”

            I don’t know if they are correct, but it’s the opposite of your unsupported claim.

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          • “Do you have any explanation for Iran’s willingness to bear very large costs in order to develop a nuclear industry that could be used to produce a nuclear weapon other than their trying to do so? ”

            Since that “willingness to bear very large costs” has effectively vanished with the presidency of Rouhani, there is actually nothing to explain, and the original claim is in accordance with the current evidence as long as one takes care of noticing the present tense.

            American intelligence agencies do aknowledge that Iran *may have*, at some point, tried to acquire the bomb, but add that, provided that these efforts were even a reality to begin with, they have ceased in 2003 ( http://www.richardsilverstein.com/wp-content/uploads/2011/06/Hersh-6-6-11.pdf )

            As for the shrinking of Islam, it’s a well discussed subject both among adherents and opponents of Islam.

            http://www.theguardian.com/global/2015/may/17/losing-their-religion-british-ex-muslims-non-believers-hidden-crisis-faith

            http://www.jihadwatch.org/2015/07/islam-fastest-shrinking-religion-in-the-world

            The Pew institutes notes that the apparent growth of Islam is mostly due to demographic factors, and that otherwise Islam loses at least as many people as it gain from conversions.

            The number of people who join the Islamic State is extremely low, they attract only the fringe of the fringe, and it’s pretty clear that the Islamic State’s actions disgust more than they inspire a large majority of muslims; the Paris attacks has been denounced by ordinary muslims in demonstrations, by muslim governments, and even by other organizations classified as terrorist in the west. This is not the face of a united, strong religion, this is the face of an imploding religion, just like Christianity was imploding in Europe in the early modern era, even though “Christian population” was growing.

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        • sabril says:

          “Islamists have used the tactic of winning a democratic election to gain power from which they can dismantle democracy and impose the Islamic caliphate on a country, however this requires a certain percentage of Muslims to be successful. ”

          This is basically what happened in Gaza. I would not call it a “caliphate,” but Hamas got elected and hasn’t permitted any challenges to its power democratic or otherwise since then.

          By the way, I should warn you that the poster “Machine Interface” seems to have a tendency to just invent whatever facts suit his mood. In a previous discussion, he said this:

          “When the Israli army last retreated from Lebanon, soliers were given order to empty all their ammunitions, in order to leave as many unexploded ordinances as possible.”

          As of yet, he has provided no evidence for this claim.

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          • Hamas hasn’t started a caliphate nor even imposed more strictly islamist laws, which was the allegation.

            As for Israel behaviour in Lebanon, here’s what can be read in “The Israel Lobby and US Foreign Policy” (a book whose authors are neither anti-zionist nor pro-palestinian), from page 322 onward:

            “One of the more devastating punitive tactics was Israel’s use of cluster bombs, which spray large number of bomblets over a large area. […] Given how lethal these weapons can be when used in civilian areas, the United States has always insisted that Israel use them against clearly defined military targets.(80) Indeed, as noted, the Reagan administration banned the sale of cluster bombs to Israel for six years during the 1980s, after it discovered that the IDF had used them against civilian areas in its 1982 invasion of Lebanon.(81)

            In the last three days of the recent Lebanon war, when a cease-fire was known to be imminent, the IDF fired over one million bomblets into southern Lebanon, which has a population of 650,000.(82) The aim was to “saturate the area” with these small but deadly bombs. One Israeli soldier in an artillery battalion said. “In the last 72 hours we fired all the munitions we had, all at the same spot. We didn’t even alter the direction of the gun. Friends of mine in the battalion told me they also fired everything in the last three days— ordinary shells, clusters, whatever we had.”(83) Over the course of the entire war, the IDF estimed to have fired roughly four million bomblets into Lebanon. When the fighting stopped in mid-August, UN officials estimated that there were about one million unexploded bomblets in the southern part of the country. Researchers from Human Right Watch said that “the density of cluster bombs in southern Lebanon was higher than in any place they had seen.”(84) One Israeli soldier who helped “flood” the area with cluster bombs said, “What we did was insane and monstruous, we covered entire towns in cluster bombs.”(85) Jan Egeland, the UN’s under-secretary-general for humanitarian affairs, labeled Israel’s actions “shocking” and “completely immoral”.(86) In the first eight months after the war, 26 lebanese were killed by cluster bombs and another 215 were injured, 90 of them children.(87)

            […]There is no question that Israel deliberatedly attacked a wide array of civilian targets in Lebanon, just as General Halutz said that they would. The description of the devastation in the Amnesty International report makes this clear. […] Indeed, it “noted a pattern of destruction by Israeli attacks that indicated that Israeli forces had targeted objects that are indispensable to the survival of the civilian population.”(89) In a separate study of Israel’s offensive in Lebanon, Human Rights Watch (HRW) concluded that “Israel violated one of the most fundamental tenets of the laws of war: the duty to carry out attacks on only military targets.” (90)”

            (this is only a short excerpt of the passage)

            (numbered citations on demand)

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          • Cliff says:

            I see such claims about Israel very commonly, but when investigated they all turn out to be fabricated. What possible reason could Israel have for attacking civilian populations? Israel certainly takes much stronger precautions against civilian casualties than the U.S. and was extraordinarily successful at avoiding casualties in the recent incursion into Gaza. Civilian casualties are devastating for Israel and they seem to avoid them at all costs.

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          • sabril says:

            @Machine Interface

            “Hamas hasn’t started a caliphate nor even imposed more strictly islamist laws, which was the allegation.”

            1. More strictly islamist laws than what?

            2. Even if Hamas did not go as far as the poster suggested was possible, what they did is bad enough: a. The people freely elected an Islamic-based party; b. The Islamic-based party took over and did not permit further elections or challenges to its power.

            “[a book excerpt]”

            Assuming for the sake of argument that your source is completely accurate, there is nothing there indicating that Israel deliberately attempted to leave as much unexploded ordinance as possible in Lebanon.

            @Cliff

            “I see such claims about Israel very commonly, but when investigated they all turn out to be fabricated.”

            Yes I agree. Of course it should be noted that it’s 100% correct that Israel attacks civilian areas and kills civilians. For the simple reason that groups like Hamas and Hezbollah operate out of civilian areas and use civilians as human shields. Indeed, by criticizing Israel for attacking civilian areas, Leftists are encouraging Hamas and Hezbollah to continue their cynical use of human shields.

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          • The latest Gaza conflict killed over 2,000 Palestinians, a number agreed upon by different sources, including the Israel Ministry of Foreign Affairs. The point of disagreement is the proportion of civilians in that numbers.

            The Gaza Health Ministry claims 70% civilian casualties (probably too high).

            The Israel MFA claims only 36% civilian casualties, but adds 20% of casualties that could not be classified as either civilians or fighters.

            The United Nations Human Right Commitees claims 65% civilians. This is probably closer to the real number.

            Thus, there is little numerical evidence that precautions were taken not to harm civilians, or that the raid was less deadly than the previous raids on Gaza.

            @ Sabril: the claim was about a islamic party being democratically elected and starting a caliphate. Which has never happened.

            The book citation in fact says exactly the thing in question.

            The human shield argument is a diversion: when someone has a hostage, the police isn’t justified in shooting the hostage in order to get to the hostage taker.

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          • sabril says:

            “the claim was about a islamic party being democratically elected and starting a caliphate”

            So you concede then, that it HAS happened that an Islamic party was democratically elected and then put an end to democracy?

            “The book citation in fact says exactly the thing in question.”

            Please quote the book where it says in substance that Israel’s intention was to leave unexploded ordinance in Lebanon. If it says “exactly the thing,” then one sentence should be enough.

            The only sentence I could find about unexploded ordinance was this one:

            “When the fighting stopped in mid-August, UN officials estimated that there were about one million unexploded bomblets in the southern part of the country. ”

            It that what you were referring to?

            “The human shield argument is a diversion: when someone has a hostage, the police isn’t justified in shooting the hostage in order to get to the hostage taker.”

            If the hostage-taker is actively shooting at innocents from behind his human shield, are the police justified in shooting at the hostage-taker even though it will endanger the hostage?

            Or must they allow the hostage-taker free reign to shoot and kill as many innocents as he likes?

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          • That wasn’t the claim being made.

            The citation makes it pretty clear that Israel deliberatedly fired cluster bombs over civilian areas with no justification.

            More diversion and shifting the goalpost. Multiple international observers, both governmental and non-governmental, of all kinds of political obedience, including Israeli sources, attest of the IDF’s reckless behaviour, disregard for civilian life and punitive bent. Israeli ultra-nationalists and their foreign supporters are pretty much the only source claiming otherwise.

            Nationalism is not compatible with reason and truth, and making every comment thread about Israel (without even mentioning frequent personal attacks) doesn’t speak well of the obsessive and relentless nature of zionists.

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          • sabril says:

            @machine interface

            “That wasn’t the claim being made. The citation makes it pretty clear that Israel deliberatedly fired cluster bombs over civilian areas with no justification.”

            Nonsense, here’s what you said:

            ““When the Israli army last retreated from Lebanon, soliers were given order to empty all their ammunitions, IN ORDER TO LEAVE AS MANY UNEXPLODED ORDINANCES AS POSSIBLE.”

            (my emphasis)

            You accused Israel of deliberately attempting to create a problem of unexploded bombs in Lebanon. The excerpt you provided says no such thing.

            Whether or Israel had justification for using bombs in civilian areas is a different story, of course. Given Hezbollah’s tendency to fight from civilian areas, they probably did. But that’s not the claim you made.

            Can I take it you now concede, at a minimum, that Israel did not deliberately attempt to leave large amounts of unexploded ordinances in Lebanon?

            “More diversion and shifting the goalpost.”

            Nice description of your own behavior.

            By the way, it looks like you did not answer my questions:

            If the hostage-taker is actively shooting at innocents from behind his human shield, are the police justified in shooting at the hostage-taker even though it will endanger the hostage?

            Or must they allow the hostage-taker free reign to shoot and kill as many innocents as he likes?

            Do you concede that it HAS happened that an Islamic party was democratically elected and then put an end to democracy?

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    • anon says:

      Always nice to see “autistic” used to refer to Nerds We Don’t Like. Another step toward making the SSC comment section indistinguishable from /v/

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  18. Cord Shirt says:

    This reminds me of the achievements celebrated by the GI generation…that the baby boomers went on to condemn them for because they had ignored some of the costs. (cf. /Silent Spring/…not by a baby boomer, but adopted and touted by them.)

    But that’s how it goes, I guess.

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  19. Made a small donation. Good to hear good news of this kind. 🙂

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  20. Max says:

    This gif is probably best argument for charity I seen for a while. Which makes me immediately suspicious – how badly stats were doctored?

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  21. Alphaceph says:

    We should aggressively push for a genetic plague to wipe out mosquitos, it would be far more effective than any bed net could possibly be.

    And whilst we’re at it, a bunch of other parasites of humans that reproduce sexually are probably also vulnerable to being wiped off the face of the earth using this method.

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    • JBeshir says:

      There’s been talk of a genetic plague to make mosquitoes resistant to malaria which I found exciting, if slightly scary, because the gene drive approach to spreading it would effectively override normal selective pressures by being an absurd 99% heritable and apparently we essentially have all the technology we need to do this now, we’re just holding off because the people involved feel the “social science” isn’t there.

      I’m hoping it happens soon. It sounds like as good a test case for playing with genetics as we could find, and I think seeing it in use would spur the needed conversations about how to manage this technology before the theory progresses much further.

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      • Tibor says:

        I read about regular mosquitos being replaced by a genetically engineered version which is resistant to malaria in the sense that they don’t carry it. That way, one does not have to worry about secondary effects such animals who eat mosquitos losing their source of nutrition. I don’t know if it’s actually being implemented though.

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        • Alphaceph says:

          Malaria would inevitably evolve resistance, right?

          Go to the source of the problem: destroy all the mosquitos, wipe them off the face of the earth.

          Malaria will then also die out.

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          • Tibor says:

            I don’t know much about medicine or biology so I am on a thin ice here, but since Malaria is not a virus (it is actually caused by a parasitic microorganism, so it is not even a bacteria, I guess) it should not mutate that fast. Malaria is almost exclusively transferred by female mosquitos, so if you cut off that mean of spreading, it will die out too. Also, if you replaced regular mosquitos with these mosquitos, you would not have to worry about these things:

            a) that the genetically engineered plague to wipe them out mutates itself (although maybe you can engineer “safe” plagues)

            b) that wiping out mosquitos does not bring something even worse. Mosquitos might be a competition for another insect which could also do a lot of harm. Eradicate them and you have another group of insects to eradicate. Also, some animals probably eat mosquitos. You get rid of mosquitos and you endanger these animals as well.

            c) that you completely ruin the business of people who make bednets! (don’t take this point too seriously 😉 )

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    • onyomi says:

      I’m not certain this is a bad idea, but it does remind me, at lest superficially, of that time Mao Zedong urged everyone to kill birds on the theory that they eat crops. The result, of course, was an explosion in insect populations which ate even more crops.

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

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      • Alphaceph says:

        People have looked into this question scientifically. destroying certain species of mosquito is fine. I can’t google the source now but it’s there.

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        • onyomi says:

          Yes, if we could preferentially kill just the mosquitoes which transmit malaria than that would seem much less likely to negatively impact the food chain, etc. Reminds me of the idea of killing just the bacteria which cause tooth decay or, for that, matter, pimples and staph infections… of course it might cause some unforeseeable problems given how we have evolved alongside such bacteria for millenia, but if possible, it sure is tempting.

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          • Douglas Knight says:

            Alphaceph called for a “genetic plague.” That would be highly species-specific.

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          • Nornagest says:

            A number of options, like the sterile male technique, do target individual species. The insecticide bednet approach casts a broader net (no pun intended), but not all species of mosquito suck blood, and of those that do not all attack humans, or attack resting humans in their homes.

            (I seem to recall that eradicating mosquitoes more generally has also been studied and found not to be especially ecologically dangerous, but one might feel justified in a little more skepticism there.)

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  22. JBeshir says:

    What do people who have high views of investing to donate at the end of their lives make of these trends?

    Personally, I think the true reason I want to donate now rather than later is psychological, wanting to “feel like I’m doing something” but I’ve also perhaps optimistically hoped that by the time I died a lot of the good giving opportunities would no longer exist.

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  23. Any thoughts about anti-war charities?

    It would be really hard to judge effectiveness, but it seems kind of pointless to protect people from malaria who end up dying in a war.

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    • Anon says:

      They’re often very well funded already, so I think it only makes sense to donate if there’s some reason to believe we can find (or found) one which is either effective and underfunded or which will be able to make effective use of the marginal dollar donated even at operating budgets in the tens or hundreds of millions.

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    • Nathan says:

      I would be extremely surprised and impressed if any charity had any meaningful ability to prevent war.

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  24. Urstoff says:

    How much ecological devastation would occur if somehow through science/magic, we were able to make mosquitoes go extinct in the span of a few years? Are they a major food source for a lot of animals?

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    • keranih says:

      It’s been explored here. I think the column’s conclusion ignores several issues that were brought up in the text, and I don’t see enough emphasis given to the population-suppression role of skeeters in transmitting diseases. We’ve seen what happens when different organisms have their primary predators removed, and it’s not generally good for the environment.

      Whether or not we’d care about skeeter-eating fish or plants that need skeeter pollination, though, enough to tolerate dengue and malaria is another story.

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    • Douglas Knight says:

      Would wiping out mosquitoes have ecological consequences? Maybe. Would wiping out the 10% of species that prey on humans? Probably not. The 1% that carry malaria? No.

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    • onyomi says:

      I know spiders and birds eat them. Not sure how damaging it would be to them to lose that particular food source.

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  25. Paul says:

    I was surprised to see such a dramatic change, having just spent some time in WHO’s burden of disease statistics. (http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html)

    For Africa, in 2000, they reported 796,000 DALYs lost to Malaria in Africa (out of 4.3 million infectious disease and 10 million, all causes). In 2012, the Malaria number is 554,000 (out of 3.1 million infectious disease and 9.2 million all cause).

    Things are certainly better, but not quite as stark as the cute video.

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    • Douglas Knight says:

      First of all, those numbers are deaths, not DALYs. Second, they are absolute, while this map is per capita. There has been massive population growth over the period, making the two figures diverge. The source claims that 6.2 million lives were saved, of which maybe 4.9 million were in Africa (based on its claims about cases). That’s 320k/year, larger than the discrepancy between your starting and ending figures, but I think about right taking into account population growth.

      This map is of the number of infections, not deaths. Actually, it’s the percentage with an infection in the previous year, probably for ease of surveying. Moreover, it is for children aged 2-10. They are a small proportion of the total population, thus of total deaths, but they would be heavily weighted for DALYs.

      Here is a graph from a WHO report (p35aka49) showing that cases among children have declined much faster than total cases. Cut in half, which seems about the same as the map. However, the GWWC link has a map for adult numbers that doesn’t seem very different from the children map. Of course, maps don’t weight by population.

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      • Paul says:

        Thanks Doug, I had been on the DALY sheet earlier, and didn’t realize I had switched to total mortality. The proportional change is roughly the same — 72 million to 50 million over 12 years. Against 36% population growth, this gives us a fall of close to 50% per person. I thought the nature video gave the impression that malaria was all but eradicated, when in fact the disease burden is still serious. Nevertheless the progress is impressive.

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  26. onyomi says:

    It’s kind of exciting to know there is still so much low-hanging fruit in terms of alleviating misery and death. Depressing in a sense, of course, but also exciting in the sense that we might be able to make the third world a lot better with a lot less money/effort than we think. Making the third world a lot better will, in turn, make the global economy a lot better too.

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  27. Douglas Knight says:

    GWWC says: globally, 6.2 million fewer people died of malaria over the last 15 years because of malaria interventions

    Actually, that’s not what their source says. It says something very weird:

    It is estimated that a cumulative 1.2 billion fewer malaria cases and 6.2 million fewer malaria deaths occurred globally between 2001 and 2015 than would have been the case had incidence and mortality rates remained unchanged since 2000. In sub-Saharan Africa, it is estimated that malaria control interventions accounted for 70% of the 943 million fewer malaria cases page xi AKA 13

    There is some kind of counterfactual claim, but only 70% of the change is due to “malaria control interventions.” What is the rest of the change? Maybe the rest is also due to malaria control interventions, but not the specific ones they list?

    If it isn’t an intervention, why talk about it in counterfactual terms? For example, if the change is urbanization, that’s a modeling error in their definition of “constant incidence,” not an interesting counterfactual.

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  28. Troy says:

    (I don’t think this has come up yet, although I haven’t read all the comments.)

    I showed the map in this post to my wife, and her reaction was that a lot of the change in malaria levels seems to be correlated with the rise and fall of civil wars in several countries — the DRC being the biggest one, and the Lord’s Resistance Army in Uganda and the Rwandan genocide being smaller ones.

    I don’t know what this says about the effectiveness of this charity in reducing malaria, but war seems to be an important causal variable here to take into consideration.

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    • Douglas Knight says:

      It’s true that Rwanda cut its incidence by a factor of 4 in this time period, but people don’t usually date the genocide to 2000-2015. It looks like you or your wife just looked at the big spot of red in Congo and tried to brainstorm wars that took place there. But what about the other big red spot in the northwest? Burkina Faso has been pretty much peaceful the whole time. War in the Ivory Coast seems to have been good! Did war reduce malaria in CAR by sending the refugees north, where there’s no malaria?

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      • Troy says:

        It’s true that Rwanda cut its incidence by a factor of 4 in this time period, but people don’t usually date the genocide to 2000-2015.

        Right, if the genocide had an effect in Rwanda, it would have been in the initial rate, which then seems to go down for the rest of the time period; although perhaps 6 years is too long to expect those effects to linger on. The genocide also had spillover effects in neighboring countries, especially the Congo, that lasted into this time period.

        But what about the other big red spot in the northwest?

        Yes, we both identified the northwest as harder to account for under this theory. She also observed that there is no recent increase in CAR on this map, despite the recent conflict there.

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    • Douglas Knight says:

      GWWC has three videos: the one of children that Scott copied, a similar one for adults, and a third of the concentration of bednets. I find the videos unwieldy. I prefer the original website, or even better, downloading the images from there.

      I was surprised to see that the two hotspots generally had higher rates of bednets than the rest of Africa. Of course people want to target them because of their high rates of malaria, but I expected charities to stay out of Congo.

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  29. Linch says:

    For people interested in population control/contraceptives access, PSI is a great resource:

    http://www.psi.org/work-impact/

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  30. “a particularly heavy-handed Ayn Rand book”

    As opposed to her usual light, almost Nabokovian touch.

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