Good News You May Have Missed in 2014

> This problem should probably be addressed before we create a problem that we can't solve.

That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.

Yes, the problem is man made, but not only due to unofficial access to antibiotics. I suspect that's not even a major factor, but correct me if I've missed something.

As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated.

This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).

The drug resistant tuberculosis is already here so we have to solve it.

But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.

Gates actually addressed this[0].

The upshot is that as countries get richer, fertility rates decrease. Allowing these poorer countries to lead better lives will paradoxically lower the population increase. If you look at the western world, negating immigration, many countries have a shrinking population.

The more pressing problem of the future, ironically, will be under population - at least if you consider the economic impact and our way of life. Our economy right now is built on so much growth and young labor. What happens without poor countries and when more people are retired than working?

[0]http://annualletter.gatesfoundation.org/#myth-three=&section...

Paradoxically, reducing death rates in the young actually slows population growth. One of the biggest reasons why people in poor countries have so many babies is because so many die young.

It is about the resource consumption, not just population number. If a species X has population 10 times than species Y but if Y consumes 100 times more then they will cause larger impact to the earth.

I had these thoughts too. They are actually very wrong, as I learned from the great Hans Rosling: http://www.gapminder.org/videos/dont-panic-the-facts-about-p...

In the first place it's pretty hard to ignore the moral argument. If moral arguments are out, and we accept the thesis that population is bad, then it's hard to see why purposefully letting people suffer and die from TB is any better than using nuclear bombs to reduce the global population.

But anyways, if we want to get around to a sustainable post-scarcity futuristic utopia, we need a global population of economically developed and educated people with replacement-level fertility. And when childhood mortality goes down, parents have an incentive to concentrate their investments (both economic and educational) into fewer children. Those children will be more successful, have better access and education about contraception, and won't need to have plenty of children to provide manual labor on their farm.

Anyways, that's how it's supposed to work, and has worked many times in recent history. I put less stock than others in the extrapolated results from the recent UN Africa study.

> Serious question though, and I would like people to ignore some sort of moral or religious argument for it; but what is the long term implication if all kinds of health advances save people but humans still reproduce and impact the planet in already unsustainable rates.

> I get it, some people have a bleeding heart and want to save everyone, everywhere, at all times; but what happens when the planet is the equivalent of a cat hoarder's house because we could never say no and we could never implement policy to limit population growth because the wealthy inherently gain from unregulated population growth?

Some of the minds saved can one day solve these and other problems, pushing the envelope of human knowledge.

Strangely it's kind of the other way around. When you have a poor, unhealthy population with labor-intensive economy, high child mortality and low life expectancy, you tend to get tons of people.

Why? Because it's economically smart to have children.

In a labor-intensive economy, you can generate more income in the family with more children.

And in a poor subsistence economy, there is no surplus wealth being generated to go to the state for redistribution and another thing I'll get to in a minute. This means that institutionally-provided social security is often non-existent (no pensions, no insurance, no universal healthcare, no benefits, food stamps etc). So instead of institutions, these services are provided by the community, i.e. children. If you have 5 kids, there's a much better chance of someone taking care of you at old age, or when you're sick, than if you have few or no kids.

You have more kids because there is a higher chance of death. Child mortality under five is absolutely STAGGERING. I literally think about this every week and wonder why we can't get the news to report on it on a weekly basis. The number is about 17 thousand per day. Try putting that into perspective. That's more than 5 times 9/11 per day, or 50% the death-rate in World War 2 year in year out. At these rates, it makes sense to have more children, parents actually expect not all their children to last.

When you take death and sickness out of a community however, there is much more chance of economic growth. There are loads of UN reports on how mortality and sickness affects education, employment, parenting, productivity etc. In short, if you improve these things significantly in a country, 10-20 years later you see millions of extra people pour into the middle class.

And what happens then? The truth is that it's economically disadvantageous to have children in a wealthy society. Children cost (way) more money than they generate. Wealthy societies have child-labor laws (well, every country does, but they're enforced more strictly), as well as laws that require all children to go to school. Standards of living in a wealthy society requires loads of expenses on children, and price levels aren't low either. And lastly we see that in wealthy societies that there is more wealth-surplus, leading to cultures that have the time and literally the money to explore non-economic interests, like the arts, and this often goes hand in hand with less time spent on simply surviving and taking care of family members, in fact leading to sharply reduced birthrates as new generations grow up with a bigger interest in traveling than raising a family. (extensive traveling for recreation being something almost only possible in wealthy societies with a wealth surplus, i.e. the minimum amount of work you need to do just to survive is something like 30% instead of 90%, so if you spend 60% of your time working you have a large wealth surplus and a lot of free time).

In short, having 10 children is the 'worst idea ever' for most parents both economically and culturally the richer a country gets.

What does this all mean? Well, if you believe me, we've established that it makes sense to have lots of children in a poor country, and very few in a rich country, which is easily seen in empirical data. (it's not a cultural thing, most western countries with low birthrates had very high birthrates before they became wealthy post industrial revolution). And we've also established that mortality and sickness are huge inhibitors of economic growth.

Lastly, I'd say that a richer society with less mortality and sickness is more stable, better educated, has better funded institutions, which means natural family planning (like contraception and sex education in best case, or authoritarian China-style 1-child policies in worst case) should also be much more effective.

In other words, in the long run, reducing death rates is actually likely to decrease the size of the population, with of course the added benefit that it's freaking awesome to save lives that every living person deserves to have. After all, none of us would volunteer to die just to be able to 'sustain the planet with a lower population'! :) But I tried to ignore this point for argument's sake.

The corollary to this story is that a wealthier society consumes much more, which is less sustainable. (e.g. 500 million people in China/India who join the middle class and turn to 'basic' items like toilet paper is like adding another Europe or US. It's insane.) The fun and optimistic corollary to that is adding 500 million educated brains, who knows how many nobel prize winners will be among them providing the solutions we need :)

Yes it is true.

However, it's not like we couldn't cure hepatitis C before, we could, but just not very well.

The old regimen was interferon + ribavirin. You had to take it for months and months and the interferon makes you feel like you have the flu (it also put the patient at risk of depression and suicide). The cure rate was ~50%.

With the new drugs you don't need to get interferon injections anymore. You just pop one pill a day and 12 weeks later there is a 95%+ likelihood that you've been cured of HCV.

It's a HUGE medical advance.

Yep. The stupidity involved in this decision is breathtaking.

Those areas did not trust foreigners with needles to begin with. The CIA vaccination gambit was undeniably stupid, but it wasn't a root cause, it made a bad problem worse.

The root cause is that those are areas with very high levels of tribal paranoia, religious fundamentalism, and outright violence.

There was a polio outbreak in China in 2011 that was traced back to Pakistan. Prior to that outbreak, the last case of polio in China had been in 1999.

The outbreak was contained after 21 confirmed infections plus another 23 suspected. The Chinese public health system mobilized 1000 health workers, spent $26 million, and vaccinated 44 million people.

If we can't get rid of polio in Pakistan and Afghanistan, then this will just keep happening.

NEJM editorial: http://www.nejm.org/doi/full/10.1056/NEJMe1311591

If you haven't read "It's Not News, It's Fark: How Mass Media Tries to Pass Off Crap As News"[1] by Drew Curtis, then I highly recommend it to explain quite a lot of the process and thinking of the news. It might not be the most serious, and it is funny, but it digs into the truths of the beast.

1) http://www.amazon.com/Its-Not-News-Fark-Media/dp/1592403662/

Yeah, I thought the site posted was his official blog. I naturally thought he would check this to see how the HN community responded.

I've cold emailed a lot of well known people before and most of them responded. I guess it was 'positivity' that skewed my thoughts. But, your right, a Lotto chance of Bill Gates coming on here.

The 122 in particular should be almost halfway between 100 and 150 but theirs is much lower.

Yes dodgy's point is probably that this tax money sent to US govt will not result in such achievements like medicine in developing countries.

As one noted in the article ""almost certainly an underestimate", because a number of climate-health relationships are not measurable due to lack of adequate data".

Milder winters expand the range of disease-carrying insects, increase risks of wars or famine with less water, mass migrations leading to political instability, more extreme weather events like draughts and flooding leading to failed crops and other natural catastrophes...

Meanwhile much of the WHO estimate is for people dying due to heat exposure. Easy to quantify, important to know - but nowhere near the full picture.

There is good news on that front too. Malaria deaths worldwide have been halved in the past decade : http://www.bbc.com/news/health-30375202

2030-2050 is still early days for climate change. The real fun is probably 2100 and beyond.

Are you saying rich countries can figure out how to deal with it so everything is OK?

I am not a climate expert, but I think you're grossly downplaying the complexity of the climate change problem. There are so many factors in play. Its not just a matter of CO2 emissions. There is methane from animal livestock, contrails from aircraft, cloud cover, methane hyderates in the ocean, sunspot activity; Even the average reflectance of the earth's surface(http://en.wikipedia.org/wiki/Albedo). Every year the scientist's models and theories seems to be changing. All we seem to know for sure is that global average temperatures are indeed rising.

I have the sneaky (unscientific) suspicion that whatever drastic measures we would inevitably have to take to curb CO2 emissions is going to open its own can of worms. The footprint of human activity is simply that large.

> Humans are rational actors when presented with cost-based options. Politics, biases and ideology fall away when looking at price.

Really? Explain Verblen Goods[1].

Fact is, while price drops do help businesses, there are other complications with home solar - utility companies need to simplify net metering so I don't have to either go off-grid or calculate exactingly to prevent wasted collection. Install costs are also high. Furthermore, there are many houses with many natural gas appliances that reduce the benefits (you're still paying utilities for gas and likely a lot in winter).

[1] http://en.wikipedia.org/wiki/Veblen_good

I didn't say malthusians are trollish, I admitted I was being trollish. I am just curious about why they're not trying to spin it in their usual fashion.

Well, it looks like the regular contrarians have finally caught on: https://news.ycombinator.com/item?id=8757464