The news about better treatment for drug-resistant tuberculosis is huge. If confirmed, that'll be the basis for saving many lives in the next decade, especially in India. Multiple-drug-resistant tuberculosis has been an alarming problem there.[1]
Agreed. Living in the age of antibiotics we (in the developed world) have quickly forgotten how deadly TB is (it was a leading cause of death just 100 years ago). Given the difficulty in developing new antibiotics (and relative lack of commercial incentive to do so) the news that they've found a more effective new drug combination (including new drugs) is very welcome.
The fact that the regimen is shorter will hopefully mean higher completion rates: a big issue at the moment as the treatment can take up to 2 years leading many patients to take incomplete courses (and of course this fuels drug resistance). In Australia we're lucky enough to have the resources to provide free treatment with mandatory monitoring by health care workers (to enforce the full course is taken), but in India, PNG etc they desperately need a cheaper and more practical solution.
Edit to add: hopefully new drugs will also help those with sensitivity to the current antibiotics. They have some pretty harsh side effects, e.g. drug-induced hepatitis is a common problem which means many patients can't tolerate the preferred regimen.
Serious question though, and I would like people to ignore some sort of moral or religious argument for it; but what is the long term implication if all kinds of health advances save people but humans still reproduce and impact the planet in already unsustainable rates.
I get it, some people have a bleeding heart and want to save everyone, everywhere, at all times; but what happens when the planet is the equivalent of a cat hoarder's house because we could never say no and we could never implement policy to limit population growth because the wealthy inherently gain from unregulated population growth?
The upshot is that as countries get richer, fertility rates decrease. Allowing these poorer countries to lead better lives will paradoxically lower the population increase. If you look at the western world, negating immigration, many countries have a shrinking population.
The more pressing problem of the future, ironically, will be under population - at least if you consider the economic impact and our way of life. Our economy right now is built on so much growth and young labor. What happens without poor countries and when more people are retired than working?
> If you look at the western world, negating immigration, many countries have a shrinking population.
Even with immigration, Germany has a slightly negative population growth rate. And the United States grew by only 0.77% in a year. Again, that's with immigration.
There's a conversation to be had about the future of non-renewable resources and the preservation of renewable ones, but the population growth fear-mongering from the likes of Dan Brown is deeply silly and not based on the whole truth.
Vaccines without sex education and birth control support programs are extremely irresponsible. We need both, just one is trading off a short term problem for a bigger long term problem.
> Vaccines without sex education and birth control support programs are extremely irresponsible
Are you sure there is no correlation between mortality and fertility rates? Assuming there is (which lots of evidence points to) there isn't actually any problem.
What is not true? He said fertility rates decrease, he didn't say fertility rates dropped below what is called 'sub replacement fertility' (which is when e.g. a man and a woman have 1 child on average, meaning every generation the population halves.)
His statement is perfectly true if say rates dropped from 5 to 4. That still causes a growing population, but the growth rates are decreasing. Once a country gets rich enough, you usually see fertility rates drop below SRF.
In fact, in Europe for example it's around 1.6, while you need roughly 2.1 or so children per woman to sustain population levels.
Perhaps if this coincides with the rise of the machine replacing cheap labor, this might actually be a good thing, but something like a BIG would be needed to supply the non-working with income.
In the first place it's pretty hard to ignore the moral argument. If moral arguments are out, and we accept the thesis that population is bad, then it's hard to see why purposefully letting people suffer and die from TB is any better than using nuclear bombs to reduce the global population.
But anyways, if we want to get around to a sustainable post-scarcity futuristic utopia, we need a global population of economically developed and educated people with replacement-level fertility. And when childhood mortality goes down, parents have an incentive to concentrate their investments (both economic and educational) into fewer children. Those children will be more successful, have better access and education about contraception, and won't need to have plenty of children to provide manual labor on their farm.
Anyways, that's how it's supposed to work, and has worked many times in recent history. I put less stock than others in the extrapolated results from the recent UN Africa study.
Paradoxically, reducing death rates in the young actually slows population growth. One of the biggest reasons why people in poor countries have so many babies is because so many die young.
> Serious question though, and I would like people to ignore some sort of moral or religious argument for it; but what is the long term implication if all kinds of health advances save people but humans still reproduce and impact the planet in already unsustainable rates.
> I get it, some people have a bleeding heart and want to save everyone, everywhere, at all times; but what happens when the planet is the equivalent of a cat hoarder's house because we could never say no and we could never implement policy to limit population growth because the wealthy inherently gain from unregulated population growth?
Some of the minds saved can one day solve these and other problems, pushing the envelope of human knowledge.
The power of imagination only gets you so far. There are diminishing returns to technology and innovation in most areas. Moore's law is a notable exception, but if you extend it to what Moore's law buys you -- what you can do with all that additional computing firepower that you couldn't do before, it's pretty minimal.
As an example: any heat engine is limited in its efficiency by Carnot's Law. You can apply all the electronic smarts to it you want, but the best you'll get in efficiency improvements is a closer approximation of the theoretical maximum.
You can phase-shift and use different technologies -- hybrid vehicle drives allow for greater engine efficiencies (constant power) and energy recover (regenerative braking), but that's fairly minimal -- the complexity of a Prius and a comparably efficient high-efficiency diesel is great.
There are other issues in expanding systems beyond certain scales -- even if you've got genius minds out there untapped, how do you 1) train and educate them, 2) find them, and 3) incorporate and utilize their advances -- in all the other noise.
Strangely it's kind of the other way around. When you have a poor, unhealthy population with labor-intensive economy, high child mortality and low life expectancy, you tend to get tons of people.
Why? Because it's economically smart to have children.
In a labor-intensive economy, you can generate more income in the family with more children.
And in a poor subsistence economy, there is no surplus wealth being generated to go to the state for redistribution and another thing I'll get to in a minute. This means that institutionally-provided social security is often non-existent (no pensions, no insurance, no universal healthcare, no benefits, food stamps etc). So instead of institutions, these services are provided by the community, i.e. children. If you have 5 kids, there's a much better chance of someone taking care of you at old age, or when you're sick, than if you have few or no kids.
You have more kids because there is a higher chance of death. Child mortality under five is absolutely STAGGERING. I literally think about this every week and wonder why we can't get the news to report on it on a weekly basis. The number is about 17 thousand per day. Try putting that into perspective. That's more than 5 times 9/11 per day, or 50% the death-rate in World War 2 year in year out. At these rates, it makes sense to have more children, parents actually expect not all their children to last.
When you take death and sickness out of a community however, there is much more chance of economic growth. There are loads of UN reports on how mortality and sickness affects education, employment, parenting, productivity etc. In short, if you improve these things significantly in a country, 10-20 years later you see millions of extra people pour into the middle class.
And what happens then? The truth is that it's economically disadvantageous to have children in a wealthy society. Children cost (way) more money than they generate. Wealthy societies have child-labor laws (well, every country does, but they're enforced more strictly), as well as laws that require all children to go to school. Standards of living in a wealthy society requires loads of expenses on children, and price levels aren't low either. And lastly we see that in wealthy societies that there is more wealth-surplus, leading to cultures that have the time and literally the money to explore non-economic interests, like the arts, and this often goes hand in hand with less time spent on simply surviving and taking care of family members, in fact leading to sharply reduced birthrates as new generations grow up with a bigger interest in traveling than raising a family. (extensive traveling for recreation being something almost only possible in wealthy societies with a wealth surplus, i.e. the minimum amount of work you need to do just to survive is something like 30% instead of 90%, so if you spend 60% of your time working you have a large wealth surplus and a lot of free time).
In short, having 10 children is the 'worst idea ever' for most parents both economically and culturally the richer a country gets.
What does this all mean? Well, if you believe me, we've established that it makes sense to have lots of children in a poor country, and very few in a rich country, which is easily seen in empirical data. (it's not a cultural thing, most western countries with low birthrates had very high birthrates before they became wealthy post industrial revolution). And we've also established that mortality and sickness are huge inhibitors of economic growth.
Lastly, I'd say that a richer society with less mortality and sickness is more stable, better educated, has better funded institutions, which means natural family planning (like contraception and sex education in best case, or authoritarian China-style 1-child policies in worst case) should also be much more effective.
In other words, in the long run, reducing death rates is actually likely to decrease the size of the population, with of course the added benefit that it's freaking awesome to save lives that every living person deserves to have. After all, none of us would volunteer to die just to be able to 'sustain the planet with a lower population'! :) But I tried to ignore this point for argument's sake.
The corollary to this story is that a wealthier society consumes much more, which is less sustainable. (e.g. 500 million people in China/India who join the middle class and turn to 'basic' items like toilet paper is like adding another Europe or US. It's insane.) The fun and optimistic corollary to that is adding 500 million educated brains, who knows how many nobel prize winners will be among them providing the solutions we need :)
It is about the resource consumption, not just population number. If a species X has population 10 times than species Y but if Y consumes 100 times more then they will cause larger impact to the earth.
In India, in particular, anyone can buy antibiotics, and they do, whether they need them or not. This problem should probably be addressed before we create a problem that we can't solve.
Yes, the problem is man made, but not only due to unofficial access to antibiotics. I suspect that's not even a major factor, but correct me if I've missed something.
As discussed: TB currently takes a long time to fully treat. A lot of patients can't afford a full course of the recommended combination of drugs. Even if they can, and are getting their drugs from official channels, they need to be monitored regularly (sometimes daily) to ensure proper treatment. The resources to do this monitoring simply don't exist in India (and many other countries). Thus, even if you could stop all unofficial access to antibiotics (impossible in practice), there is simply not enough funding to ensure every patient is properly treated.
This is why a shorter regimen is a key breakthrough. It makes proper treatment much more accessible (the big issue), while also reducing the discipline needed to complete a course (a small bonus).
> This problem should probably be addressed before we create a problem that we can't solve.
That still leaves the nasty issue of what to do with the large number of people who have contracted a highly contagious and drug-resistant / incurable disease.
The drug resistant tuberculosis is already here so we have to solve it.
But to prevent future problems, people need to stop using antibiotics as a cure all. It is particularly bad in India since patients there can aggressively demand antibiotics from hospitals and doctors.
[1] http://articles.economictimes.indiatimes.com/2013-06-23/news...
http://www.wsj.com/news/articles/SB1000142405270230344420457...
http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-R...