Why haven't we eradicated more diseases?: Effective altruists
New to public health
The math nobody argues with
A long-lasting insecticidal bed net costs about $2. It prevents roughly 0.5 cases of malaria per year. The Against Malaria Foundation distributes them. GiveWell estimates the cost per life saved at around $5,000. For comparison, a year of dialysis in the US costs $90,000.
We keep waiting for someone to argue with these numbers. Nobody does. They just don’t fund it.
The global malaria funding gap is about $2 billion a year. That’s roughly what Americans spend on Halloween costumes for their pets. The cost of fully funding the Global Polio Eradication Initiative through completion is less than a single F-35 fighter jet program overrun. These are not hard numbers to find. They’re hard numbers to act on, because the children dying of malaria are not constituents of the people holding the budgets.
The public health camp is right about the field complexity. Bed nets aren’t enough. Cold chains break. Communities resist vaccinators who showed up and left before. But the underfunding isn’t accidental. It’s structural. The money goes where the returns go, and the returns on curing diseases in poor countries are measured in lives, not revenue.
The global south camp is right that sovereignty matters. We sometimes talk about scaling interventions
like we’re deploying software, and the people on the receiving end hear something closer to colonialism with a spreadsheet. I get that. But the kid who dies of malaria tonight doesn’t care about the geopolitics of who funded the net. She just needed the net.
Where we concede ground: Cost-per-life models flatten dignity. A human life isn’t a unit of output.
What would change our mind: Sustained eradication funding at scale producing no measurable reduction in disease burden.
Read the full synthesis: Why haven’t we eradicated more diseases?