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Notes -
To be fair, the EA side does have numbers and did look at them hard. They can give numbers for malarial infection rates and deaths, both in before/after, difference-in-difference, and comparing high-malarial and low-malarial-risk environments to make sure they weren’t getting some spurious signal. There were even a couple times this lead to use of different insecticides chasing maximized numbers.
The bigger problem is how real the numbers they looked at are. The infection rates at least have some random sampling going on, but it’s a tiny fraction with some selection effects crawling back in. The bigger problem is fatality rates, which are derived from a mix of ‘verbal autopsy’ and modeled estimates from infection rates. But the verbal autopsies are known to be terrible, and the models use local funding of anti-malarial supplies as an input. Start backing them out and you end up with 10x to 20x variations that might be real or might be sampling on the dependent variable. Worse, almost all of the modeled effects (and even the difference-in-difference studies) give drastically higher results than the early RCTs, often 2-3x, and they themselves depended on comparing against people sleeping without nets at all, a scenario that basically doesn’t exist. That’s not impossible, but it’s reason to treat them with a massive grain of salt.
But on the gripping hand, the pessimistic numbers still involve at minimum tens of thousands of lives saved, and more likely hundreds of thousands. It breaks the economic argument, but not the raw effect.
The fishing nets thing is an annoying problem from an environmentalist perspective, but it’s ultimately a rounding error. There’s not much risk of fishery depletion from these nets, very little of the target areas rely on fishing for a big source of calories, and the chemicals aren’t that toxic to mammals. It’s a hundred-life problem, not a hundred-thousand-life problem.
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