Bill Gates pledges $10bn for a 'decade of vaccine'
timesonline.co.uk
timesonline.co.uk
By decreasing the amount of wealth that is necessary for a human person to remain alive - for example by introducing a new vaccine that allows a large (5+) family in unsanitary conditions to have all of their children reach adulthood - these sorts of programs in undeveloped countries actually create more poverty then they solve. There is not a cheap-manual labor shortage in these countries. There is however an acute shortage of well-paying jobs that don't involve corruption. By allowing the supply of just-surviving people to increase, you are putting even more downward pressure on the wages of unskilled labor (they are caught in the Iron Law of wages).
Keep in mind that in these countries, with no real legal system, unskilled labor doesn't mean gardening like it does in California but violence in the form of gangs/thug-ocracies who typically control access to natural resources or drug running routes. By creating more people, you are making it easier for the systems that keep them poor to grow, in a positive feedback loop.
The problem is not that a $3 drug is too expensive, and that we need to develop a 30 cent drug, the problem is that there are people who can't afford $3 for a life-saving drug. What they really need from the US is jobs, markets, and protection from the threats of climate change that we are causing by using 25% of the world's fossil fuels (more if you count the contribution from production in China to the cheap goods that we consume).
If Gates really wanted to help these people, he would campaign for an end to developed world farm subsidies, fossil fuel subsidies, and the recreational diamond market. But that would make him unpopular in the US.
EDIT: are downvotes for disagreement or for breach of etiquette?
I refuse to believe that the loss of life is perferable than the preservation of life. And quite frankly, arguments from classical economics seem rather cold given the subject matter.
The heart of your argument suggests that the political issues in these countries are the root of the problem. This is correct. However, history shows us that the amount of money spent on politically bankrupt states has little or no impact on making them politically sound. Gates money is useless on the third world political playing field; instead, Gates is choosing to spend it in an area which he can actually have an impact.
As far as domestic politics go, the positions you suggest that Gates take on "farm subsidies, fossil fuel subsidies, and the recreational diamond market" are all politically untenable at the moment. It's not clear Gates could have an impact there either.
well, it's political-economical-cultural, you can't really isolate one like that.
I'm not advocating Gates giving money to those governments, so they chose what to spend on. I agree that would be even worst - they would buy guns to strengthen their armies and luxury goods for themselves on their visits to Europe and Dubai.
10B can have quite a large impact on political realities in the US. Electing Obama cost a lot less then that.
I don't think he said that. What he said is that improving the economy might help more people than just handing out vaccines. By improving the economy, people get vaccines anyway (they can buy them themselves).
I could not disagree more strongly regarding vaccinations not being an effective economic development tool.
Take the polio vaccination program for instance. Polio. Polio doesn't often kill people, but it does often make them lame for the rest of their lives. So, for every person that gets polio, they are extremely limited in the economic goods that they can produce, but they are also an economic drag on the family, because they are a financial burden rather than producing income. Polio has been almost eradicated, and the economic benefits to poverty stricken countries has been huge.
Small Pox is another example. It has all been eradicated, life expectancies have gone up in the third world because of it, and more people are able to produce income for longer.
Other diseases like Malaria, Cholera, Dengue affect hundreds of millions of people world wide each year, and they aren't necessarily killer diseases. And, millions and millions of people are affected by these diseased, and when they are infected, they are an economic drain.
Preventing these diseases with a simple vaccine is going to give a much greater economic boost to poor countries than giving them clean energy technologies or superhighways.
Keep in mind that in these countries, with no real legal system, unskilled labor doesn't mean gardening like it does in California but violence in the form of gangs/thug-ocracies who typically control access to natural resources or drug running routes
That, sir borders on the racist. What countries are you referring to? There are well over a hundred developing countries with various levels of legal systems and economies. Are you saying that all developing nations are thugocracies? Are you suggesting that any and all unskilled labor in developing nations ends up leading to gangs?
I'm not saying we shouldn't try to help, if possible - but we need to attack the right problem. The reason we don't is that because there is a real cost to us to do so. People who are all for money towards cheap vaccines want to help as long as it doesn't cost them anything other then their admiration.
"Preventing these diseases with a simple vaccine is going to give a much greater economic boost to poor countries than giving them clean energy technologies or superhighways."
If America continues polluting the world to the point where temperatures rise above 2C and global climate patterns are disrupted, we will have directly caused the deaths and suffering of tens or hundreds of millions of people. Not causing those deaths is indeed a greater economic boost then cheaper vaccines. We need clean energy everywhere, starting with the US and China.
Infrastructure that supports trade is an excellent investment. Superhighways? That makes it sound like you've never left the suburbs, man. These places need a road connecting their capital to everywhere else that can handle 2 lanes of traffic each way, and a port that can handle a decent size ship. No, they don't already have that.
"That, sir borders on the racist. What countries are you referring to?"
Who said anything about races? I'm referring to any country where managing natural resources is a substantially larger portion of the economy then leveraging human capital. In that case, ruling elites have huge financial incentives to actively deter development of human capital. That would be a challenge to their rule. Their government might have "democracy" and laws that sound great, but at the end of the day the job of the police and military is to keep the powerful in power, and in that sense they are nothing more then a glorified gang.
I would believe Bill Gate's sincerity if he permanently moved to a developing country and tried building a profitable business (any business!) there. If you want people to live a wealthy lifestyle, they need a way to generate that wealth themselves.
Stated more simply: It is good that children in poor countries are dying because if they had lived then they would have created more poverty.
How is this getting any upvotes? marciovm, Gates isn't spending this money to play up his image to the American public and to tug at America's heart strings. He's doing this because it's right. Giving people vaccines to live is right. Letting them die because it might create less poverty isn't - it's missing the point that all lives are important.
I completely agree that empowering the economies of developing nations is a very high priority. Higher GDP's lead to longer life, lower infant mortality, more education, less children per mother (because the opportunity cost of having a child is higher once the mother gets a high salary), etc. However, researching vaccines is just as important and necessary for developing countries that are crippled by HIV/AIDS, malaria and tuberculosis.
I grew up in Brazil and that makes you more cynical then growing up in California. When you live in a place like that, you learn that just because something sounds good doesn't mean it is.
I'm also a graduate student at MIT working on cancer nanotechnology. When not being provocative online I spent all my hours in lab developing tools for oncologists to detect cancer earlier and treat it better. I have a patent from my undergrad research at Berkeley for a needle-free drug delivery device that is moving through animal trials to hopefully make injections less painful for people (even kids - think of the kids!).
I also spent a ton of time making the MIT Clean Energy Prize into a national organization, to help students across the US get access to capital and mentorship so they can start clean energy companies when they graduate.
Is that altruistic enough for you?
You have to look at the margins. Is the benefit of $10 billion spent on vaccine research greater than $10 billion spent on clean energy or infrastructure? I think it is.
There are already many companies, subsidies, and grants for clean energy. Honda has revenues of about $120 billion per year and it spends 5% of that on R&D. Of course not all of that is spent on clean energy, but Honda is only one car company. $10 billion is a small fraction of the amount spent per year on clean energy research. For comparison, the WHO's yearly budget is around $1 billion.
What about infrastructure? The new bay bridge has a price tag of $6 billion. If that's anything close to the typical price of building big stuff, then vaccine research is definitely more cost-effective in terms of lives saved.
> these sorts of programs in undeveloped countries actually create more poverty then they solve.
Yes, it's a trade-off. More poor people for fewer dead people.
Living in Somalia sucks, but living in a Somalia with smallpox would be even worse. We know the problems of many 3rd world countries are more than just matters of supplying basic needs. You point out the harm caused by corruption and crime, but you neglect another reason for the lack of progress: disease. Workers can't work if they're stricken with malaria, or crippled from polio, or dead from smallpox.
It's true that many cannot afford to pay for vaccines. Luckily, philanthropists and governments like to give money to groups like the Pan American Health Organization (which eradicated smallpox and polio in the americas). If everyone had to pay for their vaccines, smallpox and polio would still kill millions.
Smallpox killed 400 million human beings in the 20th century. That's more than every war since 1900. Now it is gone. Polio crippled hundreds of millions. It remains in only four countries. There are hundreds of millions of cases of malaria each year. Several million die from it, mostly children. It is the biggest killer without a vaccine, and it's about fucking time that changed.
1) Are there any studies that support the "making people healthier would be a net loss to many societies" claim I keep seeing? It's one of those things that sounds like it makes sense, but no one really quotes any credible sources.
2) I would be utterly shocked if he did this to make himself popular in the US. You may put your own money elsewhere, but he's really a pretty smart dude who seems to do a great deal of research before making decisions. It's a little childish to write it off like that.
2) I don't think he is being uber-sneaky about this - I believe he has mostly intentions. But good intentions don't guarantee positive (or optimal) results.
I also think Gates wants to be respected by society, and before he started giving billions away his street-rep was of a geeky, conniving person. Now he is a Times person of the year and everyone loves him. You don't think he thought about that?
Also, it should be noted that the foundation (according to Wikipedia) specifically targets problems "ignored by governments and other organizations".
But I think you can improve lifestyle in two ways -- increase income like you mentioned, or decrease costs. It's possible for technology to bring costs down. And when costs come down, a $100 income can buy the lifestyle that $300 used to. So even if you depress wages, you can still win by depressing costs even further through technology.
Deleted comment
I think that's not true, and population trends are strongly against it, largely because of improved sanitation.
For example, Nigeria is the most populous country in Africa, urban population is about 50%. I'd bet their urban population is growing like crazy while the rural is shrinking.
"Job opportunities are important, but lowering mortality rates helps this."
Not always. That's a big assumption. Are there massive job opportunities around that require cheap labor? There are in China. They are getting to be rich by manufacturing. Not because Americans came in and solved all their health problems. Because Americans opened their markets and there was a government in place that enable the country to take advantage of that (a dictatorship with a bunch of problems, no doubt, but you can't say they haven't fueled economic growth).
"People dying young is inefficient, since it makes education and training more expensive"
Unskilled labor is by definition not educated or trained.
"eliminating Smallpox has made the world a worse place"
Well, it's highly subjective to say what makes a place better or worse. What are we trying to maximize? Human-life-years lived? Or human-life-years-lived without living under dictatorships, constant war and corruption?
Sure, research in medicine always has value. But making existing vaccines 10x cheaper the best alternative right now for our society to spend it's excess wealth in? Why does any of this matter if sea levels go up a few feet, and tens/hundreds of millions are forced to flee over national borders (and that leads to massive conflict)?
This is not to say I think short term goals are bad, just the fact you need to mix them. If I had Bill Gates’ wealth I would build a full scale fusion reactor using an updated and modular version of ITER's design. It might only reduce the time till the first commercial power plant by 10 years but I would still do it
We should be investing in all of them. But as you say, corruption gets in the way of good will.
From a neighbour country, down south, have an upvote :)
Edit: Clarification in square brackets.
We were surprised when we saw a newspaper article in 1998 showing that only a few diseases cause most childhood deaths and showing how little money was being invested in creating and providing vaccines for these diseases. A chart in the article showed that a particular type of diarrheal disease—rotavirus—was killing over 400,000 children per year. How could a disease we had never heard of get so little attention and kill this many children? We sent the article to my father and asked him to look into how we could help. A surprising but critical fact we learned was that reducing the number of deaths actually reduces population growth. Contrary to the Malthusian view that population will grow to the limit of however many kids can be fed, in fact parents choose to have enough kids to give them a high chance that several will survive to support them as they grow old. As the number of kids who survive to adulthood goes up, parents can achieve this goal without having as many children."
2009 Annual Letter from Bill Gates: Childhood Deaths: http://www.gatesfoundation.org/annual-letter/2009/Pages/2009...
Also, "you techies" strikes me as distancing language with a hostile tone. I think you're projecting a broad, unfounded stereotype on people of developed countries. Personally I've very conscious that I was born one of the most advantageous positions in the world. I donate portions of my income with that thought in mind.
What is wrong with you? This is like watching guitar playing videos on youtube, where you watch a great guy going at it, playing virtuously some fine piece of music - it's about him, his skill and that piece of music - yet someone posts about some other guitarist how great he is and whatnot.
Let me be the one who says this. Who cares about Steve Jobs and Apple and his fans or whatever where we are talking about what Bill Gates and Bill and Melinda Gates Foundation are doing about fixing the shit world we live in.
Stop being a teenage girl, this ain't no Backstreet Boys vs East17 or something like that. Though sometimes it is exactly like that and I am truly ashamed of people that behave like that in a group of people I gravitate to.
</harsh_rant>
edit: apparently maxwin edited his post and I hadn't realized it. My sincere apologies then, but if I'd seen original post by maxwin - a bit altered rant would be directed towards him.
It appears that maxwin edited his post after being called out over it.
The irony is that you're doing what you're talking about.
For several years, I have had an idea for a nonprofit that would bring top next-gen leaders & influencers from the USA over to third world countries (in Africa, in the current plan), to open their eyes to conditions so they can learn the point you just wrote, maxwin. We're all human beings, and we need to do all we can to help our fellow (wo)man. The hope would be, these people would go on to become the Bill Gates of the next generation and would use their influence to do good.
Check out http://www.africafellowship.org/ (ugly design, I know, but it's a work in progress)
It is exactly like marciovm123 says, "This sort of spending tugs at the heart strings but unfortunately it can actually be quite counter-productive at improving the lives of people in undeveloped regions."
If a country is really that badly off, what difference does it make if we save people from one form of suffering only to have them be subjected to a different form. I agree with some of the above statements that the money would be better spent developing the infrastructure of 3rd world countries, rather than trying to solve a more isolated problem. Simply making vaccines cheaper is treating a symptom and not the problem itself.
It would matter to me if someone saved my life from sickness, even if I did die of starvation shortly afterwards.
>If a country is really that badly off, what difference does it make if we save people from one form of suffering only to have them be subjected to a different form
I don't understand. By that logic, action is only worthwhile if there is exactly one form of suffering. Surely that can't be right.
I'm not sure if the money would stretch this far, but what if instead of saving you, the money was spent developing the country in a way that would save 10x more people. Looking at this problem from a personal perspective gets in the way of doing the most good for the most number of people.
>I don't understand. By that logic, action is only worthwhile if there is exactly one form of suffering. Surely that can't be right.
Or action is worthwhile if it treats multiple forms, which I believe infrastructure development would do.
Perhaps I'm wrong and vaccination is the first step in the path to pull the countries out of poverty.
But as I said, I could be wrong. Either ways, props to Gates for trying to help out.
He's making the same point. This is why you will probably be down voted.
The essay Lifeboat Ethics: the Case Against Helping the Poor from 1974 is probably the essay available online that is more applicable to the current discussion.
I do not yet have a well-formed opinion on this one way or the other, I simply find Garrett Hardin's arguments to be thought-provoking. Saving millions of lives will mean that those millions of lives need to be sustained in some way. The resources to do this have to come from somewhere. By saving those millions of lives is that going to lower the quality of life of millions of others? It is a tough problem with, as Hardin mentions, "no technical solution".
Lifeboat Ethics: the Case Against Helping the Poor essay: http://www.garretthardinsociety.org/articles/art_lifeboat_et...
Tragedy of the Commons essay: http://www.garretthardinsociety.org/articles/art_tragedy_of_...
I am fully aware that if someone close to me was sick that I would do what I could to help them. It doesn't change the problem. I was replying to a question about unintended consequences. One of the potentially unintentional consequences of this is that it might make a lot more people suffer in the future overall.
It is a tough problem.
I can't believe I never read that before - thanks for link. Disagree with a good bit (I'm very pro-immigration/open borders to anyone who can support themselves) but the discussion on how programs like Food For Peace are lobbied hard and silently for by businesses who stand to profit was crazy. Wow, what an interesting summary. Can't believe I haven't seen that one before.
Who's to decide that person x is to live while person y is to die? Everyone deserves a chance to be the one that lives. Yes, sure, with the famine and the wars and the political problems in these regions it is an interesting thought that perhaps more people will lead to more problems, but it is so very cruel to say that maybe it's best that people die to disease and sickness rather than be given a chance to prove themselves.
mberning didn't say that. Just because dying of dysentery is bad, doesn't mean that throwing money at the problem in isolation is necessarily better.
It seems like there are a lot of other pieces to the puzzle that you need to figure out before you introduce a population swell, otherwise you could be creating a generational problem. Save a few million lives today and at the expense of future misery for rather more people.
On the other hand, it could work out great and alleviate a lot of the problems that are holding people back in the first place.
So the current situation is high birth rates with high death rates, which keeps population in a grim equilibrium while the rest of society's resources are spent trying to keep as many people alive as possible rather than engaged in productive development. Reducing the burden of disease is a necessary first step in freeing up these resources to be used in other ways, like girl's education, which will help to alleviate many of the problems of a "sudden" population boom that you mention.
It would seem to me that focusing on only one aspect of the hardships suffered by a people is like you said, going to give rise to many unintended consequences. Granted "improving infrastructure" isn't quite as sexy as "providing vaccines", it would probably make more sense to focus on a holistic approach than an isolated problem.
The video linked above talks about exactly this issue.
However this is a massive opportunity for the vaccine companies who stand to gain a lot (far more than the $10bn) from this. Bill Gates might be in this to make the world better, but they are in it for the profit - and it's reasonable to question their recommendations and motivations.
For example look at the Pentavalent vaccine in india: DPT + Hib + Hep B
GAVI pays Rs 145 subsidy
India pays Rs 380 extra
Subsidy for 5 years
After that India pays Rs 525
Similarly it's suggested India include a number of new vaccines on their schedule (HPV @ Rs 9000/child, Rotavirus @ Rs 2000/child, and Pneumococcal vaccine @ Rs 650/child), but the situation in India is that 50% of the population don’t receive the basic EPI vaccines costing Rs 30. (not a typo, rs30 vs rs9000). In a nation of limited resources surely the first priority needs to be getting the basic vaccines to the rural poor. But the vaccine companies aren't interested in spending Gates' money on low margin vaccines, they want their foot in the door of a national program. And the WHO and UN unfortunately aren't immune to their pressure.
Away from India here's an article about the swine flu 'pandemic' http://www.spiegel.de/international/world/0,1518,637119,00.h...
If anybody's interested I've half a dozen well cited papers and presentations on the topic of vaccines in India - and they make quite depressing reading. Email in profile.
Are we that close to a decent malaria vaccine? I might have to delay some travel plans if that's the case. Biohackers care to comment?
Until it's tested more extensively for travelers, don't hold your breath for a readily available vaccine. As always, evaluate the malaria risk of your destination and take the appropriate antimalarial for that area.
The charity contribution I offer is limited and do the best I can through organizations like Kiva.org. I just wish that other well known and well off tech leaders e.g. Larry Ellison, Steve Jobs would be more active. Maybe the Gates Foundation with their actions encourages them to do something on a bigger scale.
it's sort of like the old Chinese saying: Give a person a fish, and you feed them for a day. Teach a person how to fish, and you feed them for a lifetime.
See: http://www.reddit.com/r/cogsci/comments/au7t7/why_not_provid...
Just read the first paragraphs of the original investigation:
http://www.latimes.com/news/nationworld/nation/la-na-gatesx0... http://en.wikipedia.org/wiki/Bill_&_Melinda_Gates_Founda...
I linked a story from the LA Times and Wikipedia. I didn't add a single thing.
On the other hand, Microsoft, while BG was still in command, pushed incredibly evil (in my view) laws in my (developing) country (as in many others) regarding software, costing plenty of money. This doesn't now make it right for me, at all.
Note: I don't insult you, I don't wish you bad things, I just think differently and would love to express myself freely granted by our constitution and laws, and yours if you happen to be from USA.
It saddens me you both get, IMHO, up-votes of irrational bandwagon self-validation instead of having a good rational discussion.