Byron Carson is an associate professor of economics and business at Hampton-Sydney College in Virginia. He is also the author of a recently published book, Challenging Malaria, which we talk about today. He explains to us what malaria is and the different ways that individuals and private interests responded to it before the invention of pesticides. We talk about why it is so difficult for larger groups to respond quickly and how individuals moving towards an emergency solution can align with societal interests. He gives examples of private malaria prevention action and private COVID prevention action, giving us insight into how we as members of our communities can solve problems held up by collective action.



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Juliette Sellgren 

Science is the great antidote to the poison of enthusiasm and superstition. Hi, I'm Juliette Sellgren, and this is my podcast, the Great Antidote- named for Adam Smith, brought to you by Liberty Fund. To learn more, visit www Adam Smith works.org. Welcome back. Today on March 26th, 2024, we're going to be talking about something that was all the rage and super important before I was born and even before I was born, and is still important in the world today, malaria and the incentives and methods of malaria prevention. I'm excited to welcome Byron [Trey] Carson to the podcast today. He is an associate professor of economics and business at Hampden Sydney College in Virginia, and the author of Challenging Malaria, the Private and Social Incentives of Mosquito Control. Welcome to the podcast.

Juliette, thank you so much for having me.

So my first question for you, not necessarily related to malaria, maybe related to malaria, what is the most important thing that people my age or in my generation should know that we don't?

Yeah, so I'm an economist, right? And so I think it is super important to think about how behavior is based off of marginal considerations. We do things for the additional benefits and the additional costs. I think that's just so important. It is so applicable to individual behaviors, the behaviors and situations we have with each other, but even for policy as well. And so it's just such a super simple concept. You can apply through all kinds of examples. So just for example, people often get upset if you have a boyfriend, girlfriend, someone doesn't want to spend time with you, maybe they're studying for an exam, maybe they have other things to do. The claim might be, oh, you don't like me, you don't want to spend time with me, marginal, no considerations, and that simply just changes how we interpret those kinds of behaviors. So again, marginalism a great concept and it's really, really helpful.

I always think about this in terms of when I get stressed out for studying for an exam. So a week before, catch me feeling like I have no work to do, even though I have a huge exam in a week, and then the night before I'm like, why didn't I study more earlier? Exactly. The econ kid in me realizes that it's entirely because I didn't have the pressures. It wasn't as valuable to me compared to lounging in the sun on the first sunny day of the season when I maybe could have been studying a week in advance for the test. But yeah, no, that's a great answer. And I think the thing that's hard and what I'm wondering about is how do you actually teach people this? Because you can know the definitions and you can kind of have this external understanding, but it takes living with that definition and that theory for a while and just seeing it in your own life, I think, to make it clear. So how do you speed run that process to actually teach students what it means and show them how applicable it is?

That's a great point. You're exactly right. It takes many, many days and many examples to internalize this. And so yes, it does take a while, but I will say that the more you apply it and kind of think about it, the easier it becomes. So in that, a simple example you just gave, let's say it's March 1st and the sun just popped out that first unit of sunshine or that first hour, that first trip to the beach is really, really valuable relative to studying perhaps. And so of course it's understandable that many people, many students might be like, oh, you know what? Of course I have an exam to study for in a couple of days, but you know what? Right now it's really important that I go get a tan or something. So again, it's just kind of simple examples like that that I think are really helpful.

And if my mother is listening, that's why I can't study a week before the exam. Please excuse me. Alright, let's get into it. Before we seriously get into the topic, I kind of joked about this before, but are you related to Rachel Carson, the woman who wrote Silent Spring and made the pesticide that killed the human killing mosquitoes illegal?

Not to my knowledge, I don't think so.

I just had to check because that would be very ironic.

That would be in terms of a nationwide policy or many countries have been very anti DDT, and yeah, it would be ironic.

Alright, so let's get into that and maybe what DDT is. Let's start from the very simple building blocks because I realized effectively right before this interview what it really meant that malaria has never been a problem for my generation, but not only that, but for a few generations now. So for most people who are listening to the podcast, they have never been in a world, especially in America, that has malaria super present. The most exposure I had before thinking about malaria in this context was the philosophy of thought experiment from Peter Singer about malaria nets and utilitarianism and should you stop consuming so that you can send malaria nets overseas, that sort of thing. It's never really been real to me, which is crazy because it used to kill so many people and it still does just not right in front of me. So what is malaria and can you give us a brief history of malaria and how it affected Americans and people worldwide and how it still does? Big question.

Yeah, great. So malaria is a disease spread by malaria parasites. There are several different kinds of those parasites, but they are spread through infectious, sorry, they're spread through mosquitoes. There are various kinds of mosquitoes that spread those parasites, and that's part of the problem. And so malaria parasites get into the bloodstream, they start spreading and they kind of elicit a variety of symptoms. Now, the main problem with malaria isn't necessarily death rates, although in many areas death rates are attributed to malaria. But the problem is just that it makes people sick, it makes them sleepy, gives them colds, it gives them fever. There are other symptoms there, but the main problem is that it just more or less, and so malaria has a huge global footprint. Malaria was prevalent in the United States throughout the 1800s, throughout the early 20th century, prevalent in or it's been found in areas in many parts of the world. So it's not like some local public health issue, and it's not just something that is unique to Sub-Saharan Africa, for example. So when I was growing up, the poster child of malaria been some poorly sick child in some Sub-Saharan African country. But again, it's a more widespread phenomenon.

And it hasn't been in the US for so long. So how did you get motivated to write this book? What caused you to become interested in malaria and challenging malaria?

Yeah, so actually I started working in grad school on public health and epidemiology. I was still trying to figure things out and trying to figure out things to write about, but I'd always had in the back of my mind being from Memphis, Tennessee, the yellow fever epidemic of 1878. And so that kind of experience, that history actually first got me thinking about how people respond to those kinds of situations. How was it that individuals and communities can respond to those kinds of problems? So yellow fever actually was again, another disease spread by mosquitoes was the first foray into thinking about these topics. But you're exactly right, people in the US have not dealt with malaria since the forties and fifties.

So I guess this is a collective action problem because one person can't just fix it or fix it for themselves. The people who you're surrounded by all have this impact on you and your health and your likelihood to get malaria. So how should we be thinking about malaria and malaria spread and prevention when we're trying to think about fixing it and kind of using economics to do that?

Yeah, great question. This is actually the core argument of the book, and I think it's just super important to recognize the problem first and foremost or part of the problem before we think through things to do about it. So the first part of the book is laying out these connections. Is it actually the case that the provision of mosquito control and ultimately connected with that is malaria prevention? Are those things actually a collective action problem? So I spend a good number of pages trying to detail and explain, okay, what are these problems like in theory, how have other scholars approached these topics and then ultimately laying the groundwork to think about malaria. So yeah, I think so, yeah, the way we typically define collective action problems is to think through situations where if I'm producing one thing and it benefits someone else, well that other person has an incentive to free ride.

So you might've heard of free riding, and the idea is, well, if someone else is providing this good, whether it's mosquito control or draining a swamp, that mosquitoes breed, in many cases, stagnant bodies of water, if allergy of my area, I think that my neighbors, it's benefiting my neighborhood and community. So again, just thinking through that situation, if I start to do that for my own reasons, there may be a free writing effect such that people might be less interested in providing that good. And so that's how I think about collective action problems and issues of externalities and public goods.

There's a long line of thinkers here as well. That's again, I kind of detail and try to tie into, go back to David Hume. David Hume has this wonderful just little short description of two neighbors trying to, not malaria, not malaria, but it's so close. It's like how wonderful that it's so close, he's talking draining a meadow. How is it that two neighbors can kind of meet and drain this meadow that they hold in common is kind of the idea. And he says there may be a variety of factors there, but they know each other's minds. That's the phrase he uses. They know each other's minds. And what he's kind of indicating there is that they're neighbors, they know each other. If one of them doesn't contribute, the other one's going to get upset.

And again, they know each other's minds, which indicates they are probably going to be more likely to cooperate than not. And so that's kind of a first foray into thinking about collective action problems, but also solutions, or at least in that context, if we're neighbors, we may actually have social pressure and things like that that can help us out. Go to Alexis to Tocqueville- Tocqueville's writing in the 1800s. And he says, look, people in the US are so cool. They have all these clubs and societies and civil organizations. They are using those things to provide public goods in many cases.

And this is the underlying framework for which people like the entomologist, Leland Howard is working and growing up in. And Leland Howard's an interesting figure. I open the book and describe some of his work. He's an entomologist, so he's studying insects, all kinds of insects. He actually does some early work on mosquito control before we knew exactly what spread malaria, but he's going around to different places and trying to think about tinkering with solutions of oil and kerosene and things like that. But ultimately, he writes a book on mosquitoes and he says, look, it's great that some communities are kind of awakening to this problem of mosquitoes, but what is everyone's problem? No one's problem is more or less the argument he makes. And he, he's identifying at least in a very small way, this kind of collective action problem. If everyone has an incentive to make this good, well then no one does.

And so that just has always fascinated me and struck me, and it helps to motivate the book because we have this public health figure. He's a relatively well-known entomologist of the early 20th century, and he says, Hey, there are other problems that are relevant here. There are other ways in which malaria is spreading. It's not just because of the epidemiology of malaria and mosquitoes, the ecology, all those things are well and good, but there are social factors that are relevant. And I think the collective action thinking about collective action is really relevant. So just last thing I'll say again, I also tie this into the work of Mancur Olson and Elinor Ostrom, as well as Steven Strong. These are economists and social scientists who more formally develop this idea of collective action, but they're also very large stepping stones into developing the argument and forth noting solutions, noting how individuals can resolve these problems.

So what are the sorts of ways I think about preventing mosquito bites? And I just think about mosquito spray or those weird candles that smell really weird, that don't actually really prevent mosquitoes or bugs. What are the ways that you actually can prevent malaria? What are the things that have to be done, done, I guess, communally globally or even individually to prevent yourself from getting sick, but also preventing everyone from getting sick?

So there are a variety of ways and means of producing mosquito control, but also malaria prevention. So think about malaria prevention as a broad category of things. We could, in the last couple years or so, we've been developing malaria vaccines. So if the malaria vaccine was more available and common usage, that would be an amazing kind of feat in pharmacology and the development of science and malaria biology. So that would be very helpful. That would be a means of malaria prevention. We might also think about other responses and other kinds of interventions, mosquito nets, which we've mentioned before. That is a physical barrier that more often than not prohibits or discourages mosquitoes from biting and spreading malaria parasites. So that's also a means of prevention. It might also think about mosquito control going around to a local area, changing the ecology, changing the course of a riverbed or streams, cleaning up those rivers.

So mosquitoes are less lucky to reproduce. So it's those kinds of interventions that I focus on most often. I don't know quite why that is. So I focus on mosquito control to make the point that there is a lot of room for human choices in trying to understand malaria. So yeah, if we go around giving everyone mosquito nets and malaria vaccines, that's a very wonderful intervention, but it doesn't often help us think through the incentives people face. And again, that's kind of what I wanted to focus on and think through what are the private incentives, what are also the social incentives? And so mosquito control is a neat way to think through those kinds of issues.

And I'm sure…

No, continue. I can keep going through examples, but you were going to say something.

I was just going to say, I'm sure that when you're, I'm trying to not think in the modern day, but maybe this will actually work. Anything to do with the environment is so inflammatory. There must be 1,000,010 interest groups that are immediately trying to seize control. And I know I was joking about Rachel Carson earlier, but people like that who think that killing mosquitoes, even if they're killing humans or even preventing mosquito reproduction, which effectively, I guess you could call killing mosquitoes, that that's bad, that we're changing the earth and the environment. And so even if it's better for human beings because it's saving lives, that's a bad thing.

And we could talk about how I have a hard time not putting human lives first, but I think that that maybe goes without saying, but maybe not. But what was the sort of tension there? If you have to take these collective actions and you have maybe groups that are trying to use their interests to direct that action, either towards actually controlling mosquitoes or not for whatever reason, what were the tensions and specific problems that had to be worked through in each of these cases to actually achieve any sort of action? Because the hardest thing about collective action sometimes is actually taking an action, right?

For sure. Okay, so there's a lot. I think one response is to, again, kind of critique the Rachel Carson and the others, that kind of movement and recognize just very simply, if we prohibit the use of DDT, you're welcome to pursue those goals as we all value the environment, it's going to come with a consequence, it's going to come with people being less likely to prevent malaria. And so there's a human cost to that. Another response is to also note exactly like you mentioned that many of the cases that I do talk about are right after we realized the connection between mosquitoes and malaria. So we're talking the very late 1890s, early 1900s. And so we're not talking about vaccines here. We're not talking about long lasting insecticide treated bed nets, right? Those are relatively modern technological responses that again, are wonderful. This just wasn't the world we were living in in 1900.

And so that, again, it's fascinating for me. These are great examples. They highlight the private and social incentives, and it gives us an opportunity to tease those incentives out. So what were people doing? So one example that I walked through is there was an owner of a hotel. It was called the Omni Hotel, I believe in Connecticut. I might have that wrong, but it was somewhere in New England. It was kind of a resort kind of hotel. People like Mark Twain would go there. So it's not like some motel kind of place. It was a very kind of well-established hotel. It became a well-established hotel in the 20th century. But how did it become that is kind of the issue. Well, in the early 1900s, people were still kind of dealing with this issue of mosquitoes. And this is kind of a little caveat, wasn't necessarily that they were preventing malaria, it said in this case, they were also just very concerned about mosquitoes as a nuisance.

But in any event, they are annoying. They are annoying. Google mosquito swarms, and you'll get a whole bunch of videos. But the owner of this hotel, he and his son realizes this problem, and they literally just go around and they started to drain the little divots in their yards. They started killing mosquitoes, spray oil, oil kerosene. So of course, now we think of this as an environmental kind of tension, but it just wasn't a consideration back then. And so the argument that I'm making is that there are cases where individuals have incentives to overcome these externality problems. So why is it that works out in this case? Well, the owner was doing this thing, the owner had a financial incentive to go around and kill mosquitoes that going to do, that's an input into their production of providing a hotel. So just simply, they want to have more customers, they want to have more revenue. How do they do that? They're going to provide mosquito control. So that alignment of the private incentives of the hotel owner and the social incentives of providing mosquito control is like a representative example. If we can find more cases like that or other ways in which we align those incentives, that's a win that helps us to resolve this collective action problem.

I'm going to go ahead and use the word, but then explain myself. Yeah. It seems as though if we properly define who has the right to, I don't want to say the problem, but the thing that is the potential solution to the problem. So having ownership of the land where the problem is, makes it so that you're more likely to actually fix the problem. That seems to kind of be the way that these solutions work out privately, which is maybe the most effective way for them to work. And so how do we do that in cases where property rights or whose problem it is not as well defined?

Great question. So yes, I completely agree. The cases like the hotel owner, there are other cases of residential areas like developers trying to, if you're a residential developer in the early 1900s and you just learned that mosquitoes are kind of these pesky, not just that they're pesky, but they also might be spreading diseases, you now have an incentive to provide this as a means to developing an area. So if you have a couple hundred acres and you want to build that up and build summer homes, well again, you now have an incentive to care about the mosquito population and limited. So you're exactly right. I think those are cases where as property rights are clear and as they're even more clear than that, that it would be very easy for us to see how those private and social incentives are aligned there. Later in the book, I try to wrestle with the other part of this side, if property rights work so well here, what happens when they don't?

That is, yeah, because there are definitely cases when they don't work or don't apply or any of the above.

And I try to wrestle with this. So in one of the later chapters, I walk through examples from mid 20th century China, mid 20th century Bangladesh and Venezuela. These are cases that have had relatively severe malaria outbreaks and also cases where property rights have been eroded, to say the least, right? There are a lot of problems with those areas aside from malaria, but I kind of try to push the argument and readers can decide how well I make that argument, but I make that connection a little bit clearer. That is, hey, look, in addition to all the other bad things that happen, whether it's assassinations or the great leap forward in China, things like that, malaria increased in part, and this is the argument I'm trying to develop because of property rights disruptions. No one individual had an incentive to care about mosquito control, whereas they might have had those incentives if they had a better set of property rights. So that's the argument I make in the later part of the book. It's not perfect, but I think it's part of one of the weaker parts of the book. But that's my argument.

So are there ways to get around that? What are we supposed to do when that sort of situation arises in order to restore the situation to one where then we can actually find a remedy to the problem? That's a big question, I think.

Yeah. Well, so again, I try to hint at some responses or broad level policy solutions at the end of the book, but here, I just don't toss my hands up, but I say, look, think there are genuine connections to be made here. And so if we take a step back, just that the idea is property rights are important. We should expect to see people being more considerate of these kinds of issues in areas where property rights protections are stronger. And so if we are concerned about malaria and controlling mosquito populations, aside from providing bed nets, maybe we should also advocate whole debate we could have, but just thinking about an important aspect of this, just making that connection clear.

Well, so let's kind of get into the history a bit and kind of talk about this other, not other example, but other aspect of what went down. So actually how we ended up preventing in a lot of cases, so there was drainage, but also there's the use of DDT, which I don't actually know the full name of because it's long and complicated in science, but it's a chemical that was used to effectively just get rid of the mosquitoes. How did that go down? How is it that we could essentially use it all over the country? Was that a government action? And how was it created? Discovered? What was kind of the relationship there between that solution being discovered and employed in malaria prevention and mosquito control? And I guess how can we learn from it? What are ways that it could have been better or what it actually got? I mean, we don't have mosquitoes the way we used to.

So fortunately, I don't deal a lot with DDT in the book because most of the cases I'm looking at are in the us. That is prior to maybe 1930. And so DDT was a technological innovation that was developed after that more or less effectively kills mosquitoes. So fortunately I don't have to wrestle with that for, yeah.

So what are ways then that the property rights defining clearly, who has ownership over the problem and who needs to solve it? What are the limitations to that? What do you do when it is, I don't know, it's hard to say. Not quite clear, but when it truly is collective, whether it's privately collective or publicly collective, maybe you could just get rid of public roads, but do mosquitoes even collect on roads? I don't know. And then how do you deal with the environmentalists who want to protect? I guess maybe they didn't always want to protect the streams, but yeah.

Yeah, great question. So in the first part of the book where I'm developing this argument, I not only focus on individuals and individual hotel owners and homeowners, things that I discussed previously. I also look at firms, firms in the private sector. I look at entrepreneurs, I look at organizations of civil society. So these are all different ways in which we're making that alignment between private and social incentives. So great question. We want to recognize the conditions under which these property rights are not effective. But before we get to that, I want to recognize the ways in which property rights can be effective. And so I look at individuals, I look at entrepreneurs firms in the private sector and civil society. So firms in the private sector, right? Again, think about the context. We're talking about the early 20th century. Imagine if you have a textile mill in North Carolina.

Well, you want workers to be working for you. You want them to not be sick. You want them to be working in the looms. If they're mosquitoes, and this is a case where malaria was actually prevalent, you are going to have an incentive now to provide mosquito control. So it benefits you, your bottom line. It benefits your workers in the local community as well. So cotton mills in North Carolina, railroads in eastern Texas, as well as many other railroads throughout the south face these incentives. And so there's a chapter on these firms and the extent to which they can provide mosquito control. Again, I think it's just a great example. Again, tie that to property rights. To what extent is this a function of the property rights that these firms have? Well, yeah, they have the expectation of receiving revenue, of doing the things they need to do to produce. And so that encourages them to provide mosquito control.

Civil society, we might very well recognize, okay, great, you've got individual homeowners doing this thing. You've got some firms doing this. Well, what about the independent sector? One of the first instances of a community response, what was advanced by an organization of civil society in New Jersey, I believe there was the 20th Century Club, so I forget her name, but she was a treasurer, Martha, her name. So apparently, according to this story, she was just kind of walking around one day in New Jersey, I think it's in Long Island or the Richmond Hill area of Long Island. And she happens upon a pamphlet from the London School of Medicine that again had just kind of announced or was studying mosquitoes in malaria. And she makes this connection. Again, this is a story that I think comes from Reader's Digest or something like that. But she realizes connection.

And so as a member of the 20th Century Club, she goes around and encourages her group. They were very much interested in improving the quality of life in the Richmond Hill area. And they go around posting placards, requesting donations, encouraging people to take, if you've got trash in your yard, get rid of it because not just unsightly, it's collecting water that helps to free mosquitoes. So that kind of communal response, right? She's going around talking to people and she's encouraging mosquito control, kind of a local mosquito control throughout the community. People in that area later respond and said, this was amazing, right? I, I've been living here for 20 years and I've never seen it where there's so few mosquitoes. And so again, there's evidence and qualitative evidence to support that connection. So yeah, I think it's exactly, you're hitting the nail on the head here that we got to understand the conditions under which collective action is relevant and under which individuals and private actors can be responsive. And those are some of the ways I tackle that kind of issue.

And that's so cool because, I don't know, to think that we don't have to wait around When Covid happened, everyone kind of halted and was waiting for the government to do something, and the government was telling us to stay home, and the government was telling us we were going to get a vaccine, and it was the fastest we'd gotten a vaccine in human history, which was crazy. But it still took a long time. And to think that there was so much that could be done and even probably was done, that I'm just not super aware of at the community level to kind of make that better faster if it's not a vaccine, especially because the malaria vaccine, who knows? I don't actually know if it's valid and good, but it's starting to exist now, and it hasn't been a problem in the US for a long time because we've had all these other solutions. So what sort of ways can we today reevaluate our hands, offedness with respect to collective action problems or problems that we could actually solve ourselves, or at least lighten the burden of them on ourselves and our communities? How should we start to think about this ourselves and apply it in our own lives? Big question again.

That's a great question. It's an amazing question. There's one response is, it is literally how we think about the problem. So Tyler Cowen has a really fascinating piece, maybe from 1985, mid eighties, and it's about public goods and how we deal with those problems. One of the factors that he kind of hones in on, kind of standard Olson and responses there is the marginal unit of production. And that's kind of a technical sounding term here, but his argument is that that's really, really important when we think about the implications for public goods and externalities. So if we're trying to build a road, for example, there may be huge externalities or public good if we think about the entire road network of a country.

So imagine if our objective or if we define roads as an entire country's road network, that's a huge public good problem, and it's probably likely that government is the only to provide that kind of good. But notice that that's merely, and I think this is Tyler's argument. It's only because we define the problem that way, that we have government as the only provider. Well, what happens now if we change the marginal unit of production to thinking about the single lane of a highway or a single stretch of a highway? So if we're talking about the road between Richmond and DC, that's a very different problem. And that's one where maybe there's a little bit more room for private and maybe even public actors to think about. There's more room for competition, and that changes the nature of the problem entirely. So again, I always kind of fall back on Tyler's argument there. I think it's great. It's the same for mosquito control. If we think about providing mosquito control throughout the entire country, of course it's the public good for which government is probably the only provider or some international agency. Well, if we think about mosquito control as a local problem, in many cases it is individual homeowners firms in the private sector, civil society organizations might be able to deal with those kinds of problems. It's a very different story, and I think that's part of the important argument of the book. So that's wonderful response there.

Thank you so much for coming on the podcast and for sharing all of the public choice and non-public choice solutions, I guess, to malaria and for educating us on what malaria is.

Oh, I wanted to mention about covid too, right? Yes. One example there that I caught on earlier or heard about, and I've written about this, firms changing their production process to producing hand sanitizer or face masks. Those were just kind of amazing parts of the responses people took that I think still goes unnoticed. 

We might have heard that the homemade masks…

And there was a local kayak maker. I'm in Hampden-Sydney, Virginia, and there's a local kayak maker that deals a lot with plastics. Well, guess what they did? They started producing face masks, like the plexiglass kind of face masks that you could put on your head and things like that. And again, it's just a great example of private responses and entrepreneurial responses to changing prevalence rates. So I think that kind of argument is still underappreciated.

Yeah. Yeah. I'm glad we're here. Bringing it to light. I have one last question for you. Sure. What is one thing that you believed at one time in your life that you later changed your position on and why?

Oh, wow.

Big question. Seriously.

Sometimes I think about this, I used to have this weird conception of money and exchange. So again, let's say I was 15 or younger, I would think, oh, well, why can't we just trade everything? So obviously I hadn't read Adam Smith. I hadn't read anything about transaction costs, and I just had this idea that we can acquire goods by trading. And I always had kind not thought deeply enough, obviously, but that's kind of just how I viewed the world for a good number of years. And now after learning more and more about economics, I obviously realized there are transaction costs of exchange. And it's very difficult for people to find goods and services they want and willing suppliers of those goods. And so money is a very important aspect and part of the exchange process. So that would be one example.

Once again, I'd like to thank my guests for their time and insight. I'd also like to thank you for listening to the Great Antidote Podcast. It means a lot. The Great Antidote is sound engineered by Rich Goyette. If you have any questions, any guests or topic recommendations, please feel free to reach out to me at Great antidote@libertyfund.org. Thank you.