The Impatient Optimist

30 Apr 2013

A few weeks ago I recorded Bill Gates delivering the Richard Dimbleby lecture at the Royal Institution. It was entitled ‘The Impatient Optimist’ and centred on the efforts of the Bill and Melinda Gates Foundation to reduce child deaths from disease.

The Gates Foundation is huge, worth $US 36 billion. Not all the money has come from Bill Gates; Warren Buffet, the investment guru, has also contributed billions. They come from a long line of great American philanthropists who have given huge amounts of money to society.

I watched the recording of the lecture recently. What was refreshing about Bill Gates’ lecture was that he saw innovation as the key to reducing child deaths from disease. This is in contrast to the hand-wrenching of European society to anything new and innovative. For instance, he sees merit in using GM mosquitoes in order to reduce the transmission of dengue fever and malaria. The great cynics of our society say that this is just an excuse to get GM introduced. But why go to the expense of developing and registering GM mosquitoes if they do not have a potentially useful role? Surely not just for good PR?

As far as I know, there are two types of GM mosquitoes being developed. One approach is to modify mosquitoes to make them sterile, an alternative to irradiating them. They are then released and mate with the local population but of course there are no progeny and so total numbers are reduced. The concern about this approach is that mosquitoes may be an essential component in local ecosystems. So an alternative approach is to modify the mosquitoes so that they do not transmit disease. Large releases will allow local populations to be dominated by these harmless (in terms of disease transmission) mosquitoes.

Whisper it quietly but DDT is still being used in the fight against malaria. It seems sense to me to spend a few pence to spray the inside of a one-room mud-brick house with DDT and kill mosquitoes (and other nasty creepy crawlies) rather than to spend £5 per mosquito net in order to give people an imperfect barrier against insect bites. Now this really sounds like heresy but think about it.Spraying DDT against mosquitos

The problems with DDT arose when it was massively sprayed and slopped all over the place, not when it was used in a targeted way and in quantities just sufficient to rid homes near malarial swamps of mosquitoes. So, as usual, it is how a pesticide is used that is important and not necessarily its potential for harm when used irresponsibly.

In addition, there is talk of developing vaccines against malaria but in his lecture Bill Gates described the huge challenge of getting all vulnerable groups vaccinated. You have only to think of the less than complete vaccination coverage against measles in the UK to understand the scale of the problem.

So there may be no single ‘silver bullet’ solution to dengue fever and malaria. Perhaps the biggest impediment to solving this huge source of human misery is those who do not suffer from the problem trying to impose their views on those who do.