There is also a chance that there will not be any human beings around to still gain the benefit of the disease’s being eradicated – in which case expending the time and effort

now to complete the last mile of the disease’s eradication would turn out to have been futile. Notice that this time discounting is due to epistemic uncertainty, and not to any intrinsic lesser importance of lives in the future. Because of this, it seems implausible to think that this discount rate should be large, as “even a 1% discount rate implies that there is a 50% chance that the world will end in 69.7 years” [25]. It is possible to claim that lives in the future are intrinsically less important Dasatinib mw than those now – quite separate from the thoughts about PD-0332991 datasheet uncertainty. Within the economics and philosophy literature, this is known as pure time discounting: discounting the value of benefits and harms in the future solely for the reason that they are in the future. Most philosophers have followed Ramsey’s lead in thinking that pure discounting “is ethically indefensible and arises merely from the weakness of the imagination” [26]. The reason for thinking this is simple: there seems to be no reason to think that the mere fact that suffering or death is proximal

in time provides a reason to prioritise it, any more than there is a reason to think that suffering or death is proximal in space does. It is interesting to note that the latest version of the Global Burden of Disease Tryptophan synthase Report [27] no longer features time discounting of health improvements. The philosopher Derek Parfit [28] provides a powerful way of conceptualising what is at stake here. Suppose we are thinking about three scenarios for the future of malaria. 1. Status quo. It is obvious that, other things being equal, 3 is better than

2, and 2 is better than 1. But how much better is the successful eradication campaign than the control campaign, which merely reduces the burden of its disease to 1% of its current level? Many people would assume that the successful eradication campaign is only marginally better than the successful control measures. But this is to ignore the fact that if we simply reduce the current burden of malaria by 99%, then malaria will (absent some further attempt at eradication, or dramatic change to the environment) continue to cause illness and death for the rest of human history. The likely benefits of the eradication campaign are thus huge in comparison to the control campaign. I have suggested that the main arguments for thinking that eradication is an ethically exceptional goal are weak. But my aim has not been to oppose eradication as a policy goal, but to give a better explanation of why it is compelling.