
Xkcd and Bill Gates on Polio Eradication - Amorymeltzer
http://www.gatesnotes.com/Health/XKCD-Marks-the-Spot
======
epalmer
My oldest brother got polio at 5 years old and I was exposed to him when I was
2. But I got the vaccine shortly after (in 1955). I am so grateful for the
vaccine. For the record my brother is still alive and has had numerous
surgeries. Most recently both hips were replaced and they used that as an
opportunity to add some length to his shorter leg. This has made a tremendous
positive difference in his life.

Stay focused.... "We don't need no stinking app".

~~~
alsetmusic
My father contracted polio as a child. His doctor told his parents that it was
too advanced and that he would certainly die. That he survived was pure luck.
I recently learned (from my mother) that the latent stress of the experience
caused him to be unable to say the name of the disease during the first years
that my parents knew each other. He would refer to it as "when he was sick,"
and couldn't say "when I had polio," until much later.

I'm grateful that we've made such progress in this area.

~~~
TeMPOraL
Thank you both for sharing those stories. I'm happy that you and your parents
endured.

I sometimes see a person with a... specific way of walking on the streets of
my city. Only recently a friend pointed out to me what disease caused that
problem. I am grateful that my generation didn't have to experience it, to the
point most people don't even know what the disease is and that it was a
problem only so recently. People who helped this happen are true heroes of our
times.

I was relieved to learn recently that we're 2/3 done with polio, only the last
strain of the virus remaining. Here's to hoping it will be over soon, and then
the next disease, and the next one after that!

~~~
epalmer
Thanks

Many younger people have no idea what modern medicine does for us that was not
available when I was young. I had Rubella (german measles) that almost killed
me, mumps which I remember being very sick, and ChickenPox. We still have to
fight the flu but I had the Asian flu when I was very young as well. Many
people died that year, 1957. Estimates are about 70,000 in the USA.
[http://www.britannica.com/event/Asian-flu-
of-1957](http://www.britannica.com/event/Asian-flu-of-1957)

An interesting story about the German Measles. Our family physician at the
time told my mother to expose me to my next door neighbor that had the measles
because I would get it anyway. So I remember sitting with him for an
afternoon. I don't remember anything else from the next 2 weeks. My mother
apologized till the day she died for doing that to me.

"What doesn't kill you makes you stronger." Or at least that is the lie that I
remind myself once in awhile.

------
beaker52
It's not a case of just carrying on as we were.

Here are the pockets of Polio:
[http://voices.nationalgeographic.com/files/2014/04/gitn_1204...](http://voices.nationalgeographic.com/files/2014/04/gitn_1204_polio.png)

Why?

1) Vaccinators can't access some regions of Afghanistan and Pakistan because
of violent resistance to Western aid.

2) Western vaccines are resisted by Muslim Nigerians who fear Polio vaccines
are a Western plot to sterilise Muslims.

3) Hajj is a great opportunity for the disease to spread between members of
these regions.

[http://www.irinnews.org/report/48667/nigeria-muslim-
suspicio...](http://www.irinnews.org/report/48667/nigeria-muslim-suspicion-of-
polio-vaccine-lingers-on)

[http://news.nationalgeographic.com/2015/03/150303-polio-
paki...](http://news.nationalgeographic.com/2015/03/150303-polio-pakistan-
islamic-state-refugees-vaccination-health/)

Hearts and minds need to be won or brute force needs to be used, if decades of
effort are going to pay off. Until it's eradicated in these regions, we're
stuck vaccinating our children to avoid re-establishment of the disease.

~~~
yongjik
1) Vaccinators can't access some regions of California because of violent
resistance to vaccination.

2) Western vaccines are resisted by hippie Californians who fear Measles
vaccines are a Western pharmaceutical plot to spread autism.

3) Disneyland is a great opportunity for the disease to spread between members
of these regions.

Let's see if Jenny McCarthy is forcefully vaccinated. Until then, it will be
hard for me to take your "They aren't the same people as us, so let's use
brute force, for _humanity_ " attitude seriously.

~~~
beaker52
Yes, luckily for these people, they live in a region where Polio is uncommon.

Most of the world could stop vaccinating their children if they chose to. It'd
be fine. Until the disease spreads to their population and people start to get
infected.

One case of Polio could quite quickly cause California to become a Polio
infected region, like Nigeria, Afghanistan and Pakistan. Then we'd have to
deal with that area too.

Though without the conviction of other populations, I imagine a once-defiant
Western population would quickly revert to willingly accepting the vaccine
once they've seen the horrors of the disease with their own eyes.

~~~
fossuser
Yeah - in some ways the effectiveness of vaccines is the only reason that
people in western countries can argue against vaccinations at all.

------
mattlutze
The continued eradication of Poliovirus is a testament to the almost inhuman
tenacity of the medical and perimedical community that's dedicated so much of
their time and professional lives to the issue.

There's been a number of other public nuisance / threat viruses that haven't
fared so well in recent years. HIV among them; treatment has improved so
significantly that the previous risk communication ethos, "avoid risky
behaviors or you might die," just doesn't cut the mustard anymore.

Transmission reductions have stalled in adolescent to middle-aged groups is
still high and over the total population looks to have been stalled for some
time.[1] CDC [2] and other reporting numbers show it stalled for most of the
last 15 years.

~~~
munificent
> The continued eradication of Poliovirus is a testament to the almost inhuman
> tenacity of the medical and perimedical community that's dedicated so much
> of their time and professional lives to the issue.

We see a lot of things like crowdsourcing, crowd funding, and the constant
stream of stories like "sick kid gets a million get well cards after plea goes
viral". Those are all interesting lessons in the power of the attention of a
_lot_ of people for a _short_ amount of time.

But I think we forget what is ultimately a greater contributor to human
progress: the attention of a _few_ for a _long_ time.

You don't need a crowd to change the world. You just need persistence.

------
peter303
Hope he gets the Nobel Peace Prize some day for aggressive billionaire
philanthropy. There are plenty of other generous donors out there, but he sets
an example of what do with tech wealth.

------
zellyn
So confused by the lack of hover text… :-)

~~~
adricnet
I saw World Polio Day XKCD Comic, which wasn't the usual extra joke but is
certainly accurate and appropriate an ALT tag.

Possibly because I have a FireFox extension just for those, actually:
[http://piro.sakura.ne.jp/xul/_popupalt.html.en](http://piro.sakura.ne.jp/xul/_popupalt.html.en)

Anyway, thanks Randall and Mr Bill!

~~~
PhantomGremlin
_Anyway, thanks Randall and Mr Bill!_

Mr Bill has an entirely different meaning to those of us who watched Saturday
Night Live back in the 1970s.
[https://en.wikipedia.org/wiki/Mr._Bill](https://en.wikipedia.org/wiki/Mr._Bill)

------
asgard1024
I think Feynman is worth quoting here:

All the major problems of the relations between society and science lie in
this same area. When the scientist is told that he must be more responsible
for his effects on society, it is the applications of science that are
referred to. If you work to develop nuclear energy you must realize also that
it can be used harmfully. Therefore, you would expect that, in a discussion of
this kind by a scientist, this would be the most important topic. But I will
not talk about it further. I think that to say these are scientific problems
is an exaggeration. They are far more humanitarian problems. The fact that how
to work the power is clear, but how to control it is not, is something not so
scientific and is not something that the scientist knows so much about.

Let me illustrate why I do not want to talk about this. Some time ago, in
about 1949 or 1950, I went to Brazil to teach physics. There was a Point Four
program in those days, which was very exciting--everyone was going to help the
underdeveloped countries. What they needed, of course, was technical know-how.

In Brazil I lived in the city of Rio. In Rio there are hills on which are
homes made with broken pieces of wood from old signs and so forth. The people
are extremely poor. They have no sewers and no water. In order to get water
they carry old gasoline cans on their heads down the hills. They go to a place
where a new building is being built, because there they have water for mixing
cement. The people fill their cans with water and carry them up the hills. And
later you see the water dripping down the hill in dirty sewage. It is a
pitiful thing.

Right next to these hills are the exciting buildings of the Copacabana beach,
beautiful apartments, and so on.

And I said to my friends in the Point Four program, "Is this a problem of
technical know-how? They don't know how to put a pipe up the hill? They don't
know how to put a pipe to the top of the hill so that the people can at least
walk uphill with the empty cans and downhill with the full cans?"

So it is not a problem of technical know-how. Certainly not, because in the
neighboring apartment buildings there are pipes, and there are pumps. We
realize that now. Now we think it is a problem of economic assistance, and we
do not know whether that really works or not. And the question of how much it
costs to put a pipe and a pump to the top of each of the hills is not one that
seems worth discussing, to me.

(from [https://www.nytimes.com/books/first/f/feynman-
meaning.html](https://www.nytimes.com/books/first/f/feynman-meaning.html))

------
afarrell
I thought there was a problem with the Taliban fighting against polio-
eradication efforts due to the Bin Laden thing? I would guess that they might
need some new tactics to deal with that?

Maybe the CIA is secretly doing some work to make itself look less bad and
kill an enemy that used to murder American children? Sounds like a decision
they might plausibly make.

Or maybe they're just staying out of the way and we happen to have a bunch of
nurses accepting the risk of violent death.

~~~
mikeash
The comic really needs a panel that goes something like, "Hey, since
vaccination programs are so common, let's take advantage of that by using
undercover nurses as scouts so we can kill terrorists!" And then that gets
shot down as the completely idiotic idea it is.

I would really like to see an estimate of how many deaths will result from the
CIA's subversion of Pakistani vaccination programs, and how it compares to the
deaths caused by bin Laden. I'd wager the former will outweigh the latter by a
substantial margin.

------
Beltiras
Funny. We had a chat in the office this morning about Gates. Original comment
was about how his philanthropic work made him so worthy of enjoying the fruits
of his labors. My take on it was that the permanent damage he inflicted on
computing was justified by how he is spending the proceeds. It was not a well
received comment then, no different from whenever I get to make it (and I
fully expect this thread to be no different).

You rock Bill. Rock on.

~~~
whatever_dude
When I look at the field when commercial microcomputing started, it's hard to
complain too much about any "permanent damage" Gates' might or might not have
made. He was the one who survived, and he was smart, but remember software
companies at the time were completely taken over by some of the biggest
assholes in modern history. On that topic, "In Search of Stupidity" is a book
which is very revealing of the times, and of much worse characters. I
completely recommend it for anyone who likes to think Microsoft is especially
evil.

~~~
itgoon
Agreed. It's also easy to forget that Gates was able to do it all because he
was so drastically undercutting the very expensive status-quo.

Had he not insisted on keeping so much control, it might have been even longer
before computing was available to the general masses.

------
hackuser
Miracles can be accomplished when people work together. That may sound trite
but today many doubt it, insisting government can do nothing right, reducing
funding for research and health programs, etc.

------
thenipper
Holy crap. That is so dead on in how people are approaching international
development lately.

~~~
pinko
Can you give some examples? (To be clear, I'm not at all skeptical but would
just love to hear specifics!)

~~~
thenipper
Thought of one on my lunch break:

Drones! Lately Drones have been seen as something that is going to
revolutionize international development. You can map things quickly! Get tons
of info! Etc.

However the problem is something like a drone tends to make host governments
pretty nervous. Nepal from what I understand was a great example of that.
There was a ton of drone usage there by NGOs, journalists and other groups.
This increased the tensions that the government has with foreign aid workers
which in turn slowed down the rate of recovery.

As a counterpoint there are great things like the 'contact tracking' apps used
in the Ebola response. Various ICT4D companies made a mobile app that allowed
field workers and local health workers to track who people had contact with
and do followup appointments to make sure that they remained disease free.
It's a simple concept but one that proved to be from what I understand very
helpful.

------
nsgi
Mobile apps can actually play an important role in polio eradication

[http://www.polioeradication.org/Research/PolioPipeline/No7Wi...](http://www.polioeradication.org/Research/PolioPipeline/No7Winter2011/Mobilephoneshelpassessqualityofpoliocampaig.aspx)

------
dekhn
I'll give Gates credit: it only took him about a decade of futile ultra-
technological attempts to understand that curing disease is often best done
more simply.

~~~
josefresco
Source? Would like to read more about this if there's a write up somewhere. My
perception was that they were doing was was effective very early on
(vaccination drives etc.)

~~~
rgbrenner
What he says is literally impossible.. it hasn't even been a decade since the
Gates foundation started funding polio eradication. The first the Gates
foundation did anything was in 2007, when they gave $100m.

[http://www.boston.com/news/nation/washington/articles/2007/1...](http://www.boston.com/news/nation/washington/articles/2007/11/27/gates_group_gives_100m_to_polio_fight/)

[http://www.gatesfoundation.org/Media-Center/Press-
Releases/2...](http://www.gatesfoundation.org/Media-Center/Press-
Releases/2007/11/Rotary-International-and-Gates-Foundation-Together-
Commit-$200-million-to-Eradicate-Polio)

And that money (along with $100m from Rotary International) went to the Global
Polio Eradication Initiative, which is the World Health Org's immunization
program (started in 1988).

~~~
dekhn
8 years, not 10, but:
[https://en.wikipedia.org/wiki/Mosquito_laser](https://en.wikipedia.org/wiki/Mosquito_laser)

In 2007, the Bill & Melinda Gates Foundation requested Intellectual Ventures
LLC to find a way to fight and eventually end malaria. Intellectual Ventures
resurrected the idea of using lasers to kill mosquitoes and now has a working
prototype.[2] The idea has been criticized because most areas where malaria is
prevalent do not have reliable electrical power.[3]

~~~
rgbrenner
Good point. In fairness though, that began with a $100k challenge to
Intellectual Ventures, and they came up with the idea. Gates then gave them
$1m to continue developing it with the idea it could be used to protect large
areas.

[http://www.theregister.co.uk/2011/11/03/laser_mpsquito_repel...](http://www.theregister.co.uk/2011/11/03/laser_mpsquito_repellent/)

The funding is peanuts compared to what Gates has been spent on Malaria..
here's a couple of the press releases I could find for 2003 ($160m), 2005
(250m) and 2008 ($200m).

[http://www.gatesfoundation.org/Media-Center/Press-
Releases/2...](http://www.gatesfoundation.org/Media-Center/Press-
Releases/2003/09/Grants-for-Malaria-Research)

[http://www.gatesfoundation.org/Media-Center/Press-
Releases/2...](http://www.gatesfoundation.org/Media-Center/Press-
Releases/2008/03/Malaria-Partners-Letter)

[http://www.gatesfoundation.org/Media-Center/Press-
Releases/2...](http://www.gatesfoundation.org/Media-Center/Press-
Releases/2005/10/Gates-Foundation-Commits-2583-Million-for-Malaria-Research)

