I think I’d be more convinced if you backed your claim up with some numbers, even loose ones. Maybe I’m missing something, but imo there just aren’t enough zeros for this to be a massive fuckup.
Fairly simple BOTEC:
2 billion people at significant risk of malaria (WHO says 3 billion “at risk” but I assume the first 2 billion is at significantly higher risk than the last billion).
note that Africa has ~95% of cases/deaths and a population of 1.2 billion; I assume you can get a large majority of the benefits if you ignore northern Africa too.
LLINs last 3 years.
a bednet covers ~1.5 people (can’t find a source so just a guess; note that the main protected population for bednets are mothers and their young children, who usually sleep in the same bed).
Say LLINs cost ~$4.50 for simple math (AMF says $2, GiveWell says $5-6; I think it depends on how you do moral accounting)
So it costs $2B/year to cover almost all vulnerable people with bednets at current margins.
and likely <1B/year if we are fine with just covering the most vulnerable 5⁄6 of Africa.
At 5-10%/year cost of capital, this is equivalent to $20B-$40B to have bednets forever.
even less if it’s more targeted.
Given how much money has already went into malaria R&D, we’re already at less than one OOM difference (This is assuming that future R&D costs and implementation costs are a rounding error, which seems very unlikely to me).
Getting rid of malaria forever is a lot better than bednets forever, but given how effective bednets are, and noting that even gene drives and vaccines are unlikely to be a completely “clean” solution either, adding half an OOM sounds about right, maybe 1 OOM is the upper bound.
Meanwhile the diminishing marginal curve for R&D is likely to be a lot sharper than the diminishing marginal returns curve for bednets.
I’ve never drawn out the curve so I don’t know what it looks like but I can easily see >1 OOM difference here.
So at least the view from 10,000 feet up doesn’t give you an obvious win for research vs bednets; and on balance I think it tilts in the other direction locally on EV grounds, even if you don’t adjust for benefits of certainty.
This analysis lacks a bunch of fairly important considerations in both directions (eg economic growth pushes in favor of wanting “band-aid” solutions now because richer countries are better equipped to deal with their own systemic problems, climate change pushes in favor of eradication), which might be enough to flip the direction of the inequality, but very unlikely to flip it by >1 OOM. And I suspect ballpicking numbers or analysis like the above is the core reason why some of the more quant-y committed global health/poverty EAs aren’t sold on the “obviously technological solutions are better than band-aid solutions” argument that SV people sometimes make unreflectively.
A different BOTEC: 500k deaths per year, at $5000 per death prevented by bednets, we’d have to get a year of vaccine speedup for $2.5 billion to match bednets.
I agree that $2.5 billion to speed up development of vaccines by a year is tricky. But I expect that $2.5 billion, or $250 million, or perhaps even $25 million to speed up deployment of vaccines by a year is pretty plausible. I don’t know the details but apparently a vaccine was approved in 2021 that will only be rolled out widely in a few months, and another vaccine will be delayed until mid-2024: https://marginalrevolution.com/marginalrevolution/2023/10/what-is-an-emergency-the-case-of-rapid-malaria-vaccination.html
So I think it’s less a question of whether EA could have piled more money on and more a question of whether EA could have used that money + our talent advantage to target key bottlenecks.
(Plus the possibility of getting gene drives done much earlier, but I don’t know how to estimate that.)
@Linch, see the article I linked above, which identifies a bunch of specific bottlenecks where lobbying and/or targeted funding could have been really useful. I didn’t know about these when I wrote my comment above, but I claim prediction points for having a high-level heuristic that led to the right conclusion anyway.
Do you want to discuss this in a higher-bandwidth channel at some point? Eg next time we’re in an EA social or something, have an organized chat with a moderator and access to a shared monitor? I feel like we’re not engaging with each other’s arguments as much in this setting, but we can maybe clarify things better in a higher-bandwidth setting.
(No worries if you don’t want to do it; it’s not like global health is either of our day jobs)
I think I’d be more convinced if you backed your claim up with some numbers, even loose ones. Maybe I’m missing something, but imo there just aren’t enough zeros for this to be a massive fuckup.
Fairly simple BOTEC:
2 billion people at significant risk of malaria (WHO says 3 billion “at risk” but I assume the first 2 billion is at significantly higher risk than the last billion).
note that Africa has ~95% of cases/deaths and a population of 1.2 billion; I assume you can get a large majority of the benefits if you ignore northern Africa too.
LLINs last 3 years.
a bednet covers ~1.5 people (can’t find a source so just a guess; note that the main protected population for bednets are mothers and their young children, who usually sleep in the same bed).
Say LLINs cost ~$4.50 for simple math (AMF says $2, GiveWell says $5-6; I think it depends on how you do moral accounting)
So it costs $2B/year to cover almost all vulnerable people with bednets at current margins.
and likely <1B/year if we are fine with just covering the most vulnerable 5⁄6 of Africa.
At 5-10%/year cost of capital, this is equivalent to $20B-$40B to have bednets forever.
even less if it’s more targeted.
Given how much money has already went into malaria R&D, we’re already at less than one OOM difference (This is assuming that future R&D costs and implementation costs are a rounding error, which seems very unlikely to me).
Getting rid of malaria forever is a lot better than bednets forever, but given how effective bednets are, and noting that even gene drives and vaccines are unlikely to be a completely “clean” solution either, adding half an OOM sounds about right, maybe 1 OOM is the upper bound.
Meanwhile the diminishing marginal curve for R&D is likely to be a lot sharper than the diminishing marginal returns curve for bednets.
I’ve never drawn out the curve so I don’t know what it looks like but I can easily see >1 OOM difference here.
So at least the view from 10,000 feet up doesn’t give you an obvious win for research vs bednets; and on balance I think it tilts in the other direction locally on EV grounds, even if you don’t adjust for benefits of certainty.
This analysis lacks a bunch of fairly important considerations in both directions (eg economic growth pushes in favor of wanting “band-aid” solutions now because richer countries are better equipped to deal with their own systemic problems, climate change pushes in favor of eradication), which might be enough to flip the direction of the inequality, but very unlikely to flip it by >1 OOM. And I suspect ballpicking numbers or analysis like the above is the core reason why some of the more quant-y committed global health/poverty EAs aren’t sold on the “obviously technological solutions are better than band-aid solutions” argument that SV people sometimes make unreflectively.
A different BOTEC: 500k deaths per year, at $5000 per death prevented by bednets, we’d have to get a year of vaccine speedup for $2.5 billion to match bednets.
I agree that $2.5 billion to speed up development of vaccines by a year is tricky. But I expect that $2.5 billion, or $250 million, or perhaps even $25 million to speed up deployment of vaccines by a year is pretty plausible. I don’t know the details but apparently a vaccine was approved in 2021 that will only be rolled out widely in a few months, and another vaccine will be delayed until mid-2024: https://marginalrevolution.com/marginalrevolution/2023/10/what-is-an-emergency-the-case-of-rapid-malaria-vaccination.html
So I think it’s less a question of whether EA could have piled more money on and more a question of whether EA could have used that money + our talent advantage to target key bottlenecks.
(Plus the possibility of getting gene drives done much earlier, but I don’t know how to estimate that.)
@Linch, see the article I linked above, which identifies a bunch of specific bottlenecks where lobbying and/or targeted funding could have been really useful. I didn’t know about these when I wrote my comment above, but I claim prediction points for having a high-level heuristic that led to the right conclusion anyway.
Do you want to discuss this in a higher-bandwidth channel at some point? Eg next time we’re in an EA social or something, have an organized chat with a moderator and access to a shared monitor? I feel like we’re not engaging with each other’s arguments as much in this setting, but we can maybe clarify things better in a higher-bandwidth setting.
(No worries if you don’t want to do it; it’s not like global health is either of our day jobs)