Eradication Game Theory

Can you crowdsource disease eradictaion?

I mentioned in this post on 2030 that I expect Polio and Guinea worm to be eradicated by then. It becomes a tricky issue when a disease gets really uncommon how you find and treat the last few cases? So far only smallpox and rinderpest have been eradicated. Eradication is great because once its done its done. You would not have to immunise every child for polio any more. Every polio vaccine has a small cost and risk and once thats gone you can go spend the money on something better


India has tried an interesting tack 'Cash awards for info on diseases'

Alert the government on the occurrence of new cases of certain ailments and you may get a cash award! The government has targeted vaccine preventable diseases such as diphtheria, pertussis, measles, tetanus, and leprosy for elimination by 2016. India is also on the verge of being declared polio-free.
District medical and health officer Dr G. Srinivasulu explains that even after being declared polio-free, there should not be a single new case for 14 consecutive months in the country. This is where the reward comes in. “If anybody succeeds in detecting a new polio case meanwhile, the government will give a cash award. Even in case of detection of new leprosy cases, ASHA health workers are given Rs 150-Rs 200,” he said.

There was a competition last year from DARPA to encourage new ways to pool information held my many people.
'MIT wins $40,000 prize in nationwide balloon-hunt contest'

A team from the Massachusetts Institute of Technology won $40,000 in a high-tech scavenger hunt on Saturday by discovering the location of 10 red weather balloons.

"We're giving $2,000 per balloon to the first person to send us the correct coordinates, but that's not all -- we're also giving $1,000 to the person who invited them. Then we're giving $500 whoever invited the inviter, and $250 to whoever invited them, and so on..." it said.

Some similar system that set up a chain of reward could be really useful in disease eradication. Many security protocols rely on a sort of iterative proof of trustworthiness. Something similar could be used to allow steps toward eradication without fear some other country is going to stop efforts.

Assurance contracts are another approach. It is possible that some regions are scared that once a disease is eradicated to their area they will lose funds. Some way to guarantee that funding will not reduce or to reward successful eradication might help here. Something like Dominant assurance contracts might help to change incentives to encourage eradication.



How about a guarantee fund for each of the remaining countries with polio and guinea worm that when who declares them free they get some cash bonus. You could imagine a kickstarter project that gave the minister of health in Nigeria money when polio was declared eradicated from the country.

Another good plan is not to have fake immunisation drives against polio

The juice of the carrot, the smile of the parrot
A little drop of claret - anything that rocks
Elvis and Scotty, days when I ain't spotty,
Sitting on the potty - curing smallpox

We want to discourage deliberately being lax about a disease so you have to be clever about incentives. Anyone have any good idea for how you could bribe people and governments to further incentivise disease eradication?

Malaria Modeling

There are two very interesting passages in Shah's 'The Fever' that suggest modeling of malaria can have an important role

HIV-positive people are most infective to others when the levels of virus in their bodies are high...Malaria triggers such spikes. Malaria infection, by inducing HIV to replicate, increases the viral load in HIV infected people. According to mathematical models, HIV may be responsible for 980,000 episodes of malaria and malaria responsible for mare than 8,000 Hiv infections in a single district of Kenya. The global effect of the malevolent partnership has yet to be mapped

This paper is the source of this information.

Another interesting point seems to suggest that a scapegoat that is more attractive to mosquitoes than people are.

the greater availability of cow and hog flesh attracted the interest of malaria mosquitoes.Hovering between home and stable ninety-nine out of one hundred times. That bit of anopheline caprice cost Plasmodeum dearly. As cows and sheep sprouted across the English countryside, malaria transmissionground to a halt

Increasing livestock numbers has serious effects on any ecosystem. the pig under the bad scheme should not be promoted without serious analysis. Which leads to a more general problem with complex problems like malaria. I want to talk about these issues in another post. There is an interesting Ted talk on malaria here. A lot of the ideas are impractical which is another reason to talk about practicality later.

Jeffrey Sacks also talks about the important role of livestock that distract mosquitoes in the end of poverty

Another important point is that some types of mosquitoes prefer to bite people, whereas others feed off cattle. Transmitting malaria requires two consecutive human bites: the first for the mosquito to ingest the parasite and the second for the mosquito to infect another person, roughly two weeks later. If the mosquito feeds frequently on cattle rather than on people, the odds are that at least one of the bites, if not both, will be taken from cattle. In India, for example, the predominant type of anopheles tends to bite humans about one third of the time, and cattle the rest. Africa, sadly has another predominating mosquito type which prefers human biting nearly 100 per cent of the time. Mathematically, the chance that an Indian mosquito will feed off two humans in a row is about one in nine, whereas in Africa it's about one in one

While on the subject of development I thought this quote was fascinating Justin Kilcullen head of Troicaire 48:18 in the Frontline 30/05/11 here
"Development aid is what we give to the developing world because we do not give them a decent deal in trade, because we have screwed them on their debts, because the flow of resources...lets change the economic structures that keeps these people poor thats the long term answer". If the head of an aid agency does not think they are the long term answer for development then they are probably not.

For the moment I am going to examine OpenMalaria to see how it can model these issues.