I understand the sentiment, but there’s a lot here I disagree with. I’ll discuss mainly one.
In the case of global health, I disagree that”thoughtful people trying very hard to address a serious problem still almost always dramatically underrate the scale of technological progress.”
This doesn’t fit with the history of malaria and other infectious diseases where the opposite has happened, optimism about technological progress has often exceed reality.
About 60 years ago humanity was positive about eradicating malaria with technological progress. We had used (non-political) swamp draining and DDT spraying to massively reduce the global burden of malaria, wiping it out from countries like the USA and India. If you had done a prediction market in 1970, many malaria experts would have predicted we would have eradicated malaria by now—including potentially with vaccines, in fact it was a vibrant topic of conversation at the time, with many in the 60s believing a malaria vaccine would be here before now.
Again in 1979 after smallpox was eradicated, if you asked global health people how many human diseases we would eradicate by 2023, I’m sure the answer would have been higher than zero—the current situation.
Many diseases have had disturbingly slow technological progress, despite decades passing and billions of dollars spent. Tuberculosis for example could be considered a better vaccine candidate than malaria, yet it took 100 years to get a vaccine which might be 50% effective at best. We still have no good point of care test for the disease.
There are also rational reasons that led us to believe that in this specific case, making a malaria vaccine would be extremely difficult or even impossible—not just because we were luddites who lacked optimism. Malaria vaccines are the first ever to be invented that works against a large parasite—all previous vaccines worked against bacteria and viruses, and this even while we have failed to invent reliable vaccinations for many diseases that should be far easier than malaria. In the specific case of malaria you might be correct, we may have underrated the scale of progress, but I don’t think this can be generalised across the global health field, and certainly not “dramatically)
A couple of other notes
First, I don’t think anyone has mentioned that vaccine trials have all been undertaken in the context of widespread mosquito net use. Their efficacy would be far far worse, and maybe even not over useful thresholds without the widespread net distributions which Effective Altruists have pushed so hard. Vaccine rollouts may have been partially made possible or sped up by fairly ubiquitous mosquito net use, rather than what you seem to suggest that progress may have been hampered by resources diverted away form vaccine development towards nets
I also think there are some misunderstandings about the fundamentals of malaria here as well. For example @John G. Halstead mentioned countries eradicating malaria through draining swamps, but this was only possible because they were at the edges of the malaria map, where cutting off malaria transmission is much easier. This isn’t a magic bullet closer to the equator. Draining Sub-saharan African swamps would not wipe out malaria there (although it might improve the situation somewhat)
I don’t think you need to be mournful in this case, because
There’s still a decent chance, even with 20⁄20 hindsight that this wasn’t a failure on the EA front, given that mosquito nets may aid vaccine efficiency, and also see @Linch and other’s comments below.
Even if we did get this bet wrong, and money would have been better spent on vaccine development in this case, it may be an outlier case, not because global health people generally underestimate technological progress.
The article I linked above has changed my mind back again. Apparently the RTS,S vaccine has been in clinical trials since 1997. So the failure here wasn’t just an abstract lack of belief in technology: the technology literally already existed the whole time that the EA movement (or anyone who’s been in this space for less than two decades) has been thinking about it.
I understand the sentiment, but there’s a lot here I disagree with. I’ll discuss mainly one.
In the case of global health, I disagree that”thoughtful people trying very hard to address a serious problem still almost always dramatically underrate the scale of technological progress.”
This doesn’t fit with the history of malaria and other infectious diseases where the opposite has happened, optimism about technological progress has often exceed reality.
About 60 years ago humanity was positive about eradicating malaria with technological progress. We had used (non-political) swamp draining and DDT spraying to massively reduce the global burden of malaria, wiping it out from countries like the USA and India. If you had done a prediction market in 1970, many malaria experts would have predicted we would have eradicated malaria by now—including potentially with vaccines, in fact it was a vibrant topic of conversation at the time, with many in the 60s believing a malaria vaccine would be here before now.
Again in 1979 after smallpox was eradicated, if you asked global health people how many human diseases we would eradicate by 2023, I’m sure the answer would have been higher than zero—the current situation.
Many diseases have had disturbingly slow technological progress, despite decades passing and billions of dollars spent. Tuberculosis for example could be considered a better vaccine candidate than malaria, yet it took 100 years to get a vaccine which might be 50% effective at best. We still have no good point of care test for the disease.
There are also rational reasons that led us to believe that in this specific case, making a malaria vaccine would be extremely difficult or even impossible—not just because we were luddites who lacked optimism. Malaria vaccines are the first ever to be invented that works against a large parasite—all previous vaccines worked against bacteria and viruses, and this even while we have failed to invent reliable vaccinations for many diseases that should be far easier than malaria. In the specific case of malaria you might be correct, we may have underrated the scale of progress, but I don’t think this can be generalised across the global health field, and certainly not “dramatically)
A couple of other notes
First, I don’t think anyone has mentioned that vaccine trials have all been undertaken in the context of widespread mosquito net use. Their efficacy would be far far worse, and maybe even not over useful thresholds without the widespread net distributions which Effective Altruists have pushed so hard. Vaccine rollouts may have been partially made possible or sped up by fairly ubiquitous mosquito net use, rather than what you seem to suggest that progress may have been hampered by resources diverted away form vaccine development towards nets
I also think there are some misunderstandings about the fundamentals of malaria here as well. For example @John G. Halstead mentioned countries eradicating malaria through draining swamps, but this was only possible because they were at the edges of the malaria map, where cutting off malaria transmission is much easier. This isn’t a magic bullet closer to the equator. Draining Sub-saharan African swamps would not wipe out malaria there (although it might improve the situation somewhat)
I don’t think you need to be mournful in this case, because
There’s still a decent chance, even with 20⁄20 hindsight that this wasn’t a failure on the EA front, given that mosquito nets may aid vaccine efficiency, and also see @Linch and other’s comments below.
Even if we did get this bet wrong, and money would have been better spent on vaccine development in this case, it may be an outlier case, not because global health people generally underestimate technological progress.
Great comment, thank you :) This changed my mind.
The article I linked above has changed my mind back again. Apparently the RTS,S vaccine has been in clinical trials since 1997. So the failure here wasn’t just an abstract lack of belief in technology: the technology literally already existed the whole time that the EA movement (or anyone who’s been in this space for less than two decades) has been thinking about it.