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U.S. Malaria Donations Saved Almost 2M African Children (nytimes.com)
99 points by robertwiblin on July 9, 2017 | hide | past | favorite | 77 comments


Lest anyone think to run the headline numbers in the article [1] and think each child was saved at the cost of $2,058.82 USD across 7 years, the study cited in the article only looked at the 0-5 years cohort, and did not examine any other age cohorts.

The President's Malaria Initiative web site's About page [2] shows the extent of their program's impact upon lives protected by various measures they introduced. I imagine there might be manifold beneficial impacts upon the developed world as well, because the anti-mosquito-oriented measures do not distinguish between malarial versus Zika-bearing mosquitoes, and Zika is particularly economically debilitating in the developed nations.

[1] http://www.wolframalpha.com/input/?i=(500000000*(2017-2010))...

[2] https://www.pmi.gov/about


i've donated nets in the past, but I wonder if they ended up being used for fishing instead.

https://www.nytimes.com/2015/01/25/world/africa/mosquito-net...

I recently made it to (South) Africa for the first time. It was an incredible trip:

https://www.instagram.com/p/BVtyKWylFkt/

https://www.instagram.com/p/BVtyq0flJvL/

https://www.instagram.com/p/BVty4K8FjBG/

I wish they/we could eliminate the malaria problem.


"The reporting in this case presented an unbalanced view of the magnitudes of the benefits and harms of distributing bed nets" more here:

http://blog.givewell.org/2015/02/05/putting-the-problem-of-b...

Another analysis:

"A comprehensive analysis of 14 surveys in several countries with 14,196 households showed that that the overwhelming majority of nets were used for malaria prevention, and only 255 nets were repurposed (which make up less than 1% overall). Furthermore, the majority of the repurposed nets were already considered too torn, indicating they had already served out their useful life for malaria prevention[62]. The authors conclude that national programmes and donor agencies should remain confident in the appropriate use of bednets." https://www.givingwhatwecan.org/post/2015/04/update-against-...


> I've donated nets in the past, but I wonder if they ended up being used for fishing instead.

If the reason for donating the nets is to save lives, then this is no bad thing, right? Those people are putting the nets to the most effective purpose they can find for them. No problem, I say.

EDIT: OK, maybe these nets are suboptimal for fishing. Fine. If the people the nets are going to are in more desperate need of fishing nets than mosquito nets, and you don't want them to use mosquito nets as fishing nets, then you should be sending fishing nets instead of mosquito nets.

There's no honour in telling a hungry fisherman that the mosquito net he is using to catch fish is harmful to the environment. He doesn't give a shit. He either fishes with the net he has, or he starves.


I'll save you the reading:

- Mosquito nets have much smaller holes than normal fishing nets, so they trap almost all living organism, which is bad.

- The nets are treated with toxic chemicals which kills the fish in the ponds/rivers, and might be dangerous for humans who drink the water.

I would say it's bad.


> The nets are treated with toxic chemicals which kills the fish in the ponds/rivers, and might be dangerous for humans who drink the water.

Are we at fault for handing them out without proper education? Do they know that these nets are laced with poison? I mean if it only hurt the people who are fishing, maybe I could live with it but it hurts everyone (kind of makes me think of second hand smoke but worse).

Something they didn't bring up in the video is that a lot of fish (the net is indiscriminate) can help keep mosquito population in check. Just another thing to pile on the list.

Maybe we need to stop sending nets treating with toxic chemicals to that part of the world. This just looks like a road paved with good intentions.


No, it's a sensible trade off.

Go look up pyrethroid insecticides and malaria and then contemplate whether you'd rather risk sleeping in a treated net all the time or be sickened at length or maybe dead.


Mosquito nets make poor fishing nets. Maybe a few fishermen have tried, failed, and passed that bit of knowledge along to other fishermen.

For the same reason no one uses rubbing alcohol in an automobile. Technically it's a hydrocarbon but using it in a ICE will lead to poor results.


According to the article, the main problem is an unclear environmental impact. Those nets are treated with insecticides, which are washed into the water when used for fishing. They also have much smaller holes than actual fishing nets, which leads to potential overfishing (because fish can be caught before adulthood).


It's good to see such progress against a major disease. With this, the Gate's programs and others maybe we can hope for the near elimination of malaria in our lifetimes.

Fortunately Republican Congress members seem likely to reject[1] Trump's proposed 11% cut to the program[2], even if it seems mostly because it was setup under Bush, not because it is effective.

[1] http://www.reuters.com/article/us-usa-budget-foreign-aid-idU...

[2] http://www.npr.org/sections/goatsandsoda/2017/05/25/52987343...


You're suggesting they would have cut that because it was effective...?


I think the suggestion is that cuts are largely determined by the regime that instituted the program, independent of effectiveness.


Yes, this.


I don't know if this is a hard/cold way of looking at things, but I want a bang for my back in donating to charity. I've (almost) exclusively give to malaria foundations.

Even if you don't want to give, set your Amazon to smile.amazon and it will donate a very small portion of your purchases to the charity of your choice. It may add up to $50-$100 in money given on your behalf over time.


This is basically what the Gates Foundation does. The primarily focus on infectious disease and malaria is a big one (along with HIV, TB and others). They also dabble in charter schools and some other business, but the goal is always bang for buck.


https://www.effectivealtruism.org/ is substantially about bang for your buck.


In addition to this article, the profile about Rear Adm. Timothy Ziemer, the guy heading the effort, is also very interesting: https://www.nytimes.com/2014/10/21/science/a-quiet-approach-...


We, as humans, have the capability to eradicate mosquitoes, which would in turn prevent the spread of malaria and other mosquito-Bourne illnesses.

https://en.m.wikipedia.org/wiki/Mosquito_control#Proposals_t...


We, as humans, can't even run our own planet. Forget about mosquitoes.


And now they're all coming to Europe. Woo!


All of them?


Probably. Progress, right?!


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Not sure if it is ignorance that is making you to utter such words about Africa. Do you seriously think all African people are dying of hunger and waiting for food aid from your governments? Have you ever been to any African country? Majority of countries with food and hunger problems are those who are at war. Rest of us, citizens pf this wonderful and arable continent, can feed ourselves and don't need any food aid.

The only aid we need is for Western countries who sponsor African wars to stay away from Africa. I have been living in Africa since birth(35 years old). I have never seen anyone dying of hunger.


All of Africa is not starving, sure, but hopefully you can understand how people can reasonably believe that there are issues with food supplies in much of Africa[1][2], and that a large number of people are suffering as a consequence. It is a tagline that has been thrown about in the Western world for decades and can be remedied with counterpoints - I was frankly having trouble finding any good stats re food supply in Africa.

[1] https://www.nytimes.com/2017/03/27/world/africa/famine-somal...

[2] http://mgafrica.com/article/2016-02-12-africa-food-crisis-20...


Then why must Africa receive millions in aid from the West every single year? Why can't they help themselves?

http://www.chronicle.co.zw/one-million-receive-food-aid

In 2015, the U.S. provided more than $8 billion in assistance to 47 sub-Saharan countries; and USAID maintains 27 regional and bilateral missions in Africa.

http://thehill.com/blogs/pundits-blog/foreign-policy/323198-...


USAID "assistance" to Africa and other countries is more of a gimme to the US big agriculture lobby than to Africa. The US pays big agriculture to send food and agriculture equipment to Africa and other countries. The temporary food abundance often destroys the country's ability to build up its agriculture. Also, it comes with strings attached where the country has to use patented seeds in order to get the aid, making the local farmers dependent on sending money to Monsanto every year - this happened in Haiti and Monsanto is doing it in Africa as well.

Also, USAID is infamous for spreading money around in order to destabilize governments who do not follow the US's dictates.

This notion that USAID is some benevolent aid program is ridiculous. It is a brutal instrument of US foreign policy and big business, cloaked in a very thin veil of liberalism/charity/humanitarianism.


Majority is truly just that, benevolent aid. You want to spin some tall tales conspiracy then let's see some citation on the matter.

http://www.care.org/our-impact/usaid-technical-project-brief...

Sure American companies benefit, sure there's some fraud, sure some of it is a foreign policy decision in the US best interests. But a lot of good is done.


Because West is stealing gazillion times more from Africa in return. When you refuse, war and/or sanctions follow to cripple your country. Then they can loot in peace. You seriously think USA is just helping out of their good hearts?


Alas, if only it was even a zero-sum game were eg Africa only loses what the USA steals from them.

The reality is far bleaker---but also more hopeful: rich countries don't benefit from (causing) bad conditions in poor countries, at least nearly not as much as the bad conditions cost the poor countries.


Instability is profitable to rich countries. That's a well-known fact. Those bad conditions were artificially craeted by colonisers. Colonisers who still refuse to exit Africa because the only way they know how to make money is through exploiting African countries.

'The best time to buy is when there is blood on the streets' - Baron Rothschild.


I don't know, lots more companies are investigating in stable China than they ever did when Mao's reigned with open terror. And also more than in less stable countries.

India also got more investments since the liberalisation in the 90s (https://en.wikipedia.org/wiki/Economic_liberalisation_in_Ind...).

(I know less about Africa---but I suspect relatively stable and rich South Africa gets the lion's share of investments?)

Which instabilities are profitable to rich countries?


China isn't a profitable country to the US. China fate is in their hands. That's why they are even able to kick out big US companies like Google, Facebook, Twitter and Uber.

South Africa is very a profitable country to the West, not the other way round. It was even more profitable during the dark days of apartheid. That's why USA was sponsoring apartheid government with intelligence and arms. Google about Mandela arrest and CIA's involvement. They even listed Nelson Mandela as a terrorist. Even when he was President, he was still listed as a terrorist. US only removed him from the terrorist list few years ago.

I live in South Africa.


Wait til you hear how much Israel gets alone. Aid isn't a no-strings attached handout, it's policy in dollar units.


To Israel it's military spending.

https://explorer.usaid.gov/cd/ISR

It's not a secret.


I am not an expert, but I believe malaria is most common in humid areas, where crop failures are rare.

edit: not completely disjoint but the overlap is small

http://www.traveldoctor.co.uk/images/MalariaMap.jpg

http://vf-tropi.com/vf-kfamn.gif


Improving women's education and children's health is probably the best way to reduce uncontrolled population growth. Wanted, healthy children are more likely to grow up to be productive adults.


RIP hans rosling, I still see his bubble charts and excited babbling in my head any time this comes up. Seems like a very reasonable explanation.


A bigger problem than the children being dead? For whom is this a problem? Why won't the people who didn't die of malaria be capable of feeding themselves? And given that the there are seven billion people in the world, the 0.03% increase in world food supply efficiency seems both possible and worth doing, does it not?


Well, we have excess on one side and scarcity on the other side. Not that this can't be solved, it has never been a priority and probably will never be a priority to solve this problem. Please dont equate human life with philosophies of wealth distribution. God forbid, you may never know you may be poor in your country and your life may no longer be worth the medical treatment and maybe captitalism will win in that.

So please dont say they can have children cause they dont have money and people were interested more in looting this continents resources and destabilizing it than uplifting it.

Dare someone say something to this effect on black Americans and they will be crucified. Because these guys are from poor nations you can contemplate its a good idea millions not be born.


I know that malaria significantly impacts the ability of a family to be productive, perhaps with decreased malaria rates families will not be knocked out and with decreased child mortality families will shrink in the long term because more children will survive?


> Really, don't get me wrong

You're offering a most disingenuous argument.

Would a pediatric hospital in a relatively poorer town in the US ask the same question while treating a child?


Moving food to a poor town in the US from somewhere else is a trivial task. Africa has its own set of problems.


> Moving food to a poor town in the US from somewhere else is a trivial task.

You're missing the point, but long as we are trivializing complex social issues, let's ask why there are 13 million hungry kids in the US. https://www.nokidhungry.org/problem/hunger-facts


No need to ask: lack of nutritional education and income inequality.


Please help me understand. Why would Africans need unhealthy, pesticide-infested food from America? Unless it is a country ravaged with wars, sponsored by the same, America? We can grow our own food.


[flagged]


We are growing our own food and exporting excess food to other countries. What do you think we are doing with our land? Just play on it? Only countries who are unable to grow their own food are those who are at war. War which is started by the very same West who pretend to be feeding us.


Your claim is that most starvation in Africa is caused by war, and most war is instigated by countries outside Africa (China and the U.S.?).

Why, then, don't we see so much war in South America, where China and the U.S. are also heavily involved?


I love how you cherry-picked South America and ignore recent examples where US is directly involved in impoverishing people by destroying their country in the name of democracy. Democracy meaning installing their own puppets who will allow them to loot. Countries like Libya, Egypt, Syria, Iraq, Kuwait etc. All South American countries have been at war. All of them. Google them one by one. Leave China out of this equation because they have never started or sponsored war outside Asia. When a country isn't at war, know that it is ruled by puppets of the West.


And you're cherry picking Muslim countries, when when we talk about starvation in Africa we mean the huge barren between the Muslim countries and South Africa.

We are talking malaria here, what do the Muslim countries have to do with that?

http://www.thelancet.com/cms/attachment/2001010053/200378675...


I imagine they'll feed themselves, like you do. In fact a lot of people in the developing world grow and raise their own food.


I don't think you can possibly mean what the black-letter words of your comment say, which is that people should be allowed to die of treatable diseases until such time as the West is convinced of the stability of their food supply.


What's with the downvotes? The question is asked in good faith and it produced an interesting discussion. Would y'all prefer for the author to remain silent with his thoughts, and for the opposing arguments to remain untold?


If I had enough clout to downvote, I was going to do so. I was going to do so because the comment is totally ignorant. I don't know who is feeding people around the world this misinformation that African people are all dying of hunger and waiting for food aid.


To remove ignorance you need to have a discussion.

> I don't know who is feeding people around the world this misinformation that African people are all dying of hunger and waiting for food aid.

I guess the "Donate money" for African kids with a pictures/videos of malnourished kids in the background.


They are probably the ones responsible. If those charity organisations can change the message to stop sponsoring wars in Africa, there won't be a need to donate to African kids in less than 5 years. Then again they won't have a job because majority of that money ends up in their pockets.


I don't know who is either, but how is ignorance going to be fixed if we punish people who ask questions?


The bigger problem isn't ignorance here. Lack of emphathy is the main problem. Parent comment, which people are down-voting, is basically suggesting that those African children which were saved are better off dead.


You are right about questions asked in good faith. Media has gotten us used to assertions and allegations made from behind a question: Is Obama and American citizen ? Is your mother a whore ? etc etc


It's pretty uninvestigated, as are many responses, I'm not sure what was gained by asking whether people who intend to have children can feed them in a coy manner. I read the first bit as feigning a doubt as to whether expecting parents would be better off with dead children (even with the following disclaimer)


It was an extremely poorly-worded question that produced a nightmare of a thread.


(I'll ignore the fact that we currently produce more food than the world needs, and much of that food is destroyed. http://www1.wfp.org/zero-hunger )

Children who survive can farm the land.

Children who die cannot farm the land.

Also, because so many of your children will die you have more children.

If more of your children survive you'll have fewer children.

http://www.irinnews.org/report/94947/lesotho-weather-extreme...

> In a country where nearly 60 percent of the population live below the poverty line, and some 40 percent live in extreme poverty, such weather extremes are pushing the coping mechanisms of families already devastated by the effects of HIV and AIDS to breaking point. Lesotho has one of the highest prevalences of HIV in the world. The epidemic has created a shortage of farm labour and left 130,000 children orphaned, according to the UN Children’s Fund (UNICEF).

> Malebohang Makhoathi, a 68-year-old widow, has over four hectares of land in Ha Makhoathi, just outside the capital, Maseru - more than enough for her to grow all the food she needs to feed the four grandchildren in her care, but she has not ploughed the fields for the last six years since her son, the family's main breadwinner, passed away. She has neither the money nor the manpower to cultivate the land and is contemplating selling it for short-term relief.

> “The money will make some difference in my family, even if it’s for a short period of time,” said Makhoathi, who will have to wait another two years before she qualifies for a government pension


We are going to feed them with part of the work of two million children who will grow up to be farmers, artisans, cooks, bakers, school teachers, doctors, etc.

Humans are (on average) a net plus to society. Feeding them is not an issue, we already have the technology.


the bulk of starvation in many countries is purely political. no personal rights and just as important no private property rights. the latter means you cannot build wealth and improve your position, your families, and your community. nations that don't respect all these rights tend to stagnate or those having lost them spiral down as they burn through accumulated wealth.

we one farm a third of the arable land available, so if we want to feed all these people in the world we need to find a carrot to offer their political class, this could even mean buying them off to eventually leave. it can also eventually mean taking the hardest choice and removing those in power but this is not a tenable solution in many cases and should only be last resort.

i would prefer to pull up surrounding countries that will play ball and hopefully convert neighboring countries that way.


This will kill the rainforrest in Africa. Because the survivors will use it for bushmeat, wood, jobs, fields for cows, ...


Ignorance on this comment is on another level. Please find some time and visit Africa. Stop learning about Africa from charity organisations who want to swindle you of your hard-earned cash. Obviously they will portray a bleak picture so that you can donate. We don't live in bushes. We have cities and some of us have a better quality of life than most people in the Western countries.


Where did you get the idea about what I know and what I don't know about Africa? Is Malaria really mainly a problem for the city dwellers with high living standards? Brasil is destroying their rain forrest. And one reason why they can is because they don't have the same problem with Malaria.


A friend of mine once retitled a similar headline "U.S. Malaria Donations create an additional 2M starving Africans". I'll not add _my_ opinion of the matter, but I would love to see intelligent discussion on the matter. Is saving lives from disease just putting these same people on the path to starvation?


No, because at the same time, starvation is decreasing even though population is increasing. It's not a problem of too many people.

You don't create a self-sustainable economy by destroying human capital.


No, saving lives from disease is removing obstacles to their survival.


That is not true, but even if it were: fuck the rain forrest. What we are talking about here is peoples children.


Obviously logic is not part of your thought process. If we continue to populate the earth, which has limited local resources with more and more people nobody is helped! Fuck the rain forest? Really? The Rain forest is more worth than a few billion people. People are not worth anything. Everybody is replaceable, there are nearly 8 billion of us. Stop being so arrogant and anthropocentric. @Thread: 2 million saved are 2 million more living shitty lives and potentially suffer from starvation, malnutrition, civil wars etc. If you want to help the people make sure there are less of them! Spending money on mosquito nets...seriously people, just saying that makes it ridiculous.


Please take family planning into account: empirically parents aim for a specific number of offspring. Infant mortality does not usually change that target much, but it changes how many pregnancies are needed to reach it.

Thus: two million children saved, is two million pregnancies less. (To a first order approximation. As people get richer, all kinds of things change over time.) You are right in some sense: people are replaceable, and they will be replaced. But at a cost in resources and of course emotions.

Even if you only cared about the rainforest, and not about people at all, the smaller ecological footprint should warm your heart.


Trust me I am not a hardhearted bastard but from what I have seen in the world, despite being absolute subjective ,I can tell you that the biggest problem with population is caused by religion and old beliefs. And this ain't specific to third world countries, there are enough big families (4+ kids) from certain ethnic groups in Europe/US.

Your pregnancy point is wrong though, so you say you save resources due to not having them start another pregnancy? Well the kid uses resources too and it does that at a increasing rate throughout the years. Once that kid has its own kids....you get the idea.

Unfortunately there never will be a global population control so all is left is this: upon a certain number we'll have a massive humanitarian catastrophe, most likely ending in the death of hundreds of millions due to starvation or wars. Not only will the environment suffer heavily, but once again humanity takes a step backwards towards becoming brutes again.


I am saying that people choose a target number of offspring that make it to adulthood. If more kids die in infancy, they'll have more babies to make up the difference.

If less kids die in infancy, they will have less babies to make up the (negative) difference.

By the way, please have a look at http://economics.ucdavis.edu/events/papers/WuLeminJMPMalthus... and tell me what you think.


>> parents aim for a specific number of offspring

https://www.theguardian.com/global-development-professionals...

"women want an average of nine, while men say they want 11."


That's interesting! Most of the rest of the world (even poor countries) operate differently. Will investigate.


> fuck the rain forrest. What we are talking about here is peoples children.

tell this to those whose children die of hunger because of climate change.




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