Easily Preventable or Treatable Diseases-Full report
Report depth:
Intermediate.
Note: This research draws heavily from a post by Rob Wiblin at 80,000 Hours. It may not reflect their current research; see their up-to-date entry here.
Summary
Why focus on this problem?
Every day around 23,000 people in poorer countries die of preventable illnesses including malaria, HIV, tuberculosis, and diarrhea.
That’s really, really bad.
It’s easy for many of us who live comfortably to hear facts like this, lift a solemn prayer, and carry on with our lives.
The best Christians of every age didn’t do this. Many dropped everything and invented public hospitals, modernised the nursing profession, and otherwise risked their lives to save the sick and dying.
You too can join a rich tradition of bringing life to the sick, which goes back to Christ himself. You too can extend Christ’s healing touch in many highly impactful ways.
We share how in this summary and in our full report.
Florence Nightingale was a statistician who dedicated her life to preventing and treating disease. She saved thousands of lives by studying death rates and implementing improved hygiene and living standards.
Our Overall View
Very often recommended. We think most of our readers should consider working on and/or donating to this issue.
What is our recommendation based on?
Biblical themes:
There are over 200 bible verses about the sick (e.g. Proverbs 14:31, Psalm 147:3, Jeremiah 30:17)
Particularly strong commandments concern serving the “least of these” (Matthew 25:31-46, 1 John 3:16-18)
God is frequently portrayed as an advocate for the oppressed (e.g. Psalm 9:9, Psalm 12:5, Psalm 72:12-14)
Christ is frequently portrayed as a healer (e.g. Matt 12:25, Matt 14:26, Luke 4:40, Acts 10:38, Mark 6:5)
The eschaton has no sadness nor death (e.g. Isaiah 65:17-20 Rev 21:4)
Christian tradition:
There is a rich history of Christian institutions caring for and healing the sick.
Many exemplary Christians took care of the sick.
Strong secular evidence:
This problem area is a focus of the University of Oxford’s Global Priorities Institute, a research institute for the most pressing problems.
Top Ways To Make An Impact
Pray and think carefully.
Donate to a GiveWell recommended charity today.
Pursue any meaningful career and take the Giving What We Can pledge to donate at least 10% of your income to effective charities in global health.
Donate your kidney.
Plan a career as an economist at intergovernmental organizations such as the World Bank or World Health Organization.
Start or work in a nonprofit that scales up proven treatments.
Want To Make A Difference? Donate Now
Top Picks:
Against Malaria Foundation: Fund long-lasting insecticidal nets to prevent malaria.
Helen Keller International: Provide vitamin A tablets to deter blindness and mortality in infants and women.
Malaria Consortium: Control the spread of malaria and NTDs, especially for children under age 5.
New Incentives: Give cash to caregivers in northern Nigeria to increase childhood vaccination rates.
How Important, Neglected and Solvable is Easily Preventable or Treatable Disease?
Scale
Global health problems exist on a massive scale. About 5.2 million children under the age of five die each year, largely due to preventable causes. The damage done by easily preventable diseases in the least developed countries plus India amounts to between 200 million DALYs and 500 million DALYs per year.
Neglectedness
Preventable disease is still neglected in the global south. Current health spending for people living in low-income countries is just $30 per person per year.
Solvability
Making progress on reducing global health issues is highly solvable. It is primarily a matter of scaling up interventions that are known with near certainty to work if done correctly. For about $5,000 you can reliably save someone’s life through a donation to a GiveWell-recommended charity. There is also a wide range of careers in global health and overlap with other pressing problems, including reducing global poverty and preventing pandemics.
Where Is Our Evidence From?
We draw on research from Oxford’s Global Priorities Project, 80,000 hours, GiveWell, and the Copenhagen Consensus. Our recommendation is based on their findings, as well as basic data from the Global Burden of Disease and World Bank, among others.
What Is The Problem?
Every year around ten million people in poorer countries die of illnesses that can be very cheaply prevented or managed, including malaria, HIV, tuberculosis and diarrhoea. Tens of millions more suffer from persistent undernutrition or parasitic diseases that cause them to be less mentally and physically capable than they otherwise would be.
Why Is It Pressing?
These diseases cause unnecessary suffering and death both to victims and their families. They also lead to a range of other negative effects:
Lower educational attainment.
Lethargy and reduced ability to think and work.
Worse health later in life.
Higher birth rates to compensate for infant mortality.
Children in 5th grade classroom at Jean de le Mennais school in Burera District in Rwanda. Image Source.
Schistosomiasis affects over 240 million people each year. It and other parasitic worms cause fever and diarrhea and also affect educational outcomes. Infected schoolchildren are more likely to want to stay home due to feeling sick or embarrassed by their symptoms.
In many cases these diseases or their impacts can be largely eliminated with cheap technologies that are known to work and have existed for decades. For example:
Schistosomiasis and other parasitic diseases can be cured with a pill that costs under $1 a year.
Malaria is prevented by insecticide-treated bednets.
TB is almost always cured by sustained treatment with antibiotics (so called DOTS).
People with HIV live nearly normal lifespans, and rarely pass on the virus to others, if promptly and consistently treated with anti-retroviral drugs.
Diarrhoea can be prevented through better sanitation, and death prevented by oral rehydration therapy.
A range of other diseases can be prevented through basic vaccination programs (e.g. diphtheria, whooping cough, etc).
While the cost-effectiveness of the above approaches ranges quite widely, they can in most cases generate an extra year of healthy life for under $1,000, in a few cases for less than $100.
Over the last 60 years, death rates from several of these diseases have been more than halved using these techniques, suggesting a very clear way to make progress.
Where Is The Problem Most Relevant?
The greatest need remains in the global south, especially in sub-Saharan African countries. One of the worst preventable diseases (measured by total lives lost) is malaria. In 2020, malaria caused 626,000 deaths worldwide, almost none if which occurred in western countries including the United States, which eradicated the disease in 1951.
What Are Other Arguments Against It Being Pressing?
You might think that it is not a particularly neglected problem, given it is very widely recognised and is funded by organizations, including aid agencies, with billions of dollars to spend each year. Governments in developing countries are also making significant progress in improving health, although some gaps certainly remain in practice. In this view it will be hard to find exceptional opportunities because there are so many other people trying to do so.
You might worry that reducing poverty and improving health in poor countries will not have major long-run effects on the future, which will instead be determined in other ways, for example through war or the invention of new technologies.
You might think that other means for reducing poverty will be more effective, such as reforming government and legal institutions in developing countries.
Key Judgement Calls To Prioritise This Problem
That the lives of people in other countries are not much less important than the lives of people in the country you (probably) live in.
That improving health will cause developing countries to become sustainably richer and nicer to live in, for example by reducing fertility or improving education and governance.
What Can You Do About This Problem?
Is there a big difference in impact between different interventions?
There exist well-documented differences in impact between various global health interventions.
While some interventions have no proven impact, others can be 10 - 100 times more impactful than average.
A comparison of 108 different health interventions by their cost-effectiveness, measured in disability-adjusted-life-years (DALYs) and adapted by Toby Ord (Dean Jamison, et al. 2006).
What’s most needed to contribute to this problem?
Deliver basic health services to all people who have or are at risk of contracting easily prevented contagious diseases. For example:
Get all children to receive the basic schedule of vaccinations (currently around 85% do). [2] (Listen to 80k’s 2021 podcast with Varsha Venugopal about recent work in this space.)
Get everyone exposed to malaria sleeping under bednets. Currently a bit over half of people in the relevant parts of Africa have access to bednets. [3]
Get all TB cases treated – currently at least a third are not diagnosed. [4]
Ensure everyone has access to clean drinking water – currently at least a billion people do not. [5]
This is primarily a funding and logistical issue. The treatments are usually simple and do not require advanced medical training to deliver (though treatment of TB and HIV requires medical oversight).
What skill sets and resources are most needed?
The ability to fundraise large sums, or move money within bureaucracies to better projects.
People with on-the-ground logistical skills in international development (i.e. the kind of person who could get 100,000 malaria nets distributed in Africa).
Entrepreneurs (mostly in nonprofits but also sometimes for-profits) who could found one of these charities.
Development economists and cost-effectiveness researchers, including economists, statisticians, and disease control experts.
Money to fund GiveWell recommended charities.
We think that people capable of starting outstanding projects in this area are likely to be able to attract the necessary funding, making the area mostly talent constrained.
What organisations are working on this problem?
See 80k’s extended list of places to potentially apply to work within this cause.
Domestic health departments in developing countries.
A range of foundations such as the Bill and Melinda Gates Foundation and Children’s Investment Fund Foundation.
Also intergovernmental organizations such as the World Health Organization, Global Alliance for Improved Nutrition, GAVI, World Bank, and the Global Fund.
A range of NGOs such as Doctors Without Borders, CARE, UNICEF, and Evidence Action.
What can you concretely do to help?
Donate to a GiveWell recommended charity today.
Take the Giving What We Can pledge to donate at least 10% of your income to people in extreme poverty.
Plan a career around founding a new global health nonprofit – see 80k’s profile for next steps.
Apply to work at GiveWell (example research role) or at one of these dozens of organisations in the field.
Study an economics PhD, then apply your skills to development, for example by working in an intergovernmental organization such as the World Bank or World Health Organization.
Become a grantmaker in a foundation that funds (or could fund) global health projects, for example the Gates Foundation.
Get a job in any organization scaling up proven health treatments, for example Against Malaria Foundation, SCI, Stop TB, Evidence Action and Project Healthy Children.
Become a biomedical researcher and work on better ways to prevent neglected diseases of the poor.
Some Recommended Organizations
GiveWell conducts thorough research to find the best charities available to help people in the developing world. See current vacancies.
The Center for Global Development is a U.S. nonprofit think tank that focuses on international development. See current vacancies.
Evidence Action scales proven interventions to improve life for the global poor. Their Deworm the World Initiative was one of GiveWell’s top-rated charities. See current vacancies.
Charity Entrepreneurship helps people start new charities that have the potential to become recommended by GiveWell.
Against Malaria Foundation is one of charity evaluator of GiveWell’s top charities and provides funding for antimalarial bed net distributions.
Schistosomiasis Control Initiative is one of charity evaluator GiveWell’s top charities and works with governments across Sub-Saharan Africa and Yemen to develop national schistosomiasis control programs.
Innovations for Poverty Action is a nonprofit research and policy organisation that, since its inception in 2002, has conducted over 600 randomised controlled trials and other evaluations. See current vacancies.
GiveDirectly, one of GiveWell’s top-rated charities distributes unconditional cash transfers to people living in East Africa. See current vacancies.
Who Are Some Christians In the CFI Network Working On This?
Adam Winnifrith, a master’s candidate at Oxford University, working on anti-microbial resistance.
Ana Karina Pitol, a research associate at the Liverpool School of Tropical Medicine.
Katie Fantaguzzi, a senior M&E advisor at the SCI foundation.
Various economists studying global development and health.
Various others who earn-to-give.
Interested in talking to someone about tackling this problem with your career?
Sign up for 1-on-1 mentorship. We’ll pair you with a Christian who can talk to you about how to make an impact in this problem area.
Notes:
[1] World Health Organisation: Global expenditure on health: Public spending on the rise? Global Report 2021. https://files.aho.afro.who.int/afahobckpcontainer/production/files/2_Global_expenditure_on_health_Public_spending_on_the_rise.pdf
[2] WHO immunization coverage, https://web.archive.org/web/20160310102925/http://www.who.int/mediacentre/factsheets/fs378/en/
[3] Giving What We Can statistics on preventing malaria through issuing bed nets https://web.archive.org/web/20160322180901/https://www.givingwhatwecan.org/post/2015/12/bednets-have-prevented-450-million-cases-of-malaria/
[4] R Wiblin, Easily Preventable Diseases, 80,000 Hours Blog https://80000hours.org/problem-profiles/health-in-poor-countries/#fn-3
[5] Source 4.
