6 ms·

At an earlier stage, this work attracted a fair bit of methodological controversy, e.g. https://www.vox.com/2015/7/24/9031909/worm-wars-explained https://www.v

At an earlier stage, this work attracted a fair bit of methodological controversy, e.g. https://www.vox.com/2015/7/24/9031909/worm-wars-explained https://www.vox.com/2015/7/24/9031909/worm-wars-explained https://statmodeling.stat.columbia.edu/2015/08/18/macartan-humphreys-on-the-worm-wars/ https://statmodeling.stat.columbia.edu/2015/08/18/macartan-h...

jessaustin 6y ago
Presumably the 2019 Nobel Prize committee had seen that criticism? Frankly I'm appalled that intestinal worms still plague so many human beings. I happily spend about $50 a year to worm a herd of horses, a herd of cattle, and a dog. Surely as a species we can find the resources to buy these children some pills, at least until we cowboy up and eradicate these worms from our planet entirely.
- DaiPlusPlus 6y ago
  > Surely as a species we can find the resources to buy these children some pills We did: it's called universal healthcare - and many of our species' nation-states already use this system and have been seeing the overall positive results for about a century now - but some societies, for a variety of reasons, do not.
  - jessaustin 6y ago
    One supposes Kenya and other, poorer nations in Africa will appreciate this advice, and then they'll snap their fingers and all will be well...
    - neves 6y ago
      I think the parent was talking about the USA.
      - refurb 6y ago
        It's actually relatively straightforward to get Medicaid coverage for children in the US. There is a specific program to cover them (and pregnant women). https://www.medicaid.gov/chip/index.html https://www.medicaid.gov/chip/index.html "The Children’s Health Insurance Program (CHIP) is a joint federal and state program that provides health coverage to uninsured children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage."
        tialaramex 6y ago
        I appreciate that for many Americans this feels like it's enough, or at least almost enough, but it's nowhere close. Dozens (every US state and territory is handled separately) of separate systems in which you can fill out a bunch of paperwork to apply to have insurance for children is nowhere close to the zero friction "free at the point of use" goal of universal healthcare. Some countries with universal healthcare don't do a great job of achieving zero friction, but they're all way ahead of a disjointed paperwork process that only results in getting insurance that ought to have been free for everyone from the outset. And, one of the most obvious problems is: CHIP only covers children you can provide an SSN for. So maybe Steve, aged 4 is covered because you had him in San Antonio but his older sister Esther was born in Mexico and travelled over the border with you. She can't get CHIP because she doesn't have an SSN and powerful people want to make sure it stays that way.
        tristor 6y ago
        Esther’s situation is problematic, but extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies that supporters of single-payer universal healthcare would like to model the US system on. I am not going to enumerate all the reasons why it’s a nonstarter, but at least one is that it massively increases the cost of any such social program to a point it becomes both practically and politically untenable. I’ve visited and used healthcare services in many of those other Western countries as a foreigner, and every single time I was required to file paperwork and pay a deposit in cash (or rarely by card) before receiving services. I would not have expected any differently, as I’m not a tax-paying citizen in those countries. On a mostly unrelated note, I write this while currently residing in San Antonio (as used in your example scenario).
    - alex_anglin 6y ago
      How does this demonstrate the universal healthcare doesn't work?
- aaron695 6y ago
  I image you also give your animals nutrient supplements. If, and that's a big if, as a species we can find the resources to buy these children some cheap pills then it's not necessarily worming tablets. But it's complex, people love the idea of de-worming kids. It sells well, and once you open up aid to communities then you can do a lot of other stuff. It's not the 50 cent pills it's the $1000s finding them and training someone to get to them, so tomato tomato who pays for that.
  - jessaustin 6y ago
    I agree, international aid is problematic. Much better would be improving "gene drive" tech to the point that we wipe out helminths completely. That seems a few decades away, and in the meantime maybe lives can be improved via other methods.
    - eaandkw 6y ago
      Not that I am in favor of parasitic worms or anything but I would be careful to assume that erraticating helminths or any species for that matter would only be beneficial. I don't know where they fall in the food chain. Maybe they are essential for some other species to thrive that we depend on.
      - jessaustin 6y ago
        ...any species... There are at least 300 species from multiple phyla that feed on humans. We might also consider those species that feed on our livestock, although such an action would have less ethical urgency. It isn't impossible that other species might eat them, but given their baroque life cycles it seems quite unlikely that any other species depends on them for survival. But sure, if people decide to start with tests on isolated tropical islands, I won't argue.
      - taneq 6y ago
        Compared with the thousands of species that go extinct every year as a normal part of evolution, much less the tens or hundreds of thousands of species currently being wiped out by human activity, surely wiping out small group of species is not that big a price to pay for ridding humanity of a truly horrible affliction?
- setgree 6y ago
  I'm sure they did! Kremer is a really important figure in the history of economics, and the magnitude of the effects of his work on deworming are debatable. These things are perfectly compatible. I think the articles I posted might help readers form their own conclusions about the work, rather than deferring on account of Kremer's prestige and authority; per Feynman, "Science is the belief in the ignorance of experts." [0] Regarding the fact that it's appalling that so many people still deal with this problem -- I agree. As Gelman says (second link I posted in GP), the reason that magnitude of effects is important is opportunity costs: > The 800-pound gorilla in the room is opportunity cost, or cost-benefit analysis. As you say, who could be against de-worming kids? I’m reminded of Jeff Sachs’s argument that all of these sorts of interventions are worth doing, and that rather than trying so hard to rank the cost-effectiveness of different health and economic interventions, the rich countries should just kick in that 1% of GDP or whatever and do all of them. I’m not saying Sachs is necessarily right on this, I’m just saying that most of the discussion seems to be on traditional statistical grounds (Is there an effect? Is it statistically significant? Has it been proven beyond a reasonable doubt?) and the cost-benefit or opportunity cost calculations are implicit. [0] https://news.ycombinator.com/item?id=23816584 https://news.ycombinator.com/item?id=23816584
- triceratops 6y ago
  How do you spend so little? My dog's monthly heartworm medicine alone costs $5/dose.
  - Shog9 6y ago
    Dog heartworm pills are a MASSIVE rip-off. The active ingredient - ivermectin - can be purchased without prescription at any farm supply shop in sufficient quantity to last several dogs' lifetimes with plenty to spare. The maintenance dosage is miniscule. Pet prescription meds are only slightly less of a scam than human prescription meds.
    - rubyron 6y ago
      I’m a retired DVM. What you say is true, but I just want to caution anyone reading this that ivermectin is deadly for collies and many herding breeds. Rule of thumb is “white feet, do not treat.”
      - krustyburger 6y ago
        Please don’t be offended, but I find this absolutely fascinating. Abstractly I know veterinary science is at least as complex as anything involving humans. But somehow I tend to dismiss just how much variability a veterinarian is expected to be able to account for.
        fsckboy 6y ago
        please don't be offended but if you find yourself saying "please, don't be offended", LPT, you can generally reword what you are about to say so it's simply a compliment instead of containing the negative messsage. You are impressed by how much variation a veterinarian must account for in a single species, and they handle multiple species.
        deleted 6y ago
        [deleted]
- erikerikson 6y ago
  Please see [0]. Many people do find the money to buy those children pills. Pretty sure the study is tracking the consequences of that intervention. You could give a little as well to help make it even more broadly effective. So could the readers of this comment. In fact, please consider doing so. [0] https://www.givewell.org/charities/sci-foundation https://www.givewell.org/charities/sci-foundation
  - setgree 6y ago
    Perhaps of interest: GiveWell touched on the ‘Worm Wars’ here: https://blog.givewell.org/2016/12/06/why-i-mostly-believe-in-worms/ https://blog.givewell.org/2016/12/06/why-i-mostly-believe-in...
    - Tyr42 6y ago
      Does this new paper change the conclusions or decisions made by give well?

jessaustin 6y ago

Presumably the 2019 Nobel Prize committee had seen that criticism? Frankly I'm appalled that intestinal worms still plague so many human beings. I happily spend about $50 a year to worm a herd of horses, a herd of cattle, and a dog. Surely as a species we can find the resources to buy these children some pills, at least until we cowboy up and eradicate these worms from our planet entirely.

DaiPlusPlus 6y ago
> Surely as a species we can find the resources to buy these children some pills We did: it's called universal healthcare - and many of our species' nation-states already use this system and have been seeing the overall positive results for about a century now - but some societies, for a variety of reasons, do not.
- jessaustin 6y ago
  One supposes Kenya and other, poorer nations in Africa will appreciate this advice, and then they'll snap their fingers and all will be well...
  - neves 6y ago
    I think the parent was talking about the USA.
    - refurb 6y ago
      It's actually relatively straightforward to get Medicaid coverage for children in the US. There is a specific program to cover them (and pregnant women). https://www.medicaid.gov/chip/index.html https://www.medicaid.gov/chip/index.html "The Children’s Health Insurance Program (CHIP) is a joint federal and state program that provides health coverage to uninsured children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage."
      - tialaramex 6y ago
        I appreciate that for many Americans this feels like it's enough, or at least almost enough, but it's nowhere close. Dozens (every US state and territory is handled separately) of separate systems in which you can fill out a bunch of paperwork to apply to have insurance for children is nowhere close to the zero friction "free at the point of use" goal of universal healthcare. Some countries with universal healthcare don't do a great job of achieving zero friction, but they're all way ahead of a disjointed paperwork process that only results in getting insurance that ought to have been free for everyone from the outset. And, one of the most obvious problems is: CHIP only covers children you can provide an SSN for. So maybe Steve, aged 4 is covered because you had him in San Antonio but his older sister Esther was born in Mexico and travelled over the border with you. She can't get CHIP because she doesn't have an SSN and powerful people want to make sure it stays that way.
        tristor 6y ago
        Esther’s situation is problematic, but extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies that supporters of single-payer universal healthcare would like to model the US system on. I am not going to enumerate all the reasons why it’s a nonstarter, but at least one is that it massively increases the cost of any such social program to a point it becomes both practically and politically untenable. I’ve visited and used healthcare services in many of those other Western countries as a foreigner, and every single time I was required to file paperwork and pay a deposit in cash (or rarely by card) before receiving services. I would not have expected any differently, as I’m not a tax-paying citizen in those countries. On a mostly unrelated note, I write this while currently residing in San Antonio (as used in your example scenario).
  - alex_anglin 6y ago
    How does this demonstrate the universal healthcare doesn't work?
aaron695 6y ago
I image you also give your animals nutrient supplements. If, and that's a big if, as a species we can find the resources to buy these children some cheap pills then it's not necessarily worming tablets. But it's complex, people love the idea of de-worming kids. It sells well, and once you open up aid to communities then you can do a lot of other stuff. It's not the 50 cent pills it's the $1000s finding them and training someone to get to them, so tomato tomato who pays for that.
- jessaustin 6y ago
  I agree, international aid is problematic. Much better would be improving "gene drive" tech to the point that we wipe out helminths completely. That seems a few decades away, and in the meantime maybe lives can be improved via other methods.
  - eaandkw 6y ago
    Not that I am in favor of parasitic worms or anything but I would be careful to assume that erraticating helminths or any species for that matter would only be beneficial. I don't know where they fall in the food chain. Maybe they are essential for some other species to thrive that we depend on.
    - jessaustin 6y ago
      ...any species... There are at least 300 species from multiple phyla that feed on humans. We might also consider those species that feed on our livestock, although such an action would have less ethical urgency. It isn't impossible that other species might eat them, but given their baroque life cycles it seems quite unlikely that any other species depends on them for survival. But sure, if people decide to start with tests on isolated tropical islands, I won't argue.
    - taneq 6y ago
      Compared with the thousands of species that go extinct every year as a normal part of evolution, much less the tens or hundreds of thousands of species currently being wiped out by human activity, surely wiping out small group of species is not that big a price to pay for ridding humanity of a truly horrible affliction?
setgree 6y ago
I'm sure they did! Kremer is a really important figure in the history of economics, and the magnitude of the effects of his work on deworming are debatable. These things are perfectly compatible. I think the articles I posted might help readers form their own conclusions about the work, rather than deferring on account of Kremer's prestige and authority; per Feynman, "Science is the belief in the ignorance of experts." [0] Regarding the fact that it's appalling that so many people still deal with this problem -- I agree. As Gelman says (second link I posted in GP), the reason that magnitude of effects is important is opportunity costs: > The 800-pound gorilla in the room is opportunity cost, or cost-benefit analysis. As you say, who could be against de-worming kids? I’m reminded of Jeff Sachs’s argument that all of these sorts of interventions are worth doing, and that rather than trying so hard to rank the cost-effectiveness of different health and economic interventions, the rich countries should just kick in that 1% of GDP or whatever and do all of them. I’m not saying Sachs is necessarily right on this, I’m just saying that most of the discussion seems to be on traditional statistical grounds (Is there an effect? Is it statistically significant? Has it been proven beyond a reasonable doubt?) and the cost-benefit or opportunity cost calculations are implicit. [0] https://news.ycombinator.com/item?id=23816584 https://news.ycombinator.com/item?id=23816584
triceratops 6y ago
How do you spend so little? My dog's monthly heartworm medicine alone costs $5/dose.
- Shog9 6y ago
  Dog heartworm pills are a MASSIVE rip-off. The active ingredient - ivermectin - can be purchased without prescription at any farm supply shop in sufficient quantity to last several dogs' lifetimes with plenty to spare. The maintenance dosage is miniscule. Pet prescription meds are only slightly less of a scam than human prescription meds.
  - rubyron 6y ago
    I’m a retired DVM. What you say is true, but I just want to caution anyone reading this that ivermectin is deadly for collies and many herding breeds. Rule of thumb is “white feet, do not treat.”
    - krustyburger 6y ago
      Please don’t be offended, but I find this absolutely fascinating. Abstractly I know veterinary science is at least as complex as anything involving humans. But somehow I tend to dismiss just how much variability a veterinarian is expected to be able to account for.
      - fsckboy 6y ago
        please don't be offended but if you find yourself saying "please, don't be offended", LPT, you can generally reword what you are about to say so it's simply a compliment instead of containing the negative messsage. You are impressed by how much variation a veterinarian must account for in a single species, and they handle multiple species.
        deleted 6y ago
        [deleted]
erikerikson 6y ago
Please see [0]. Many people do find the money to buy those children pills. Pretty sure the study is tracking the consequences of that intervention. You could give a little as well to help make it even more broadly effective. So could the readers of this comment. In fact, please consider doing so. [0] https://www.givewell.org/charities/sci-foundation https://www.givewell.org/charities/sci-foundation
- setgree 6y ago
  Perhaps of interest: GiveWell touched on the ‘Worm Wars’ here: https://blog.givewell.org/2016/12/06/why-i-mostly-believe-in-worms/ https://blog.givewell.org/2016/12/06/why-i-mostly-believe-in...
  - Tyr42 6y ago
    Does this new paper change the conclusions or decisions made by give well?