gwern comments on On Charities and Linear Utility - Less Wrong

13 Post author: Anatoly_Vorobey 04 February 2011 02:13PM

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Comment author: gwern 05 February 2011 05:49:06PM *  1 point [-]

Let's look at some relevant quotes I noticed when I read that a few days ago and was posting excerpts into #lesswrong:

By contrast, the 14-year drive to wipe out smallpox, according to Dr. Donald A. Henderson, the former World Health Organization officer who began it, cost only $500 million in today’s dollars.

...

Right now, there are fewer than 2,000. The skeptics acknowledge that they are arguing for accepting more paralysis and death as the price of shifting that $1 billion to vaccines and other measures that prevent millions of deaths from pneumonia, diarrhea, measles, meningitis and malaria.

“And think of all the money that would be saved,” Mr. Gates went on, turning sarcastic. “It’d be like 5 percent of the dog food market in the United States.”

(I believe there is a fine Eliezer post on exactly the fallacious argument Mr. Gates is using there.)

One injection stops smallpox, but in countries with open sewers, children need polio drops up to 10 times.

Only one victim in every 200 shows symptoms, so when there are 500 paralysis cases, as in the recent Congo Republic outbreak, there are 100,000 more silent carriers.

Other causes of paralysis, from food poisoning to Epstein-Barr virus, complicate surveillance.

Also, in roughly one of every two million vaccinations, the live vaccine strain can mutate and paralyze the child getting it. And many poor families whose children are dying of other diseases are fed up with polio drives.

Smallpox has no natural reservoirs; its vaccine is made from cowpox, not weakened or dead smallpox, while polio vaccines are made from weakened or dead polio viruses and may themselves undo eradication. No one speaks of eradicating anthrax because it's impossible to reach all the natural sources of anthrax spores in deserts in Mongolia or where-ever. Nor do we speak of eradicating ebola because we don't want to extinguish various primate species.

Does squeezing polio jell-o offer the best marginal returns? Are we appealing to sunk-costs here? Eradicating polio may offer permanent benefits (though this is dubious for previously mentioned reasons), but still be a bad investment - similar to how one rarely invests in perpetual bonds.

I see no reason why the usual apparatus of highest marginal return and discount rates do not cover your finite charity distinction.

Comment author: [deleted] 05 February 2011 07:15:41PM 0 points [-]

Correcting factual errors:

Smallpox has no natural reservoirs

Neither does polio. "Some diseases have no non-human reservoir: poliomyelitis and smallpox are prominent examples."

polio vaccines are made from weakened or dead polio viruses and may themselves undo eradication.

First, the inactivated/killed polio vaccine cannot come back to life. Second, that risk for the attenuated vaccine is well known.

Eradicating polio may offer permanent benefits

Will.

You can disagree as to whether the benefits are worth the costs, of course. And perhaps finite problems can be analyzed within the usual framework - but I wanted to bring them up.

Comment author: gwern 05 February 2011 08:24:55PM *  -1 points [-]

No, may. Even if you have zero known cases, you have not eradicated polio for sure because of the carriers and natural reservoirs and obscure little hidden villages. So you still need vaccines. And your own links point out that the attenuated vaccine can still be infectious!

This is believed to be a rare event, but outbreaks of vaccine-associated paralytic poliomyelitis (VAPP) have been reported, and tend to occur in areas of low coverage by OPV, presumably because the OPV is itself protective against the related outbreak strain.

To quote from one of the references:

The rate and pattern of VP1 divergence among the circulating vaccine-derived poliovirus (cVDPV) isolates suggested that all lineages were derived from a single OPV infection that occurred around 1983 and that progeny from the initiating infection circulated for approximately a decade within Egypt along several independent chains of transmission.

Comment author: [deleted] 06 February 2011 07:31:59AM 0 points [-]

What is a "contaminated natural source"? I am genuinely curious.

Comment author: gwern 06 February 2011 04:53:36PM -1 points [-]

A variation on natural reservoir.

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