Good News You May Have Missed in 2014(gatesnotes.com)
gatesnotes.com
Good News You May Have Missed in 2014
http://www.gatesnotes.com/About-Bill-Gates/Year-in-Review-2014
118 comments
Agreed. Living in the age of antibiotics we (in the developed world) have quickly forgotten how deadly TB is (it was a leading cause of death just 100 years ago). Given the difficulty in developing new antibiotics (and relative lack of commercial incentive to do so) the news that they've found a more effective new drug combination (including new drugs) is very welcome.
The fact that the regimen is shorter will hopefully mean higher completion rates: a big issue at the moment as the treatment can take up to 2 years leading many patients to take incomplete courses (and of course this fuels drug resistance). In Australia we're lucky enough to have the resources to provide free treatment with mandatory monitoring by health care workers (to enforce the full course is taken), but in India, PNG etc they desperately need a cheaper and more practical solution.
Edit to add: hopefully new drugs will also help those with sensitivity to the current antibiotics. They have some pretty harsh side effects, e.g. drug-induced hepatitis is a common problem which means many patients can't tolerate the preferred regimen.
The fact that the regimen is shorter will hopefully mean higher completion rates: a big issue at the moment as the treatment can take up to 2 years leading many patients to take incomplete courses (and of course this fuels drug resistance). In Australia we're lucky enough to have the resources to provide free treatment with mandatory monitoring by health care workers (to enforce the full course is taken), but in India, PNG etc they desperately need a cheaper and more practical solution.
Edit to add: hopefully new drugs will also help those with sensitivity to the current antibiotics. They have some pretty harsh side effects, e.g. drug-induced hepatitis is a common problem which means many patients can't tolerate the preferred regimen.
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?
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?
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=§ion...
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=§ion...
> If you look at the western world, negating immigration, many countries have a shrinking population.
Even with immigration, Germany has a slightly negative population growth rate. And the United States grew by only 0.77% in a year. Again, that's with immigration.
https://www.cia.gov/library/publications/the-world-factbook/...
There's a conversation to be had about the future of non-renewable resources and the preservation of renewable ones, but the population growth fear-mongering from the likes of Dan Brown is deeply silly and not based on the whole truth.
Even with immigration, Germany has a slightly negative population growth rate. And the United States grew by only 0.77% in a year. Again, that's with immigration.
https://www.cia.gov/library/publications/the-world-factbook/...
There's a conversation to be had about the future of non-renewable resources and the preservation of renewable ones, but the population growth fear-mongering from the likes of Dan Brown is deeply silly and not based on the whole truth.
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...
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.
http://www.scientificamerican.com/article/world-population-w...
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.
> 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.
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.
What is not true? He said fertility rates decrease, he didn't say fertility rates dropped below what is called 'sub replacement fertility' (which is when e.g. a man and a woman have 1 child on average, meaning every generation the population halves.)
His statement is perfectly true if say rates dropped from 5 to 4. That still causes a growing population, but the growth rates are decreasing. Once a country gets rich enough, you usually see fertility rates drop below SRF.
In fact, in Europe for example it's around 1.6, while you need roughly 2.1 or so children per woman to sustain population levels.
His statement is perfectly true if say rates dropped from 5 to 4. That still causes a growing population, but the growth rates are decreasing. Once a country gets rich enough, you usually see fertility rates drop below SRF.
In fact, in Europe for example it's around 1.6, while you need roughly 2.1 or so children per woman to sustain population levels.
Isn't that because infant mortality is still a problem in Africa? i.e. more children are born because the parents don't know how many will survive.
Perhaps if this coincides with the rise of the machine replacing cheap labor, this might actually be a good thing, but something like a BIG would be needed to supply the non-working with income.
In the first place it's pretty hard to ignore the moral argument. If moral arguments are out, and we accept the thesis that population is bad, then it's hard to see why purposefully letting people suffer and die from TB is any better than using nuclear bombs to reduce the global population.
But anyways, if we want to get around to a sustainable post-scarcity futuristic utopia, we need a global population of economically developed and educated people with replacement-level fertility. And when childhood mortality goes down, parents have an incentive to concentrate their investments (both economic and educational) into fewer children. Those children will be more successful, have better access and education about contraception, and won't need to have plenty of children to provide manual labor on their farm.
Anyways, that's how it's supposed to work, and has worked many times in recent history. I put less stock than others in the extrapolated results from the recent UN Africa study.
But anyways, if we want to get around to a sustainable post-scarcity futuristic utopia, we need a global population of economically developed and educated people with replacement-level fertility. And when childhood mortality goes down, parents have an incentive to concentrate their investments (both economic and educational) into fewer children. Those children will be more successful, have better access and education about contraception, and won't need to have plenty of children to provide manual labor on their farm.
Anyways, that's how it's supposed to work, and has worked many times in recent history. I put less stock than others in the extrapolated results from the recent UN Africa study.
Paradoxically, reducing death rates in the young actually slows population growth. One of the biggest reasons why people in poor countries have so many babies is because so many die young.
I had these thoughts too. They are actually very wrong, as I learned from the great Hans Rosling: http://www.gapminder.org/videos/dont-panic-the-facts-about-p...
I believed him, too. But Rosling & co.'s assumptions were completely wrong with regards to Africa.
http://www.scientificamerican.com/article/world-population-w...
http://www.scientificamerican.com/article/world-population-w...
> 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?
Some of the minds saved can one day solve these and other problems, pushing the envelope of human knowledge.
> 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?
Some of the minds saved can one day solve these and other problems, pushing the envelope of human knowledge.
The power of imagination only gets you so far. There are diminishing returns to technology and innovation in most areas. Moore's law is a notable exception, but if you extend it to what Moore's law buys you -- what you can do with all that additional computing firepower that you couldn't do before, it's pretty minimal.
As an example: any heat engine is limited in its efficiency by Carnot's Law. You can apply all the electronic smarts to it you want, but the best you'll get in efficiency improvements is a closer approximation of the theoretical maximum.
You can phase-shift and use different technologies -- hybrid vehicle drives allow for greater engine efficiencies (constant power) and energy recover (regenerative braking), but that's fairly minimal -- the complexity of a Prius and a comparably efficient high-efficiency diesel is great.
There are other issues in expanding systems beyond certain scales -- even if you've got genius minds out there untapped, how do you 1) train and educate them, 2) find them, and 3) incorporate and utilize their advances -- in all the other noise.
I don't see a huge win here.
As an example: any heat engine is limited in its efficiency by Carnot's Law. You can apply all the electronic smarts to it you want, but the best you'll get in efficiency improvements is a closer approximation of the theoretical maximum.
You can phase-shift and use different technologies -- hybrid vehicle drives allow for greater engine efficiencies (constant power) and energy recover (regenerative braking), but that's fairly minimal -- the complexity of a Prius and a comparably efficient high-efficiency diesel is great.
There are other issues in expanding systems beyond certain scales -- even if you've got genius minds out there untapped, how do you 1) train and educate them, 2) find them, and 3) incorporate and utilize their advances -- in all the other noise.
I don't see a huge win here.
Strangely it's kind of the other way around. When you have a poor, unhealthy population with labor-intensive economy, high child mortality and low life expectancy, you tend to get tons of people.
Why? Because it's economically smart to have children.
In a labor-intensive economy, you can generate more income in the family with more children.
And in a poor subsistence economy, there is no surplus wealth being generated to go to the state for redistribution and another thing I'll get to in a minute. This means that institutionally-provided social security is often non-existent (no pensions, no insurance, no universal healthcare, no benefits, food stamps etc). So instead of institutions, these services are provided by the community, i.e. children. If you have 5 kids, there's a much better chance of someone taking care of you at old age, or when you're sick, than if you have few or no kids.
You have more kids because there is a higher chance of death. Child mortality under five is absolutely STAGGERING. I literally think about this every week and wonder why we can't get the news to report on it on a weekly basis. The number is about 17 thousand per day. Try putting that into perspective. That's more than 5 times 9/11 per day, or 50% the death-rate in World War 2 year in year out. At these rates, it makes sense to have more children, parents actually expect not all their children to last.
When you take death and sickness out of a community however, there is much more chance of economic growth. There are loads of UN reports on how mortality and sickness affects education, employment, parenting, productivity etc. In short, if you improve these things significantly in a country, 10-20 years later you see millions of extra people pour into the middle class.
And what happens then? The truth is that it's economically disadvantageous to have children in a wealthy society. Children cost (way) more money than they generate. Wealthy societies have child-labor laws (well, every country does, but they're enforced more strictly), as well as laws that require all children to go to school. Standards of living in a wealthy society requires loads of expenses on children, and price levels aren't low either. And lastly we see that in wealthy societies that there is more wealth-surplus, leading to cultures that have the time and literally the money to explore non-economic interests, like the arts, and this often goes hand in hand with less time spent on simply surviving and taking care of family members, in fact leading to sharply reduced birthrates as new generations grow up with a bigger interest in traveling than raising a family. (extensive traveling for recreation being something almost only possible in wealthy societies with a wealth surplus, i.e. the minimum amount of work you need to do just to survive is something like 30% instead of 90%, so if you spend 60% of your time working you have a large wealth surplus and a lot of free time).
In short, having 10 children is the 'worst idea ever' for most parents both economically and culturally the richer a country gets.
What does this all mean? Well, if you believe me, we've established that it makes sense to have lots of children in a poor country, and very few in a rich country, which is easily seen in empirical data. (it's not a cultural thing, most western countries with low birthrates had very high birthrates before they became wealthy post industrial revolution). And we've also established that mortality and sickness are huge inhibitors of economic growth.
Lastly, I'd say that a richer society with less mortality and sickness is more stable, better educated, has better funded institutions, which means natural family planning (like contraception and sex education in best case, or authoritarian China-style 1-child policies in worst case) should also be much more effective.
In other words, in the long run, reducing death rates is actually likely to decrease the size of the population, with of course the added benefit that it's freaking awesome to save lives that every living person deserves to have. After all, none of us would volunteer to die just to be able to 'sustain the planet with a lower population'! :) But I tried to ignore this point for argument's sake.
The corollary to this story is that a wealthier society consumes much more, which is less sustainable. (e.g. 500 million people in China/India who join the middle class and turn to 'basic' items like toilet paper is like adding another Europe or US. It's insane.) The fun and optimistic corollary to that is adding 500 million educated brains, who knows how many nobel prize winners will be among them providing the solutions we need :)
Why? Because it's economically smart to have children.
In a labor-intensive economy, you can generate more income in the family with more children.
And in a poor subsistence economy, there is no surplus wealth being generated to go to the state for redistribution and another thing I'll get to in a minute. This means that institutionally-provided social security is often non-existent (no pensions, no insurance, no universal healthcare, no benefits, food stamps etc). So instead of institutions, these services are provided by the community, i.e. children. If you have 5 kids, there's a much better chance of someone taking care of you at old age, or when you're sick, than if you have few or no kids.
You have more kids because there is a higher chance of death. Child mortality under five is absolutely STAGGERING. I literally think about this every week and wonder why we can't get the news to report on it on a weekly basis. The number is about 17 thousand per day. Try putting that into perspective. That's more than 5 times 9/11 per day, or 50% the death-rate in World War 2 year in year out. At these rates, it makes sense to have more children, parents actually expect not all their children to last.
When you take death and sickness out of a community however, there is much more chance of economic growth. There are loads of UN reports on how mortality and sickness affects education, employment, parenting, productivity etc. In short, if you improve these things significantly in a country, 10-20 years later you see millions of extra people pour into the middle class.
And what happens then? The truth is that it's economically disadvantageous to have children in a wealthy society. Children cost (way) more money than they generate. Wealthy societies have child-labor laws (well, every country does, but they're enforced more strictly), as well as laws that require all children to go to school. Standards of living in a wealthy society requires loads of expenses on children, and price levels aren't low either. And lastly we see that in wealthy societies that there is more wealth-surplus, leading to cultures that have the time and literally the money to explore non-economic interests, like the arts, and this often goes hand in hand with less time spent on simply surviving and taking care of family members, in fact leading to sharply reduced birthrates as new generations grow up with a bigger interest in traveling than raising a family. (extensive traveling for recreation being something almost only possible in wealthy societies with a wealth surplus, i.e. the minimum amount of work you need to do just to survive is something like 30% instead of 90%, so if you spend 60% of your time working you have a large wealth surplus and a lot of free time).
In short, having 10 children is the 'worst idea ever' for most parents both economically and culturally the richer a country gets.
What does this all mean? Well, if you believe me, we've established that it makes sense to have lots of children in a poor country, and very few in a rich country, which is easily seen in empirical data. (it's not a cultural thing, most western countries with low birthrates had very high birthrates before they became wealthy post industrial revolution). And we've also established that mortality and sickness are huge inhibitors of economic growth.
Lastly, I'd say that a richer society with less mortality and sickness is more stable, better educated, has better funded institutions, which means natural family planning (like contraception and sex education in best case, or authoritarian China-style 1-child policies in worst case) should also be much more effective.
In other words, in the long run, reducing death rates is actually likely to decrease the size of the population, with of course the added benefit that it's freaking awesome to save lives that every living person deserves to have. After all, none of us would volunteer to die just to be able to 'sustain the planet with a lower population'! :) But I tried to ignore this point for argument's sake.
The corollary to this story is that a wealthier society consumes much more, which is less sustainable. (e.g. 500 million people in China/India who join the middle class and turn to 'basic' items like toilet paper is like adding another Europe or US. It's insane.) The fun and optimistic corollary to that is adding 500 million educated brains, who knows how many nobel prize winners will be among them providing the solutions we need :)
It is about the resource consumption, not just population number. If a species X has population 10 times than species Y but if Y consumes 100 times more then they will cause larger impact to the earth.
Isn't the problem of drug resistance made-made?
http://www.who.int/tb/challenges/mdr/en/
In India, in particular, anyone can buy antibiotics, and they do, whether they need them or not. This problem should probably be addressed before we create a problem that we can't solve.
http://www.who.int/tb/challenges/mdr/en/
In India, in particular, anyone can buy antibiotics, and they do, whether they need them or not. This problem should probably be addressed before we create a problem that we can't solve.
Yes, the problem is man made, but not only due to unofficial access to antibiotics. I suspect that's not even a major factor, but correct me if I've missed something.
As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated.
This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).
As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated.
This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).
> This problem should probably be addressed before we create a problem that we can't solve.
That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.
That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.
The drug resistant tuberculosis is already here so we have to solve it.
But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.
But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.
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-...
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?
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.
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.
That's quite frankly amazing. I'm really happy to read stuff like this on here.
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.
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.
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
[1]: https://www.nice.org.uk/guidance/indevelopment/gid-tag445
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...
[1]http://www.forbes.com/sites/theapothecary/2014/08/18/uk-says...
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.
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.
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.
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.
> 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://www.npr.org/blogs/health/2014/10/28/359553282/insurer...
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.
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://www.npr.org/blogs/health/2014/10/28/359553282/insurer...
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.
Your take is correct, there are some insurers playing hard ball and saying "no" to patients. A few state Medicaid plans are the best example.
I should have be clearer as I was referring to private insurers. Yes, a few of them (Express Scripts is one) are saying no, initially, but appeals are getting approved.
I actually work in the HCV field and saw some data the other day that showed the vast majority of plans are reimbursing for Sovaldi. It was pretty surprising to me.
And yes, we'll have to see what Abbvie and Merck do. Rumor is they won't be competing on price although the insurance companies are hoping they do.
I should have be clearer as I was referring to private insurers. Yes, a few of them (Express Scripts is one) are saying no, initially, but appeals are getting approved.
I actually work in the HCV field and saw some data the other day that showed the vast majority of plans are reimbursing for Sovaldi. It was pretty surprising to me.
And yes, we'll have to see what Abbvie and Merck do. Rumor is they won't be competing on price although the insurance companies are hoping they do.
> 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.
Why? If you apply game theory, one of the three will try to defect and undercut the other two.
> 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.
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.
doing an X-prize style competition will probably cause a lot of "wastage" in resources spent by other contestents that _almost_ get the cure, but didn't make it. It will mean that only those who _know_ they have the cure (or it's within reach) would invest in it, and hence, won't get cures for diseases for which we don't know much about. I reckon better way is to have publically funded labs that do the lions share of research, budget split by how common the disease is.
I reckon better way is to have publically funded labs that do the lions share of research, budget split by how common the disease is.
What incentive would any of those labs have to spend their budgets efficiently?
What incentive would any of those labs have to spend their budgets efficiently?
How do you measure efficiency in research? If you use a commercial success metric - then drugs (or things in general) that aren't profitable because they target the most poor/vulnerable people don't get into consideration.
If there was some way to pick a referee for x-prizes fairly, I would put money behind that.
Not only that, but also a source of funds to pay x-prizes. Gilead will sell close to $10B worth of Sovaldi/Harvoni in 2014 alone. Probably close to $30-50B over their patent lifetime.
Considering most pharmaceutical companies have profit margins of ~30%, you'd need an x-prize of $10-$15B to equal their current "prize". The NIH total budget is under $40B.
Considering most pharmaceutical companies have profit margins of ~30%, you'd need an x-prize of $10-$15B to equal their current "prize". The NIH total budget is under $40B.
If the choices offered to pharmaceutical companies are x prizes or the current patent regime, then sure, you need multi-billion dollar prizes. I'm not convinced patents are a good thing to continue to offer, in which case the option of the 30-50 billion dollar payday won't be available.
That would likely mean fewer baldness treatments, which I'm fine with. What's unclear is whether we'd get a more socially optimal investment level for DALY improvements. I tend to think we would.
That would likely mean fewer baldness treatments, which I'm fine with. What's unclear is whether we'd get a more socially optimal investment level for DALY improvements. I tend to think we would.
The example I gave was a cure for hepatitis C, not a baldness treatment.
What you're suggesting is limiting the upside for investment. How do you think investors (the ones giving money to develop a drug) would react if you told them that the best they can do is a 2x return on their money when before they could get a 5-15x return?
What you're suggesting is limiting the upside for investment. How do you think investors (the ones giving money to develop a drug) would react if you told them that the best they can do is a 2x return on their money when before they could get a 5-15x return?
It is! In the next 10-20 years hepatitis C will likely be eliminated from developed countries.
The company who makes the drug is offering it a very low price to developing countries so the impact will be worldwide.
The company who makes the drug is offering it a very low price to developing countries so the impact will be worldwide.
Very low price means 2k/person for Egypt. It is immensely expensive for this country and not sustainable for the egyptian healthcare system.
But it's the same for developped countries. There is an inherent conflict of interest in producing a cure that heals a chronic disease. You only get the money once. So you'd better get as much as you can.
Why not take a page from the financial industry?
Solvadi could be paid for with monthly payments, say, 90% of the average price of conventional Hepatitis C treatment. Once the total payments add up to the price of Solvadi, they stop.
The patient gets cured right away. The healthcare system sees a 10% savings instead of a $90,000 bill. Gilead gets a smoothed-out income stream that helps to insulate it from the feast-or-famine cycle.
What's more, this places a built-in limit on the price of the drug. If Gilead sets the price too high, then the monthly payments never add up.
In a system where the patient could switch insurers, the monthly payments would have to be imposed on the new insurer. Otherwise, we're back to the US game-theory standoff.
Solvadi could be paid for with monthly payments, say, 90% of the average price of conventional Hepatitis C treatment. Once the total payments add up to the price of Solvadi, they stop.
The patient gets cured right away. The healthcare system sees a 10% savings instead of a $90,000 bill. Gilead gets a smoothed-out income stream that helps to insulate it from the feast-or-famine cycle.
What's more, this places a built-in limit on the price of the drug. If Gilead sets the price too high, then the monthly payments never add up.
In a system where the patient could switch insurers, the monthly payments would have to be imposed on the new insurer. Otherwise, we're back to the US game-theory standoff.
People are looking at that already, believe it or not. Since it takes a number of years to see the benefit of curing HCV, it makes sense to spread the payments out.
The interesting thing is that Sovaldi is not more expensive than earlier therapies (last generation therapies were around $85K). The issue is that Sovaldi is so good that everyone wants to take it now, where before, very few patients were willing to put up with the old therapies.
The interesting thing is that Sovaldi is not more expensive than earlier therapies (last generation therapies were around $85K). The issue is that Sovaldi is so good that everyone wants to take it now, where before, very few patients were willing to put up with the old therapies.
The number I saw was $300/person.[1] Which was the result of an agreement between the Egyptian gov't and Gilead.
I'm sure that's a not insignificant amount of money for Egypt, but it's less than 1% of the price charged in the US.
[1]http://www.hepmag.com/articles/egypt_gets_sovaldi_for_cheap_...
I'm sure that's a not insignificant amount of money for Egypt, but it's less than 1% of the price charged in the US.
[1]http://www.hepmag.com/articles/egypt_gets_sovaldi_for_cheap_...
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.
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.
Yep. The stupidity involved in this decision is breathtaking.
Not stupid, evil. Those people are evil. Everyone who signed off on that deception should be tried for crimes against humanity.
I agree the people who signed off on this decision should be brought to trial, but I am not to sure that they intended the outcome that occurred. This is still no excuse for a decision that will kill 10,000s of innocent children.
We prosecute people for negligence for way less impactful decisions. Whoever signed off on that decision either weighed the consequences of their actions and decided that was worth it or they were so incompetent that they didn't even think about it. Considering they're responsible for one of the premiere spy networks on the planet, I'm going to guess they're pretty intelligent. So that leaves one option.
It is hard to know without a full trial. This is the one thing that should happen, but if torture can be swept under the rug with nobody being held responsible I am not too hopeful :(
The Taliban/Al Qaeda are evil, not the CIA.
Why not both?
A fair point. I'm sure they have done some evil stuff. But then I read this: http://www.bbc.co.uk/news/world-asia-30491435
Hundreds of children dead in a school attack versus millions dead because trust in vaccines is destroyed. I don't see the "but."
Oh, if only things were so black and white what an uncomplicated world we'd be living in. Unfortunately the reality you describe is not the reality we live in.
True enough, but I'm not fully on board with moral relativism either. "The West" (if not the CIA) is on the side of good, and AQ/The Taliban/ISIS obviously is not.
Nobody is in the "side of good", everybody is in their own side, that's all. If you think killing 130 hospital patients is bad then this is a bit tad worse: http://www.informationclearinghouse.info/article4068.htm
[deleted]
No one is exempt from responsibility.
Those areas did not trust foreigners with needles to begin with. The CIA vaccination gambit was undeniably stupid, but it wasn't a root cause, it made a bad problem worse.
The root cause is that those are areas with very high levels of tribal paranoia, religious fundamentalism, and outright violence.
The root cause is that those are areas with very high levels of tribal paranoia, religious fundamentalism, and outright violence.
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
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
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.
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.
The irony is that the "news" often focuses on exceptional events, which tends to result in having a skewed view of the world.
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/
1) http://www.amazon.com/Its-Not-News-Fark-Media/dp/1592403662/
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.
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.
I'd actually recommend the Economist - the writing is generally pretty good (in my opinion), but more importantly, as a weekly publication rather than daily, it's less knee-jerk about getting out the story quickly, and more focused on actually understanding the news and the implications of it.
I learn more from reading the 2 front page summaries (news + business) in the Economist than from all my internet daily news reading.
I learn more from reading the 2 front page summaries (news + business) in the Economist than from all my internet daily news reading.
I also cut out mainstream news consumption.
For the most part, I simply haven't missed it. Events worthy of my attention (i.e. that will change my behavior) tend to bubble up through more specialized news sources (like Ars Technica or my Twitter feed) anyway.
That said, I have found NextDraft (http://nextdraft.com/) very useful.
For the most part, I simply haven't missed it. Events worthy of my attention (i.e. that will change my behavior) tend to bubble up through more specialized news sources (like Ars Technica or my Twitter feed) anyway.
That said, I have found NextDraft (http://nextdraft.com/) very useful.
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.
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.
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.
Pick the fantasy you're most comfortable with.
Yes, a lot of the analysis is quite silly. It's a good way to find out about stuff though.
Last Week Tonight by John Oliver is a good source of news when it is in-season.
[1] https://www.youtube.com/user/LastWeekTonight
[1] https://www.youtube.com/user/LastWeekTonight
Sibling mentioned The Economist; I read Prospect for similar reasons (it's monthly, so even more so), and reading something a bit leftist helps balance something a bit rightist. (I also read TIME, but I hear the US edition is quite dumbed down, so maybe only if you can get a European or Asian edition).
I've just read "Trust Me, I'm Lying" by Ryan Holliday - a very similar book by the sounds of it, and also one I'd heartily recommend if you want to understand what you're seeing any time you look at Twitter, Facebook, or any mass media.
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.
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.
Curious side note/question: What makes you think Bill Gates or someone involved with the website reads the comments on this HN submission?
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.
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.
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.
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?
What effects do these trends have on poverty and food insecurity?
The numbers in the polio graph doesn't match the positions! Comparison: http://i.imgur.com/3kGXyRA.png
Not a massive problem in this case but worrying.
Not a massive problem in this case but worrying.
All I'm seeing from the comparison is that your circles are a bit smaller than the original.
The 122 in particular should be almost halfway between 100 and 150 but theirs is much lower.
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
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) 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.
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) 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.
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.
My mind added an exclamation point to that headline.
Good News! You May Have Missed 2014!
Good News! You May Have Missed 2014!
[deleted]
[deleted]
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.
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.who.int/features/factfiles/malaria/en/
Sources: http://www.scientificamerican.com/article/premature-deaths-m... http://www.who.int/features/factfiles/malaria/en/
2030-2050 is still early days for climate change. The real fun is probably 2100 and beyond.
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.
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.
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?
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.
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.
No, not really. Only looking at the present without taking the future into account leads to a lot of problems. We have to tackle both.
> ""almost certainly an underestimate", because a number of climate-health relationships are not measurable due to lack of adequate data".
How can the very lack of evidence and data logically support a claim that any estimate is either too low or too high with any "certainty"?
How can the very lack of evidence and data logically support a claim that any estimate is either too low or too high with any "certainty"?
I suspect they did a "conservative estimate" that pops out "almost certainly at least this many people will die due to effects we understand pretty well. Other, largely independent effects could be lurking that we don't understand."
There is good news on that front too.
Malaria deaths worldwide have been halved in the past decade : http://www.bbc.com/news/health-30375202
Long term, the threats posed by climate change are far more of a threat than any disease.
As another reply has already noted, that seems incorrect even for just one disease that the Gates Foundation is working on eradicating. That would be even more incorrect with reference to "any" disease, meaning even diseases that are in the top five worldwide as causes of death. Most people will survive global climate change by adjusting to local weather, the same as most people long have done throughout human history. People in the Netherlands have already figured out how to live below sea level, people here in Minnesota have already figured out how to live in a place with wild annual extremes of temperature, and so on.
As another reply has already noted, that seems incorrect even for just one disease that the Gates Foundation is working on eradicating. That would be even more incorrect with reference to "any" disease, meaning even diseases that are in the top five worldwide as causes of death. Most people will survive global climate change by adjusting to local weather, the same as most people long have done throughout human history. People in the Netherlands have already figured out how to live below sea level, people here in Minnesota have already figured out how to live in a place with wild annual extremes of temperature, and so on.
Are you saying rich countries can figure out how to deal with it so everything is OK?
On one hand, Bill himself seems to support rather strongly "energy miracles" [1] as well as some sort of carbon tax (he thinks certainty is important)[2]. But the Foundation notably does not address any carbon issues, instead looking for opportunities to provide aid where the climate is creating harm.[3]
1. http://www.ted.com/talks/bill_gates?language=en
2. http://www.rollingstone.com/culture/news/bill-gates-the-roll...
3. http://www.gatesfoundation.org/Who-We-Are/General-Informatio...
1. http://www.ted.com/talks/bill_gates?language=en
2. http://www.rollingstone.com/culture/news/bill-gates-the-roll...
3. http://www.gatesfoundation.org/Who-We-Are/General-Informatio...
From my culture, this is arguable. What Gates is displaying is concrete evidence of progress... What you're saying there isn't any mention of is still argumented largely on if it's a real threat, or not... If it is a real threat, it will take a LOT of change and human resources to correct. I think every bit of this is a step in the right direction. If humanity cannot survive with what they're presented with now, how can they with what they're presented with tomorrow?
Solar Photovoltaic panel prices have fallen 75% from where they were just four years ago. In giant swaths of the world solar is the cheapest form of new energy, cheaper than coal & natural gas.
This is the most important graph of this century:
http://fund-balance.com/wp-content/uploads/2014/04/Solar-Mod...
It was made in 2012 when solar costs were $1 per watt. The Chinese solar industry has gotten the price down below .50 per watt this year.
Solar PV panels are going beyond grid parity. 70% of the power generated by a coal plant is wasted in the transmission line before it reaches your home. The data has spoken and solar has won.
I believe this is the development that will let us avoid run away catastrophic warming.
Humans are rational actors when presented with cost-based options. Politics, biases and ideology fall away when looking at price.
And ramping up and scaling production of high demand items and bringing cost down in the process is where modern capitalism shines ie. the relentless deflation in consumer technology (pcs, tablets, flat panel displays)
In order to avoid catastrophic warming we have to reduce emissions by something like 80% by 2050. That seemed a pipe dream before cheap solar panels, now it feels inevitable to me.
Cheap solar is the energy miracle Bill has been waiting for. I hope that he includes it in his 2015 post when solar is $.25-.40 per watt.
This is the most important graph of this century:
http://fund-balance.com/wp-content/uploads/2014/04/Solar-Mod...
It was made in 2012 when solar costs were $1 per watt. The Chinese solar industry has gotten the price down below .50 per watt this year.
Solar PV panels are going beyond grid parity. 70% of the power generated by a coal plant is wasted in the transmission line before it reaches your home. The data has spoken and solar has won.
I believe this is the development that will let us avoid run away catastrophic warming.
Humans are rational actors when presented with cost-based options. Politics, biases and ideology fall away when looking at price.
And ramping up and scaling production of high demand items and bringing cost down in the process is where modern capitalism shines ie. the relentless deflation in consumer technology (pcs, tablets, flat panel displays)
In order to avoid catastrophic warming we have to reduce emissions by something like 80% by 2050. That seemed a pipe dream before cheap solar panels, now it feels inevitable to me.
Cheap solar is the energy miracle Bill has been waiting for. I hope that he includes it in his 2015 post when solar is $.25-.40 per watt.
> Humans are rational actors when presented with cost-based options. Politics, biases and ideology fall away when looking at price.
Really? Explain Verblen Goods[1].
Fact is, while price drops do help businesses, there are other complications with home solar - utility companies need to simplify net metering so I don't have to either go off-grid or calculate exactingly to prevent wasted collection. Install costs are also high. Furthermore, there are many houses with many natural gas appliances that reduce the benefits (you're still paying utilities for gas and likely a lot in winter).
[1] http://en.wikipedia.org/wiki/Veblen_good
Really? Explain Verblen Goods[1].
Fact is, while price drops do help businesses, there are other complications with home solar - utility companies need to simplify net metering so I don't have to either go off-grid or calculate exactingly to prevent wasted collection. Install costs are also high. Furthermore, there are many houses with many natural gas appliances that reduce the benefits (you're still paying utilities for gas and likely a lot in winter).
[1] http://en.wikipedia.org/wiki/Veblen_good
Be that as it may, Gates has the most leverage to solve the problems he does. Climate change is 80% a political problem. Convince the G-7 to pass carbon taxes or cap-and-trade and you've solved climate change. Anything less and you've probably failed. Contrary to rumor, money is not an effective means of effecting political change, outside of maybe a little bit of graft and corruption on the side.
I am not a climate expert, but I think you're grossly downplaying the complexity of the climate change problem. There are so many factors in play. Its not just a matter of CO2 emissions. There is methane from animal livestock, contrails from aircraft, cloud cover, methane hyderates in the ocean, sunspot activity; Even the average reflectance of the earth's surface(http://en.wikipedia.org/wiki/Albedo). Every year the scientist's models and theories seems to be changing. All we seem to know for sure is that global average temperatures are indeed rising.
I have the sneaky (unscientific) suspicion that whatever drastic measures we would inevitably have to take to curb CO2 emissions is going to open its own can of worms. The footprint of human activity is simply that large.
I have the sneaky (unscientific) suspicion that whatever drastic measures we would inevitably have to take to curb CO2 emissions is going to open its own can of worms. The footprint of human activity is simply that large.
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)
(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)
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?
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.
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
Everybody here already knows this of course. ;)
Everybody here already knows this of course. ;)
Sadly for you, we're second-order contrarians around here!
Non-contrarian: "Saving kids is good!"
First-order contrarian: "Malthusianism! Overpopulation! Blargh!"
Second-order contrarian: "Education leads to reduced population. People have fewer kids when they know child death is very rare."
Third-order contrarian: "Population collapse! End of growth! Blargh!"
Fourth-order contrarian: "We've dealt with worse and survived. Maybe space colonization will provide a positive impetus for population growth and a new engine for economic growth."
Non-contrarian: "Saving kids is good!"
First-order contrarian: "Malthusianism! Overpopulation! Blargh!"
Second-order contrarian: "Education leads to reduced population. People have fewer kids when they know child death is very rare."
Third-order contrarian: "Population collapse! End of growth! Blargh!"
Fourth-order contrarian: "We've dealt with worse and survived. Maybe space colonization will provide a positive impetus for population growth and a new engine for economic growth."
Well, it looks like the regular contrarians have finally caught on: https://news.ycombinator.com/item?id=8757464
[1] http://articles.economictimes.indiatimes.com/2013-06-23/news...
http://www.wsj.com/news/articles/SB1000142405270230344420457...
http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-R...