Thank you for the top level post. Itâs much easier to engage here than on the various comment threads.
I have some clarifying questions about your claims, and in particular I would like to have a better understanding of where and why you disagree with Givewellâs/âAMFâs read of the situation. You say that they are simply ignoring these issues, implying that they would agree with you if they paid attention. I donât think this is true, as detailed on a point-by-point basis below.
However hard they work, they canât make enough nets to combat the malaria-carrying mosquito. Enter vociferous Hollywood movie star who rallies the masses and goads Western governments to collect and send 100,000 mosquito nets to the affected region, at the cost of a million dollars. The nets arrive, the nets are distributed, and a âgoodâ deed is done.
It seems the implied premise here is that 100,000 nets is more than that region actually needed? For example if the region needs 200,000 nets per year, only currently has 50,000 being manufactured per year, and some foreign donors distribute 100,000 nets per year, then I would have thought there was a lot of room for the local factory. This goes double if the donated nets are targeted to the poorest areas, while the factory presumably will prefer to sell to the richer areas.
Far from Givewell ignoring this issue, they pay a lot of attention to how many more nets affected regions can usefully absorb in their analysis of AMFâs Room For More Funding. They conclude that there is huge scope for more nets that AMF is unlikely to get close to filling any time soon, see below quote. If you disagree with them on this concrete level, it would be worth saying why.
I agree that if we get anywhere close to filling local net gaps, itâs likely not worth displacing local capacity, or at the very least we should seriously weigh the downsides of doing so. Though unless Iâm missing something the most obvious solution to this would be for AMF (or whoever) to buy the nets locally, it seems like the origin of the donations isnât actually the problem here, just where the nets are manufactured.
Dr. Renshaw roughly estimated that there will be a funding gap for 100 million nets in 2018-2020. She estimated that the gap in Nigeria would account for a quarter of the total gap, or about 25 million nets. This assumes that funders other than the Global Fund (including AMF) will maintain their current level of support for LLINs in this period. Dr. Renshaw believed that less funding from the Global Fund would be available for LLINs because of changes in the way it is structuring its funding.
Iâm not sure what youâre trying to get at with your planners versus searchers quote. AMF does a lot of things that sound like a âsearcherâ in your dichotomy. They look for local distribution partners whose methods vary by country, and also follow-up to check whether the nets are actually being used. Nor does it pick countries and areas at random, but rather on the basis of its assessment of need and in at least one major case in response to a request. Can you clarify more why you consider this a âplanningâ approach?
The NMCP has been working with AMF for a relatively short period of time. Their working relationship has proceeded relatively smoothly thus far, especially since AMF has shown willingness to negotiate and compromise on some areas to conform with the countryâs specific scenario
AMF told us that it has been receiving more funding requests since it started funding larger distributions,8 and notes that its largest commitment so farâ10.6 million LLINs in Uganda in 2017âwas made in response to an in-bound request.
Finally, reading your first two criticisms I was inclined to suggest Give Directly as something you might be willing to support. So I read your third section with interest, but I donât think I understand it.
[Give Directly] simply [does] the work for a community, instead of building capacity and increasing autonomy and dependence. This is great for the organization, since it ensures that the community will need aid forever, by destroying the infrastructure that the community previously used to make a living. If you get rid of the need for structures which produce food, or organizations which provide jobs, they will go out of business, so that when the community will be unable to return to them when the aid money eventually dries up.
Iâm very confused by this section. For instance, by what mechanism do you propose Give Directly gets ârid of the need for structures which produce foodâ? Unsurprisingly, giving people extra cash increases the amount of money they spend on food (among many other things):
Treatment households consumed about $51 more per month (95% CI: $32 to $70) than control households.209 About half of this additional consumption was on food.210 This additional consumption also included increased spending on social expenditures and various other expenditures.
Thanks for the thoughtful response. Thereâs a difference between demand and need. Need is the number of people that could use nets but do not. Demand is the number of people that actually want nets. The problem is that the need for nets is significantly higher than the demand. Oversupply decreases the demand for nets, no one will pay for something that is being given out for free. If you want people to actually use a net, you need to create demand, not just fill a need. Most people here literally put up their nets when they see the people that are coming to survey a village on the road. They lie about whether they sleep under a net, and spend most of peak mosquito biting time outside talking, not sleeping, so nets are left ineffective. Imagine that instead of buying many nets and shipping them in, AMF invested in local companies that produce nets to employ more people, expand their business, while simultaneously going to communities and sensitizing them about the importance of bednet use. This would increase demand as well as fill need. And, importantly it would be sustainable, AMF would eventually work themselves out of a job instead of killing off all of the local competition, and making the society completely dependent on their bed nets.
If I understand your point, you are claiming that, since bed net distributions are targeted to the poorest, the factories, which cater to the richer populations, would not have a problem. I have three concerns with this claim. First it represents a fundamental misunderstanding of the sheer level of corruption that perpetrates many of these societies. In order to get resources to the poorest, (at least where I live, which is admittedly pretty high on the corruption index) you must give them to the wealthy who control the distribution centers, the ports, and the laws, and simply to be culturally appropriate and respectful. Second, this still does not address the problem that there is not actually a demand for these nets in the poorest communities, they donât want it, so of course they are going to sell it at a cheaper price than the factory can produce to the people that actually want it. Third, organizations which come into these countries rarely are able to distinguish the extreme poor from the moderately well off. Most people will pretend to be poor here in order to get handouts. I have seen families hide their television in the hopes of getting an organization to donate to them. Organizations frequently fail to actually give to the people that need it the most.
As for searchers and planners, the problem is, once again the difference between need and demand. AMF goes into areas that need nets, they donât go into areas that want nets. They go into areas that want jobs, electricity, or clean water. They donât sit down with the community and say, what do you need the most? A new market? Okay we will get that for you. They sit down with a community and say, you need bed nets, we are going to give you bed nets. If you say that you donât need them, we will go to the next village and give them bed nets instead. I have seen it. They do assessments of how many people get malaria in an area, not what people want if given the choice. The only comparable thing for someone that has not lived here is the flu. Have you gotten a flu shot every single year? Why not? People die of the flu at about the same rate as they die of malaria every year. Maybe because you think that other things are more important. These communities do too. Governments and organizations may request funding and nets, but I have spoken to many communities up and down this country, and never have they said that the thing that they need is bed nets, or malaria reduction. This is top down because AMF is not talking to the actual recipients of the aid, they are talking to intermediary organizations or governments, who ignore the needs of the people, just as much as AMF.
As for Give Directly, hereâs what Iâm talking about. Imagine that you are a village tailor. You donât make enough as a tailor to support your three wives and 20 children (no thatâs not an exaggeration) so you are also a subsistence farmer. Give Directly comes in and provides you with money. You use these funds to supply your immediate needs. Give Directy proudly claims âThis year we plan to provide entire communities of people with a basic income: regular cash payments that are enough for them to live on, for more than 10 years.â Imagine you are one of the recipients, for ten years you get payments, so you have no need to work in your field or sew clothes. Your equipment breaks, villagers go to other tailors and you loose market share. Other people that need it more use your farms, and you let them, because culturally, those that have more must give to those that have less. Now ten years later, you were able to âeat your moneyâ as they say, but now you have no business, no farm, and no more free income. You are worse off than you were before.
The video goes into these individual points in greater depth. What I fail to see is why effective altruists should not focus on programs that build capacity, provide jobs, actually listen to what the people want, not what international organizations determine that they need, and increase independence, instead of making recipients more and more dependent on foreign aid. I would be surprised if others who have actually lived in these communities for any substantial amount of time would disagree. The problem is that those that evaluate these charities are so far removed from the actual needs of the people, and the consequences of their actions, that they donât realize the harm that they do.
âfor ten years you get payments, so you have no need to work in your field or sew clothesâ
I donât believe that these cash payments, the equivalent of less than $1 a day, are sufficient to cause people to stop working. And the evidence is fairly clear from GiveDirectlyâs research that they do not have that effect. In fact by allowing people to invest in their education/âhealth/âbusiness where previously they were credit constrained, they could fairly easily raise their work effort and productivity.
I personally do not live in a country where give directly operates, but I can speak to what people here with money they receive from similar programs, and what they tell the people who have them the money what they did with it. I have seen literally over a hundred families receive donations tell the organization that they spent it on everything from healthy vegetables to school fees when in fact they spent it on sugar, tea, larger celebrations, new sound systems and more. It is completely culturally acceptable to lie to strangers, especially if those strangers are giving you money. So I am skeptical of their statistics to say the least.
As for people refusing to do work when they have enough to get by, I live in a place where most people are subsistence farmers. Due to the lack of jobs, when there is no work to do on the farm, most people sit around and do nothing. If there are no jobs and people have enough to get by, they wonât do anything. Why are there no jobs, because of organizations like AMF.
âI have seen literally over a hundred families receive donations tell the organization that they spent it on everything from healthy vegetables to school fees when in fact they spent it on sugar, tea, larger celebrations, new sound systems and more.â
Even if that turns out to be true, this kind of spending could still help the countryâs economy and support local businesses. It seems like cash transfers to people in developing countries donât do enough harm to outweigh the positives associated with them. Your argument might still work for AMF, but Iâm not so sure about GiveDirectly.
If you doubt the claim, I would encourage you to come live here for years and see what you think. But as for the claim about the economy, I would agree that GiveDirectly, would probably fall more in the ânot doing as much good as it saysâ category in terms of jobs and economic development than the âactively doing harmâ category. However, in terms of dependence I would argue that the harm outweighs the good. GiveDirectly clearly creates dependence of foreign aid by supplying communities with money for basic necessities for years and then cutting them off. These communities loose the ability to be productive after years of dependence, and will in fact end more dependent on aid than they started, since those people in the community who were working, did not need to, and so their tools and equipment will need to be replaced, or if they passed on, their expertise could be lost for good. The harm that GiveDirectly does is that it deepens the need for aid in these communities instead of lessening it. This is great for aid organizations, because it keeps them in business, but it is bad for communities because if the aid ever stops, they will be much worse off than before. An ethical aid organization should work itself out of a job, not increase the need for more organizations like itself.
Thank you for the top level post. Itâs much easier to engage here than on the various comment threads.
I have some clarifying questions about your claims, and in particular I would like to have a better understanding of where and why you disagree with Givewellâs/âAMFâs read of the situation. You say that they are simply ignoring these issues, implying that they would agree with you if they paid attention. I donât think this is true, as detailed on a point-by-point basis below.
It seems the implied premise here is that 100,000 nets is more than that region actually needed? For example if the region needs 200,000 nets per year, only currently has 50,000 being manufactured per year, and some foreign donors distribute 100,000 nets per year, then I would have thought there was a lot of room for the local factory. This goes double if the donated nets are targeted to the poorest areas, while the factory presumably will prefer to sell to the richer areas.
Far from Givewell ignoring this issue, they pay a lot of attention to how many more nets affected regions can usefully absorb in their analysis of AMFâs Room For More Funding. They conclude that there is huge scope for more nets that AMF is unlikely to get close to filling any time soon, see below quote. If you disagree with them on this concrete level, it would be worth saying why.
I agree that if we get anywhere close to filling local net gaps, itâs likely not worth displacing local capacity, or at the very least we should seriously weigh the downsides of doing so. Though unless Iâm missing something the most obvious solution to this would be for AMF (or whoever) to buy the nets locally, it seems like the origin of the donations isnât actually the problem here, just where the nets are manufactured.
Iâm not sure what youâre trying to get at with your planners versus searchers quote. AMF does a lot of things that sound like a âsearcherâ in your dichotomy. They look for local distribution partners whose methods vary by country, and also follow-up to check whether the nets are actually being used. Nor does it pick countries and areas at random, but rather on the basis of its assessment of need and in at least one major case in response to a request. Can you clarify more why you consider this a âplanningâ approach?
Finally, reading your first two criticisms I was inclined to suggest Give Directly as something you might be willing to support. So I read your third section with interest, but I donât think I understand it.
Iâm very confused by this section. For instance, by what mechanism do you propose Give Directly gets ârid of the need for structures which produce foodâ? Unsurprisingly, giving people extra cash increases the amount of money they spend on food (among many other things):
Thanks for the thoughtful response. Thereâs a difference between demand and need. Need is the number of people that could use nets but do not. Demand is the number of people that actually want nets. The problem is that the need for nets is significantly higher than the demand. Oversupply decreases the demand for nets, no one will pay for something that is being given out for free. If you want people to actually use a net, you need to create demand, not just fill a need. Most people here literally put up their nets when they see the people that are coming to survey a village on the road. They lie about whether they sleep under a net, and spend most of peak mosquito biting time outside talking, not sleeping, so nets are left ineffective. Imagine that instead of buying many nets and shipping them in, AMF invested in local companies that produce nets to employ more people, expand their business, while simultaneously going to communities and sensitizing them about the importance of bednet use. This would increase demand as well as fill need. And, importantly it would be sustainable, AMF would eventually work themselves out of a job instead of killing off all of the local competition, and making the society completely dependent on their bed nets.
If I understand your point, you are claiming that, since bed net distributions are targeted to the poorest, the factories, which cater to the richer populations, would not have a problem. I have three concerns with this claim. First it represents a fundamental misunderstanding of the sheer level of corruption that perpetrates many of these societies. In order to get resources to the poorest, (at least where I live, which is admittedly pretty high on the corruption index) you must give them to the wealthy who control the distribution centers, the ports, and the laws, and simply to be culturally appropriate and respectful. Second, this still does not address the problem that there is not actually a demand for these nets in the poorest communities, they donât want it, so of course they are going to sell it at a cheaper price than the factory can produce to the people that actually want it. Third, organizations which come into these countries rarely are able to distinguish the extreme poor from the moderately well off. Most people will pretend to be poor here in order to get handouts. I have seen families hide their television in the hopes of getting an organization to donate to them. Organizations frequently fail to actually give to the people that need it the most.
As for searchers and planners, the problem is, once again the difference between need and demand. AMF goes into areas that need nets, they donât go into areas that want nets. They go into areas that want jobs, electricity, or clean water. They donât sit down with the community and say, what do you need the most? A new market? Okay we will get that for you. They sit down with a community and say, you need bed nets, we are going to give you bed nets. If you say that you donât need them, we will go to the next village and give them bed nets instead. I have seen it. They do assessments of how many people get malaria in an area, not what people want if given the choice. The only comparable thing for someone that has not lived here is the flu. Have you gotten a flu shot every single year? Why not? People die of the flu at about the same rate as they die of malaria every year. Maybe because you think that other things are more important. These communities do too. Governments and organizations may request funding and nets, but I have spoken to many communities up and down this country, and never have they said that the thing that they need is bed nets, or malaria reduction. This is top down because AMF is not talking to the actual recipients of the aid, they are talking to intermediary organizations or governments, who ignore the needs of the people, just as much as AMF.
As for Give Directly, hereâs what Iâm talking about. Imagine that you are a village tailor. You donât make enough as a tailor to support your three wives and 20 children (no thatâs not an exaggeration) so you are also a subsistence farmer. Give Directly comes in and provides you with money. You use these funds to supply your immediate needs. Give Directy proudly claims âThis year we plan to provide entire communities of people with a basic income: regular cash payments that are enough for them to live on, for more than 10 years.â Imagine you are one of the recipients, for ten years you get payments, so you have no need to work in your field or sew clothes. Your equipment breaks, villagers go to other tailors and you loose market share. Other people that need it more use your farms, and you let them, because culturally, those that have more must give to those that have less. Now ten years later, you were able to âeat your moneyâ as they say, but now you have no business, no farm, and no more free income. You are worse off than you were before.
The video goes into these individual points in greater depth. What I fail to see is why effective altruists should not focus on programs that build capacity, provide jobs, actually listen to what the people want, not what international organizations determine that they need, and increase independence, instead of making recipients more and more dependent on foreign aid. I would be surprised if others who have actually lived in these communities for any substantial amount of time would disagree. The problem is that those that evaluate these charities are so far removed from the actual needs of the people, and the consequences of their actions, that they donât realize the harm that they do.
âfor ten years you get payments, so you have no need to work in your field or sew clothesâ
I donât believe that these cash payments, the equivalent of less than $1 a day, are sufficient to cause people to stop working. And the evidence is fairly clear from GiveDirectlyâs research that they do not have that effect. In fact by allowing people to invest in their education/âhealth/âbusiness where previously they were credit constrained, they could fairly easily raise their work effort and productivity.
I personally do not live in a country where give directly operates, but I can speak to what people here with money they receive from similar programs, and what they tell the people who have them the money what they did with it. I have seen literally over a hundred families receive donations tell the organization that they spent it on everything from healthy vegetables to school fees when in fact they spent it on sugar, tea, larger celebrations, new sound systems and more. It is completely culturally acceptable to lie to strangers, especially if those strangers are giving you money. So I am skeptical of their statistics to say the least.
As for people refusing to do work when they have enough to get by, I live in a place where most people are subsistence farmers. Due to the lack of jobs, when there is no work to do on the farm, most people sit around and do nothing. If there are no jobs and people have enough to get by, they wonât do anything. Why are there no jobs, because of organizations like AMF.
âI have seen literally over a hundred families receive donations tell the organization that they spent it on everything from healthy vegetables to school fees when in fact they spent it on sugar, tea, larger celebrations, new sound systems and more.â
Even if that turns out to be true, this kind of spending could still help the countryâs economy and support local businesses. It seems like cash transfers to people in developing countries donât do enough harm to outweigh the positives associated with them. Your argument might still work for AMF, but Iâm not so sure about GiveDirectly.
If you doubt the claim, I would encourage you to come live here for years and see what you think. But as for the claim about the economy, I would agree that GiveDirectly, would probably fall more in the ânot doing as much good as it saysâ category in terms of jobs and economic development than the âactively doing harmâ category. However, in terms of dependence I would argue that the harm outweighs the good. GiveDirectly clearly creates dependence of foreign aid by supplying communities with money for basic necessities for years and then cutting them off. These communities loose the ability to be productive after years of dependence, and will in fact end more dependent on aid than they started, since those people in the community who were working, did not need to, and so their tools and equipment will need to be replaced, or if they passed on, their expertise could be lost for good. The harm that GiveDirectly does is that it deepens the need for aid in these communities instead of lessening it. This is great for aid organizations, because it keeps them in business, but it is bad for communities because if the aid ever stops, they will be much worse off than before. An ethical aid organization should work itself out of a job, not increase the need for more organizations like itself.