GiveWell claims that AMF is about 10 times more cost-effective than GiveDirectly, and GiveWell ranks AMF as its top charity partially on this basis (see “Summary of key considerations for top charities” in the linked article). This claim depends on the assumption that saving a life creates 35 QALYs.
I’m sorry but I didn’t have time to read this post in full and can’t comment on the philosophical issues. I also cannot speak for GiveWell and the following is just my personal interpretation of their cost-effectiveness analysis.
I think the statement above is a based on a misunderstanding of Givewell’s cost-effectiveness analyses.
GiveWell writes here:
“We do include possible developmental impacts on children who sleep under an LLIN: we estimate that sleeping under an LLIN provides the same developmental impacts that a deworming pill provides. However, most of the benefit provided by LLINs is in the lives that LLINs save, not in their impact on development.”
http://www.givewell.org/international/top-charities/amf#Costperlifesaved
I think this is what the 10x better than GiveDirectly refers to. Deworming charities have a similar effect on development and are also ranked as about 10x as good as cash-transfers and rarely cause mortality, which leads me to believe that the child mortality reduction is not included in that part of the cost-effectiveness analysis, but rather modelled separately.
Have you looked at GiveWell’s cost-effectiveness model? I don’t believe that’s correct. GiveWell estimates the cost-effectiveness of bednets as
((long-term benefits to income) / (cost per person-year of protection * relative development benefits)) + ((DALYs per life * conversion factor from DALYs to income) / (cost per life saved))
(making some simplifying assumptions but that’s the gist of it.)
So it’s a sum of the development benefits to income and the life-saving benefits. Estimates vary between employees, but on average the life-saving benefits account for about 2⁄3 of the total benefits. The claim that AMF is 10x more cost-effective than GiveDirectly comes from the total figure, and most of that comes from life-saving benefits. Therefore the cost-effectiveness estimate for AMF critically depends on how you estimate the value of saving lives.
And anyway, many people cite the benefits of AMF as “saving a life for $3000” or something along those lines, which falls prey to the problems I discuss here.
Sorry I was being unclear. The part of the equation that you call ‘Life saving benefits’ (e.g. ((DALYs per life * conversion factor from DALYs to income) / (cost per life saved)) is only of instrumental value—it crucially depend on the conversion factor of from DALYs to income (if you were to set it to zero so that there would be no increase in income due to the morbidity and mortality, the life saving benefits would be zero). So I believe there is no intrinsic valuing of QALYs/Life in the cost-effectiveness model that suggests that bednets are 10 times more effective than cash-transfers, as I thought your argument implies. Rather I believe cost-per-life saved is modelled separately.
It sounds like you’re saying the conversion factor from DALYs to income is based on how much more income people have when their lives are saved, but that’s not correct. The conversion factor from DALYs to income is written on GiveWell’s spreadsheet as “1 DALY is equivalent to increasing ln(income) by one unit for how many years”. In other words, how good is increasing income relative to extending someone’s life? This number is determined by taking the median of value judgments by about a dozen different GiveWell staff members. So what I said originally is correct.
I’m sorry but I didn’t have time to read this post in full and can’t comment on the philosophical issues. I also cannot speak for GiveWell and the following is just my personal interpretation of their cost-effectiveness analysis.
I think the statement above is a based on a misunderstanding of Givewell’s cost-effectiveness analyses.
GiveWell writes here: “We do include possible developmental impacts on children who sleep under an LLIN: we estimate that sleeping under an LLIN provides the same developmental impacts that a deworming pill provides. However, most of the benefit provided by LLINs is in the lives that LLINs save, not in their impact on development.” http://www.givewell.org/international/top-charities/amf#Costperlifesaved
I think this is what the 10x better than GiveDirectly refers to. Deworming charities have a similar effect on development and are also ranked as about 10x as good as cash-transfers and rarely cause mortality, which leads me to believe that the child mortality reduction is not included in that part of the cost-effectiveness analysis, but rather modelled separately.
Have you looked at GiveWell’s cost-effectiveness model? I don’t believe that’s correct. GiveWell estimates the cost-effectiveness of bednets as
(making some simplifying assumptions but that’s the gist of it.)
So it’s a sum of the development benefits to income and the life-saving benefits. Estimates vary between employees, but on average the life-saving benefits account for about 2⁄3 of the total benefits. The claim that AMF is 10x more cost-effective than GiveDirectly comes from the total figure, and most of that comes from life-saving benefits. Therefore the cost-effectiveness estimate for AMF critically depends on how you estimate the value of saving lives.
And anyway, many people cite the benefits of AMF as “saving a life for $3000” or something along those lines, which falls prey to the problems I discuss here.
Sorry I was being unclear. The part of the equation that you call ‘Life saving benefits’ (e.g. ((DALYs per life * conversion factor from DALYs to income) / (cost per life saved)) is only of instrumental value—it crucially depend on the conversion factor of from DALYs to income (if you were to set it to zero so that there would be no increase in income due to the morbidity and mortality, the life saving benefits would be zero). So I believe there is no intrinsic valuing of QALYs/Life in the cost-effectiveness model that suggests that bednets are 10 times more effective than cash-transfers, as I thought your argument implies. Rather I believe cost-per-life saved is modelled separately.
It sounds like you’re saying the conversion factor from DALYs to income is based on how much more income people have when their lives are saved, but that’s not correct. The conversion factor from DALYs to income is written on GiveWell’s spreadsheet as “1 DALY is equivalent to increasing ln(income) by one unit for how many years”. In other words, how good is increasing income relative to extending someone’s life? This number is determined by taking the median of value judgments by about a dozen different GiveWell staff members. So what I said originally is correct.