“We have good evidence and reason to believe that bednets reduce the incidence and burden of malaria. The big question is over the economic impact, not so much the health impact.”
But we don’t have good evidence that bednets are in fact being used in these communities and are actually actively reducing malaria rates, and I have experiential evidence that communities are not using these nets, and both families and health workers are lying to researchers when they come through about net use and malaria prevalence. Are some families using them, possibly. Is it significantly fewer than what AMF claims, I would argue yes.
To conflate AMF and bednets is to miss the whole point. There will be bednets without AMF. Those bednets will go to communities that actually want them and would pay for them, and support local jobs either in factories or import businesses. With AMF, the communities that want bednets will still get them, so there’s no impact there, and communities that don’t want them will not use them, so there’s no impact there. The only appreciable impact is the loss of jobs and infrastructure to get nets to those that want them without AMF’s help.
As for the claim about reduced malaria rates increasing household income, the study you quote claims that shocks like drastic malaria reduction would reduce household incomes for 30 years and significantly increase populations. In a country like this where there are already too few jobs and most people are barely getting by, that could be catastrophic. Most communities might not survive to see the eventual increase in household income, which comes as much from higher rates of education as anything else according to the study.
To the final point, I don’t have the statistics, as noted above, I’m skeptical of any statistics that are coming out of this part of the world, because of the culture around telling strangers what they want to hear. Without accurate information, I feel, once again we must default to what the people actually want, as if anyone knows what they need, they do.
Which brings up a concern. You, and it seems most of the interlocutors here have failed to address to question of choice. The question of freedom. There is no dispute that AMF ignores the requests of communities. That they insist on top down development initiative instead of systematically bottom up initiatives. This is harmful because it does not give people a voice in what is done to them. It destroys the ideals of democracy and self determination. And it is the reason that people don’t use the bed nets, because they don’t care about what you think is valuable, because you never asked them what they want. Interventions which come from the community will be more effective, period. Because the community will actually need them and use them. Effective Altruism fails because it does not realize that the effectiveness of a program is contingent on how invested a community is in that program, and the community’s investment is contingent on you actually asking them what they need.
Let’s back up, because you are continuing to ignore two of my arguments against AMF, that they create dependency, and that they limit freedom. I’m skeptical of the studies for many reasons, everything from a lack of professional ethics of local translators and surveyors, to the troubles of conducting longitudinal studies with children in compounds which often have different children staying in them from day to day, to dissimilarities between what AMF does and what is done in these studies, to philosophical concerns that I have with any such studies that I have from a methodological standpoint. However, the claim I make at the top of the article is that we need to reassess the criteria that we use for determining an effective charity, while debating whether or not the interventions of AMF do what they claim to do may help us to determine if it is inevitably effective, it misses the central point, that effective altruists ignore metrics like job creation, freedom and dependence when evaluating charities.
You still have failed to address the problem of choice. Why can you not care less about what the people want? Why do you think that money gives someone the right to determine how others live their lives? Should we live in a world where only those with money have the right to choose what happens to everyone? That’s the world AMF promotes. By giving to charities that ignore the voices of the populations on the ground you perpetuate the culture of corruption, ubiquitous in modern politics (especially here). People here feel powerless to change their own destinies, because you decided their destiny for them. You condemn them to a generation of poverty with the hope that their economy will recover, when maybe they don’t want that. If I told you that you could live in poverty for 30 years and based on some economic models which may or may not apply you can improve in your income modestly afterward would you agree? If someone you had never met decided that you should live in poverty for 30 years to eventually see a possible increase in income, do you think that they would be right to make that decision for you?
Please stop cheery picking one or two points which are tangential to the actual argument, and answer this: why should we ignore the will of the people? What gives you the right to decide for them? Did they elect you? Do you know them? Have you ever even visited the places that you are making choices for? Why does wealth give you the right to dictate how people you have never met overcome poverty?