The WHO reported today that anti-malaria efforts in Rwanda and Ethiopia have cut the number of deaths from the disease in half. It attributes the success to the use of insecticide-treated bed nets and better drugs. This is great news because malaria is a huge public health problem — probably more than most of us in the developed world realize: a million deaths and maybe 300 million more clinical cases each year. In Africa, malaria accounts for nine percent of all deaths. And this from a disease that we’re learning we really can do something about.

But the numbers are so daunting. According to the WHO, roughly two billion people live in areas affected by malaria. The scale is almost too much to really get your head around.

A while back Clive Thompson wrote in Wired about research into the psychology of numeracy and how that affects our feelings of empathy:

I’ve been reading the fascinating work of Paul Slovic, a psychologist who runs the social-science think tank Decision Research. He studies a troubling paradox in human empathy: We’ll usually race to help a single stranger in dire straits, while ignoring huge numbers of people in precisely the same plight. We’ll donate thousands of dollars to bring a single African war orphan to the US for lifesaving surgery, but we don’t offer much money or political pressure to stop widespread genocides in Rwanda or Darfur.

You could argue that we’re simply callous, or hypocrites. But Slovic doesn’t think so. The problem isn’t a moral failing: It’s a cognitive one. We’re very good at processing the plight of tiny groups of people but horrible at conceptualizing the suffering of large ones.

In one recent experiment, Slovic presented subjects with a picture of “Rokia,” a starving child in Mali, and asked them how much they’d be willing to give to help feed her. Then he showed a different group photos of two Malinese children “Rokia and Moussa.” The group presented with two kids gave 15 percent less than those shown just one child. In a related experiment, people were asked to donate money to help a dying child. When a second set of subjects was asked to donate to a group of eight children dying of the same cause, the average donation was 50 percent lower.

Slovic suspects this stuff is hardwired. Psychologists have long observed that our ability to discriminate among quantities is finely tuned when dealing with small amounts but quickly degrades as the numbers get larger. Our ears work that way, too. When a very quiet sound becomes slightly louder, we detect the difference right away. But once a noise is really loud, it has to increase dramatically for it to seem “louder.” The same holds true for our judgments of weight and, of course, less tangible quantities like money. We’ll break the bank to save Baby Jessica, but when half of Africa is dying, we’re buying iPhones.

All this leads Thompson to speculate that people who “feel your pain” are, in some cases, exactly the wrong people to be in charge of efforts to help others. It’s actually people like Bill Gates — whom Thompson describes as “practically a social cripple” — who are best equipped to help large numbers of people because, wealth aside, their sense for systems and numbers allows their empathy and compassion to scale better. And as it happens, anti-malaria efforts are one focus of the Gates Foundation.

With that in mind, it was interesting to read this part of a recent Fortune profile of Melinda Gates (emphasis added):

When it comes to investing their philanthropic assets, Melinda wields even greater influence. Early on she and Bill agreed to focus on a few areas of giving, choosing where to place their money by asking two questions: Which problems affect the most people? And which have been neglected in the past? While many philanthropists take the same tack, the Gateses, who love puzzles, apply particular rigor. “We literally go down the chart of the greatest inequities and give where we can effect the greatest change,” Melinda says. So while they don’t give to the American Cancer Society, they have pumped billions into the world’s deadliest diseases – most importantly AIDS, malaria, and tuberculosis – and failing public high schools in the U.S. And while Bill is drawn, naturally, to vaccine research and scientific solutions that may be decades away, Melinda is interested in alleviating suffering right now. “You can’t save kids just with vaccines,” she says. “I’d go into rural villages in India and think, ‘Okay, we saved this child. But the cows are defecating in the stream coming into the village. There are other things we need to be doing.'”

Those other things include funding insecticide-treated bed nets to ward off malaria-carrying mosquitoes, providing microbicides to prevent the transmission of AIDS, and offering microloans and insurance to help the poorest of the poor start businesses and farms. The Gateses’ latest mission, which developed out of a trip Melinda took to Kenya two years ago, is to recreate for Africa a green revolution similar to the program that increased crop yields in Latin America and Asia beginning in the 1940s. In 2006 the Gates Foundation formed a $150 million alliance with the Rockefeller Foundation. “Melinda is a total-systems thinker,” says Rockefeller president Judith Rodin. “She and Bill dive into issues. They care deeply, deeply, deeply about making a difference, but they don’t get starry-eyed. They demand impact.”

-Greg Dahlmann

The photo above is of an Anopheles funestus mosquito, one of the varieties that transmits malaria in Africa.
Credit: CDC/ James Gathany, Dr. Frank Collins, University of Notre Dame