Tuesday, May 11, 2010

Unintended Consequences #3

I can't keep track of what parts of the Wall Street Journal are behind subscription firewalls, so I'll just directly reference a fascinating front-page article from Friday, April 23, 2010: "Gates Rethinks His War on Polio" by Robert A. Guth.

Mr. Guth traveled extensively with Bill Gates in preparing the article, including many stops in Africa, where the Gates Foundation is one of the major players attempting to eradicate polio.

The article highlights two sources of unintended consequences in compassion policies: a) the behavior and choices or individuals, and b) complicated medical, engineering, or environmental relationships. We've blogged extensively about the first category. The second category addresses questions such as if you see two cars parked next to each other, how do you know which one has a lower "carbon footprint," much less which one would be create fewer overall environmental externalities. The term "dust to dust" analysis has come to be associated with attempts to answer the second question, because it's not just the driving of the car that matters, it's also the production and disposal.

The article in the Journal shows Mr. Gates confronting both of these sources of unintended consequences. For example, one argument being debated is whether money should be diverted from polio vaccination narrowly defined to a broader effort to make people healthier and thus better able to resist infections. But, there's also the possibility that cleaning up the water supply can paradoxically cut down on processes of passive or community immunization from the mild childhood "stomach flu" manifestations of the virus. This potential unintended consequence is discussed in greater detail in the Wikipedia article on polio.

Likewise, Mr. Gates confronts behavioral issues, such as unfounded rumors of personal costs of immunization (rumors of sterilization of children who received the vaccine). So, Gates schedules a visit with the religious leader of Muslims in Nigeria for help in setting the record straight.

The closing words of the article are the following:

"As polio shows, technology can be hampered by political, religious and societal obstacles in countries where he's spending his money.
"In Nigeria last year, Mr. Gates sat on the lawn behind his hotel reflecting on that. Science can simplify the job, he said, but 'the human piece is the ultimate test'."

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