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09/24/2006

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Lee

That's a neat argument, and I agree, but every libertarian blogger covers this once a year as a poke in the eye to those darn old leftists.

I'm a big fan of both of you guys, but too often you choose well-worn topics. You ought to write with the assumption that your smart readers know all the standard libertarian stories and are looking for something unique and original.

James

When I was in India, I tried using a mosquito net, but it wasn't too effective (it also prevented me from using the ceiling fan, because the fan was the only thing to hang the net from). My hosts got me a product called Good Knight, which works like a Glade air freshener except that it releases some sort of insecticide. I have no idea if it is legal in the US, and it requires an outlet (or some source of heat to release the chemical), but it was very effective. Mosquitoes rarely ventured into my room, and when they did they seemed to go crazy. I still got a few mosquito bites when I wasn't in my room, but overall it was great.

Not sure this has any bearing on the discussion, but if Good Knight doesn't use DDT, maybe it's a feasible alternative in places with electricity.

Actually, now that I think about it, I had a persistent cough while I was in India, but I attributed it to the filthy New Delhi air. You'd want to test this thing pretty thoroughly before adopting its use.

James

A little research reveals that Good Knight products (which are apparently manufactured by a joint venture company partly owned by Sara Lee) contain allethrin, which has low toxicity for humans and birds (according to wikipedia). Good Knight worked well for me, but obviously I can't vouch for its overall effectiveness.

Wes

...malaria deaths could be greatly reduced in a cheap way...Suppose there are 100 million people who are at high risk for malaria and it would cost $1/person/month to supply enough DDT. That would be over 1 billion dollars per year. Compared to the hundreds of billions cost of the Iraq war that's pretty cheap but compared to Bill Gates' fortune that's quite a bit. Furthermore, even at $200,000 per scientist (salary and supplies) that's enough to hire 5,000 scientists working for a year on a malaria vaccine that would completely eliminate malaria if discovered....without requiring any fundamental changes in behavior,...That depends. If the village was located in a mosquito free area but people were getting infected when they went down to the river to get water then providing the village with a water supply might be more effective. Also, if people in the village congregated outside in the evening to socialize, then spraying inside the houses might have minimal effect.I'm not personally opposed to spraying DDT in homes but I'm very skeptical that it's some sort of magical solution.

Haris

1.2 billion dollars per year to save 100 million lives works out to $12 a life. Unbelievably cheap. Even over 70 years [probably too high given low life expectancies], that's $840 per life. Still crazy cheap. Adding the fact that maybe only 1% of people at risk would otherwise die, that works out to 1 million lives saved for $84 billion, or roughly $84,000 per life. [Someone check my math.] Given that statistical lives in the US are valued in the millions, I think it's pretty certain that even African lives are worth more than $84,000. I'll grant that African lives are worth less than Americans in a pure accounting sense - Africans produce less in their lifetimes than Americans because Americans are more productive. But there is more value to a life than its contribution to GDP, and I'm not even referring to the metaphysical value of a human life. But a living person creates utility to friends and family, adding to their happiness in a way that is not accounted for. In addition, deaths produce negative utility. I know people are reluctant to apply economic valuation to lives, but I'm using it to promote saving lives, so cut me some slack.

Anyway, I know Wes's point was basically to question whether DDT is the most efficient use of limited resources for Malaria prevention. The answer is that we don't really know. It's pretty impossible to know if and when a malaria vaccine can be created. And we do know that DDT spraying helps now. And despite being an econ major, I have to ask the following question: is it fair to spend money on vaccine research to save future generations when we could spend money on DDT to save present generations? Given that we don't know the cost of one of the alternatives [vaccine], I find it hard to justify not spraying.

Hannah

I do hope that Professor Becker has been misled by someone and that these comments don't reflect his own lack of research into the topic. Tim Lambert's response outlines the major mistakes in his posting so I won't repeat them here.

Those of us who actually work in malaria control know that there is no one solution to this problem. DDT and IRS can be an effective part of a comprehensive strategy that includes effective treatment (artemisinin combination therapy is currently the best drug we have) and use of long-lasting insecticide treated nets (LLINs). The WHO, the Bank, and USAID have understood this for a while, and the recent WHO announcement does not reflect a change in policy, just politics.

Malaria is transmitted differently in different regions; even within the same city transmission patterns can vary widely. IRS is great in some situations (for epidemics and in areas where malaria does not occur all year-round) but not in others (very rainy environments; year-round malarious areas).

For those interested in cost-effectiveness, there are a variety of good studies that have been (Morel et al, 2005; Hanson et al 2004 among others). ACTs are the most effective at reducing fatalities, and nets and spraying both reduce incidence by about 50%. The best bang for the buck though comes when you combine all these approaches.

Instead of pitting interventions against each other, we need to call on donors to fully fund malaria prevention and control programs, so that we can use all the tools at our disposal to prevent unnecessary deaths from this disease.

Agrian Redobog

It is sorely disappointing to see a serious thinker give vent to what is no more than a second-rate conspiracy theory.

happyjuggler0

Please don't be mislead by Lambert. He seems to have made a serious hobby of bashing people who want to use DDT. This is a link to t post, where in the thread Lambert convincingly (to me anyway) loses the debate despite a valiant attempt. gcochran seems more on the ball and without an agenda beyond saving poor people from needless deaths and suffering.

Niels Olson

AIDS should be in all caps: it stands for Auto-Immune Deficiency Syndrome.

Peter Pearson

@Lee:

"You ought to write with the assumption that your smart readers know all the standard libertarian stories and are looking for something unique and original."

Becker and Posner bring an immense amount of respectability to a position. For that reason, I'm especially happy to see them tackle an issue that has been popular with libertarian bloggers.

Wes

Anyway, I know Wes's point was basically to question whether DDT is the most efficient use of limited resources for Malaria prevention.It's not just resources for malaria prevention that are limited. It's all resources. Money that gets spent on spraying DDT in homes is not available for anything else and money that is spent on anything else is not available to be spent on spraying DDT in homes. If you want DDT sprayed in homes then you either have to advocate that private individuals spend less on other things (to afford private donations or increased taxes) or you have to advocate that governments spend less on other things (like the Iraq war).To put it simply, you can't just say "We should spend billions on spraying DDT in homes", you have to say "We should stop spending billions on wars/jewelry/science so we can spend billions on spraying DDT". The challenge, in my view, is less to figure out where to start spending the money and more to figure out where to stop spending the money.If Becker said "The US government should raise taxes and stop spending money on expensive discretionary items like the Iraq war and, after it has payed off the national debt, it should then fund malaria prevention.", I would be like "Yeah, that makes a lot of sense." As it is, I'm like "Yeah, OK, but the US government already spent it's money on things like tax cuts and the Iraq war. Thanks to the Republicans, there just ain't nothin' left." (Actually less than nothing when you consider the national debt.

happyjuggler0

Wes,

I disagree with the notion that one needs to figure out which tradeoffs to make in order to recognize that one ought to be making a different tradeoff than is currently the case.

Becker and Posner are making the case that indoor DDT spraying in malarial areas has a hugh added value, in contrast with those who simply assume that all DDT use is negative.

Ideally everyone who reads this blog already assumes there are tradeoffs for every action chosen or not chosen.

HEDGG

I think the international organization concerned with malaria erradication is the WHO (World Health Organization) rather than the WTO. WTO has enough work trying to save the Doha Round from completely collapsing to be working on health issues as well. By the way, are health issues trade related? As far as I see, they are only pretenses for protectionism against cheap food stuffs from developing countries.

ZZTop

I think Ms. Carson should be tried in the International Criminal Court.

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