Monday, 2 September 2013

Is Gareth Bale worth more than eradicating malaria?

Many moons ago, in what now feels like a different life, I went on a trip to London. The date was October 12th, 2009, and I was armed with a long pole, a dispensing basket I had nicked from work, and a mosquito net.

I had an hour. An hour, to do whatever I wanted, in Central London. Its not particularly unusual to have an hour to kill in the capital, but it just so happened that I would be spending this hour atop the Fourth Plinth in a moonlit Trafalgar Square. I had been lucky enough to have been selected to take part in Anthony Gormley's One & Other artwork. I decided, after much deliberation, to represent the Malaria No More charity. I gave out packs of sweets and leaflets about the cause, wore a dress made of a mosquito net, and even did a little bit of crafting, sewing the words Malaria No More onto a large blue mosquito net. Mostly, I felt utterly terrified, and had horrendous stage fright, more so than I had ever imagined I would have.

Malaria No More, amongst other things, aim to distribute insecticide-treated bed nets (ITNs), eventually with a view to eradicate malaria entirely. According to them:
"£10 can transport 150 life-saving nets to a community in rural Ghana; enough to protect 300 people."
 Blimey, that sounds far too good to be true, doesn't it? But luckily, there is good, robust, independent evidence that impregnated mosquito nets really do prevent deaths from malaria:
"About 5.5 lives (95% CI 3.39 to 7.67) can be saved each year for every 1000 children protected with ITNs...ITNs are highly effective in reducing childhood mortality and morbidity from malaria. Widespread access to ITNs is currently being advocated by Roll Back Malaria, but universal deployment will require major financial, technical, and operational inputs.." -Cochrane Database Syst Rev. 2000;(2):CD000363.
So the idea is that two people can sleep under one net, but because of the insecticide, there is an area outside the nets which is also protected. If there are enough nets in a household, or even a village, then the whole area could be protected, even when people are out and about and not just when they are sleeping under the net. The available evidence seems to back this up-the little extract I have copied above only refers to deaths, but the results are even better when it comes to reducing the incidence of malaria illness- a reduction of 62% in areas of unstable malaria, for example.

This got me thinking a bit. With the news today that Gareth Bale, a man that I have never heard of, who runs about on a bit of grass after an inflatable round thing is apparently worth a record £85.3 million, I can't help but do some little calculations. Obviously these are all estimates, but it makes for an interesting thought experiment.

  • £10= 150 mosquito nets

  • £85,300,000/10=8,530,000 mosquito nets
  • As each of those 8,530,000 nets can protect two people= 17,060,000 people could be protected.
  • 5.5 lives can be saved for every 1000 children protected with ITNs. If we assume all the people protected are children:
    • 17,060,000/1000= 17,060
    • 17.060*5.5=93,830 children could be saved.

The WHO estimates that there were 660 000 malaria deaths in 2010. So that amount of mosquito nets, could, in actual fact, prevent a large chunk of those deaths (we dont know how many adult deaths it could prevent, either) meaning that over a few years, malaria could potentially be eradicated.

Now, I'm sure this Bale chap is very good and all, but I do wonder whether, in the context of all the World's problems, this sort of amount is appropriate. Personally, I would rather opt for reducing the massive morbidity and mortality caused by a disease that is potentially eradicable given the right resources, but then what do I know?

Before anyone complains, yes I know this is terribly simplistic, and its not as easy as that, and all of that sort of hoohah. I just want to make a bit of a point about how vast sums of money need a context, and in my humble opinion, I don't think it is particularly appropriate or such sums to exchange hands when there are still people dying of hunger or preventable diseases.  I'm sure some men doing footballing makes some people happy and all, but come on. I'm not even convinced that Christian Bale is worth that much, despite that scene of him running around naked, bloodstained, and with chainsaw in hand in American Pyscho.