This is the same reason rich people should put a ton of their resources into basic science, tech, and health infrastructure.
This is the same reason rich people should put a ton of their resources into basic science, tech, and health infrastructure.
And since philanthropic approaches to such aspirations demonstrably do not work, we need extremely high taxes on the ultra wealthy.
Before the six-seven digit earning engineers here lambast me, I'm talking billionaires.
No one intelligent can/has yet looked me in the eye and told me earnestly: anyone with a billion + $ would have a single degree lower quality of life if their wealth was capped at 999 million
If you want empirics google "highest marginal tax rate 1950- present" and "infrastructure spending 1950- present".
So, the state should control any large enough corporation? Or there should be a ban on over $999m in cash? Or should the government just not waste the absurd amounts of money we already give them?
state should control any large enough corporation
Not necessarily, company could be broken down in to smaller, become employee owned in some part, could have some amount of stock become owned by an infrastructure fund or something. There's many ways to skin a cat
Not necessarily, company could be broken down in to smaller, become employee owned in some part, could have some amount of stock become owned by an infrastructure fund or something. There's many ways to skin a cat
If you think taking money from paper billionaires is going to make a material difference to the US's $6 trillion spending each year, can you quantify how much are you expecting it to raise?
You're right that reducing spending, particularly the pentagon's blank check and the military budget is going to play a larger role but stop reading ahead! I can only push leftist politics one point at a time out here!
Well, if you go after the actual problem and not just talking points, you'll know it's a lot bigger than the military. And that the US military is extremely important for the whole global house of cards to stay standing.
Glad to hear that limited government is now considered leftist politics. No more pork barrels for the Democrats?
Reign in unlimited military spending is not "limited government", it's "limited military". Making sure the pentagon stops "losing" trillions is not small government it's basic accountability. But you're right it's more than that. And the billionaires. But like I said, one point at a time! You've clearly read ahead of the class. And "no more pork barrels for democrats"? I said leftist, not democrat.
I still believe in state solutions to healthcare to start, since that's the topic at hand.
And yes, I know it's much bigger than the military and pentagon, but I can't exactly summarize Pikkety's Capital and ideology or the socialist manifesto by sunkara in a couple hn comments can I?
Re the "we're vital for the whole house of cards" to remain standing, lol.
What good have we done recently besides maybe funding ukraine? Were we keeping the house of cards standing in iraq? vietnam? Korea? points to latin america in general Need I go on? Iran? Were we keeping the cards up when we spent money arming the Mujahadeen?
I mean, taxation is actually theft, even if you're stealing from the rich to give to the state. In order to justify that, you have to provide a lot of value, which we currently don't do. Angrily wanting to tax people more successful than yourself just makes you sound jealous, not optimistic. Cut the spending first, and then if the government is still in trouble, cut the spending more.
To control the hyper-rich, the solution is simple. Corporate tax breaks for your lowest paid employee's salary. The higher that floor, the less tax you pay. Incentivize prosperity, not taxation and slavery.
Military spending isn’t a binary. The US could probably spend significantly less, while still keeping the status quo.
The US military has not one, but three aerobatics teams spending over a hundred million per year total. To cite a single example of completely pointless spending
When I say it's a lot bigger than the military, I'm not meaning to exclude the military.
I'd love for this to work, but in practise I feel the owner on the 999m will more likely stop investing in sed company when it reaches 999m and spin up a new company or some other loophole to get around it. (or if it's individual wealth, then they'll use trusts or some of the many other options available to them.)
If there are no options, you better believe they'll create them soon enough.
or some other loophole to get around it. (or if it's individual wealth, then they'll use trusts or some of the many other options available to them
Completely agree, it will always be a cat and mouse game. But it's a worthy aspiration, and I'd argue the reason the wealthy have been the cat more than the mouse in the relationship with the state is due only to the budget disparity between them.
Start to shrink the disparity between the enforcement budget (think IRS special forces for the ultra wealthy) and the "avoid taxes" budget and the aspiration looks a lot more doable.
owner of the 999m will stop investing
Maybe. Or maybe they'll get better and spending rather than hoarding and continuously need to replenish that stock.
Even if these "winners" of a more 'social capitalism' stopped gracing us with their genius, the surplus of wealth in endeavors like free stem schooling for everyone (that wants it) would surely make up for that loss??
And since philanthropic approaches to such aspirations demonstrably do not work, we need extremely high taxes on the ultra wealthy.
Pretty bold to claim that government intervention post-taxes would work better than philanthropic fundations.
Is it bold? What percentage of all of our modern infrastructure is from the benevolence of philanthropists?? I am sure it's not zero, but I can't imagine it being a majority... But please enlighten me. For "billionaires know best what to do with all that wealth, they'll take care of us" sounds an awful lot like what sbf was preaching.
This reasoning doesn't seem very sound. Infrastructure is far too broad, to the point of irrelevance. "Sounds like SBF" is also not reasonable.
How about this: the state is bad because it declares war and sends people to their deaths. Its projects often go astonishingly over budget, corruption is high in many countries, and its funding is unreliable, as it's prone to not keeping the promises of the people previously in charge.
That accurately describes almost every state that ever existed. If you have a similar list for all philanthropic institutions, that would be a good start in justifying your claim that philanthropy doesn't work, so we have to take the money and let the bureaucrats handle it.
It sounds like you view the state as bad. Even when that state is democratic?
The less average a citizen is, the less accurately the democratic function approximates their interests.
Additionally, our democratic function has strange domain mismatches were it has been overfit on unusual cases. Anyone who is more agency seeking than average will likely confront some vogonic laws and develop conflicting feelings.
try the book Everything I Want To Do Is Illegal.
Alternatively, the farther away you are from average when it comes to wealth and resources, the more the state can benefit you.
People in the bottom percentile are tremendously well served by many modern democracies, despite your assertion to the opposite.
If I’m going to be severely disabled (extremely far from average), I would much rather do it in a modern western democracy, instead of any other form of government.
the state is bad because it declares war and sends people to their deaths
Wouldn't it make more sense to conclude war is bad, rather than states themselves?
Its projects often go astonishingly over budget, corruption is high in many countries, and its funding is unreliable, as it's prone to not keeping the promises of the people previously in charge
All of this I agree with. But the solution isn't "less states" it's... Better states, surely? What am I missing here?
My point with the question about where a majority of our infrastructure comes from, (roads, schools, hospitals, water, electricity and sewage systems to specify as a start) the state or the benevolence of philanthropists was to demonstrate that there is quite a bit of evidence as to what structure is the better steward of societies, a bunch of rich guys, or a state with some mandate to do right by its constituents.
The state can do both good and bad things. Even in your war analogy, Russia (a state) can invade Ukraine and murder it's citizens, but Ukraine (a state) can defend it's citizens. USA can have no affordable healthcare for citizens, Sweden can have affordable healthcare for it's citizens.
A state can provide e.g safety or healthcare for millions, a philanthropist could not operate at that scale for a long time. Philanthropists also die on a shorter time frame than states and their successors may not want to continue to support the same things.
I don't think the claim was that philanthropy doesn't work. But it doesn't scale to the levels of what a state can achieve. And therefore it is an inefficient way to use the resources. For every billionaire philanthropist that builds a hospital wing there are 50 more who buy 2 yachts. Tax them all and you can build 51 hospital wings and they can all have a single yacht each.
No, I agree that government investment in infrastructure is usually good.
My point is, when you're talking about investing in foreign developing countries, government programs will face the exact same failure modes as philanthropist-backed NGOs, with about as much accountability.
I agree that this is a bold claim. However, tax-deductible philanthropy is profoundly undemocratic, because it effectively amounts to everyone else subsidizing the philanthropic preferences of the ultra-wealthy. I think the onus is therefore on proponents of private philanthropy to prove its efficacy outweighs its democratic deficit.
billionaires existing is an indictment on our greed and failures of our systems. nobody needs 1000+ million dollars.
You're confusing resources they have control over with resources for their own personal utilization. Money is power; not to force someone to do what they don't want to do, but to pay them to do what they're willing to do. When capitalism works well, it's because people who made "good" choices with their money-power were rewarded with more, and people who made "bad" choices were rewarded with less.
Warren Buffet doesn't have an extravagant lifestyle. He's been entrusted to make decisions about how to spend our economy's resources in part because he's made good decisions in the past.
Obviously it doesn't always happen this way; but the accumulation of wealth by itself isn't necessarily bad. It's bad when it can be accumulated by ways which destroy value for society rather than creating it; and it's bad when it can continue to be accumulated by doing nothing.
The problem is that people who have more aren't necessarily smarter. Musk is a posterboy for that. So they really don't deserve the power that money awards them and we can't just blindly believe money to be a proxy for someone's decision making prowess.
It's still the same primate but now it's got a gun.
So they really don't deserve the power that money awards them and we can't just blindly believe money to be a proxy for someone's decision making prowess.
I think we basically agree on this. The question is whether a flat policy of "nobody can ever control more than a billion dollars" has any justification, either pragmatically or ethically. "Wow that's a lot" and "Maybe they aren't actually very smart" aren't really that well founded.
Basically by splitting the money among many people you increase the odds that by sheer accident somebody does something smart with a part of it. When it's in a single hand it's devoted to single persons whims.
You're confusing resources they have control over with resources for their own personal utilization
I don't know if they're as different as you portray in practice. I agree with the notion in theory, which is why I distinctly used "wealth" in my original comment and not "income".
He's been entrusted to make decisions about how to spend our economy's resources in part because he's made good decisions in the past.
Sure, no one is saying don't aspire to a meritocracy when considering control of the state's purse strings.
The key to your example and your "accumulation of wealth by itself isn't necessarily bad" notion is the reason I didn't say "no organization" should have more than 999m. I was strictly referring to excess personal accumulation of capital. Which harms us all.
Like I said, no one's quality of life is going to get worse if personal wealth were capped at 999m, but I can think of infinite ways to make a lot of people's quality of life better with the money we'd have in such an organization of the economy.
and it's bad when it can continue to be accumulated by doing nothing
I don't even know if I agree with this. A state fund that earns interest and spends that interest makes sense. I think the key is the first case you note where it's bad.
Ive heard tax evasion rates were much higher historically, and that though tax rates were considersbly higher and taxes more complicated, many people simply did not pay. The simplification of taxes and reduction may have resulted in a larger amount of collected taxes.
Do you suspect if taxes were set to 99% that people would honestly pay them? To me it seems like a solution to two equations intersecting. Find the number that maximizes willing participation (a decreasing function of rates) and maximizes tax revenue (an increasing function of rates).
Do you suspect if taxes were set to 99% that people would honestly pay them?
Truly rich have most of their money in assets like real estate and companies. And goverment through laws is in control of what it even means to own those things. Government could make a law that when any company goes public 20% of shares are a tax.
With appropriate funds to the revenue services it's easier to flag and investigate likely tax evasion these days than in days of yore.
And since philanthropic approaches to such actions demonstrably do not work...
It baffles me that you chose to share this comment on, of all things, a post about the eradication of Polio, which was primarily funded by the Bill and Melinda Gates Foundation in a _clear_ example of a "philanthropic approach" working quite well. If I had to identify one organization that has contributed the _most_ to positive changes in public health infrastructure in the last decade it would be them, above any governments, churches, or other non-billionare organizations.
Reaching back further, many/most top universities have billionaires to thank for their existence (Stanford, Carnegie Mellon, etc.), the widespread existence of public libraries is mostly due to Andrew Carnegie, and a lot of tech/science innovation comes from for-profit companies primarily controlled by or funded by billionaires.
I won't deny that billionaire philanthropy _sometimes_ doesn't work, but that's true for any system of building infrastructure that I can imagine, and is a far cry from your claim that philanthropy is demonstrably an ineffective way to solve public infrastructure problems.
I'm curious if there are other processes you see as being historically more effective, either overall or per-dollar, at producing effective public health outcomes than philanthropic organizations? If so, I'd definitely like to find ways to give them more resources.
Saying the eradication of Polio "was primarily funded by the Bill and Melinda Gates Foundation" is a vast overstatement. Less than a third of the main organization's funding came from the Gates Foundation, and outside of funding, a lot more of the effort was from your run-of-the-mill local civil health organizations, community outreach programs, etc.. There's no solid evidence that billionaires made such programs successful, especially given that the polio eradication effort has notoriously been mired by repeated setbacks.
It's also a vast overstatement to claim "most top universities have billionaires to thank for their existence" or that "the widespread existence of public libraries is mostly due to" Carnegie libraries. Most top universities in the world are public institutions, and public libraries existed long before Carnegie (there was never a point in American history where most public libraries were Carnegie libraries, let alone in other countries).
Ok, so first off happy thanksgiving. I'm drunk at this point so forgive my probable incoherence.
while there's some validity in the notion that philanthropists do good occasionally, a better question is would their good more effective than a state solution? I don't have a ton of evidence on hand right now, but highways, the whole new deal america stuff pretty clearly did more for infrastructure than any philanthropist. In the terms of stuff like the gates foundation, at the end of the day I'm a utilitarian. They do good I'm happy.
All I'm sayin is a more egalitarian state might have achieved the goal quicker had they any rich guys' will to solve it.
At the end of the day I don't have the evidence off hand but everything I've read points to the state as the source of modern amenities but admittedly I'm biased towards tech and leftism and I'm no expert. I haven't exactly read ayn rand. I've read stuff like pikkety and sunkara.
In the cases where billionaires do good I ask, Couldn't a state with that same will do more?
Since we are talking about health, the ultra wealthy are still human beings, they get sick and die like the rest of us.
And they want to stay healthy and live long, also like the rest of us.
It means it is in their own selfish interest to invest loads of money into health, because that is what will help them achieve that goal.
But again, their body is much like our bodies, so every advance in medicine that can help them live longer will ultimately help us live longer. Maybe at first, only the wealthy will be able to get these state of the art treatment, but processes will improve, patents will expire, and sooner or later, they will be available to all of us.
This is one instance where there is no real need to "tax the rich", research is good for all of mankind, the rich are not taking away knowledge from the poor. This is in contrast to natural resources, like land. If the rich want to build their manor on some good spot, the poor that live there will have to leave. But if a cancer treatment is found for the rich, it will not take away a cancer treatment for the poor, in fact, that's the opposite, as it is likely that a few years after, the poor will also get the rich treatment.
This notion that medical inventions are the benevolent gift of billionaires' ability to accumulate wealth is just wrong. What medical advances were made by the process you imagine in this comment? Maybe if brian johnson's blood magic from his son works I'll cede a single point here.
Science is a communal, collective effort, more evidently than anything else I can think of. To need to say that here of all places is really unfortunate
To try and act like taxing the rich is incompatible with medical advancement is just wrong. In the 50's and 60's we still made advancements and google the top marginal tax rate then. Do you think research would even slow down if rich people were capped at 999m? Seriously?
This notion that medical inventions are the benevolent gift of billionaires' ability to accumulate wealth is just wrong.
No one said that. We are saying that billionaires do NOT do that, and because they don't, they are flaming idiots. Literally killing their own children, and often hastening their own personal deaths.
Alas, spending their untold riches to make the government better is not in vogue. Never has been.
Instead, their mission is to gut governments, "burn it all down" for the sake of eradicating those cursed regulations, in the name of making the government "more efficient". In reality it just means "get those pesky bureaucrats out of my way of making even more money with immoral, destructive, and even illegal ways".
Instead we get "effective altruism" which basically means - "my mission is to get as rich as possible in unholy ways, and if you are lucky enough to be within the gravity field of the pet causes I happen to be a fan of, then you get some money".
You cannot find a worse way of a civilized way of distributing money to those in need. It's ineffective by definition.
People need to remind themselves once in a while that the world like this already existed. A bunch of feudal lords running around, trying to get favors with the king. Most people suffered, and rivers of blood were spent to shed that kind of system to create, you know, a civilization.
So stop worshipping the ultra-rich - they are the most destructive anti-civilization force were are dealing with right now, unleashing their wrath if they are not adored enough, stewing in anger and grievances.
And no, I am not saying Capitalism is bad. Sure, greed is good and all that, but running amok and without any oversight, it leads to no good.
I mean, I sympathize with the "burn it all down" attitude because the (US) government needs to be culled. Education costs exploded in the last 50 years because the government got involved. Fiscal irresponsibility is the new normal because the government will get involved to bail out the banks; why not give out credit like candy? Housing costs are insane because governments get involved via zoning to artificially reduce supply. US military spending today is (inflation adjusted) almost as high as during WW2. Federal government spending is 37% of our annual GDP which is almost certainly slowing our economic growth.
Someone needs to take an axe to the US fed. If we reduce federal spending by 75%, do you honestly think that would be a bad thing?
The US has produced all the innovation and prosperity and our government was founded on the principle of "fuck the government". Government overgrowth is the problem.
It's comments like these that make wanting a better world feel like a truly thankless, sisyphean task.
All I can say without wasting too much of my own personal time is: in the world of federal spending you suggested
US military spending today is (inflation adjusted) almost as high as during WW2.
would be unchanged, if not exacerbated (to continue exerting military/police control on a populace who's tax dollars aren't returned to them in the form of non-private, non-profit entities but now live in literally Bladerunner)
and the privately owned companies that lobbied to have that considerable amount of society's tax dollars spent on their products will certainly not be displaced. See also: basically every other industry
Sometimes I'm jealous of the uber wealthy not because they have nicer bathrooms or destroyed entire generation's qualities of lives and the reliable longevity of the future...but because of how many people seem eager to step up to bat for them, for nothing more than a thin veneer of "yeah well, fuck that other guy, amirite?"
Our social instincts are still tied to old institutional forms. Individuals with economic empires without borders seem to escape our otherwise commonly more organized criticisms.
This makes it painfully easy to get people to rally against "the state", but rallying against the vague, shadowy amalgamation/political party of wealth concentration proves elusive, I suppose. Like rallying against feudalism as a whole. Where do you start or end is the only real question.
It's 23% of GDP, not 37%. [0]
Anyone who says "we need to cull the feds" doesn't understand what we actually spend money on.
25% of our spending is Social Security, and 20% is the military. That's 45% right there.
Old people vote. Social Security is going nowhere. You literally can't cut the budget by 75%.
[0] https://fiscaldata.treasury.gov/americas-finance-guide/feder...
US military spending today is (inflation adjusted) almost as high as during WW2.
Not in % of GDP.
"Education costs exploded in the last 50 years because the government got involved"
You do realize that the reason costs have increased is that State funding for public Universities has been significantly cut over that period? This "government can't do anything right" attitude has been a major driver in this increased cost?
Yes, the availability of some grants and guaranteed loans to people barely old enough to sign contracts did't help, but the big driver of the cost increases is the reduction of public funding. State funding for secondary education has been continuously reduced in the name of lower taxes and "fiscal responsibility".
As for Federal spending, it depends on how you slice it. If you count Social Security and Medicare and other "entitlements"* then SS and Medicare are huge.
If you don't, then the Military is the biggest expenditure. That's a little misleading though, since a large amount of basic and applied research is funded through the military (such as through DARPA and other agencies). If we reduce here we'd need corresponding increases elsewhere to avoid starving basic research. There are some expenditures that are wasteful there (I'm not sure how well the F-22 will handle the shift to drone warfare), so we could back there if we wanted to.
Funding for many other agencies is actually too low to accomplish their stated mission. We either need to reduce the scope of what they are legally required to do or increase funding. For the IRS, one thing we could do is to simplify the tax code to make audits less expensive. Similar changes could be made for the INS.
As for wastefulness, if you compare the government to private companies to implement the same standards, government is always cheaper. The only way private companies get cheaper is to provide less or offset the cost in some other way (unexpected externalities). The real reason expenses are so high is that the government is big -- it provides services to every person in the US and many others around the world. It covers a large number of markets from healthcare, security, finance, etc. There is literally no company comparable to the Federal government in totality. But if you compare just the pieces you still find government usually comes out ahead.
*"Entitlements" really should be considered contractual obligations and treated separately from the budget -- after all, would we allow a private company to include disbursements from their pension fund as part of their budget? Fuck no, that's a separate pile of money that doesn't belong to you. The entire framing around "entitlements" is designed to trick people out of their money.
stewing in anger and grievances
It seems as if the targets of your ire are not the only ones in the stewpot.
Well you totally missed the point. Calm down dude.
spending their untold riches to make the government better is not in vogue. Never has been.
Isn't this just lobbying/political contributions? That definitely happens, but I think I'm generally more in favor of keeping the government and laws somewhat isolated from the influence of money, and keeping philanthropic organizations as a separate category from government agencies.
For the most part, private organizations (especially nonprofits) seem mostly willing to operate within the bounds of the laws as currently written, and government organizations like the CIA and NSA and military seem much less perturbed by commiting physical violence to achieve their aims. There are maybe some exceptions, but I can think of a lot more examples of governments being toppled by the CIA than by nonprofits (unless you count the Taliban and ilk as charities, which seems like a stretch).
Polio would already be eliminated if not for extremely superstitious people and religious governments.
Coordinating the public health efforts across all countries is incredibly difficult and expensive work that requires constant investment and upkeep. Teaching people to be skeptical of the superstitions that were passed down and to look for real, reproducible evidence is what produced all of the benefits of The Enlightenment and continues to pay off.
We must collectively understand the reason why some countries stay "developing". The reason is very simple - the rate of population growth exceeds the rate of infrastructure development by large margin. You can make large investments and build everything for 1 million people, but after two decades there are now 2 million people and then 4 and then 8. Africa started out with 200 million people After the WW2 period. In the beginning of this century there were around 800 people. Now there are 1.5 billion people. The rate of population growth is just unbearable. And Africa is here just an example. The same problem affects also India and other places.
That's not the reason that nations stay "developing". Nations stay "developing" due to extractive economic and political institutions that prevent economic growth. Great book about the topic by economist Daron Acemoglu ("Why nations fail").
The reason that countries that have high population growth tend to be poor is because when a country gets rich its people have fewer children. The high fertility rate does not cause the poverty, instead its the other way around: the poverty causes the high fertility rate.
I can't agree with this unfortunately. While getting rich further lowers the fertility rate then there is a certain threshold that must be first exceeded to get rich (relatively speaking of course).
There must be a feedback loop that incentivizes to get better education, to get better productivity to get richer. Raising a child is expensive, raising a highly educated child is very expensive. If you have 8 children then you can barely feed them unless you are very rich indeed. Even if you manage to provide good education for few of your children then the larger part of them continues the poverty loop. Breaking out of poverty requires breaking of this loop.
It should be very obvious - if your economy grows 5% but your population grows 10% then everybody is getting poorer as the growth per capita is negative. The same applies for everything, education, sanitation, food production. If you capacity to provide any of them is lower than the population growth then the amount of the poor continues to increase.
And providing more basics, like improved agriculture, education and essential infrastructure like clean water access, is a better means to combat that issue than sending in surgeons to play hero and have a feel-good moment without making any real difference in the root causes that led to someone needing surgery.
Current problem in Africa is that their capacity to produce food, while it is increasing relatively fast, doesn't increase enough to keep up with the population growth. This is why Russia can play with the grain shortage to begin with.
I don't think we really disagree per se. Not sure why you seem so adversarial.
And Russia is probably not playing with the grain shortage. They had an agreement in place to let the country they are at war with sell grain because it's so critical.
It's probably more complicated than that and a tangent.
No, I don't think that I provided a counter argument but rather a supplementary one. Population growth rate is a huge problem that hinders capacity to provide enough aid.
Russia certainly used the risk of hunger as a weapon to increase political pressure on Ukraine on the international level. Fortunately that attempt didn't play out and Russia was instead pressurized to make concessions. But they stopped the agreement the same moment they thought that it is not beneficial for them anymore. But this is just a side topic and was given as an example how the African incapacity to keep up with the population growth has wider geopolitical implications.
Ah, so it's me. Thank you.
There was a time when HN was more conversational than it typically seems these days. It gets hard to assume someone is making conversation rather than making an argument when the default seems to be the latter.
why some countries stay "developing". The reason is very simple - the rate of population growth exceeds the rate of infrastructure development
Opinions are divided: <https://www.youtube.com/watch?v=xP8CzlFhc14#t=3m>
Yes, the communist argument - everybody else is at fault but not myself. Yet the communist paradise, the 1/6 of all the land with incredible riches stayed poor and finally collapsed.
That argument has nothing to do with communism. At most, it could be seen as anti-capitalist. As I understand it, the argument is that some so-called “underdeveloped” country is actually rich in natural resources, but foreign companies have come in and extracted the vast majority of the wealth, given some resources only to a select elite, as essentially bribes, and the large masses of people get nothing, and so remain poor. Even though the wealth extracted, had it remained in the country, would have made the country on the same level, or even higher, than the so-called “developed” countries. I can see no argument for communism here.
If anything, the argument is a nationalistic one, and nationalism have traditionally been associated with the right, not the left.
You have to know the history to understand why this argument is communist.
Also forgot the part where India and North/West African regions were incredibly wealthy in the past and were basically strip mined by colonialism. It's been only 50 years or so that they're trying to catch up.
West Africa was never "incredibly wealthy". Yes, before Europeans it was part of long-range trading routes with the Muslim world, but empires were feudalistic and only a tiny elite had access to that trade-related wealth, while the vast majority of the population was barely surviving through subsistence farming and pastoralism, just like so many do today, or hunting and gathering.
Lets also not forget the slavery and slave trade that was practiced in Western and Northern Africa.
Although some might be interpreting the previous poster as having some bad motives for saying what they’re saying, it does seem to be objectively true that population growth in developing countries is absolutely huge. If the population level had remained the same as 50 years ago the level of development would be much higher. But of course the population growth rate is declining so standards of living should hopefully start to catch up.
Yes and no. This is my argument indeed that if the population growth stayed lower then a lot more people would have been able to rise above the poverty level (or even much higher).
UN prediction for Africa is that they fall close to the reproduction threshold for the end of century. Until that the poverty trap will continue. It also means that by that time now 4 billion people require their needs satisfied instead.
But the population growth has been huge and exponential. From 200 million to 4 billion in 150 years is an incredible amount of growth.
The Malthusian argument is incorrect and I disagree with the concept of physical infrastructure being the end-all-be-all. Japan, South Korea, Germany, as well as the USSR had explosive growth after WW2 not because they had massive existing infrastructure, but because of social systems & processes that enable a reliable, stable, productive society.
If the societies are fragile (vulnerable to drought, markets, or violence), or rotting (corruption, superstition, tribalism), even great infrastructure can make for subpar growth.
An analogy I always think of are Wadis (dry riverbeds); in very dry places with little rainfall (like Hudaydah in Yemen / Saudi Arabia), when it DOES rain, the dry dirt riverbeds don't soak up any water and transport it all out in flash floods - but it IS possible (and has been done) to invest in the land's ability to hold that water rather than purge it. Similarly, in a "always-developing" society, there'd have to be a investment in the people to ensure they can benefit from solutions to their issues.
I don’t think they’re making a Malthusian argument. It’s about the difference in the rate of change or two variables, not the absolute carrying capacity of a set of resources as in the Malthusian argument.
Malawi is one of the countries mentioned in this article as a source of polio outbreaks. A famous singer has invested millions in hospitals there and they still lack adequate water infrastructure. I imagine their post operative stats are probably not great. Getting surgery in a modern hospital and going home to inadequate clean water and inadequate nutrition likely actively fosters post operative infections.
Population growth tends to stop with adequate education plus reproductive rights for women. Development isn't just about infrastructure. It's also about culture, education, developing the local population so they can sustain a more developed society.
My recollection: water.org was started by a man who went to Africa with a medical charity, concluded that a lot of the health issues they were treating were directly caused by lack of clean water, decided we should fix that.
We already invest in other countries, just not necessarily wisely. Advanced surgery being brought to primitive conditions is more about people wanting to feel heroic than about really improving things.
We currently are de facto breeding antibiotic resistant infections
For my understanding, if no one else's: are there a lot of places without decent water, but with antibiotics? What's causing that strange inconsistency?
Anecdotal, but most towns in Vietnam you'd want to boil your water, and if you want antibiotics you go to the pharmacy, pay about $2, and get some.
What's causing it? The free market is working great to build the systems to get drugs to people. In fact if a pharmacist refused to give out antibiotics when they weren't needed, the pharmacist would probably just go out of business because the customer would just head up the street to the next guy.
The free market is not so hot at building expensive infrastructure like safe water in a tropical biome, that requires government involvement (not meaning to rag on SE Asian governments: building this stuff is difficult even if your country has been stable for the last 100 years, which is a luxury they haven't been lucky enough to have)
I dunno if safe drinking water is a great example. There are many success stories both of public and private provisioning.
It’s not rocket science. You need to:
1. Build, operate, and maintain wastewater treatment plants
2. Require everyone send their wastewater to a treatment plant
Vietnam has a neat loophole for 2. where if you simply generate too much wastewater for your zone’s plant to handle, you don’t have to send it to the plant. That’s more a policy decision with a side of administrative corruption that’s unrelated to who’s handling the infra.
Build, operate, and maintain wastewater treatment plants
You'd be surprised at how difficult this is in shitty countries.
First, wastewater plants are rather expensive. Maintaining them is also both expensive and required. And you don't get bonus points for doing the right thing.
My home city of Chişinău, Moldova has a population of about 800 000. The whole city stank of feces for almost two years (and districts close to the sewage treatment facility for much longer than that) because no one cared to maintain the old Soviet-built facility.
Only when you could smell (and almost taste) shit over 20km away, did they scramble to do something (ask for more money from IMF/EU, steal most of it, ask for more money, implement a patchwork solution that barely holds)
It's a well known problem in economy: the tragedy of the commons.
In a free market, even the river or the sea has an owner (might be a group of people), so you cannot throw your waste on a river that is not yours. But currently rivers are "common" or public property, so the state cannot limit who polutes the rivers unless they provide an alternative. In rich countries, such alternatives exist. In poor countries they just dump waste in public/common rivers.
It's a self-imposed problem however. The economical system requires every interaction to be transactional and disincentivizes activities outside the economical system itself. This leads to transactional relationships supplanting those which previously provided mutual benefit.
In poor countries rivers used to be maintained by the community because of a shared interest in them. This works fine in a gift economy. But in a transactional free market economy the communal river is an externality because it isn't privately owned, which requires outside intervention to create a financial incentive (either via subsidies or regulations/fines).
The tragedy of the commons is not a natural law, it's an emergent property of the economical system. There are three remedies: privatization of the commons (which has its limits unless you literally want to commodify every atom in the biosphere), state intervention (which is how most functional mixed market systems approach it) or changing the system (which goes against the interests of those currently benefiting from it and may as well lead to a worse system than a better one).
EDIT: For sake of clarity: creating a gift economy alongside a transactional free market economy is extremely difficult in an open system. They keep being reinvented in peer groups (e.g. buying "rounds" of drinks among friends without keeping tabs on who spent how much) but they rapidly break down when exposed to a transactional system because "freeloading" becomes an optimal move without the "honor system" enforced by social pressure (e.g. your peers thinking you're taking advantage of them and no longer inviting you to drink with them or having a stern word with you).
From an engineering point of view decent water may be overkill. Just send shitty water down the pipes and filter it on premises. Putting to one side “ooh that sounds disgusting / what poor people do” emotions, is there any downside?
Probably the main one is the cost of RO but if that cost can be got down it might work.
It's much, much cheaper to make the water supply for a city clean at the source than it is to install several million water filters.
Lot easier to ship pills than to clean and ship water
but with antibiotics? What's causing that strange inconsistency?
There are a number of reasons, but one that hasn't been mentioned so far is the heavy use of antibiotics in food production: https://ourworldindata.org/grapher/antibiotic-usage-in-lives...
Yes, absolutely. Proper water infrastructure is both difficult and expensive to develop, and requires constant maintenance.
Antibiotic pills are cheap and easy to distribute.
Flint, Michigan?
In a global assessment for 103 countries, after accounting for type of governance, education, economy, health care spending and community infrastructure, it was concluded that reducing antibiotic consumption alone would not control resistance. Independent of antibiotic consumption, poor infrastructure (e.g. sanitation), poor governance (e.g. corruption) and low health expenditure were all associated with higher rates of resistance.
If only we had some sort of massive example that had killed literally a million Americans. Then maybe we'd learn.
Oh well. Maybe when that happens.
You are apparently shadow banned. I have vouched for your comment with some trepidation hoping you will clarify what incident or issue you mean.
Yeah, I'm aware. Happens to all my comments.
And as the other poster correctly guesses, this was a sarcastic reference to covid.
Thank you.
It's visible now, so your vouching worked. It seems obvious to me GP is writing about COVID-19. The US CDC lists estimated US deaths from COVID at currently 1,153,910.
But we've had plenty of other examples in living memory, with influenza currently averaging about a million deaths in the US every 30 years.
I had this realization when I was like 8 years old. It goes to show how undemocratic our governments are that we still cannot get the leaders, who are more insulated from the effects, to act on our vulnerability.
It’s amazing what vaccines can do when people take them and they aren’t politically weaponized by AI and social media algorithms.
Sorry if I’m bitter, I just had a nurse tell me yesterday to not take the flu vaccine because she said it doesn’t prevent flu and why would I “put that junk in my body.”
Also, when the CIA doesn't ruin everything.
On May 2, 2011, President Barack Obama announced that the US Central Intelligence Agency (CIA) had located and killed Osama Bin Laden. The agency organised a fake hepatitis vaccination campaign in Abottabad, Pakistan, in a bid to obtain DNA from the children of Bin Laden, to confirm the presence of the family in a compound and sanction the rollout of a risky and extensive operation. Release of this information has had a disastrous effect on worldwide eradication of infectious diseases, especially polio.
On May 16, 2014, the White House announced that the CIA will no longer use vaccination programmes as a cover for espionage. The news comes in the wake of a series of militant attacks on polio vaccination workers in Pakistan, with legitimate health-care workers targeted as being US spies. The attacks have forced organisations such as the UN to suspend polio vaccination efforts in Pakistan, and have severely hampered anti-polio efforts, with parents refusing to have their children vaccinated. News of the vaccination programme led to a banning of vaccination in areas controlled by the Pakistan Taliban, and added to existing scepticism surrounding the sincerity of public health efforts by the international health community.
https://www.theguardian.com/world/2011/jul/11/cia-fake-vacci...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
News of the vaccination programme led to a banning of vaccination in areas controlled by the Pakistan Taliban, and added to existing scepticism surrounding the sincerity of public health efforts by the international health community.
If I recall correctly, the conspiracy theory that emerged was that vaccines were secretly being used to render the people sterile.
It is interesting how 8 years later nearly the same line of thinking took hold in the West (albeit with claim of injected mind control chips) amid anti-vaxxers.
Considering the United States forcefully sterilized some 70,000 people, and that there is an ongoing investigation over nonconsensual sterilization procedures being performed by the government three years ago, your handwaving over “conspiracy theorists” is pointless.
After all, it isn’t like the government has a long history of eugenics, forcefully drugging people for weeks at a time with combinations of LSD, barbiturates, and other fun stuff, right?
Our government would never do that.
Considering the United States forcefully sterilized some 70,000 people, and that there is an ongoing investigation over nonconsensual sterilization procedures being performed by the government three years ago
Context is everything. The US government did that in the context of their genocidal war against indigenous peoples. There were fully transparent laws on the books that rewarded people for murdering native populations. No conspiracy needed.
As for your claim from 3 years ago, you've thrown out an allegation without providing any evidence. Involuntary sterilizations likely do occur, but that's far from an indication of a systemic government conspiracy.
The context of COVID vaccines was a global pandemic, not a genocide.
Also, nobody has shown up at the hospital yet to discover that their ailments were caused by a malfunctioning mind control chip delivered in a vaccine. Defect rates for such a "chip" if it existed would not be that low.
Of the 7,600 women who were sterilized by the state between the years of 1933 and 1973, about 5,000 were African American.
Stop lying. You come in with a false faith argument and can’t be bothered to research elementary facts.
Where is the evidence for the claim that they happened systemically 3 years ago?
"Three generations of imbeciles is enough" doesn't ring a bell for you, eh? Those who don't read history...
It is interesting how 8 years later nearly the same line of thinking took hold in the West (albeit with claim of injected mind control chips) amid anti-vaxxers.
That line of thinking always existed in the West, among the "Mark of the Beast" set. The interesting thing is the degree to which it, and conspiratorial politics in general, became so normalized in such a short time. Also how the anti-vax movement switched from a generally leftist ideology to being captured by right-wing identity politics.
The parties have realigned around populism.
Interesting how many people realigned their values instead of changing their party loyalty.
Indeed, although some of the same groups still feel supported but just not for the same reasons as before.
The actual program of sterilizing indigenous people and experimenting on black people in the US sure didn't help.
https://en.wikipedia.org/wiki/Sterilization_of_Native_Americ...
https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study
Notions of conspiracy form easily when reality provides so much material.
Israel also sterilized Ethiopian Jews without their consent
One thing that boosts conspiracy theories is the existence of conspiracy agencies in the government.
Yeah I remember hearing about this and being similarly appalled. I get it. The US really wanted to kill Bin Laden. But the manner in which they did it is sickening.
The ends cannot justify the means.
The ends cannot justify the means.
Oh they absolutely can in an utilitarian sense. But a basic utilitarian argument would tell that jeopardizing an entire region's vaccine rollout program to get revenge on some asshole already living the rest of his life out of a hole was not worth it.
And any utilitarian thinker who wanted to do the op would tell you that they weren't going to get caught, so that outcome won't be relevant to their calculus.
Is that good reasoning? No.
Is it what some humans will do? Yes.
And any utilitarian thinker who wanted to do the op would tell you that they weren't going to get caught
Then they aren't being utilitarian because they are not including the risk into their cost calculation.
Or at least not a good one. Definitely not "any"
edit:
Oh I see this now > who wanted to do the op
Yeah any person can make any false argument to justify a conclusion they wanna reach. You don't have to be utilitarian for that. Just unethical.
Given she's a health care professional I'd probably follow up with her for more of her reasoning. Has she seen it fail clinically? Is she aware of any adverse side-effects? Is it an issue with this specific brand?
Health care professional covers a huge range of people. This is not in any way meant to dismiss the incredible hard work that these people do, but health care is a notoriously low paid profession and many people have little to no qualifications. If you are assuming the “health care professional” equates to informed and well trained then I have a bridge that you might be interested in…
health care is a notoriously low paid profession
Where is that, exactly? Because it certainly isn’t in the US.
Surgeons and specialists are high paid. Regular physicians not so much. Nurses are not at all highly paid.
As a nurse I make $100/hr.
Try again.
You must be in California.. in many states, RNs are making more like $15/hr and BSNs closer to $20-$25/hr.
No, I’m not. Nor am I in any of the other high paying states you might name.
You are a travel nurse?
Median annual wage for a Registered Nurse in the US is $81K. That is way higher than the national average worker income of only $54K.
In the UK nurses appear to start around £22K https://www.nurses.co.uk/careers-hub/nursing-pay-guide/
It depends where in healthcare.
Geriatric nurses tend to not get paid well, but resident nurses in hospitals do.
It’s a wide field.
Every profession has a spectrum of quality of worker. Any health care professional is more experienced than me. What does it hurt to follow-up for clarity? Her rationale may be completely unconvincing and that's fine I can then ignore it. Or she might tell me something interesting I can keep in mind and see if it gets corroborated by other sources.
Has she seen it fail clinically?
Flu vaccine efficacy has been <50% for over a decade. Usually it floats around 30-40%. So even by the official numbers, it doesn't do a lot for groups not really at risk.
This is not a surprise: The yearly shots are for a subset of flus, created in the spring/summer for the strains they think will be most prevalent in the fall.
The polio vaccine is also clearly more effective at limiting the disease than the flu or covid vaccines (granted that this is in part just the nature of the virus).
Indeed - from my understanding, they have to "guess"timate which strains of Flu will be prevalent in a given year, if they get it right, fantastic - if they get it wrong, lower effectiveness. Of course, it's not really a guess so much as an educated assessment.
Having said that, as an asthmatic I've had the Flu vaccine every year for the last 20 or so years, and knock on wood haven't had Flu since. I also had the multivalent pneumonia vaccine a while ago, so fingers crossed!
TBH my last flu vaccine was something like 25 years ago (I am not antivax, I am just too lazy to get it) and I had "true" flu (not seasonal colds or covid) precisely once since then.
My doctor friend doesn't get flu vaccine even when recommended, because, to quote her, "in my line of work, I was already exposed to everything ten times at least". She works as an ORL expert in a big hospital, so she is constantly staring down some sick throats.
I try to get them when I remember. There's more evidence , especially since Covid open peoples eyes, that colds , flus etc can have long term effects even after they are gone.
Just to be clear, there is no vaccine for the common cold, nor has there been any evidence, such as a properly conducted study, to suggest a cold can have long term effects.
Interesting, I have many family members who work in healthcare and all who are in regular contact with patients are required, by hospital policy, to get the flu vaccine annually. They would not be allowed to clock in if they don't get vaccinated as its determined to be a risk to the patients (the Dr or nurse can easily become typhoid mary).
Here, such policies vary even across a single hospital. Some healthcare workers are required by law to be vaxed against HepB or HepA, or measles, or rabies, but flu is, nation-wide, only "recommended".
(I am not antivax, I am just too lazy to get it)
Startup idea - vaccine delivery service. Pay a fee or subscription and someone comes to your house or workplace and jabs you with flu vaccine plus any travel shots required.
Funnily enough, this was the first year I got a flu vaccine, because it was being offered basically at my door and I thought it'd be useful to have before visiting family. I still managed to get sick afterwards, just instead of a flu it ended up being a particularly bad viral cold.
Not a slight against the flu shot, just a funny tidbit since it reminded me that the vaccine doesn't make me invincible from all similar disease.
While it's just an anecdote, it's more than just a funny tidbit as an increased risk of non-influenza respiratory virus is a possible side effect of flu vaccines.
"We identified a statistically significant increased risk of noninfluenza respiratory virus infection among TIV recipients (Table 3), including significant increases in the risk of rhinovirus and coxsackie/echovirus infection" [1]
That's one of the complications in assessing efficacy: if the benefit in flu vaccine is potentially quite modest (as determined by some long-running studies [2]), and it causes an increased risk of other noninfluenza respiratory viruses, then we need higher-quality, more detailed studies to understand what's happening.
But based on the discussion of the Cochrane review it seems unlikely. [3]
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404712/
[2] https://www.cochrane.org/news/featured-review-three-updated-...
[3] https://community.cochrane.org/news/why-have-three-long-runn...
I recommend reporting them to their employer. If you don’t believe in the efficacy of vaccines, you don’t belong in healthcare. If you hold the belief outside of healthcare, that’s a right and a choice.
Flu vaccines are many times not effective. It's not like they told them to skip a tetanus vaccine. I know it became a polarised topic but we don't need to pretend like all vaccines are the same. It's possible and likely to take a yearly flu shot and still get sick: https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
CDC conducts studies each year to determine how well influenza (flu) vaccines protect against flu. While vaccine effectiveness (VE) can vary, recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to those used to make flu vaccines
How well flu vaccines work (or their ability to protect against a certain outcome) can vary from season to season. Protection can vary depending on who is being vaccinated. At least two factors play an important role in determining the likelihood that vaccination will protect a person from flu illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) how well the vaccines “match” the flu viruses spreading in the community. When flu vaccines are not well matched to some viruses spreading in the community, vaccination may provide little or no protection against illness caused by those viruses.
Compare it with something like tetanus vaccines:
Today, diphtheria and tetanus are at historic low rates in the United States. No one has ever studied the efficacy of tetanus toxoid and diphtheria toxoid in a vaccine trial. However, experts infer efficacy from protective antitoxin levels. A complete vaccine series has a clinical efficacy of virtually 100% for tetanus and 97% for diphtheria.
https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vacc...
It's not crazy to behave differently around something with 40-60% efficacy and something with 97-100% efficacy.
There is steelmanning an argument, and then there is completely changing it.
There is a world of difference between having your healthcare provider tell you "the flu vaccine has to be made in advance and often targets the wrong strain, so can therefore be ineffective even the majority of the time" vs calling the vaccine putting "junk in [your] body".
I'm not sure what was so wrong about the reply, the person I replied to said it should be a fireable offense to "not believe in the efficacy of vaccines" but the specific vaccines they were talking about have around 40-60% efficacy vs 97%+ for other types. Maybe I'd agree that they could be fired / reprimanded for addressing such topics without more rigor (and not call them junk), but the specific point I addressed I think wasn't "changing the point".
Words matter. If you tell an unsophisticated healthcare consumer a vaccine is junk, you should be fired. If you provide efficacy around different types or classes of vaccines and allow the healthcare consumer to make an informed decision, that is reasonable. It is about the information delivered and its delivery in significant matters.
Tangentially, there is no value in arguing with antivaxxers or conspiracy theorists. You might as well attempt to talk them out of their religion. Effort better spent elsewhere. Regardless, informed consent must be mandatory in a healthcare or medical setting, so the patient can make a choice with all available information. I am not arguing choice in this subthread. I’m also not willing to argue vaccine safety data or statistics.
not crazy to behave differently around something with 40-60% efficacy and something with 97-100% efficacy
Why is 50% less flu not a good thing?
This is like the sterilising argument about the Covid vaccine. It’s somehow damning for the Covid jab but not for polio.
It's that much less across all age groups, so there's even less benefit for the demographics not at risk. Plus for the past decade or so the overall efficacy has dropped even further, floating around 30-40%.
On top of that, vaccines need >50% efficacy to get approval. If the flu vaccine was invented today, it wouldn't pass.
Is it logical to assume all vaccines are equally well-made, safe and effective? By calling something a "vaccine" do we elevate it above all reproach?
The remarks about "junk in my body" is a huge red flag. That's blatantly unprofessional.
It lacks tack, IMO, but maybe there's a reason for their comment. Doesn't seem like it hurts to ask someone why they have their particular opinion vs. knee-jerk bucket them into a stereotype we have imagined and completely dismiss them.
nurses are a diverse lot. You meet plenty that could be equivalent to or sometimes more medically experience than doctors.
And then unfortunately the one you met(who is probably otherwise good at their job)
Same is true for doctors. Some good, some very bad. In fact, the same is true (don’t hate me for saying so) various other types of pharmaceutical products, including vaccines that rely on herd immunity and those that are merely “vax treatments” or whatever they’ve renamed it to in late 2023 (I think I was told that they are allowed to call it a “jab” or a “spike vax” but not a booster.)
Someone is feeding you BS information.
I’m not trying to relay information, rather was attempting to make a conceptual point which I’ll restate for clarity: the world is filled with shades of grey. Just as some doctors are bad, some vaccines are bad. You can redefine vaccines to be something that can never be bad, and imbue the word with an assumption of safety and efficacy which isn’t deserved. To the contrary we by default assume vaccines are not safe or effective until proven otherwise. Despite this obvious fact, large portions of society have allowed the definition to be altered to where we aren’t even talking about the same things. That includes various health professionals. I tend to group those vaccines that confer herd immunity and “others” and it seems to me that the wording used for the “others” is dynamic and ought not be the same as the word for those that are intended to confer herd immunity. If we used two words, the problem of anti vaxx would be partially ameliorated it seems. But people want little hills to die on.
Are you relating a stupid thing a doctor said to you? It isn't entirely clear.
who is probably otherwise good at their job
What would make you think that?
Because unless one's a researcher, their job doesn't require a fully consistent set of beliefs. Being wrong or even stupid about one area usually doesn't affect any other areas - if it does, it probably means one's spending too much time rethinking everything from first principles, when they should've long ago developed a feel for it.
Being a researcher doesn't require a fully consistent set of beliefs.
You do need to be willing to go where the evidence leads you, but that doesn't require or guarantee a fully-consistent belief system.
Calling it a vaccine (like COVID vaccine) is a problem IMO
Non-immunizing treatments should not be called vaccines, the annual flu shot should not be considered a vaccine, nor should the mRNA COVID "vaccine", for which they had to change the very definition of what a vaccine is to even include it for legal purposes.
For the flu shot it is a crap shot, as there are soo many flu variants annually they make a best guess as to which one(s) will likely because prominent based on trends and package them up, often they are correct sometimes they are not...
For more traditional vaccines like Polio and other long term immunizing vaccines society ends up suffering because of the inclusion of these short term annual or less treatments and over all is a net negative
As to " politically weaponized by AI and social media algorithms" it was more than AI and Social media that made these things political, it was the political branches of government that made it so by mandates and rhetoric that pitted people against each other. Attempting to exile people that even questioned their government masters... That is what made it political.
The problem is that they are vaccines, "vaccine" doesn't mean what you think.
The best vaccines are sterilizing, meaning that they prevent disease and transmission often enough that very high rates of vaccination extirpate the virus.
It might be useful for discussion purposes if "vaccine" meant "sterilizing vaccine" and vaccines which don't work as well had some other name, but that's not how it works.
>"vaccine" doesn't mean what you think.
yes they keep changing the definition to include more and more things legally as "vaccines" are shielded from any liability so you can not sue big pharma if they injury with their "vaccine"
this however does not change the fact that the way the law (and you) use the term is very very very different than what the ordinary person thinks and understands a vaccine to be
When this person then discovers that the government uses a different (your) "correct" definition to include things they traditionally would not think of as a vaccine this erodes trust in the entire system.
This was made very very clear with COVID.
Nobody changed any definitions - laymen started becoming interested in the topic due to obvious reasons so the CDC and others clarified some publicly facing websites but nobody involved was remotely confused about the vaccines.
If it doesn't contain cowpox it's not a vaccine. Definitions are always strictly limited to their first use, and must be studiously maintained or we'll destroy the English language.
it was more than AI and Social media that made these things political, it was the political branches of government that made it so by mandates and rhetoric that pitted people against each other
But social media did wonders at spreading & amplifying that message, since pitting people against each other in endless arguments generates lots of "engagement".
Non-immunizing treatments should not be called vaccines
What do you consider immunizing?
This comment is solely to collect internet points. Never happened. Id be money on it.
I've done pro vaccine advocacy work like testifying as a parent at bill hearings. The anti vaccination folks testifying include nurses and will be very loud about that fact. We've also had problems where a nurse doing pre natal classes turned put to be anti vaccine.
My partner works with a lot of nurses and some of them say things that are this uninformed.
Maybe she was confused with Tamiflu which only works when administered no more than 48 hours after onset of symptoms, at which point there can be no certainty it's an influenza infection at all without the expense of testing.
In direct experience a lot or nurses are dumb and crazy just like the general population. There are plenty of antivax nurses and nurses who believe in things like Kinoki Foot Pads
> I just had a nurse tell me yesterday to not take the flu vaccine because she said it doesn’t prevent flu
The flu vaccine is notoriously kinda like shooting in the dark because it's hard to predict which strain will dominate the winter.
The flu vaccine has upwards of a 30% reduction in all cause mortality in at-risk populations. It’s insanely effective even when the chosen variants aren’t ideal. People are so ridiculous, they’ll get a flu vaccine, contract a flu that makes them pretty sick and then decide that the vaccine didn’t work rather than realizing it did work and saved them from a much worse illness.
That did not happen. Uff tiresome to read the conspiracy crap on vaccine usage, all of a sudden even nurses are anti-vaxxers (or whatever rage inducing crap gets comment votes these days). I am stating the comment is for internet points only and never happened and Id bet money on it.
You should report the nurse. They could be doing real damage to community health.
I would report her to the responsible in the hospital and to the regulatory agency in your country.
I did it twice during the pandemic. In one case it was someone I trusted for many years.
Was this a registered nurse (4-year nursing degree)?
politically weaponized by AI
What is this referring to?
As someone who lived through the polio epidemic during my childhood and having seen kids die of the disease or end up in iron lungs or having to wear calipers for life, I can only say hallelujah I hope this announcement about its likely eradication ends up being true.
Indeed, it'd be wonderful to see polio eradicated. Eradication has been a decades long program; they originally aimed to do it by the year 2000, then ?, then 2018.
Even if the last stage of eradication is stubbornly slow, we have obviously been quite successful at limiting the number of cases.
Well it didn't help when the CIA got caught posing as health workers giving out polio vaccination in Pakistan.
Why that certainly didn't help, the main reason has been misconception and religious belief:
According to a study conducted in Khyber Pakhtunkhwa, Pakistan, respondents misconceived the vaccine to be capable of causing harm to the immune system (93%), triggering adverse reactions 97.5%, to be against their social and moral values (95%), and to be not as good as traditional methods for treating children 98.5%
https://www.emro.who.int/emhj-volume-28-2022/volume-28-issue...
Pakistani parents have good reason to not trust anything administered by a needle. 700 children recently contracted HIV. https://www.washingtonpost.com/world/asia_pacific/hundreds-o...
"Pakistani parents have good reason to not trust anything administered by a needle. 700 children recently contracted HIV."
Is not a good rationale for making a decision. Parents, indeed anyone, shouldn't be worried about anything administered by a needle unless proper protocols are not followed, and they always should.
That's like saying the cure for cancer is not getting cancer.
works every time.
Also works against speeding tickets. But don't tell anyone
They should pretend proper protocols are followed because proper protocols should be followed?
The outbreak of HIV in Pakistan is because of needle reuse.
Polio vaccine can be administered orally.
Yeah there was an X-Files episode where the CIA gathered DNA via polio vaccines.
Which means someone at the CIA said, “Hey that thing that happened in the X-Files, let’s do that but for real!”
It doesn't inspire confidence when your spy agencies start stealing ideas from the villain spies who got caught in a TV show from the 90s
The scheme was for hepatitis vaccinations. The article linked below just mentions that only health workers giving polio vaccines had previously been able to access the compound.
https://www.theguardian.com/world/2011/jul/11/cia-fake-vacci...
The taliban started attacking polio vaccine workers and the UN suspended operations. Polio exists in Pakistan, Afghanistan, and Nigeria
Honestly never thought i’d see the day.
Jonas Salk is one of my personal heroes. Probably the best and most selfless human I can think of. A true credit of and benefit to humanity. A stark contrast with most of today's innovators.
https://en.wikipedia.org/wiki/Jonas_Salk
Salk was immediately hailed as a "miracle worker" when the vaccine's success was first made public in April 1955, and chose to not patent the vaccine or seek any profit from it in order to maximize its global distribution.
Salk tried and failed to patent the polio vaccine because it was rejected by the USPTO as not being novel. He didn't choose not to patent the vaccine out of the goodness of his heart.
The patent was pursued by National Foundation for Infantile Paralysis who funded Salk's research.
Salk himself wasn't much in favour of a patent, stating that his techniques weren’t novel and the work was built upon the research of others.
https://www.latimes.com/business/hiltzik/la-fi-mh-polio-vacc...
All of those famous public statements by Salk occurred after his work was determined to be unpatentable by the funding agency. We don't really know what happened behind closed doors other than the normal university/nonprofit research process, which involves a lot of profiteering. The same thing happened with Sabin before that vaccine was also released without a patent (Sabin would have been a Soviet/Russian patent, so it's a slightly different system).
The famous "could you patent the sun" quote was about obviousness, not about anything else.
This runs counter to every source I've read - do you have a source for it?
There's been a lot of progress, but sadly the GPEI is still at least a decade from eradication if they are agressive... and already starting to slow down. They really need one last push, and it's becoming clear that it's not going to come from Gates or the WHO.
Dealing with vaccine-derived polio is going to be the big issue for the next decade, but projections suggest that type 1 polio will go out of control if OPV cessation happens on the desired timeline and the status quo is kept up until then.
If Ken Griffin or Jim Simons (or any hedge fund guy) wants some extra karma or has beef with Bill Gates, this is probably an $X billion project in total, but it seems to need someone who can out-asshole Afghan warlords and is willing to crack a few skulls to get it done.
it's becoming clear that it's not going to come from Gates or the WHO.
Wasn't the gates foundation a big promoter of this? I thought it was one of their main focuses.
Publicly, the Gates foundation wants to take credit for polio eradication, but they never seem to want to actually spend the money on the things that are required for polio eradication. If you look at the modeling results, Gates and the WHO manage to do less than the minimum required to have a decent chance of "turning the corner," while also doing a lot of fun science projects like making a new version of OPV.
Gates himself moves between a lot of different "current things" - it was polio 15 years ago, then it became malaria, and now it seems to be the climate (with a brief stopover on COVID).
I wasn’t familiar with the term calipers outside of the measuring tool. For anyone else wondering, it refers to the leg braces used by those who have polio induced nerve damage and subsequent muscle weakness (poliomyelitis).
I wasn’t familiar with the term calipers outside of the measuring tool.
It also refers to the part in disc brakes which holds the brake pads and squeezes them together onto the rotor.
We may be of a similar age cohort.
I vividly recall my parents' mounting anxiety as three of our neighborhood kids were stricken and put in iron lungs. One died (age 4), two recovered (ages 5 & 6) after around 6 months in hospital. I've kept track of one - she's 74. In her 50s, she developed muscle degeneration as part of post-polio syndrome. Wrecked her ability to live independently.
I got both the Salk and the later Sabin vaccine. That took a huge weight from my parents' spirit, improved our family dynamics.
I'll track this story. I deeply hope for polio to follow smallpox into oblivion.
When I was a kid a friend of the family was a polio survivor. It definitely made an impression on me. Polio is truly horrific. Eradicating it will truly be one of humanity's great achievements.
> Only one human disease has so far been declared eradicated: smallpox
I was reading a post by someone, a few years ago, lamenting that we had “killed” a virus.
I am not 100% sure they were being serious, but they gave every indication that they were.
In any case, I’m sure that some bioweapons lab, somewhere (like, maybe, in Frederick, MD) has samples of the virus, “just in case it comes back.”
Don't need to wonder, the US and Russian (Soviet at the time) have made it public that they keep samples of smallpox.
https://en.wikipedia.org/wiki/Smallpox_virus_retention_debat...
Ostensibly this serves a purpose beyond the MAD incentive, having stocks of the virus on hand makes manufacturing the old style smallpox vaccine easier should the need ever arise in the future. As we saw with monkeypox last year there is much more limited capacity for more modern pox vaccines due to the more advanced manufacturing process and limited demand.
Someday soon we’ll just be able to sequence its genome and reconstruct it without needing to keep samples alive (and no longer have the risk with all the maintenance and security protocols that will entail).
Of course however we store that genomic code had better be on physical media in a sealed vault that isn’t even within spitting distance of anything with an internet connection.
Oh, we already sequenced it awhile back. As for physical media, that's not exactly what happened... https://www.ncbi.nlm.nih.gov/nuccore/NC_001611.1?report=fast...
I kinda doubt there's not some critical "mutation" in there that'll prevent it from replicating.
Someday soon we’ll just be able to sequence its genome and reconstruct it without needing to keep samples alive
That's already been done, I think.
Some guy did a chimeric horsepox by ordering stuff off GeneArt and IDT.
Yeah, as you allude to in your parting sentence, I'm not sure if this idea makes me more or less secure. Chance for accidental infection at the storage facility goes way down, but should the sequence ever leak to the internet chance for accidental infection from some stupid amateur biohacker goes way up in my opinion, and that's before we get to purposeful infection.
If it's going to be preserved, I think I'm happier with it not being digital and stored in highly secured areas by professionals, but perhaps the threat model in my head isn't accurate enough.
Is that really true? Don't epigenetics play a factor here?
The alternative is what we've seen with COVID-19, where they had to take samples and spent months devising a vaccine. That said, that one advanced vaccine technology by a lot, and I think it was a record speed for developing a vaccine.
That is, if smallpox or another new disease shows up, I hope that vaccine development will be quicker and quicker.
I’m old enough to have a smallpox vaccination scar on my arm.
I never got one since the doctor didn't like the look of a birthmark on my arm. I don't have that puffy scar. My sister got one though.
Damn I just though I could have been a left arm bicep model.
Many variations of the full genome are available online, and current technology makes it feasible to synthesize de novo.
Just in case you didn't have enough things to worry about!
Ready for the AGI. Just needs some wrapping paper and a ribbon.
Don't even need AGI. Some idiot will do it sooner or later.
Keeping samples is honestly a good thing as it allows for further research into the virus should it ever mutate and come back.
It’s only 186ish megabases. There are a few facilities that could re-create it, given sufficient time and budget.
Well, there are still 12 other viruses in the genus (including one newly discovered in 2015 and the monkeypox outbreak of 2022-2023) so I think we are still good on source genetic material. Still possible for one of those species to evolve to be more virulent and deadly...
The sacredness of every species is a fundamental belief for many people!
My dad is a severe paralytic polio survivor and turns 70 next year. He’s a happy man, but his life has been hard in incomprehensible ways. As a father now, I cannot imagine what his parents went through when he was paralysed in the hospital at the age of 2. The world will be a better place without the fear of polio. Let us hope.
I wish we would also figure out how to fix people damaged in this fashion rather than accepting that you will just be maimed for life.
What are you referring to peiple accepting? That polio has no cure, or that we we don't know how to cure paralysis due to nerve and motor neuron destruction?
The former I think people accept because if we can eradicate it through vaccination then it's a problem solved, so we are working towards that. The latter I don't think anyone actually accepts, it's just a hard problem and progress is slow.
You tend to hear mostly about research into repairing nerves damaged due to injury. It seems to me that a broken neck would be a harder thing to fix than neurons impaired by infection.
It seems likely to me that if you can identify the nutrients depleted by the infection and also actually clear the infection from the body, this should be relatively easy to repair compared to something like a broken neck.
I did a quick search ("are there any organizations working specifically on polio paralysis" on Bing) and most hits are about the news currently under discussion, not about research into treating the paralysis. I did find this page on The Christopher and Dana Reeve Foundation site:
https://www.christopherreeve.org/todays-care/living-with-par...
They indicate there are a lot of studies on Post Polio Syndrome, which is not per se research into treating paralysis. Some stats from the page:
Over 12 million people, worldwide have been affected by polio as indicated by the CDC.
There is no central system for reporting post-polio syndrome, but it is estimated that 300,000 individuals are survivors of polio in the United States and have mild to severe symptoms.
Of the 300,000 survivors of polio, it is estimated that of one fourth to one half may develop some form of post-polio symptoms.
It seems to me that a broken neck would be a harder thing to fix than neurons impaired by infection.
Does it? We're still unable to cure MS, just slow or stall the progression of it.
Yes, it seems to me that way.
AKA personal opinion.
I think your intuition is probably a bit backwards in this case. Viruses (especially ones like Polio) wreak havoc. A broken neck is mostly "superficial", in that the connection is severed but the underlying structures can be mostly undamaged. Polio is destroying motor neurons throughout the CNS, including the brain (which in general is always going to be the hardest organ on which to perform any interventions).
But even when a virus is not targeting the CNS, generally they have the ability to do a lot more lasting damage than blunt force trauma, as a virus can cause DNA mutations / changes at a sub-cellular level, which you will not see from BFT.
Compare it to a skin issue. Which is more difficult to treat: a large blister caused by touching the hot stove, or a blister caused by herpes?
I live with a serious genetic disorder and deal a lot with illness. I've pursued a lot of alternative remedies to cope with a condition Western medicine can't fix.
In my experience, viral infections aren't that hard to treat and I no longer get fever blisters (which happen to be caused by herpes, coincidentally). There are lots of natural antivirals out there and this was common knowledge on an email list I once frequented which no longer exists.
I list it as my personal opinion not to say that it's merely a wild-assed guess based on nothing in particular but to say that you aren't going to change my mind and I don't have any sources to cite and don't wish to get into an argument over it.
Herpes is a normally-dormant virus that, when it flares up, causes those annoying blisters, until it goes dormant again. Tons of people have this problem, it's extremely common (this virus causes cold sores, canker sores, etc. Probably most of the population has this virus.). So sure, if you can find some kind of antiviral that suppresses or kills the virus, you can avoid those blisters. And luckily, the effects of herpes simplex are almost always minor and temporary in nature, not life-changing.
What we're talking about here with polio isn't suppressing or eliminating a virus, we're talking about fixing damage caused by a viral infection to the CNS. At this point, the polio virus isn't even a problem: people who recover from it don't have the virus anymore, they're just stuck with the damage it's caused, much like people today with "long Covid". This isn't something that's going to be easy to fix.
I never said it would be easy to fix. Saying "X seems easier than Y" is not saying "X is easy!"
We've been on the brink of eradicating polio for something like 60 years.
And then vaccine manufacturers across the world fuck up and cause an outbreak.
This is one of those cases that I have no sympathy for the hype piece, no sympathy for "the science", or the pharma companies making bank off of keeping this thing rolling. Only sympathy goes out to the people hurt by polio and human idiocy.
then vaccine manufacturers across the world fuck up and cause an outbreak
What?
In recent decades, infection from vaccines based on the live virus, instead of the killed virus, has been a primary source of outbreaks. The usual mechanism: Someone who was never vaccinated changes the diaper of a child who has gotten the live vaccine, gets exposed, gets sick.
Many years ago on Sixty Minutes, an elderly man who changed the diaper for his grandchild caught it and diagnosis and treatment was delayed because the doctor literally said something like "Decades ago, I would say this was polio. You have all the symptoms." and didn't consider that was possible because "we've eradicated it."
How is that vaccine manufacturers fucking up? Also, this is literally what this article is about.
(And we use the non-sterilising, non-virus containing non-polio-producing IPV in the United States. So the unvaccinated can change babies’ diapers without fear.)
(And we use the non-sterilising, non-virus containing non-polio-producing IPV in the United States. So the unvaccinated can change babies’ diapers without fear.)
Not necessarily. All those migrants coming into the country? Mostly they got the cheaper OPV vaccine, if they got any. There was a case of it last year in New York: https://www.cdc.gov/vaccines/vpd/polio/hcp/vaccine-derived-p...
I'm not suggesting it is. But "What?" is hardly a rebuttal a la "That's not a fuck up." So I explained what I think the OP likely is referring to because you sounded to me like you had no idea what they meant.
I'm not sure what exactly GP is referencing, but maybe it's the rare cases when the weakened virus in OPV mutates and someone excretes infectious, vaccine-derived poliovirus. I still don't see how that's the fault of the vaccine providers, since it's due to mutation and not a mistake in production of the vaccine, and OPV is a reasonable thing to use and certainly better than doing nothing.
Apt. Took the kids for vaccinations this morning and was telling kiddo last night about how amazing vaccines are and how polio doesn’t exist anymore because of it. Sounds like I was technically wrong, but practically right.
I also told him how amazing it is that when I was his age, I had the chickenpox, but that he will never get it because they developed a vaccine for it.
None of this helped him today with not freaking out over getting a shot, but hey, I tried and I made it clear why I had to hold him down. Sometimes, irrational fears win. We’ll get there, he’s just a kid.
Sometimes, irrational fears win
IMHO it's quite natural to have an aversion to being pierced.
Of course it is! That’s why I have nothing but love and patience for my son. But we usually learn to put that aversion aside when we understand that it’s for a good reason. That part takes time and maturity.
My kids are into superheros. We explained how vaccines are basically super powers! Now they are sad when they go to the doctor and don’t get one they also get all their friends and class mates pumped about vaccines which I take as a win
In a real sense, vaccinations are superpowers. Immunity from pestilence was historically taken, across cultures and for obvious reasons, as signs of divine influence.
I had no idea there was a chicken pox vaccine. That’s awesome.
Even awesomer - the vaccine also helps prevent shingles - which many many people get after middleage.
Brian is at high risk of shingles, and Logan isn't. https://xkcd.com/1950/
I got the chickenpox vaccine as a kid, but still managed to pick it up a couple of years ago - efficacy wanes as you age apparently, and it had been over a decade since I’d been vaccinated. So, there’s still the possibility :D
I'm from Pakistan, and polio eradication has been frustrating to say the least.
Polio teams workers still get killed regularly, and in fact, in searching for news on polio workers, discovered tragically that one worker was killed just today:
https://twitter.com/TNNEnglish/status/1727695070906957889
and polio vaccination drives have been delayed in other areas too (separate from the unfortunate incident above)
https://twitter.com/MajidBuhair/status/1727755867666452722
I mean what can I say of others, back in my own extended family, I have cousins who refused to vaccinate their kids at all, like no vaccine of any kind, and nothing I or anyone can say will change their mind. Thing is that they are not illiterate, they have been to schools, they are just.. stubborn.
That means attack vectors exist in all directions.
I personally discovered this the hard way when I randomly caught a case of mumps despite having been vaccinated as a child with the MMR vaccine (my dumbass doctor thought I had "mild-tonsillitis" and sent me home with antibiotics) Not sure where I caught it from but thankfully it was mild and I recovered after 10 days of absolute misery.
But the moral of the story is, not only is polio unlikely to be eradicated, but even people like me who thought they were covered by vaccination from dutiful parents, are still vulnerable to all these diseases, either as patients or carriers.
Our vaccination drives are not forming effective vaccine shields, and that means we have to think of treatment and not prevention as the "first" step of our fights against diseases.
____
> The result came back a month later: it was wild polio type 1, not seen in the continent since 2016.
> Sequencing traced its origin to Pakistan, but also revealed that the virus had been circulating for two years undetected — possibly in Malawi, and possibly elsewhere. Because Malawi had no wastewater surveillance at the time, it was impossible to know.
I have done some work with Kids Risk (quoted in the article) in the past, and it's been an interesting journey to watch Pakistan. The Osama bin Laden raid really screwed the GPEI in 2010 and still has knock-on effects. Thankfully the Pakistani health ministry is finally getting serious about polio again, but it's tough to rebuild that level of trust. The Taliban in Afghanistan also used to be good at vaccination, but that also changed with bin Laden.
Yep. They are 100% correct that vaccine drives can be hijacked by geopolitical enemies. It is not an unreasonable fear.
Before 2010, they didn't used to get hijacked like that despite the risk. There was a bit of a gentleman's agreement about organizations like MSF, UNICEF, and the GPEI. These sorts of NGOs got a lot of access in many countries because they were "off-limits" for espionage.
There's not a terrible chance (although I would give it less than a coin flip) that the CIA hasn't developed any assets in any of these medical NGOs since then, but the illusion has been shattered with the one incident.
even people like me who thought they were covered by vaccination from dutiful parents, are still vulnerable to all these diseases
I was surprised to see that some of the vaccines I thought are rock solid share some traits with the great COVID vaccines: not everyone develops immunity, and the immunity gets worse and worse over time, so you need "boosters" every 5-10 years, and most adults have very little actual protection against the diseases they thought they are vaxxed against.
Example, whooping cough:
In children, DTaP protects: > (...) About 7 out of 10 children for five years after the fifth shot. > In adults, Tdap protects: > About 7 in 10 people for the first year after the shot. > About 4 in 10 people for four years after the shot.
https://my.clevelandclinic.org/health/drugs/21639-pertussis-...
These numbers don't look all that great to me.
What I saw on Pakistani TV/newspapers was people complaining that government just wanted them to get tika (vaccination) but wouldn’t listen to them about anything else or fix any of their other problems (roads, schools, jobs)
For some added context on the vaccine distrust:
In the early 2010s, the CIA ran a fake vaccination program in Abbottabad, offering free Hepatitis B vaccines to children in an attempt to collect DNA evidence linking Osama bin Laden to the compound where he was suspected of residing. It is unclear how samples were to be collected or how they would lead to bin Laden, but when news of this scheme broke, it added proof to existing conspiracy theories about vaccinations. As a consequence, many local leaders began urging people not to vaccinate their kids, various districts banned vaccination teams, and the Taliban issued a fatwa against vaccination programs. To this day, local leaders rail against vaccines as Western spying programs.
- https://www.vox.com/first-person/22256595/vaccine-covid-paki...
Don't worry, Rockland County NY will ensure it remains "on the Brink" indefinitely.
Since I had no idea what this referred to: "the county has the largest Jewish population percentage of any U.S. county".
So looks another "(((them))) in (((control)))" bollocks.
Rockland County recently had an unvaccinated man paralyzed by polio, despite the disease supposedly being eliminated from the US in 1979. https://www.chop.edu/news/2022-ny-polio-case-why-and-what-do...
There's a large concentration of ultra-orthodox Jews living there that don't vaccinate for anything on religious grounds. As a result the county is notorious for essentially being a living archive of otherwise eliminated diseases, in particular they have outsized issues with any disease that could be dealt with through vaccination.
All of this is on the first page of google search results for "Rockland County polio", but thanks for not doing even that much and jumping straight to "hmm, lots of jews live there, this guy must be a neonazi!".
As the original article explains, whilst the inactivated polio vaccine used in developed countries like the USA does provide good protection against being paralyzed by polio it's not terribly effective at preventing transmission. So it's not actually all that clear whether Rockland County's attitude to vaccination will impact anything other than the people living there in this case.
All of this is on the first page of google search results for "Rockland County polio", but thanks for not doing even that much and jumping straight to "hmm, lots of jews live there, this guy must be a neonazi!".
I look up "Rockland County"; I see a bunch of things that specifically mention it being Jewish. So okay, what am I supposed to assume on a topic that 1) has nothing to do with Jews, but which 2) has a long history of conspiracy theories attached to it, which sometimes includes Jews (because all conspiracy theories do)?
I did not think of a list of search queries I could possibly do in order to find some obscure event I didn't know existed.
If you don't want people making assumptions then try being less vague in your references to some obscure little-known non-obvious event, because "making assumptions" is pretty much the only think anyone can do with a cryptic comment like that unless they're already aware of what you're on about.
Its probably about a particular subculture within the Orthodox Jewish community in that county that leads to certain environments (notably, private schools in that community) having vaccination rates persistently below the level needed to prevent outbreaks of several diseases that are controlled by vaccination otherwise, not about any kind of deliberate plan or other conspiracy theory, antisemitic or otherwise.
https://kffhealthnews.org/news/why-measles-hits-so-hard-with...
Polio virus isn’t close to eradication and people who work on it are coming to the conclusion that it probably never will be unless a different sort of vaccine is created. [0]
Polio the disease caused by polio virus could be eradicated with widespread and continuous vaccination.
The problem is the current vaccine used in most places around the world is an attenuated live virus vaccine.
It gives the recipient immunity by infecting them with a strain that doesn’t cause disease in most people but is still able to replicate in the gut and spread to others and eventually reverts to being able to cause disease. So anyone who isn’t vaccinated can still get the reverted vaccine strain. The most common cause of polio outbreaks now is the vaccine strain.
In rich countries they use an inactivated vaccine that works great against disease and can’t become virulent but is expensive, requires more infrastructure for delivery (needles etc), and doesn’t give enough immunity to prevent spreading the virus if infected.
There are possible solutions to all of these problems but they require research and the eradication campaigners are making research more and more difficult by restricting which labs can work on polio research.
The podcast TWiV is hosted by the guy who first figured out the Polio virus genome and they frequently discuss it. The episode below is about a new attenuated vaccine that was recently created with hopes of not reverting but even it has reverted in some small number of cases.
0: https://asm.org/podcasts/twiv/episodes/driven-to-immunodistr...
All of that, and the strategies used to combat it (including a better oral vaccine), are described in detail in the article.
How dare you assume someone who didn’t read the article and then unknowingly posted contents from the article didn’t read the article lol
If it helps with the pain of downvotes, I appreciated your sarcasm.
Both the headline and the article imply that eradication is possible. Being "on the brink" even makes it sound inevitable. But eradicating the virus probably isn't possible and I think it's important for people who only read headlines and comments to understand that and why it's the case.
eradicating the virus probably isn't possible
Every domains expert disagrees. That most people get the non-sterilizing IPV is not a secret. Switching from the sterilizing, but virus-producing OPV to the non-sterilizing, but non-spreading (and more expensive) IPV is a well-run playbook.
Yes, it means when an unvaccinated nutter from Brooklyn gets polio in Europe [1] that it spreads--inefficiently and without further consequence--through the vaccinated population. But those are edge cases which are diminishing in frequency as we switch from OPV to IPV on the periphery.
First we eradicate the wild type. Then we eradicate the weaker vaccine-derived virus. It's a simple, precedented and achievable playbook. All we have to do is keep vaccinating (and keep our poop water away from our drinking water).
[1] https://www.cnn.com/2022/07/21/health/new-york-polio/index.h...
DON'T JINX IT!!!
I've been visiting https://polioeradication.org/ over the years, and every time I get my hopes high, discover more polio cases or polio-positive samples are discovered :(
They have a regularly updates summary: https://polioeradication.org/wp-content/uploads/2023/11/week...
And the most recent case was on Oct 15 in Pakistan.
I suspect science has had more to do with the reduction than superstitions like jinxes.
Some people play lip service to superstitions like this as a form of fun or a way to communicate feelings on a topic, and not necessarily because they believe the superstitions.
For example, if I followed up a statement with "knock on wood" it wouldn't be because I believe it helps, or expect anyone to actually take that physical act (I probably won't unless to emphasize my feeling more), it's to convey I hope something succeeds or does not fail in a way that provides a lot of context in a small amount of words.
Jinxing means you hat people might consider the problem solved and pay less attention to it.
I pray to god people let go of their superstitions.
From the article, wild polio cases have been less than 50 per year for the past 3 years, but vaccine derived cases have been 300 - 900 per year. The details in the article as to why this is are interesting and alarming.
It just shows that a lot can go wrong in this process and good intentions are not enough.
Well, during the 80's there were 300,000 to 400,000 cases worldwide per year[1], so I have a hard time seeing how this is bad thing.
details in the article as to why this is are interesting and alarming
Why is it alarming? The sterilising vaccine produces vaccine-derived polioviruses. The non-sterilising type does not.
First you sterilise, then switch to non-sterilising as the wild type is eradicated. It’s a precedented playbook which makes it the opposite of alarming.
Polio would likely be eradicated already, if not for a CIA op that used a vaccination program as a cover to get DNA from bin Laden.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
As a result part of the Afghan and Pakistani population stopped believing in what WHO workers told them.
The CIA thing was bad, but absolutely not the cause of eradication failure. That's 100% becuause type 2 polio is REALLY good at mutating and changing the OPV version to an infectious version.
The CIA operation was definitely a setback for polio eradication and doubtless caused other harms to public health, but the article this thread is about discusses numerous challenges to eradication so I suspect even without the CIA campaign, we’d still be a ways away from eradication.
Polio is coming back, a little.[1]
There are two polio vaccines. One takes four injections, spaced months apart, and cannot cause polio because it doesn't contain an active virus. The other is a live-virus vaccine, as a pill, and has about a one in a million chance of causing polio. These are both 1950s technology.
"For most people, (polio) has no symptoms. For about a quarter of people who get the polio virus, they will have mild symptoms that may include fever, gastroenteritis, upset stomach, aches, and so-on—in other words, flu-like symptoms. Most people would not know they have a polio infection because those symptoms are so common to many other infections."
"Somewhere around one in 200 to one in 1000 people that get infected with the polio virus will develop poliomyelitis, which is also known as paralytic polio or acute flaccid paralysis but can also include presentations that are less and more severe, including delayed post-polio syndrome with mild disability or acute respiratory failure and death."
Those who are not suffering still spread the disease.
What happened when the anti-vaxxers reached Pakistan.[2]
[1] https://medicine.yale.edu/news-article/is-polio-making-a-com...
You mean the CIA reached Pakistan.
The CIA’s efforts to capture Osama bin Laden via a fake vaccination drive in Pakistan led to a rise in vaccine hesitancy in the years after the scheme was revealed.
https://www.newscientist.com/article/2277145-cias-hunt-for-o...
Polio is coming back, a little
This was a valid question in 2022. I don't think it's the case anymore in 2023. We seem to have eliminated it from the African continent. At this point, it's contained to Pakistan and Afghanistan. One of those is cooperating with vaccination efforts; the other is effectively quarantining itself.
Slightly OT:
A kid once told me that when he was about 8 he went to visit his grandparents, who live in the desert. He played outside, alone, for awhile. When he returned, he had an odd mark on his arm.
His grandparents told him it needed immediate attention, and brought him to the hospital.
The guard who inspected their car at the hospital parking, told them not to leave the car and to keep the windows up. Within a few minutes, several men in "Corona suits" escorted them all into a closed room, and left them for a few hours.
The docs then came and told the child and his grandad, that the marks looked liked the bubonic plague, and so they immediately quarantined them. The fact that they are both alive and healthy three hours later, implies that it is something else, so they will now get regular treatment.
I have no way of verifying the story but I imagine it is true (though perhaps not recalled 100%, he was 8 at the time).
It reminded me just how close we really could be to having another worldwide plague.
I feel like I've been reading optimistic articles about this for many years and it seems the last 1% of the work is still elusive.
Look at the chart in TFA: 2022 is in line with 2017.
Still: there is progress, even the current numbers are already incredibly low. This is already a story of success, even if the "brink" is still a bit off.
First polio cases linked to new oral vaccine detected in Africa: https://www.science.org/content/article/first-polio-cases-li...
Unfortunately, I believe the vaccine-type cases won't be eliminated for decades or maybe centuries...
Stopping vaccinating populations with oral polio vaccine tends to make cases trend upwards, and the only fix for that I suspect is to change over to injectable vaccines for a whole generation of people (ie. 50 years).
To viruses and bacteria the human body is like a buffet table. If one virus is eliminated, another virus will evolve to take its place. Already we have acute flaccid paralysis, a disease with the symptoms of polio that is not caused by the polio virus. Although we can celebrate our successes, we shouldn't imagine we can eliminate all childhood diseases through vaccination programs.
What about Pakistan, Afghanistan and Nigeria?
That is great news. I sincerely hope we continue that trajectory. I am afraid at the uptick of recent antivaxxers but hopefully that is just temporary.
I went to the ER recently and saw an orthodox jewish kid in a polio bed. I felt so sad for him. (This was in NYC).
What about the scourge of forced/economic-imperative based labor and social murder?
After seeing news about a rise in polio cases last year I immediately looked at my vaccinations.
Turned out I was a few years overdue for a 10 year booster (which was immediately remedied).
Their imagined future resurgence scenario -- someone in a lab gets infected, then travels abroad -- highlights one of the reasons developed countries need to help less developed countries: Out of enlightened self interest, not "charity" nor "the goodness of their hearts."
We currently are de facto breeding antibiotic resistant infections in places without adequate sanitation or water infrastructure and you can go from pretty much anywhere on the planet to pretty much anywhere else these days in 24 hours or less. When people from developed countries get sick while someplace else, they are often medevaced out to get them good care in a modern facility, thereby potentially exposing people in their country to whatever they have.
We need to do a better job of providing basics like adequate water infrastructure worldwide if we want to be free from such diseases in our cushy developed countries.