
Malaria No More - nate
http://malarianomore.org
======
schemescape
For what it’s worth, GiveWell recommends the Against Malaria Foundation:

[https://www.givewell.org/charities/amf](https://www.givewell.org/charities/amf)

~~~
colinmhayes
People who donate to domestic charities when AMF and the malaria consortium
are saving lives for $5 a net are immoral or naive.

~~~
yboris
I'm a big fan of the Effective Altruism (EA) movement. If you also are
interested in making the world a better place, it's worth spending time
learning how to communicate better.

Even when you say something that is true, the way you say it matters. As
sympathetic as I am to the view that people ought to do the most good, I find
your phrasing of this sentiment hard to endorse.

Your goal is probably to encourage more people to give to AMF. You may have
better success at expressing how much good AMF does with the money given, and
that you would love to see more people considering donating to AMF.

Example: "Donating to AMF and the Malaria Consortium is a very effective way
to help people. For $5 you provide a net that protects people from malaria for
3-4 years. This is a very cost-effective way to help others!"

~~~
colinmhayes
EA is a shrinking movement because it is not effective at utilizing the
strongest card philanthropy has. Shame. Donating to domestic charities is
shameful, just like hoarding billions of dollars is shameful. Telling people
AMF is effective isn't enough, we need everyone to know that other charities
are not, otherwise they'll go on immorally donating to causes they care about
or people that look like them.

~~~
yboris
I wholeheartedly disagree.

You can shame someone into giving $10 in front of you. Good luck shaming
someone to part with >10% of their income through such a negative feeling.

EA has a forum which welcomes (contrarian) opinions. Perhaps you should write
up your reasons for thinking that shame is a good motivator with some research
backing it up. EAs are very open minded. I'm also willing to change my mind.

~~~
colinmhayes
The hard part is shaming people without them realizing that's what's
happening. Red cross is great at this, but some organizations like PETA have
gone to far. Once the shame has sunk in it's important to quickly capitalize
by saying stuff about how great AMF is as you said and not double down like
PETA does. Singer inadvertently figured this out with the drowning child
thought experiment. People don't want to look into a bottomless pit.

~~~
yboris
Sounds like you're not describing what most people would imagine when they
hear "shaming a person". You're aiming for some dark-arts psychological
jujitsu.

Even if possible, even if maneuvers like this might work on some people, it is
likely harder to pull off something like this consistently (thus creating
damage along the way), than to just be up-front-and-honest about the good.

People in general want to come to their own conclusions, and not be told what
to do. Telling them "do this" can back fire. Having a discussion, where you
inquire about their point of view, and structure a conversation as a
collaborative exploration, I think, is better.

Peter Singer's drowning child example is a brilliant argument, and I think one
everyone ought to hear about. But I'm unsure if "shame" is what it evokes. It
raises an incongruity that people then have to reconcile. And if you're kind
and encouraging, providing opportunities for them to become better people (by
their own light), they will more-likely do it. If they are shamed, they might
end up doing mental gymnastics to conclude that "any argument that makes good
people I see around me into bad people is a mistaken argument".

I'm happy to discuss this more. As you can guess it's one of my favorite
topics.

~~~
colinmhayes
Let's take the drowning child. Suppose you save the child and walk by the pond
again the next day. There's another child drowning. Do you save it? Suppose
you walk by the pond everyday and everyday there's another child drowning. Is
there a point where you would not save the child? I think the vast majority of
people would eventually stop saving the kid. I think that's because shame is
what motivates the decision.Eventually they no longer feel shame pushing them
to save the children. If they knew there would be a new child drowning
everyday on the very first day would they save the child? I think it's likely
that many people would not. Saving the child is admitting you have some
responsibility for what happens to it. If you know that you will eventually
stop it feels a lot better to never admit you're responsible for the child.
Shame is a powerful emotion but once people start meta-thinking about it it's
easy for them to get around it with mental gymnastics.

EA is effectively a utility monster, so it's not surprising to me that people
mental-gymnastics their way out of it. EA needs to focus more on tractability
of these problems and less on the bottomless pit if they want mass buy in.
Because in the end donating to AMF doesn't actually feel that great when you
it makes you realize hundreds of thousands of children are dying from
preventable disease every year. It feels a lot better to pretend the problem
doesn't exist so you can ignore the shame and focus on less important issues
instead.

~~~
yboris
Good to read on this topic:

 _You want people to do the right thing? Save them the guilt trip_ [0]

HN discussion:
[https://news.ycombinator.com/item?id=24277190](https://news.ycombinator.com/item?id=24277190)

[0] [https://psyche.co/ideas/you-want-people-to-do-the-right-
thin...](https://psyche.co/ideas/you-want-people-to-do-the-right-thing-save-
them-the-guilt-trip)

------
killjoywashere
Do you have a source on this 3000 kids a day? That's over 1M children a year.
Assuming most of those are in Africa, you're claiming something like a 2%
childhood mortality from malaria alone. The all-cause childhood mortality in
Africa is considered astronomical at 7.8%. The WHO (UNICEF) says the death
rate of malaria in Africa is more like 1 every 2 minutes, which comes out to
720 a day.

One dead child is too many and I worry that number inflation only makes the
fight harder.

~~~
nate
Got that stat from UNICEF:
[https://www.unicef.org/media/files/MALARIAFACTSHEETAFRICA.pd...](https://www.unicef.org/media/files/MALARIAFACTSHEETAFRICA.pdf)

~~~
randomchars
The numbers are a bit weird:

> Malaria kills one child every 30 seconds, about 3000 children every day. >
> Over one million people die from malaria each year

3000 deaths per day * 365 days in a year = 1 095 000 deaths per year

So basically no adults die from malaria?

~~~
pizza
Most malaria victims are children, 57% of deaths are children under 5 years
old [https://ourworldindata.org/malaria](https://ourworldindata.org/malaria)

~~~
cardmagic
Malaria is just as deadly to adults who have never been exposed to it as it is
to children under 5 years old. However the more times you catch it, the more
immunity you build to it. An adult who has caught malaria multiples times is
not likely to die from it. An adult tourist catching it for the first time can
be in trouble.

------
filleduchaos
The discussion around malaria is always really strange to me, because it's so
close to home and yet so far away at the same time.

At this point I've frankly lost count of the number of times I've contracted
malaria, but I'm willing to bet it's well over fifty. I _understand_ ,
theoretically, that it kills an obscene amount of people a year, but it
doesn't really sink in that it's actually a deadly disease. I've never felt
fear for my life while sick with it.

I wonder how much simply having access to the bare minimum of standard
healthcare would reduce the number of fatalities per year.

~~~
HappyDreamer
About for how long do you stay ill each time? How does it feel? I'd suppose
you're away from work the?

I you compare with having the flu? (usually takes one or two weeks before I'm
ok again)

50 times sounds like _a lot_ to me. The illness seems to come back again and
again more often than what I could have guessed.

~~~
filleduchaos
50 times does sound like a lot, but if you're in your mid twenties that only
comes out to twice a year. Considering the frequency in my childhood, I think
it's honestly closer to seventy or eighty. To be clear, I'm counting cases
where I developed symptoms and had to be treated - you do build a tolerance to
it over time, to the point that many people get infected with the malarial
parasite but don't notice any symptoms (it's not really understood how or why
that acquired immunity works, but it does seem to pass from mother to child
and persist until the child is about four or so months old).

It starts out with a persistent headache, sometimes a cough (but with no
congestion - this is critical for figuring out early enough that it's not just
a cold). The most obvious tell though is that some of my muscles start feeling
sore and I start feeling inexplicably tired. At this point I would start
preparing for a possible full-on case; basically making sure that I have a
proper stock of NSAIDs, easy-to-eat foods, multivitamin and mineral syrup, and
oral rehydration solution (I measure and make mine with regular sugar and
salt) - malaria tends to completely suppress your appetite, and it's vital to
keep your blood sugar and iron up even if you can't eat at all.

Sometimes the illness just subsides, but if I find myself developing a fever
(usually a day or so after the headache starts) then I immediately make time
to go and get tested. The whole process including getting results takes about
an hour or two (mostly spent getting to a health care centre). If I'm malaria
positive then I get prescribed an artemisinin-based combination therapy and
sent home - the test and the full course of therapy are free under most health
insurance plans, and cost about $6 to $15 out-of-pocket depending on the brand
and hospital (an afterthought for someone in my position, but prohibitively
expensive for millions of people who live on $2 a day or less).

The medication course is three days long, and _very_ strict about the dosage -
two doses taken eight hours apart, and then four taken every twelve hours
afterwards. It's fast-acting enough that most people feel a lot better after
the first day of treatment, but you have to complete the course and make sure
you're getting excess nutrition even though you feel "fine". If I pick up on
things and start the ACT early enough, the fever doesn't have time to develop;
sometimes it hits hard/seemingly out of the blue, though, in which case I'd
get increasing muscle aches and shivering chills even though the body
temperature is climbing and climbing (the chills are extremely deceptive -
I've seen people beg for sweaters and blankets while running a fever of over a
hundred degrees). I take NSAIDs (usually ibuprofen) to manage the fever, along
with warm green or ginger tea to help with the shivering. Once I start
sweating, the worst of it is over - it's a sign of the fever breaking.

I usually take time off for the length of the ACT, and I'm generally okay to
work by the time I'm done with it. It might take up to a week afterwards for
the fatigue and lowered appetite to completely lift though. All in all, it's
rather like the flu in that the vast majority of otherwise healthy people just
manage it at home, but different in that there's a known, effective treatment
for malaria so you can avoid most of the suffering altogether if you can
afford to be responsible with your health.

~~~
HappyDreamer
Interesting to read, thanks for writing. I'm getting the impression you know
okay much about health care -- for example I had to lookup NSAIDs to know it
means "Non-steroidal anti-inflammatory drugs". I wonder if that makes the
illness less dangerous to you, and (like you wrote elsewhere) indeed indicates
how important a generally good health care system is, to handle malaria. I
actually didn't know there's a treatment nowadays.

Interesting to hear about how it feels, physically / health-wise, with chills
and muscle aches.

Looking at statistics, apparently most people who die, are children, whilst
for the flu, it's old people. That's a pretty big difference I think --
imagine one is 40 years old, and one of one's say, 70 years old parents, or
one's 10 years old child, dies.

------
Medicalidiot
Malaria is probably going to be one of the hardest maladies to overcome. There
was some promise with a vaccine, but it looks like that was fairly
disappointing. The selective pressure is so high with malaria that sickle cell
anaemia is a fairly common congenital disease that if one is homozygous for
can be lethal in early age; conventional medicine has significantly increased
life expectancy, but it's still fairly poor. Hopefully, it will be to the
point where it can be controlled because the African continent has had its
economies ravaged by it.

[https://en.wikipedia.org/wiki/Malaria#Economic_impact](https://en.wikipedia.org/wiki/Malaria#Economic_impact)

~~~
sonicggg
But I wonder how much effort is being put into it though. Take the Sars
outbreak. They tried developing a vaccine, and failed. Everybody just assumed
it was impossible to create a vaccine for a coronavirus, as we never had one
anyway.

Now with Covid-19, we have multiple vaccines in the third, and final, stage of
testing. And we also have a controversial vaccine that has been approved in
Russia. All within a couple of months. Why that hasn't been achieved with
Sars?

~~~
dflock
SARS fizzled out, so we lost interest and funding was cut.

------
arel
Serious question - Why can't we put our minds to it and kill them all?

Why can't we banish this mass killer and cause of immense suffering to humans
and animals alike.

I haven't seen any compelling evidence that they form any vital component of
ecosystems apart from obviously spreading disease and applying some adapation
pressure - which we could eliminate like we have done with lots of other
killers.

~~~
grawprog
>I haven't seen any compelling evidence that they form any vital component of
ecosystems

[https://mosquitoreviews.com/learn/mosquitoes-
purpose](https://mosquitoreviews.com/learn/mosquitoes-purpose)

>As part of their useful role, the larvae of mosquitoes live in water and
provide food for fish and other wildlife, including larger larvae of other
species such as dragonflies. The larvae themselves eat microscopic organic
matter in the water, helping to recycle it. Adult mosquitoes make up part of
the diet of some insect-eating animals, such as birds, bats, adult dragonflies
and spiders. They also help pollinate some flowers, when they consume nectar.

~~~
bryanlarsen
AFAICT, the more serious proposals to eliminate mosquitoes target the
individual mosquito species that spread disease in areas where there are
several other mosquito species that would quickly expand to fill the
ecological gap.

------
subdane
Being peaceful by nature, but also highly allergic to mosquitos, I'm cool with
completely eradicating these little flying vampires and the ecological
collapse that would ensue. Or not as the case may be
[https://www.nature.com/news/2010/100721/full/466432a.html](https://www.nature.com/news/2010/100721/full/466432a.html)

~~~
blisterpeanuts
Only 200 out of 5,000 known species of mosquitoes feed on mammalian blood. If
we could only target those 200, we could remove a great source of misery from
the planet.

In fact, only 8 species carry disease, e.g. zika, malaria.

That said, mosquitoes have been around for 100 million years and it seems
unlikely we can wipe them out without some scary technology.

Probably for the foreseeable future we're going to have to settle for managing
the problem, draining malarial swamps and encouraging predator species like
dragonflies for example.

~~~
ithkuil
> draining swamps

How does that work? I moved to a civilised place in Italy, where the swamps
have been drained centuries ago etc etc; there is no malaria anymore.

Yet, nowadays there are tons of mosquitos, I have nets on all my windows and
doors and yet I have to occasionally kill them either mechanically (I'm
getting good at it but still) or using poisons.

My <1y child has huge reactions when bit; I tend to stay inside because it's
so annoying to get bit all the time; sprays work but not 100%, as if those
mosquitos are adapting against the poisons we throw at them.

Are these non malaria-carrying mosquites more adapted to breed with less
water? Did we stop doing a good job draining the swamps?

~~~
blisterpeanuts
Different species have different attributes. The tiger mosquito (Aedes
albopictus) from SE Asia is invasive in the Americas and carries nasty
diseases -- yellow fever, dengue, zika, chikungunya. It's a highly aggressive
biter, highly adapted to marginal environments, and can breed in a tiny pool
of water the size of a bottle cap. It tends to be active in human-settled
areas. If ever a mosquito deserved to be wiped out, it's this one.

I'm not sure about Italy; I imagine you have plenty of species migrating up
from Africa. If you have a lot of mosquitoes, probably there is a water source
they're breeding in -- a pool, an old tire, a nearby pond? If you can find a
breeding source, dump a mosquito puck in it -- a safe algae that kills
mosquito larvae.

------
vezycash
We already have a surefire low tech mosquito killer - mosquito bats or
zappers. They work well, no chemicals just electricity and batteries.

We however don't have sharp eyes to track the movement of the stealth suckers.
Nor the reflexes to position the bat at the right time while pressing the
buzzer.

Blow up the size of the mosquito bat to foldable 6ft x 4ft mosquito killer and
let probability do its work.

The humans in the room are all the attractant this mosquito killer from hell
would need.

------
hu3
It's not widely known but Bill Gates is heavily invested in the fight against
Malaria for a long time now. Billions of investment.

He's responsible for saving millions of lives.

[https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundat...](https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundation#Funds_for_grants_in_developing_countries)

~~~
bserge
It's pretty widely known, tbh.

Perhaps not as widely as his involvement in 5G and vaccinations, however (jk)

~~~
hu3
Perhaps in the tech bubble it might by common knowledge. Out of it most people
don't know.

I wonder if Jobs was nearly as charitable... edit, google says nope:

> He bought an Alfa Romeo car for one of his girlfriends, Tina, and paid off
> Laurene's student loans. He also kept two cars- a Porsche and a large silver
> Mercedes-- for himself.

Which is just sad. What a waste.

