We're back: How tuberculosis is set to surge globally once again
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Maybe I misunderstood the author's assertion.
The author of the book suggested in a YouTube video (based on his contacts in the medical teams) that the sudden and unexpected cut of USAID funds led to people half way through TB treatment being abandoned which is entirely unnecessary even if you strongly politically believe that the US should not be doing this and increases the risk of new strains mutating.
Smallpox, the hole in the ozone layer, etc.
It is possible.
Shrinking away because you can’t fully solve it alone or others aren’t helping as much as you’d like?
Cowardice and/or avarice to a degree that is, in my humble opinion, indistinguishable from evil.
Are you saying the government shouldn’t have a military either?
What, pray tell, is the governments job?
By the by, avarice and cowardice ARE values. Very few people outright say “I’m a coward”, or “my wealth is more important than your life”.
Instead, when faced with a difficult choice, say for instance, have more personal disposable income or lessen the suffering of others, those values are often expressed more euphemistically, and when even that is unpalatable, then the old “it’s wasteful and inefficient” argument comes into play.
You’ll note that those who argue “waste and inefficiency!” never seem to actually attempt to address the problem that money was “wasted” trying to address. (If they did, they’d soon discover why it’s so hard, complicated, and expensive to try to actually address social issues, which is what folks who actually care about governance have known all along.)
That’s because generally speaking the “the government is wasteful and inefficient” people’s real values are greed, not frugality.
First, I'm personally not against a moderately sized government. I'm an urbanite and lean kind of socialist, to be honest. I'm ok with there being lots of well-paid government workers. Good for them. I want everyone to have opportunity, access, and safety nets. But, I also believe in the system and respect my fellow citizens enough to understand their perspectives.
The overarching American culture is anti-government. Some of it is because of waste. But, most of it comes from an innate distrust of government and the belief that government trends toward corruption, and corruption is the bane of a functioning society.
A small number of Americans believe that the government's role should only be rule of law, policing, border defense, and tax collection. A larger number believe that government should manage common infrastructure, standards, public services, intelligence, and markets. A small number believe that the US federal government should support and defend the world.
But, Americans like control. This is rooted in a founding mythos centered on rebellion and self-determination. The further removed they are from having control over government, the more anxious they get. Local government is good - state government is tolerable - federal government is bad. Federal government means academics and experts who don't know anything and only bring biases, agendas, and corruption. The federal government leads to tyranny.
Also, once a govenment program starts, it's very difficult to shut it down. Bureaucracies tend toward mission creep, institutional inertia, and self-preservation.
For TB specifically, most of it could have been managed by now if there was broad support and action from wealthy nations over the past 100 years. It could have been treated like Polio. But, wealthy nations don't see TB firsthand, so they don't think it's important. It's not just a US problem.
That said, the only trick in the history of the human experience that consistently improves the lot of a society is taking a portion of the private surplus an applying to the public good.
Best of luck making your own interstate highway system with you and your friends though. The ROI on that one is absolutely bananas, by the by.
That said, don’t get me started on the ROI of the sewer system? Bonkers. Medicaid ? About 150% ROI in 1-2 years.
What is missing from the simple ROI analysis is the counterfactual: if Medicaid didn’t exist, what would the actual aggregate cost to the economy be?
Conservative estimate? ~$500 billion in economic growth lost annually if Medicaid didn’t exist. We spend approximately $800 billion on it annually, and get $1.6 trillion of ROI over 2 years.
But yeah, donate to the Shriners.
This is a great outlook, but I think it's slightly short-sighted if you don't consider that there are several ways to achieve the same outcome outside of USAID. I think the US can lead the world through public example rather than trying to set that same example through the government.
For example, I treat my charitable donations with the same seriousness that I apply towards my 401k. I am researching organizations, determining their overall efficacy, and splitting my funds to where I think they would be the most beneficial, given the current global climate.
I would love to see this principle applied more broadly to the public. There might be services out there that already provide such "charity portfolios," but I'll admit that I'm pretty content doing it myself, so I haven't looked much. But, given our government's history of mismanagement, I think this sort of approach would have far more impact than funneling everything through a large organization like USAID.
There are very few ngo agencies that outperform the us government, and usually they operate in fields/domains that the government can’t because of political risk aversion: the voting public doesn’t like drug addicts treated like humans, and vote out politicians who do.
The single most effective non-profit dollar for dollar in terms of saving lives is UNICEF.
It is extremely easy to say the government is mismanaged/inefficient. It’s been basically the consistent drumbeat for centuries. Yet, once “reformers/efficiency/deficit hawks” take power, they discover quite quickly (if they are keen on retaining their positions) that the current state of affairs is deeply imperfect, but perfection is impossible.
What folks fail to realize is that government operates under EXTREMELY DIFFERENT CONSTRAINTS and extremely different capabilities than businesses or individuals.
They have totally different goals! Turns out, predictability > efficiency. Because people can make long term investments against predictability. Inefficiency, below a certain threshold of course, gets priced in as a fixed cost, and business routes around it/operates around it.
Interesting. I'll have to dig into the data more, then. I wouldn't be surprised if they beat out NGO's dollar-for-dollar (it's expected for the government to have far more funding via taxes), but I'm more curious about the average efficacy of those dollars.
Your gift of $10 provides 50 meals to 50 families. Well done!
It did absolutely nothing for tens of millions of other families.
The implications of the loss of tax revenue as a result of charitable giving is an exercise I will leave up to the reader.
This is the statement that stood out to me. We've had 5 years of weakening immune systems, which has, with a high probability, contributed further to the spread of TB. History is repeating, again.
I don't believe that USAID can cover, say, the whole of Africa with preventative care. The US cannot cover even all of its own citizens, for a host of reasons, much less 1,5 billion people in exotic regions far from its borders.
Purge of USAID is likely to make the situation worse, but only marginally worse. The real problem is that at least third of humanity doesn't yet have any reasonable healthcare infrastructure, reliable grid (for medical machines to work), public safety (for doctors to survive), etc., etc., etc. If we had a functional recipe to solve such problems, they would likely be solved already.
Do you have a degree in public health?
About a quarter of the entire humanity is infected with TBC bacteria. Two billion people, often in the most remote and poorest places in the world, like Niger or Afghanistan.
You don't have to be a public health professional to calculate that USAID can put a dent to this massive problem, but cannot even dream about reducing it to, say, half of its current size.
My point is that I don't think OP is qualified to say whether or not USAID is putting a meaningful dent in the TB problem.
It's entirely possible that, for example, if you deploy resources amongst individuals that are known to travel, for example, you could significantly eliminate the probability of others being infected (including you and I in the developed world).
The US already spends enough on healthcare to provide gold-standard best-in-the-world coverage to all of its citizens.
It could take any random system better than the one extant in the United States, CTRL-F the country's names in all of the rules and regulations for that system and change it to "The United States", implement that system, and have enough money left over to cure poverty, hunger, and homelessness for $0.00 in extra spending.
We choose not to.
There is too much money to be made so a constant campaign of disinformation and vilification is waged to stop that from happening.
And yes, his cuts will ensure TB and many other once close to extent diseases come back. Just look at measles in the South.