
Good News You May Have Missed in 2014 - prajjwal
http://www.gatesnotes.com/About-Bill-Gates/Year-in-Review-2014
======
tokenadult
The news about better treatment for drug-resistant tuberculosis is huge. If
confirmed, that'll be the basis for saving many lives in the next decade,
especially in India. Multiple-drug-resistant tuberculosis has been an alarming
problem there.[1]

[1]
[http://articles.economictimes.indiatimes.com/2013-06-23/news...](http://articles.economictimes.indiatimes.com/2013-06-23/news/40134749_1_stop-
tb-department-mario-raviglione-jmm-meeting)

[http://www.wsj.com/news/articles/SB1000142405270230344420457...](http://www.wsj.com/news/articles/SB10001424052702303444204577460734274201756/)

[http://www.iom.edu/Reports/2012/Facing-the-Reality-of-
Drug-R...](http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-
Resistant-Tuberculosis-Challenges-and-Potential-Solutions-in-India.aspx/)

~~~
wahsd
Serious question though, and I would like people to ignore some sort of moral
or religious argument for it; but what is the long term implication if all
kinds of health advances save people but humans still reproduce and impact the
planet in already unsustainable rates.

I get it, some people have a bleeding heart and want to save everyone,
everywhere, at all times; but what happens when the planet is the equivalent
of a cat hoarder's house because we could never say no and we could never
implement policy to limit population growth because the wealthy inherently
gain from unregulated population growth?

~~~
octaveguin
Gates actually addressed this[0].

The upshot is that as countries get richer, fertility rates decrease. Allowing
these poorer countries to lead better lives will paradoxically lower the
population increase. If you look at the western world, negating immigration,
many countries have a shrinking population.

The more pressing problem of the future, ironically, will be under population
- at least if you consider the economic impact and our way of life. Our
economy right now is built on so much growth and young labor. What happens
without poor countries and when more people are retired than working?

[0][http://annualletter.gatesfoundation.org/#myth-
three=&section...](http://annualletter.gatesfoundation.org/#myth-
three=&section=myth-three)

~~~
alecco
That's just not true, as UN stated last month. Population, particularly in
Africa, is growing instead of stabilizing.

[http://www.scientificamerican.com/article/world-
population-w...](http://www.scientificamerican.com/article/world-population-
will-soar-higher-than-predicted/)

Vaccines without sex education and birth control support programs are
extremely irresponsible. We need both, just one is trading off a short term
problem for a bigger long term problem.

~~~
Guvante
> Vaccines without sex education and birth control support programs are
> extremely irresponsible

Are you sure there is no correlation between mortality and fertility rates?
Assuming there is (which lots of evidence points to) there isn't actually any
problem.

------
dergachev
I would add they just came out with a drug to cure hepatitis C. That's amazing
news for 3.2 million Americans with the disease, including my dad.
[http://www.webmd.com/hepatitis/news/20140729/pill-
hepatitis-...](http://www.webmd.com/hepatitis/news/20140729/pill-hepatitis-c)

~~~
FunCaptcha_Jim
Oh wow, I had no idea this happened! And it's actually true? This isn't the
typical "we've cured this" then "loljk here's why we haven't cured this" news
piece?

~~~
refurb
Yes it is true.

However, it's not like we couldn't cure hepatitis C before, we could, but just
not very well.

The old regimen was interferon + ribavirin. You had to take it for months and
months and the interferon makes you feel like you have the flu (it also put
the patient at risk of depression and suicide). The cure rate was ~50%.

With the new drugs you don't need to get interferon injections anymore. You
just pop one pill a day and 12 weeks later there is a 95%+ likelihood that
you've been cured of HCV.

It's a HUGE medical advance.

~~~
ohashi
That's quite frankly amazing. I'm really happy to read stuff like this on
here.

~~~
mercutio2
It's really amazing, as Hep C kills more Americans per year than HIV.

There's a bit of a dark side, though, in that this miraculous cure's creator
was bid up to billions of dollars, and the cure is sold to American health
insurance for ~$85k a course, which is out of reach for most people without
health insurance.

Of course, if you limit the upside on the home runs, you may find yourself
with fewer batters in the pharmaceutical industry. I'd personally prefer if
governments directly funded research, or even better, offered X-prize style
contests, rather than granting patents on drugs.

But none of that diminishes what a remarkable advance this is for millions of
Americans.

~~~
simonbyrne
Given the immense cost, but huge benefit, it will be interesting to see how it
stands up to cold-hearted cost/benefit analysis. The decision as to whether it
will be available on the NHS (i.e. at taxpayer expense) in the UK is due in
January[1].

[1]: [https://www.nice.org.uk/guidance/indevelopment/gid-
tag445](https://www.nice.org.uk/guidance/indevelopment/gid-tag445)

~~~
refurb
Although the written report isn't available, NICE already came out and said
despite the price, Sovaldi is cost-effective.[1]

[1][http://www.forbes.com/sites/theapothecary/2014/08/18/uk-
says...](http://www.forbes.com/sites/theapothecary/2014/08/18/uk-says-sovaldi-
is-worth-it-we-should-listen/)

~~~
tanzam75
The British National Health Service can make that trade-off. Because the NHS
covers the entire population, it knows that it will recoup the high up-front
cost by avoiding other treatment later in the patient's life.

An American insurer would rather put you on the older treatment and make your
life so miserable that you switch to another insurance company at the next
open enrollment. It makes no sense in the aggregate, but it makes sense for
any one insurer.

No insurer wants to have the most generous policy, because it will just
attract Hepatitis C patients from other insurers, hitting them with the up-
front costs. However, they would not get all the delayed savings, because the
patients could switch to a different insurer after they were cured.

The only way to break the game-theory logjam is to force the drug to be
covered nationwide. Then, all the insurers pay the up-front cost, and on
average, all of them reap the savings.

~~~
refurb
_An American insurer would rather put you on the older treatment and make your
life so miserable that you switch to another insurance company at the next
open enrollment. It makes no sense in the aggregate, but it makes sense for
any one insurer._

The thing is, that's not happening at all. Nearly all US insurers are covering
the new therapies. There are a couple that are holding out and only doing
individual approvals.

You have to remember that private insurance competes on coverage, particularly
for the insurance purchased by large employers.

Your comments about the NHS having a different viewpoint is correct. Since the
NHS looks at total societal costs, they can reap the benefit of any immediate
costs.

~~~
tanzam75
> _The thing is, that 's not happening at all. Nearly all US insurers are
> covering the new therapies. There are a couple that are holding out and only
> doing individual approvals._

So what are all the news articles about? A problem that is only hypothetical?
The reporters don't seem to have a hard time finding cases of Hepatitis C
patients who have been denied:

[http://kaiserhealthnews.org/news/most-illinois-medicaid-
pati...](http://kaiserhealthnews.org/news/most-illinois-medicaid-patients-
denied-new-hepatitis-c-drugs/)

[http://www.npr.org/blogs/health/2014/10/28/359553282/insurer...](http://www.npr.org/blogs/health/2014/10/28/359553282/insurers-
may-cover-costly-hepatitis-c-drugs-only-for-the-very-ill)

Then there's the fact that AbbVie and Merck are coming into the market soon
with their own Hepatitis C drugs that also have 90% cure rates. It seems hard
to believe that either of these companies will come in significantly below the
price of Sovaldi, but that's what the insurance companies are hoping for.

~~~
philwelch
> Then there's the fact that AbbVie and Merck are coming into the market soon
> with their own Hepatitis C drugs that also have 90% cure rates. It seems
> hard to believe that either of these companies will come in significantly
> below the price of Sovaldi, but that's what the insurance companies are
> hoping for.

Why? If you apply game theory, one of the three will try to defect and
undercut the other two.

~~~
tanzam75
> _Why? If you apply game theory, one of the three will try to defect and
> undercut the other two._

Because they're playing a repeating game. AbbVie and Merck are big pharma
companies. They don't particularly want to get into a price war.

It would be different if a small biotech firm were coming in. They might not
get a second shot at it for a long time, so they are much more likely to
undercut on price.

Also, three is a low number. Defection is more likely when the number of
players goes up.

Of course, they're not going to come in dollar-for-dollar identical to the
pricing of Sovaldi and Harvoni. However, the insurance companies seem to be
hoping for some really sharp drops in price, which are less likely.

------
sillysaurus3
It's so cool to see the eradication of a disease. To live through it. You read
about such things in history books, but actually being alive while it happens
is pretty sweet. Especially such an awful one like polio.

~~~
philwelch
They'll have to eradicate it in Pakistan and Afghanistan first, and around
there people don't really trust foreigners who come around promising free
polio vaccines because that was the CIA's cover when they came looking for Bin
Laden.

~~~
tanzam75
There was a polio outbreak in China in 2011 that was traced back to Pakistan.
Prior to that outbreak, the last case of polio in China had been in 1999.

The outbreak was contained after 21 confirmed infections plus another 23
suspected. The Chinese public health system mobilized 1000 health workers,
spent $26 million, and vaccinated _44 million people_.

If we can't get rid of polio in Pakistan and Afghanistan, then this will just
keep happening.

NEJM editorial:
[http://www.nejm.org/doi/full/10.1056/NEJMe1311591](http://www.nejm.org/doi/full/10.1056/NEJMe1311591)

~~~
danieltillett
This will keep happening around the world. We came so close to eradicating
polio for good and to see it all thrown away is heartbreaking.

------
keyle
It's fantastic to see articles that focus on the positives. Most media and the
press are all about the daily, the shocking and the hurtful. This is good
news.

~~~
InclinedPlane
The irony is that the "news" often focuses on exceptional events, which tends
to result in having a skewed view of the world.

~~~
protomyth
If you haven't read "It's Not News, It's Fark: How Mass Media Tries to Pass
Off Crap As News"[1] by Drew Curtis, then I highly recommend it to explain
quite a lot of the process and thinking of the news. It might not be the most
serious, and it is funny, but it digs into the truths of the beast.

1) [http://www.amazon.com/Its-Not-News-Fark-
Media/dp/1592403662/](http://www.amazon.com/Its-Not-News-Fark-
Media/dp/1592403662/)

~~~
Sammi
My life has become markedly better since I cut out following daily mainstream
news. I realized I wasn't gaining anything from it, just loosing.

~~~
spain
I'm curious as to where you get your news instead. I feel like you do and I've
been looking for more thoughtful places to get news.

~~~
JonnieCache
[http://www.stratfor.com](http://www.stratfor.com) and the like.

Protip: If you abandon your subscription in last stage of the cart and come
back later, it knocks 50% off the price. It did for me anyway.

~~~
maxmax
The MSM creates a false world view by creating an impression that rare,
exciting events are the norm. Stratfor creates a false world view by
"contextualizing" current events and making predictions, thus creating a false
impression that the future is knowable.

Pick the fantasy you're most comfortable with.

~~~
JonnieCache
Yes, a lot of the analysis is quite silly. It's a good way to find out about
stuff though.

------
LukeFitzpatrick
Hi Bill,

Just wanted to let you know you have a 'bug' on the 'contact us' section, I
assume only for iOS devices. It comes up with a gray area blocking the forms,
with the text out of place.

Great site, and it's good you're giving so much back to the world to fight
worthy causes.

~~~
queeerkopf
Curious side note/question: What makes you think Bill Gates or someone
involved with the website reads the comments on this HN submission?

~~~
LukeFitzpatrick
Yeah, I thought the site posted was his official blog. I naturally thought he
would check this to see how the HN community responded.

I've cold emailed a lot of well known people before and most of them
responded. I guess it was 'positivity' that skewed my thoughts. But, your
right, a Lotto chance of Bill Gates coming on here.

~~~
jc123
Ray Ozzie had a #1 comment here recently and I wouldn't be surprised if BillG
also reads HN. He's a voracious reader and it would be interesting to see what
online sites he reads daily.

------
malloreon
These are wonderful trends that are keeping more people alive and for that we
should both be grateful and thankful to those who work on keeping them moving
in that direction.

What effects do these trends have on poverty and food insecurity?

------
tim_hutton
The numbers in the polio graph doesn't match the positions! Comparison:
[http://i.imgur.com/3kGXyRA.png](http://i.imgur.com/3kGXyRA.png)

Not a massive problem in this case but worrying.

~~~
sp332
All I'm seeing from the comparison is that your circles are a bit smaller than
the original.

~~~
tim_hutton
The 122 in particular should be almost halfway between 100 and 150 but theirs
is much lower.

------
DodgyEggplant
This is a huge case, maybe rare, how money is better used than a tax payment.
Non of this would happen if sunk into the government

~~~
gldalmaso
Not sure I understand your point. These are all state tier achievements. If
anything it's where the state is either disorganized, broke, utterly corrupt,
or all that make it difficult to achieve those goals in the first place.

You are saying we shouldn't have to pay taxes so the state can plan and
execute vaccine campaigns and offer chronic disease treatment without cost to
the patients that need it?

This is the case in Brazil (for instance
[http://en.wikipedia.org/wiki/HIV/AIDS_in_Brazil](http://en.wikipedia.org/wiki/HIV/AIDS_in_Brazil))
and I happily pay my due to make it happen.

Not all tax money is actually put to good use, but the greater part is and I
certainly wouldn't advocate against that.

Of course some countries have weird priorities IMO (yes, US) and may not share
this view.

~~~
jc123
Yes dodgy's point is probably that this tax money sent to US govt will not
result in such achievements like medicine in developing countries.

------
billpg
My mind added an exclamation point to that headline.

Good News! You May Have Missed 2014!

------
revscat
What the Gates Foundation is wonderful, laudable, noble, and good. I am
disappointed to not see mention of any environmental accomplishments in the
list, though. Long term, the threats posed by climate change are far more of a
threat than any disease.

~~~
trothamel
That doesn't seem to be true. According to the WHO, climate change has the
potential to cause 250,000 deaths per year in 2030-2050. When it comes to
disease, malaria alone kills between 376,000 and 755,000 people per year -
right now.

Sources: [http://www.scientificamerican.com/article/premature-
deaths-m...](http://www.scientificamerican.com/article/premature-deaths-
multiply-as-climate-changes/)
[http://www.who.int/features/factfiles/malaria/en/](http://www.who.int/features/factfiles/malaria/en/)

~~~
danielharan
As one noted in the article ""almost certainly an underestimate", because a
number of climate-health relationships are not measurable due to lack of
adequate data".

Milder winters expand the range of disease-carrying insects, increase risks of
wars or famine with less water, mass migrations leading to political
instability, more extreme weather events like draughts and flooding leading to
failed crops and other natural catastrophes...

Meanwhile much of the WHO estimate is for people dying due to heat exposure.
Easy to quantify, important to know - but nowhere near the full picture.

~~~
refurb
Since there is a lot of uncertainty as to what the negative impact of global
warming might be, doesn't it make sense to focus on the people who are dying
right now?

~~~
lincolnq
It depends on your risk/reward curve, and your probability estimates.

Malaria is unlikely to get much WORSE than it is now. But if you think that
global warming has a chance to cause catastrophic damage, two or three orders
of magnitude more than malaria is causing today, then you should estimate the
probability that you can impact global warming and do the EV calculation.

------
toyg
I'm surprised not to see the usual contingent of malthusians out in force.
We're saving more kids than ever; surely this means we're all doomed, right?
BillG should spend all this money on sterilising (poor, non-white) people
instead, right?

(ok, ok, this is a bit trollish, but my point stands: the world is getting
better and the sky is not falling -- deal with it)

~~~
skrebbel
Soo, you missed a trollish debate so you're trying to start it even though you
don't agree with the presumed point which, in fact, nobody is making?

~~~
toyg
I didn't say malthusians are trollish, I admitted _I_ was being trollish. I am
just curious about why they're not trying to spin it in their usual fashion.

~~~
_nedR
Well, The average intelligence of the Hacker News commenter is a tad above
that of Youtube or the Daily mail. Bill Gates himself has repeatedly stated
that reducing mortality and improving quality of life has consistently proven
to _reduce_ population growth :
[http://annualletter.gatesfoundation.org/#myth-
three](http://annualletter.gatesfoundation.org/#myth-three)

Everybody here already knows this of course. ;)

