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Saturday, May 05, 2007

Disease eradication

Neska posant el perfil bo by Ainhoa P from flickr (CC-BY)It's safe to say that the vast majority of human suffering is caused by actions and inaction of other people.

Probably the most abominable of these actions is forcing people to live in places where they were born, also known in "developing countries". Contrary to the name, most of these countries aren't "developing" much. A quick glance at life expectancy statistics for 1998 and 2006, an arbitrary cutoff of 73.5 years chosen to be the definition of a "developed country", and naive extrapolation, shows that 83 of 190 countries aren't going to get "developed" in the next 25 years.

Developed countries (life expectancy, and increase since 1998):

  • Andorra - 83.51yr (+0.01)
  • Singapore - 81.71yr (+1.61)
  • San Marino - 81.71yr (+0.61)
  • Japan - 81.25yr (+0.55)
  • Sweden - 80.51yr (+0.91)
  • Switzerland - 80.51yr (+0.91)
  • Australia - 80.50yr (+0.70)
  • Iceland - 80.31yr (+0.91)
  • Canada - 80.22yr (+0.82)
  • Italy - 79.81yr (+0.81)
  • France - 79.73yr (+0.93)
  • Monaco - 79.69yr (+0.89)
  • Liechtenstein - 79.68yr (+0.88)
  • Spain - 79.65yr (+0.85)
  • Norway - 79.54yr (+0.84)
  • Israel - 79.46yr (+0.86)
  • Greece - 79.24yr (+0.84)
  • Austria - 79.07yr (+1.37)
  • Malta - 79.01yr (+1.11)
  • Netherlands - 78.96yr (+0.66)
  • Luxembourg - 78.89yr (+1.79)
  • New Zealand - 78.81yr (+1.01)
  • Germany - 78.80yr (+1.40)
  • Belgium - 78.77yr (+0.97)
  • United Kingdom - 78.54yr (+0.84)
  • Finland - 78.50yr (+1.10)
  • Jordan - 78.40yr (+1.00)
  • Bosnia and Herzegovina - 78.00yr (+6.50)
  • United States - 77.85yr (+0.75)
  • Cyprus - 77.82yr (+1.12)
  • Denmark - 77.79yr (+1.29)
  • Ireland - 77.56yr (+0.76)
  • Portugal - 77.53yr (+1.73)
  • Republic of China (Taiwan) - 77.26yr (+0.86)
  • Albania - 77.24yr (+5.64)
  • Cuba - 77.23yr (+1.03)
  • Kuwait - 77.03yr (+2.53)
  • South Korea - 76.85yr (+2.45)
  • Costa Rica - 76.84yr (+1.04)
  • Chile - 76.58yr (+0.88)
  • Libya - 76.50yr (+1.00)
  • Ecuador - 76.21yr (+5.11)
  • Slovenia - 76.14yr (+1.24)
  • Uruguay - 76.13yr (+0.93)
  • Czech Republic - 76.02yr (+1.52)
  • Argentina - 75.91yr (+0.81)
  • Georgia - 75.88yr (+11.38)
  • Saudi Arabia - 75.46yr (+7.66)
  • Panama - 75.25yr (-0.25)
  • United Arab Emirates - 75.24yr (+1.14)
  • Mexico - 75.19yr (+3.69)
  • Paraguay - 74.89yr (+1.19)
  • Tunisia - 74.89yr (+1.19)
  • Brunei - 74.80yr (+1.20)
  • Poland - 74.74yr (+1.54)
  • Serbia and Montenegro - 74.73yr (+2.33)
  • Dominica - 74.65yr (+1.25)
  • Slovakia - 74.50yr (+0.80)
  • Croatia - 74.45yr (+0.75)
  • Venezuela - 74.31yr (+1.21)
  • Bahrain - 74.23yr (+1.23)
  • Lithuania - 73.97yr (+4.87)
  • Macedonia - 73.73yr (-0.07)
  • Qatar - 73.67yr (+1.27)
  • Saint Lucia - 73.61yr (+1.31)
Developing countries (life expectancy, increase since 1998, time to become "developed"):
  • Algeria - 73.00yr (+3.30, 1.21yr)
  • Brazil - 71.69yr (+8.79, 1.65yr)
  • Sri Lanka - 73.17yr (+1.37, 1.93yr)
  • Oman - 73.13yr (+1.33, 2.23yr)
  • Egypt - 71.00yr (+7.70, 2.60yr)
  • Armenia - 71.55yr (+5.15, 3.03yr)
  • Thailand - 71.95yr (+3.35, 3.70yr)
  • Solomon Islands - 72.66yr (+1.36, 4.94yr)
  • Lebanon - 72.63yr (+1.33, 5.23yr)
  • Estonia - 71.77yr (+2.27, 6.10yr)
  • Marshall Islands - 70.01yr (+4.51, 6.19yr)
  • Mauritius - 72.38yr (+1.38, 6.49yr)
  • Turkey - 72.36yr (+1.36, 6.71yr)
  • Malaysia - 72.24yr (+1.44, 7.00yr)
  • Latvia - 71.05yr (+2.65, 7.40yr)
  • Saint Kitts and Nevis - 72.15yr (+1.45, 7.45yr)
  • Ukraine - 69.68yr (+3.68, 8.30yr)
  • Hungary - 72.40yr (+1.00, 8.80yr)
  • Kyrgyzstan - 68.16yr (+4.76, 8.97yr)
  • Antigua and Barbuda - 71.90yr (+1.40, 9.14yr)
  • Seychelles - 71.82yr (+1.42, 9.46yr)
  • Colombia - 71.72yr (+1.42, 10.03yr)
  • Bulgaria - 72.03yr (+1.13, 10.41yr)
  • People's Republic of China - 72.27yr (+0.87, 11.31yr)
  • Romania - 71.35yr (+1.45, 11.86yr)
  • Philippines - 69.91yr (+2.41, 11.92yr)
  • El Salvador - 71.22yr (+1.52, 12.00yr)
  • Guatemala - 69.06yr (+2.86, 12.42yr)
  • Morocco - 70.66yr (+1.56, 14.56yr)
  • Samoa - 70.72yr (+1.52, 14.63yr)
  • Nicaragua - 70.33yr (+1.63, 15.56yr)
  • Cape Verde - 70.45yr (+1.55, 15.74yr)
  • Kazakhstan - 66.55yr (+3.35, 16.60yr)
  • Iraq - 68.70yr (+2.20, 17.45yr)
  • Palau - 70.14yr (+1.54, 17.45yr)
  • Vietnam - 70.61yr (+1.31, 17.65yr)
  • Burma - 60.70yr (+5.80, 17.66yr)
  • Syria - 70.03yr (+1.53, 18.14yr)
  • Fiji - 69.53yr (+1.63, 19.48yr)
  • Tonga - 69.53yr (+1.63, 19.48yr)
  • Indonesia - 69.57yr (+1.57, 20.03yr)
  • Uganda - 51.59yr (+8.69, 20.17yr)
Stagnant countries (life expectancy, increase since 1998, time to become "developed"):
  • North Korea - 71.37yr (+0.67, 25.43yr)
  • Tuvalu - 68.01yr (+1.71, 25.68yr)
  • Federated States of Micronesia - 69.75yr (+1.15, 26.09yr)
  • Rwanda - 46.96yr (+7.66, 27.72yr)
  • Gabon - 55.02yr (+4.92, 30.05yr)
  • Sao Tome and Principe - 66.99yr (+1.69, 30.82yr)
  • Republic of the Congo - 52.26yr (+4.86, 34.96yr)
  • Bolivia - 65.50yr (+1.80, 35.56yr)
  • Papua New Guinea - 64.93yr (+1.83, 37.46yr)
  • India - 64.35yr (+1.85, 39.57yr)
  • Maldives - 64.06yr (+1.86, 40.60yr)
  • Guyana - 65.50yr (+1.50, 42.67yr)
  • Pakistan - 63.00yr (+1.90, 44.21yr)
  • Haiti - 52.92yr (+3.72, 44.26yr)
  • Nauru - 62.73yr (+1.93, 44.64yr)
  • Eritrea - 58.47yr (+2.67, 45.03yr)
  • Burundi - 50.29yr (+4.09, 45.40yr)
  • Vanuatu - 62.49yr (+1.89, 46.60yr)
  • Comoros - 61.96yr (+1.96, 47.10yr)
  • Cambodia - 58.92yr (+2.42, 48.20yr)
  • Yemen - 61.75yr (+1.95, 48.21yr)
  • Bangladesh - 62.08yr (+1.88, 48.60yr)
  • Kiribati - 61.71yr (+1.91, 49.38yr)
  • Guinea - 49.36yr (+3.76, 51.36yr)
  • Belarus - 68.72yr (+0.72, 53.11yr)
  • Ethiopia - 48.83yr (+3.63, 54.37yr)
  • Nepal - 59.80yr (+2.00, 54.80yr)
  • Togo - 57.01yr (+2.31, 57.11yr)
  • Cote d'Ivoire - 48.62yr (+3.42, 58.20yr)
  • Sudan - 58.54yr (+1.94, 61.69yr)
  • Malawi - 41.43yr (+3.83, 66.99yr)
  • Benin - 52.66yr (+2.46, 67.77yr)
  • Madagascar - 56.95yr (+1.95, 67.90yr)
  • Laos - 55.08yr (+1.98, 74.42yr)
  • Bhutan - 54.39yr (+1.99, 76.82yr)
  • Democratic Republic of the Congo - 51.10yr (+2.30, 77.91yr)
  • Mauritania - 52.73yr (+1.93, 86.09yr)
  • Mozambique - 40.32yr (+2.82, 94.13yr)
  • Moldova - 65.18yr (+0.68, 97.88yr)
  • Mali - 48.64yr (+1.94, 102.52yr)
  • Somalia - 48.09yr (+1.89, 107.56yr)
  • Zambia - 39.70yr (+2.50, 108.16yr)
  • Iran - 69.96yr (+0.26, 108.92yr)
  • Niger - 43.50yr (+2.20, 109.09yr)
  • Ghana - 58.47yr (+1.07, 112.37yr)
  • Burkina Faso - 48.45yr (+1.75, 114.51yr)
  • Uzbekistan - 64.19yr (+0.49, 152.00yr)
  • Tajikistan - 64.56yr (+0.46, 155.48yr)
  • Namibia - 43.93yr (+1.43, 165.43yr)
  • Azerbaijan - 63.35yr (+0.45, 180.44yr)
  • Turkmenistan - 61.39yr (+0.49, 197.71yr)
  • The Gambia - 53.75yr (+0.55, 287.27yr)
  • Angola - 38.43yr (+0.13, 2158.15yr)
  • Grenada - 64.53yr (+0.03, 2392.00yr)
  • Zimbabwe - 37.82yr (+0.02, 14272.00yr)
  • Kenya - 47.99yr (-0.01, never)
  • Russia - 67.10yr (-0.10, never)
  • Barbados - 72.59yr (-0.41, never)
  • Peru - 69.53yr (-0.47, never)
  • Honduras - 69.30yr (-0.60, never)
  • Central African Republic - 43.39yr (-0.61, never)
  • Trinidad and Tobago - 66.73yr (-1.27, never)
  • Dominican Republic - 71.44yr (-1.76, never)
  • Jamaica - 73.33yr (-1.87, never)
  • Guinea-Bissau - 46.61yr (-2.39, never)
  • Suriname - 68.96yr (-2.44, never)
  • Belize - 68.44yr (-2.46, never)
  • Mongolia - 64.52yr (-2.78, never)
  • Afghanistan - 42.90yr (-3.00, never)
  • Senegal - 58.90yr (-3.30, never)
  • Chad - 47.18yr (-3.32, never)
  • Equatorial Guinea - 49.70yr (-3.90, never)
  • Cameroon - 50.89yr (-3.91, never)
  • Nigeria - 46.74yr (-4.86, never)
  • Botswana - 33.87yr (-5.43, never)
  • Sierra Leone - 39.87yr (-5.43, never)
  • The Bahamas - 65.54yr (-5.56, never)
  • Tanzania - 45.24yr (-7.06, never)
  • Swaziland - 33.22yr (-7.18, never)
  • Djibouti - 43.10yr (-7.70, never)
  • South Africa - 43.27yr (-7.83, never)
  • Liberia - 38.89yr (-12.11, never)
  • Lesotho - 34.47yr (-16.33, never)
Extrapolation has very high error, so each entry on the list can be disputed, but in any case by forcing people who happen to be born in these countries to live there instead of letting them move somewhere else, people are responsible for making new generations of people suffer.

There's nothing inherent about the yet unborn people in Lesotho and other fucked-up places that makes places where they live so fucked up. They just happen to be born where there is no basic healthcare, no viabale economy, no political institutions guaranteeing rule of law, respect for human rights, democracy and so no, and are forced to suffer from all that.

But xenophobia is as strong as ever. The same people who are obsessed about the Holocaust, WTC attacks, and Virginia Tech shootings, are complacent about other genocides, suicide attacks on universities and other places and other catastrophes, at least as long as they don't affect people of European descent, or whatever definition of "us" and "them" they have.

It seems that humans are evolutionarily highly predisposed to xenophobia, and typically care very little about hurting "out-group" people through actions, and not at all about doing so through inaction.

Disease eradication

Over one billion people suffer from diseases caused to being born in the wrong place. In otherwise healthy individuals, and with access to modern medicine, few infectious diseases are live-threatening or seriously debilitating. So most people living in the developed world tend not to care too much about them.

But infectious diseases have a nice side to them. They can in principle be completely eradicated. If the only way to get sick is by contacting an infectious organism, and the only way these organisms can proliferate is by infecting people, then it's enough to break this cycle once and a disease is completely eliminated.

So far only one major diseas was completely eradicated - smallpox. The cost was about US$300 million, that is about one day of ocupation of Iraq (probably a few days, adjusting for inflation). Before it was eradicated, it killed about 2 million people a year.

Currently the largest eradication effort concerns poliomyelitis, with number of cases dropping from estimated 350,000 a year to less than 2,000 a year, but eradication is taking much longer than planned. The cost so far was US$ 3 billion, or ten Iraq-days.

Efforts to eradicate dracunculiasis reduced number of affected people from 3.5 million in the 1980s to about 10,000 in 2005, at cost of US$ 90 millions, or 7 Iraq-hours.

There are realistic plans to eradicate measles, mumps, and rubella. A limited effort to fight measles reduced number of yearly deaths 871,000 (1999) to 454,000 (2004), at cost of $308 million. that is about 1 Iraq-day.

Not every disease can be easily eradicated. Efforts to eradicate malaria failed when mosquitos which transmitted it became immune to insecticides. It doesn't mean we cannot try a different way in the future. We known a lot more about malaria and about mosquitos than we used to, and we have better methods.

It wouldn't be eradication, but occurrence of many diseases like cholera can be greatly reduced by ensuring access to safe drinking water, better nutrition, and letting people in refuge camps (some of the most dangerous places to live) back home, or wherever, as long as it doesn't involve not thousands of people cramped in small space in unsanitary conditions. The cost would be a few Iraq-days at most.

Conclusion

The conclusion is simple - if occupation of Iraq ceased, and the money was spent on global health care instead (for just a month or two), it would save tens of millions of people a year from death, hundreds of millions a year from other infections, and made the world a much better place. And somehow I just don't see it happening.

1 comment:

Avinash Meetoo said...

Fantastic post.

I live in one small island, Mauritius, in the middle of the Indian Ocean and what the USA is doing in Iraq is revolting.

So much money and lives (US troops + Iraqis) being lost daily. It's tragic.

But, as you say, I can't see Bush conceding that this war is not a good idea. I think that Bush is in power because of this war i.e. he started it to be reelected...