An example of this (albeit a fairly inconsequential one):
You are driving to somewhere unfamiliar and are lost. So you wind the window down and ask a passer-by for directions. Three possible outcomes:
1) (the best) the passer-by is knowledgable and spacially articulate and tells you the way to your destination.
2) (next best) the passer-by doesn't know and politely says they can't help.
3) (the worst but in my experience most common) the passer-by feels that they ought to 'help' so they make a guess at where you might mean. And well-meaningly send you off on a wild goose chase.
there's a potential cross-over between this topic and that of the most recent econtalk episode ( https://www.econtalk.org/if-life-is-random-is-it-meaningless-with-brian-klaas/ ). the author's crucial point is the inherent unpredictability of human action. his prime example is the atomic bombing of Nagasaki, and his point that a US official had visited Kyoto 20 years before the war and had a soft spot for the city, and so passed it in favor of Nagasaki. the conclusion is to just do the right thing, as best you can, in every moment, rather than gambling on big outcomes for selected paths of behavior. this also feels like a ripe avenue of criticism against utilitarianism, which absolutely relies on the ability to make such predictions about the outcomes of our actions and post hoc predictions on the relative "utils" gained by everyone involved.
> the conclusion is to just do the right thing, as best you can, in every moment
What variable or scope am I optimizing for? Me and my family, my extended family, my country, my economic trading partners, the environment, my generation, my kids generation? And then once decided: how do I go about determining optimal, all things considered?
You found the most important aspect of the situation: it's entirely up to you. And if you take inspiration from the author interviewed on econtalk, those matters that are more distant from your ability to impact them would be discounted heavily by the immesne uncertainty. So if you had the option of helping your neighbor or doing something to reduce your environmental footprint, probably focus on helping your neighbor. But that's my subjective reading of it. If you take actions which are in-themselves good (by your judgement), you are more likely to see good resulting from them, than actions which require long chains of additional human actions to bring about the actual good result.
Kind of like a bird in the hand is worth two in the bush...but what if there are (apparently) a hundred+ birds in the bush, and no one else is trying to catch them? In a large coordinated system, wouldn't it be prudent for some effort to be directed towards catching them? I think: yes.
Just wanted to throw an entirely anecdotal account into the mix. I lived in Southern and Eastern Africa for about two years over 2016-17, and lived or had extended work trips to Zambia, Kenya, Uganda, Tanzania, and Rwanda.
One thing that first surprised me when I first arrived in Zambia (first place I lived) is how relaxed people were about malaria prevention. I arrived mildly paranoid from my charity's safety talk in London, with my pills, net, and mosquito repellant, but the local culture towards the threat of malaria was much more relaxed. It's less prevalent in big cities anyway, which is where I spent most of my time at first, but still, it surprised me to see the Zambians so unfussed about the whole thing - many of my friends didn't have a mosquito net or didn't bother untying it most nights. After a while, I relaxed into it myself. This probably sounds stupid but it's kind of a pain in the butt to get into the mosquito net each night, and a total nightmare if you have to get up to visit the loo at any point. I just stopped using it (and the pills too, actually - they can make the skin super sensitive to sunlight and I kept getting burnt), completely getting why my Zambian mates didn't either.
Over the course of my time there I began making site visits to projects all over East Africa, getting out of the cities to visit rural villages more often. It was a similar story out there, even with the risk of malaria much higher. I definitely saw one instance of a mosquito net being used for fishing, in rural Uganda if I recall correctly. Has the double whammy environmental impact because the chemical treatment seeps into the local water cycle, and the holes are too small to allow the baby fish to escape, so can be unsustainable much quicker.
I mention all this just to illustrate the fact that, even with the best will in the world, handing out mosquito nets to everyone doesn't necessarily mean everyone will end up using them all the time. The recipients, especially those in rural villages, have so many more pressing concerns - water, harvest, education for their children, money etc. - that malaria as a threat just fades into the background. Sort of like cancer - you know it's there, big and scary, but you don't think about it all the time, and minor conveniences can be enough to stop you taking the preventative measures. My guess would be that when the nets were first introduced on a big scale in the 90s, they were accompanied by lots of that they call 'Monitoring and Evaluation' in NGO speak. People going around conducting surveys and education talks, constantly reminding people to use the nets - hence the big effects. After they left, people probably mostly went back to how they were before, more scattergun with their use of them. This is common across so many projects across international development unfortunately. (Part of the reason I left the industry, actually) I went into Africa hyper aware of the risks and dangers, and my employers supplied me with all the tools to prevent mosquito bites, for free, and even I eventually slipped into bad habits. (For the record, I didn't catch malaria - though almost certainly put myself at risk. I was 21 okay, I was young and dumb!)
I love the mission of Givewell, but have always been a bit sceptical of their claims around saving lives through the nets. Just didn't map at all onto my own experiences - though they were of course a small, anecdotal sample size!
My experience is that basically everyone in most of the world, which is still mostly (undeveloped), is more relaxed about most things than most people in the rich world. This should probably tell us that the inherent stresses that come with “being on top” and the societal mechanisms in place to create those mindsets are deeply unnatural to begin with—does anyone who has put any thought into it really think, that for a million years, all of our hunter gatherer ancestors were perpetually waking up every morning, yelling at one another, and going, “where’s my club?! It’s extremely important to find it, I could die at any minute by any predator or disease, this is very serious, arghhh!!!!”?
We never would have survived to the relative present if that were the case.
In the village where I hang out its more common to use mosquito nets as fencing to keep chickens out. You know, there are all these free ranging chickens everywhere, as with pretty much every village in Africa, so everyone who want to have a little garden in their backyard need to fence out the chickens somehow. A [free] mosquito net cut open along the middle works great for that. I have never heard about people using them for fishing, but I suppose that would work too. Guess we are just a bunch of inlanders over here.
Actually, come to think of it, mosquito nets are used in a number of ways. It is quite common to use them as ropes, especially in situations where your other rope snapped or is too short, like when digging a well, or using oxen in the field. I have also seen mosquito nets tied up at the ends and used to store corn, or laid out on the ground to dry empty corn hulls (the fibery stuff that is left after corn is milled into corn meal). It is sometimes even used as bedding - as a fluffy layer in-between the grass mat and the fabric sheet (kitenge) you sleep on. Apparently mosquito nets are also good for sieving soil and sand for large particles, although i cant verify that one.
As great as it feels to get a free piece of chicken fencing mesh/mosquito net every once a while, one must admit that, yeah, the system doesn’t work quite as advertised. On the other hand, what all these aid programs does quite effectively is turning Africans into self-loathing parasites.
One of many fundamental problems with aid and do-goodery like this is the tendency to reduce society into a single dimension, as if human society is neatly compartmentalized and not just a giant sprawlig mess that no one really understands (in fact, It is a lot like consciousness and neuroscience in that way). You give someone a mosquito net and think that you can measure the net positive effect on society. That seems pretty durn naive, if not outright fraudulent.
I also donate to GiveWell. At least they are trying to grapple with the uncertainty. I do appreciate your thoughts and honesty on this topic as it is so often ignored.
I wouldn't be surprised if bed nets may not produce the 'returns' they originally did. In fact, it's just diminishing returns at work. The bed nets may have been a low hanging fruit but they are also cognitively easy for people to grasp so they will 'fund bed nets' because any type of analysis for what would work best next is seen as bad 'overhead'.
And turning around messaging is very tough, like maneuvering a big ship. If charities or the EA movement suddenly came out and said "Ah, never mind, we're on to something new now!" it might not go over well.
Eric has considered: "maybe the insecticide stops working, or maybe there’s rapid Red Queen dynamics, or maybe community involvement by the researchers plays a big role in the effectiveness of the studies, and a substantial portion of recipients stop bothering unless the mosquitoes are really bad that night, and they just leave the nets hanging up but ill-fitted and ill-used (it’s worth mentioning the Against Malaria Foundation only has thirteen employees, likely making RTC-level outreach impossible nation-wide)."
Fair enough.
But I'm surprised no one has considered the effect of declining economic growth or healthcare spending per capita or how the incentive of local policymaking officials change with aid or perhaps the other adjunct function the local public health functionaries are able to provide to support the effectiveness of malaria prevention and how that circles back to declining economic growth which deprives the host country of providing these assistance and aid money just isn't big enough to offset that shortfall.
Here's a world bank time series for Nigeria. Look at the healthcare spending per capita decline from 2015. Look at the rise in the early 2000s.
I haven't looked at the data, but won't be surprised if Nigeria shares the larger burden - in absolute numbers - of this rising malaria deaths/inefficacy of bednet use. I won't even go into the barrage of bad policies Nigerians have been subjected since 2015 that's led to this point where the country is the poverty capital of the world.
There's "Poor Economics" (Banerjee and Duflo), and there's "Gambling on Development" (Stefan Dercon) with lots of anecdotes from the works of Lant Pritchett and Bill Easterly. EA has to choose one and lay out the path to archieving the most good per its founding philosophy.
The modern West is an optimizing culture. Optimizing cultures produce better metrics than non-optimizing cultures. That's the point. That's what they care about. Of course that's what they get.
This does not mean that everyone has to choose to live in an optimizing culture. There several reasons not to.
But it does mean that if you choose to live in a non-optimizing culture, you should not complain if your metrics are not as good as those of optimizing cultures.
And if you live in an optimizing culture, you should not assume that your attempts to help none-optimizing cultures improve their metrics will be welcomed or will have the effect you intended.
The west has well optimized stripping value from not-so-enlightened cultures, in turn doing a serious number on the environment, an expense that will not be shared equally I suspect.
I'm not arguing that optimizing cultures are more moral that other cultures. Or that they are less moral. They are neither one or the other. The issue is that when they decide to do something immoral, they tend to be better at it. And when they try to do something moral, they are often puzzled that other cultures don't think as they do. For example, they think, I want to reduce mortality metrics. But they run into people who think, I would like a fish to eat. I'm not arguing that one is right or another wrong. I'm simply pointing out the disconnect.
Ok, totally agree with all this, and it is interesting and insightful!
Here's my issues, I think:
1. Most of your description is ~purely abstract (and thus, is adequately explained by your last comment), but then there is:
- my object level comment about optimizing countries stripping value from the complaining countries
- this:
> But it does mean that if you choose to live in a non-optimizing culture, you should not complain if your metrics are not as good as those of optimizing cultures.
That addresses object level reality, thus invoking the object level meaning of the word "optimizing", and there I have a very large axe to grind with "optimizing" cultures, those who live within them (and support their actions with tax dollars), and especially those who think they're swell.
Does this make any sense? People regularly complain I don't make any sense...but the domain is inescapably complex!!
Yes, it is inescapably complex. We all want to live lives according to our own preferences and values, but we don't want to live alone, nor is there enough room for us to do so if we wanted to. And so our lives are a constant process of cajoling and wheedling and romancing and bribing and bullying and blackmailing trying to maintain relationships while having things our own way. And when we don't fully understand each other, which we usually don't, it gets worse because we do things that deepen divisions without achieving any of our ends.
More specifically, what is tending to happen to the non-optimizing cultures today is that they are being used as pawns in a faction fight within the optimizing culture, which is doing them no good at all. It's not easy for the mouse to live with the elephant. Its harder still then the elephants are fighting.
Here's something ironic, though. If you go back to the ancient world and look at which peoples/cultures still exist from that time, it is the marginalized cultures, not the dominant ones. The Romans, the Carthaginians, the Goths, the Franks, the Vandals, the Vikings, the Anglo-Saxons: these are all gone as distinct cultures, merged into other things. But the Scots, the Irish, the Welsh, the Jews, the people of Brittany and Catalonia, and probably several others that I can't think of off the top of my head, are still distinct. And all of the various European peoples who settled in North America, with distinct cultures, traditions, and languages, have all melted together into a single new culture, but the native people still maintain their distinct tribal identities and customs, albeit much changed by the influx of European ideas and technology.
Optimizing cultures tend not to value continuity highly, and so they tend not to continue but to merge and change and become something new.
> Here's something ironic, though. If you go back to the ancient world and look at which peoples/cultures still exist from that time, it is the marginalized cultures, not the dominant ones.
Well this is some of the best news I've heard in some time - the sooner morally bankrupt Western "Civilization" weakens enough that the uncivilized hordes take over the better as far as I'm concerned, and anything I can do to lend us a hand in our demise is open to consideration.
Except that those cultures that disappeared did so because the merged with other dominant cultures to form new dominant cultures. Thus the Franks and the Normans merged and became the French. The Romano-Britons, the Anglo-Saxons, the Danes, and the Normans merged to form the English. And just about every country in Europe provided people who merged to become Americans. We are essentially still living in the Roman Empire, with New York the current new new new Rome, succeeding London, Paris, Aachen, Ravenna, Constantinople, etc. The uncivilized hoards provide fresh blood from time to time, but the old republic still ticks along.
The questions you ask are vital - I work in the global development sector and, prior to that, once believed most global development was doomed; ineffective, misguided, disempowering and imperialist. But my time working in the sector has proved questions like this are worth asking, and, more importantly, have allowed me to see that genuine, lasting, whole-hearted transformation even across a whole community, is actually possible.
Three books I love on this topic:
* The White Man's Burden (Easterley)
* When Helping Hurts (Corbett and Fikkert)
* The Shrewd Samaritan (Wydick)
I particularly love Wydick's chapter 'Addressing Global Poverty Through a Framework of Human Dignity'. Through his research he compares interventions (like deworming treatments, mosquito nets or international child sponsorship) on: effectiveness of the intervention, cost effectiveness and how localisable (or generalisable) they are.
Maybe a better question could be: are we so focussed on measurable outcomes or one 'type' of progress, or help, that we easily lose sight of the fullness and complexity of human flourishing?
I'll be the first to answer that I am, even in my own life.
It's a stupid idea to give 18 year olds a huge amount of money, not only but maybe especially in communities where they are unlikely to be able to earn anything like that sum through their own efforts. One of the reasons aristocrats are keen on trust funds. Just because your advice to that particular 18 year old was boring, embarrassing, and effectively unfollowable for a single almost-child who didn't want to leave their community, doesn't mean it was wrong.
You seem to be trying to use a sceptical review of some RCTs to suggest we should be focusing less on consequences, and more on intentions. It feels a bit like trying to warn people against the folly and immorality of flying to the moon by pointing out errors in the flange coupling of the second stage rocket. If you're making that case, you've already conceded that you've lost the argument.
Fascinating, though. Had no idea about the weaknesses in the evidence for malaria nets. Thank you.
Ah the eternal challenge of applying linear science to a complex adaptive system. Love your exploration of a very real challenge for those of us trained as scientists but working in community impact, Erik. I'm relatively new to it all and it's taking a big mindset shift to get to grips with what 'helping' might look like.
I've been in Nepal for 23 years now, working with INGOs, NGOs, GoN, and even normal people in this effort to "help." Your story on netting is interesting and typical of all aid and relief programs that I have ever managed. For example, the numbers drop off over time. I suspect this has to do with the monitoring & evaluations of these efforts always waning over time. Then when the accuracy of the figures and methodology of the studies also degrades, folks just declare mission accomplished and move on. Aid workers are not all Mother Teresas'. Back at HQ, these workers are not even in touch with the problems on the ground, and in the case that you sight, may not have even considered the half-life of pesticides on the nets, and then coordinated with the team on the ground for regular replacements. No, it does not work like that. More like dump the nets, and let's move on to another shiny problem. I guess to answer your question, how do you know if you are helping, the clues might be found by just staying in close contact with the recipients of aid, long after the program ends, or even near the end, as attention wanes as does the money. In addition, most analysts are looking at peak numbers and not dips in numbers, as no one likes reporting failure when it comes to money spent. No one likes reporting failures full stop, so for every one project showing success, you can bet there is one that is not. But this is the nature of aid work, finding what works, and what does not end up in the river being used to make things worse.
Bill Gates talks also about mosquitoes in Africa ??? ... 🤣🤣🤣🤣
Sheikh Google tells us: each species has its own preferences:
- Aedes feeds (stings) during the day (two hrs after sunrise and several hrs before sunset),
- Culex feeds mostly during the night, during dawn & dusk hours and
- Anopheles feeds during the night, right before dawn and right after sunset.
This clearly shows that the three species in question do not care if humans are in a vertical or horizontal position, sleeping, snoring or awake, working or busy dreaming ...
Instead, the central star is their watch.
This also clearly shows that, once again, Bill Gates on any topic out of his Microsoft-box, is pretty useless and a (fill as you wish) !!!
An example of this (albeit a fairly inconsequential one):
You are driving to somewhere unfamiliar and are lost. So you wind the window down and ask a passer-by for directions. Three possible outcomes:
1) (the best) the passer-by is knowledgable and spacially articulate and tells you the way to your destination.
2) (next best) the passer-by doesn't know and politely says they can't help.
3) (the worst but in my experience most common) the passer-by feels that they ought to 'help' so they make a guess at where you might mean. And well-meaningly send you off on a wild goose chase.
The world would be so much simpler if (1) was way more common than (3), but I fear their equivalency
When in that situation I have sometimes muttered ungraciously (when the window was back up) "Saints preserve us from people who 'want to help'"!
there's a potential cross-over between this topic and that of the most recent econtalk episode ( https://www.econtalk.org/if-life-is-random-is-it-meaningless-with-brian-klaas/ ). the author's crucial point is the inherent unpredictability of human action. his prime example is the atomic bombing of Nagasaki, and his point that a US official had visited Kyoto 20 years before the war and had a soft spot for the city, and so passed it in favor of Nagasaki. the conclusion is to just do the right thing, as best you can, in every moment, rather than gambling on big outcomes for selected paths of behavior. this also feels like a ripe avenue of criticism against utilitarianism, which absolutely relies on the ability to make such predictions about the outcomes of our actions and post hoc predictions on the relative "utils" gained by everyone involved.
> the conclusion is to just do the right thing, as best you can, in every moment
What variable or scope am I optimizing for? Me and my family, my extended family, my country, my economic trading partners, the environment, my generation, my kids generation? And then once decided: how do I go about determining optimal, all things considered?
Thought provoking comment!! 👍👍
You found the most important aspect of the situation: it's entirely up to you. And if you take inspiration from the author interviewed on econtalk, those matters that are more distant from your ability to impact them would be discounted heavily by the immesne uncertainty. So if you had the option of helping your neighbor or doing something to reduce your environmental footprint, probably focus on helping your neighbor. But that's my subjective reading of it. If you take actions which are in-themselves good (by your judgement), you are more likely to see good resulting from them, than actions which require long chains of additional human actions to bring about the actual good result.
Kind of like a bird in the hand is worth two in the bush...but what if there are (apparently) a hundred+ birds in the bush, and no one else is trying to catch them? In a large coordinated system, wouldn't it be prudent for some effort to be directed towards catching them? I think: yes.
Just wanted to throw an entirely anecdotal account into the mix. I lived in Southern and Eastern Africa for about two years over 2016-17, and lived or had extended work trips to Zambia, Kenya, Uganda, Tanzania, and Rwanda.
One thing that first surprised me when I first arrived in Zambia (first place I lived) is how relaxed people were about malaria prevention. I arrived mildly paranoid from my charity's safety talk in London, with my pills, net, and mosquito repellant, but the local culture towards the threat of malaria was much more relaxed. It's less prevalent in big cities anyway, which is where I spent most of my time at first, but still, it surprised me to see the Zambians so unfussed about the whole thing - many of my friends didn't have a mosquito net or didn't bother untying it most nights. After a while, I relaxed into it myself. This probably sounds stupid but it's kind of a pain in the butt to get into the mosquito net each night, and a total nightmare if you have to get up to visit the loo at any point. I just stopped using it (and the pills too, actually - they can make the skin super sensitive to sunlight and I kept getting burnt), completely getting why my Zambian mates didn't either.
Over the course of my time there I began making site visits to projects all over East Africa, getting out of the cities to visit rural villages more often. It was a similar story out there, even with the risk of malaria much higher. I definitely saw one instance of a mosquito net being used for fishing, in rural Uganda if I recall correctly. Has the double whammy environmental impact because the chemical treatment seeps into the local water cycle, and the holes are too small to allow the baby fish to escape, so can be unsustainable much quicker.
I mention all this just to illustrate the fact that, even with the best will in the world, handing out mosquito nets to everyone doesn't necessarily mean everyone will end up using them all the time. The recipients, especially those in rural villages, have so many more pressing concerns - water, harvest, education for their children, money etc. - that malaria as a threat just fades into the background. Sort of like cancer - you know it's there, big and scary, but you don't think about it all the time, and minor conveniences can be enough to stop you taking the preventative measures. My guess would be that when the nets were first introduced on a big scale in the 90s, they were accompanied by lots of that they call 'Monitoring and Evaluation' in NGO speak. People going around conducting surveys and education talks, constantly reminding people to use the nets - hence the big effects. After they left, people probably mostly went back to how they were before, more scattergun with their use of them. This is common across so many projects across international development unfortunately. (Part of the reason I left the industry, actually) I went into Africa hyper aware of the risks and dangers, and my employers supplied me with all the tools to prevent mosquito bites, for free, and even I eventually slipped into bad habits. (For the record, I didn't catch malaria - though almost certainly put myself at risk. I was 21 okay, I was young and dumb!)
I love the mission of Givewell, but have always been a bit sceptical of their claims around saving lives through the nets. Just didn't map at all onto my own experiences - though they were of course a small, anecdotal sample size!
My experience is that basically everyone in most of the world, which is still mostly (undeveloped), is more relaxed about most things than most people in the rich world. This should probably tell us that the inherent stresses that come with “being on top” and the societal mechanisms in place to create those mindsets are deeply unnatural to begin with—does anyone who has put any thought into it really think, that for a million years, all of our hunter gatherer ancestors were perpetually waking up every morning, yelling at one another, and going, “where’s my club?! It’s extremely important to find it, I could die at any minute by any predator or disease, this is very serious, arghhh!!!!”?
We never would have survived to the relative present if that were the case.
In the village where I hang out its more common to use mosquito nets as fencing to keep chickens out. You know, there are all these free ranging chickens everywhere, as with pretty much every village in Africa, so everyone who want to have a little garden in their backyard need to fence out the chickens somehow. A [free] mosquito net cut open along the middle works great for that. I have never heard about people using them for fishing, but I suppose that would work too. Guess we are just a bunch of inlanders over here.
Actually, come to think of it, mosquito nets are used in a number of ways. It is quite common to use them as ropes, especially in situations where your other rope snapped or is too short, like when digging a well, or using oxen in the field. I have also seen mosquito nets tied up at the ends and used to store corn, or laid out on the ground to dry empty corn hulls (the fibery stuff that is left after corn is milled into corn meal). It is sometimes even used as bedding - as a fluffy layer in-between the grass mat and the fabric sheet (kitenge) you sleep on. Apparently mosquito nets are also good for sieving soil and sand for large particles, although i cant verify that one.
As great as it feels to get a free piece of chicken fencing mesh/mosquito net every once a while, one must admit that, yeah, the system doesn’t work quite as advertised. On the other hand, what all these aid programs does quite effectively is turning Africans into self-loathing parasites.
One of many fundamental problems with aid and do-goodery like this is the tendency to reduce society into a single dimension, as if human society is neatly compartmentalized and not just a giant sprawlig mess that no one really understands (in fact, It is a lot like consciousness and neuroscience in that way). You give someone a mosquito net and think that you can measure the net positive effect on society. That seems pretty durn naive, if not outright fraudulent.
I also donate to GiveWell. At least they are trying to grapple with the uncertainty. I do appreciate your thoughts and honesty on this topic as it is so often ignored.
I wouldn't be surprised if bed nets may not produce the 'returns' they originally did. In fact, it's just diminishing returns at work. The bed nets may have been a low hanging fruit but they are also cognitively easy for people to grasp so they will 'fund bed nets' because any type of analysis for what would work best next is seen as bad 'overhead'.
And turning around messaging is very tough, like maneuvering a big ship. If charities or the EA movement suddenly came out and said "Ah, never mind, we're on to something new now!" it might not go over well.
Eric has considered: "maybe the insecticide stops working, or maybe there’s rapid Red Queen dynamics, or maybe community involvement by the researchers plays a big role in the effectiveness of the studies, and a substantial portion of recipients stop bothering unless the mosquitoes are really bad that night, and they just leave the nets hanging up but ill-fitted and ill-used (it’s worth mentioning the Against Malaria Foundation only has thirteen employees, likely making RTC-level outreach impossible nation-wide)."
Fair enough.
But I'm surprised no one has considered the effect of declining economic growth or healthcare spending per capita or how the incentive of local policymaking officials change with aid or perhaps the other adjunct function the local public health functionaries are able to provide to support the effectiveness of malaria prevention and how that circles back to declining economic growth which deprives the host country of providing these assistance and aid money just isn't big enough to offset that shortfall.
Here's a world bank time series for Nigeria. Look at the healthcare spending per capita decline from 2015. Look at the rise in the early 2000s.
https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?locations=NG
I haven't looked at the data, but won't be surprised if Nigeria shares the larger burden - in absolute numbers - of this rising malaria deaths/inefficacy of bednet use. I won't even go into the barrage of bad policies Nigerians have been subjected since 2015 that's led to this point where the country is the poverty capital of the world.
There's "Poor Economics" (Banerjee and Duflo), and there's "Gambling on Development" (Stefan Dercon) with lots of anecdotes from the works of Lant Pritchett and Bill Easterly. EA has to choose one and lay out the path to archieving the most good per its founding philosophy.
Grateful your uncertainty is vast! Uncertainty is uncomfortable, but certainty is absurd. Might as well try to do good things for other people anyway.
This is fascinating (and depressing).
The Norman Maclean quote is well-selected! That novel acutely exemplifies this central challenge.
The modern West is an optimizing culture. Optimizing cultures produce better metrics than non-optimizing cultures. That's the point. That's what they care about. Of course that's what they get.
This does not mean that everyone has to choose to live in an optimizing culture. There several reasons not to.
But it does mean that if you choose to live in a non-optimizing culture, you should not complain if your metrics are not as good as those of optimizing cultures.
And if you live in an optimizing culture, you should not assume that your attempts to help none-optimizing cultures improve their metrics will be welcomed or will have the effect you intended.
The west has well optimized stripping value from not-so-enlightened cultures, in turn doing a serious number on the environment, an expense that will not be shared equally I suspect.
Also: they are masters of deceit, and delusion.
I'm not arguing that optimizing cultures are more moral that other cultures. Or that they are less moral. They are neither one or the other. The issue is that when they decide to do something immoral, they tend to be better at it. And when they try to do something moral, they are often puzzled that other cultures don't think as they do. For example, they think, I want to reduce mortality metrics. But they run into people who think, I would like a fish to eat. I'm not arguing that one is right or another wrong. I'm simply pointing out the disconnect.
Ok, totally agree with all this, and it is interesting and insightful!
Here's my issues, I think:
1. Most of your description is ~purely abstract (and thus, is adequately explained by your last comment), but then there is:
- my object level comment about optimizing countries stripping value from the complaining countries
- this:
> But it does mean that if you choose to live in a non-optimizing culture, you should not complain if your metrics are not as good as those of optimizing cultures.
That addresses object level reality, thus invoking the object level meaning of the word "optimizing", and there I have a very large axe to grind with "optimizing" cultures, those who live within them (and support their actions with tax dollars), and especially those who think they're swell.
Does this make any sense? People regularly complain I don't make any sense...but the domain is inescapably complex!!
Yes, it is inescapably complex. We all want to live lives according to our own preferences and values, but we don't want to live alone, nor is there enough room for us to do so if we wanted to. And so our lives are a constant process of cajoling and wheedling and romancing and bribing and bullying and blackmailing trying to maintain relationships while having things our own way. And when we don't fully understand each other, which we usually don't, it gets worse because we do things that deepen divisions without achieving any of our ends.
More specifically, what is tending to happen to the non-optimizing cultures today is that they are being used as pawns in a faction fight within the optimizing culture, which is doing them no good at all. It's not easy for the mouse to live with the elephant. Its harder still then the elephants are fighting.
Here's something ironic, though. If you go back to the ancient world and look at which peoples/cultures still exist from that time, it is the marginalized cultures, not the dominant ones. The Romans, the Carthaginians, the Goths, the Franks, the Vandals, the Vikings, the Anglo-Saxons: these are all gone as distinct cultures, merged into other things. But the Scots, the Irish, the Welsh, the Jews, the people of Brittany and Catalonia, and probably several others that I can't think of off the top of my head, are still distinct. And all of the various European peoples who settled in North America, with distinct cultures, traditions, and languages, have all melted together into a single new culture, but the native people still maintain their distinct tribal identities and customs, albeit much changed by the influx of European ideas and technology.
Optimizing cultures tend not to value continuity highly, and so they tend not to continue but to merge and change and become something new.
> Here's something ironic, though. If you go back to the ancient world and look at which peoples/cultures still exist from that time, it is the marginalized cultures, not the dominant ones.
Well this is some of the best news I've heard in some time - the sooner morally bankrupt Western "Civilization" weakens enough that the uncivilized hordes take over the better as far as I'm concerned, and anything I can do to lend us a hand in our demise is open to consideration.
Except that those cultures that disappeared did so because the merged with other dominant cultures to form new dominant cultures. Thus the Franks and the Normans merged and became the French. The Romano-Britons, the Anglo-Saxons, the Danes, and the Normans merged to form the English. And just about every country in Europe provided people who merged to become Americans. We are essentially still living in the Roman Empire, with New York the current new new new Rome, succeeding London, Paris, Aachen, Ravenna, Constantinople, etc. The uncivilized hoards provide fresh blood from time to time, but the old republic still ticks along.
The questions you ask are vital - I work in the global development sector and, prior to that, once believed most global development was doomed; ineffective, misguided, disempowering and imperialist. But my time working in the sector has proved questions like this are worth asking, and, more importantly, have allowed me to see that genuine, lasting, whole-hearted transformation even across a whole community, is actually possible.
Three books I love on this topic:
* The White Man's Burden (Easterley)
* When Helping Hurts (Corbett and Fikkert)
* The Shrewd Samaritan (Wydick)
I particularly love Wydick's chapter 'Addressing Global Poverty Through a Framework of Human Dignity'. Through his research he compares interventions (like deworming treatments, mosquito nets or international child sponsorship) on: effectiveness of the intervention, cost effectiveness and how localisable (or generalisable) they are.
Maybe a better question could be: are we so focussed on measurable outcomes or one 'type' of progress, or help, that we easily lose sight of the fullness and complexity of human flourishing?
I'll be the first to answer that I am, even in my own life.
It's a stupid idea to give 18 year olds a huge amount of money, not only but maybe especially in communities where they are unlikely to be able to earn anything like that sum through their own efforts. One of the reasons aristocrats are keen on trust funds. Just because your advice to that particular 18 year old was boring, embarrassing, and effectively unfollowable for a single almost-child who didn't want to leave their community, doesn't mean it was wrong.
You seem to be trying to use a sceptical review of some RCTs to suggest we should be focusing less on consequences, and more on intentions. It feels a bit like trying to warn people against the folly and immorality of flying to the moon by pointing out errors in the flange coupling of the second stage rocket. If you're making that case, you've already conceded that you've lost the argument.
Fascinating, though. Had no idea about the weaknesses in the evidence for malaria nets. Thank you.
Ah the eternal challenge of applying linear science to a complex adaptive system. Love your exploration of a very real challenge for those of us trained as scientists but working in community impact, Erik. I'm relatively new to it all and it's taking a big mindset shift to get to grips with what 'helping' might look like.
Basically everything in reality is nonlinear. This is why a lot of doctors are dumb about a lot of things.
I've been in Nepal for 23 years now, working with INGOs, NGOs, GoN, and even normal people in this effort to "help." Your story on netting is interesting and typical of all aid and relief programs that I have ever managed. For example, the numbers drop off over time. I suspect this has to do with the monitoring & evaluations of these efforts always waning over time. Then when the accuracy of the figures and methodology of the studies also degrades, folks just declare mission accomplished and move on. Aid workers are not all Mother Teresas'. Back at HQ, these workers are not even in touch with the problems on the ground, and in the case that you sight, may not have even considered the half-life of pesticides on the nets, and then coordinated with the team on the ground for regular replacements. No, it does not work like that. More like dump the nets, and let's move on to another shiny problem. I guess to answer your question, how do you know if you are helping, the clues might be found by just staying in close contact with the recipients of aid, long after the program ends, or even near the end, as attention wanes as does the money. In addition, most analysts are looking at peak numbers and not dips in numbers, as no one likes reporting failure when it comes to money spent. No one likes reporting failures full stop, so for every one project showing success, you can bet there is one that is not. But this is the nature of aid work, finding what works, and what does not end up in the river being used to make things worse.
You slightly touch on this but Bill Gates spoke about the likelihood that mosquitoes evolved to sting people while they’re awake, outside their home.
Bill Gates talks also about mosquitoes in Africa ??? ... 🤣🤣🤣🤣
Sheikh Google tells us: each species has its own preferences:
- Aedes feeds (stings) during the day (two hrs after sunrise and several hrs before sunset),
- Culex feeds mostly during the night, during dawn & dusk hours and
- Anopheles feeds during the night, right before dawn and right after sunset.
This clearly shows that the three species in question do not care if humans are in a vertical or horizontal position, sleeping, snoring or awake, working or busy dreaming ...
Instead, the central star is their watch.
This also clearly shows that, once again, Bill Gates on any topic out of his Microsoft-box, is pretty useless and a (fill as you wish) !!!
Have a nice time (without Billy Boy of course!!)
Synchronicity?
https://substack.com/app-link/post?publication_id=327510&post_id=141034107
Team air purifier reporting for duty