Thanks for sharing this report! Happy to see more global health content on the forum.
Two quick questions on skimming it:
When working out the marginal value of sodium taxation policy advocacy, do you discount for the possibility of salt reduction policies happening independent of any EA efforts in this area? (i.e. your advocacy is speeding up the policy passing by X number of years as opposed to bringing it in a world where it otherwise would never have existed). For example, if you crudely take 2023 figures, and assume that the intervention successfully speeds up salt taxes globally by 5 years compared to a world without any additional resources, the this would mean ~1.2E9 DALYs are at stake, compared to your topline figure of 1.2E10 DALYs. [1]
The cost per intervention of US$137,000 for getting a salt tax advocacy are in part based on assessments like: i) “I assess that around 1 year of operations is a reasonable timeframe for the charity to lobby/prepare supporting research reports on the health and economics benefits of the tax/do public polling to show public support/construct a coalition of NGOs and advocates in support and hence succeed”, and ii) “my sense is that this is doable by a 2 person EA charity in the style of Charity Entrepreneurship incubatees”.
I wonder whether you’d be happy to elaborate on these assessments / how you got to these figures, as both seem optimistic to me (though perhaps I’m too cynical).
On (1): Will definitely be looking to examine the counterfactual policy passage issue more explicitly, in deeper research rounds—but one view is that this is already automatically factored in by any analysis (like the rough one here) of how age-standardized DALYs lost per capita will evolve in the future based on past trends (since any chance in sodium consumption due to policy reasons will show up in both prevalence/severity of hypertension and hence in these age-standardized DALYs).
Any advice on how counterfactual policy passage should be incorporated would be welcome! The way I’ve done it in the past (and what the way CE does it, I believe) is case study analysis (look at past instances, and calculate country-years of policy passage against total country-years, or something like that), but it’s not always wholly satisfactory.
On (2): You’re right that this may be too optimistic! My assessment here is based partly on my understanding of the work of CE policy charities (LEEP/PEN/Good Policies), researching and planning out a potential tobacco taxation charity in the recent CE incubation programme (went with CEARCH in the end), and also my past work in government/policy consulting. I have moderate confidence in the view that conditional on there being interest from policymakers, you can work your way up to cabinet ministers within a year in a LMIC and get a yes/no answer by then. I also have high confidence in the view that if the government is not interested, you get the feedback from lower level civil servants long before that, allowing you to pivot accordingly. All this is premised on a high willingness to ignore sunk costs and pivot quickly, and excludes implementation time (folding that into the next year of operations, as you juggle both advising the persuaded government and lobbying the next country)
I’ll recalibrate this as I get more expert advice (and also update on the more recent work of CE policy charities, including Mathias Bonde’s aid policy organization).
Thanks for sharing this report! Happy to see more global health content on the forum.
Two quick questions on skimming it:
When working out the marginal value of sodium taxation policy advocacy, do you discount for the possibility of salt reduction policies happening independent of any EA efforts in this area? (i.e. your advocacy is speeding up the policy passing by X number of years as opposed to bringing it in a world where it otherwise would never have existed). For example, if you crudely take 2023 figures, and assume that the intervention successfully speeds up salt taxes globally by 5 years compared to a world without any additional resources, the this would mean ~1.2E9 DALYs are at stake, compared to your topline figure of 1.2E10 DALYs. [1]
The cost per intervention of US$137,000 for getting a salt tax advocacy are in part based on assessments like:
i) “I assess that around 1 year of operations is a reasonable timeframe for the charity to lobby/prepare supporting research reports on the health and economics benefits of the tax/do public polling to show public support/construct a coalition of NGOs and advocates in support and hence succeed”, and
ii) “my sense is that this is doable by a 2 person EA charity in the style of Charity Entrepreneurship incubatees”.
I wonder whether you’d be happy to elaborate on these assessments / how you got to these figures, as both seem optimistic to me (though perhaps I’m too cynical).
Thanks again for doing this work!
(commenting in personal capacity etc)
2.43E8 * 5 = 1.215E9
Hi Bruce, thanks for the comments!
On (1): Will definitely be looking to examine the counterfactual policy passage issue more explicitly, in deeper research rounds—but one view is that this is already automatically factored in by any analysis (like the rough one here) of how age-standardized DALYs lost per capita will evolve in the future based on past trends (since any chance in sodium consumption due to policy reasons will show up in both prevalence/severity of hypertension and hence in these age-standardized DALYs).
Any advice on how counterfactual policy passage should be incorporated would be welcome! The way I’ve done it in the past (and what the way CE does it, I believe) is case study analysis (look at past instances, and calculate country-years of policy passage against total country-years, or something like that), but it’s not always wholly satisfactory.
On (2): You’re right that this may be too optimistic! My assessment here is based partly on my understanding of the work of CE policy charities (LEEP/PEN/Good Policies), researching and planning out a potential tobacco taxation charity in the recent CE incubation programme (went with CEARCH in the end), and also my past work in government/policy consulting. I have moderate confidence in the view that conditional on there being interest from policymakers, you can work your way up to cabinet ministers within a year in a LMIC and get a yes/no answer by then. I also have high confidence in the view that if the government is not interested, you get the feedback from lower level civil servants long before that, allowing you to pivot accordingly. All this is premised on a high willingness to ignore sunk costs and pivot quickly, and excludes implementation time (folding that into the next year of operations, as you juggle both advising the persuaded government and lobbying the next country)
I’ll recalibrate this as I get more expert advice (and also update on the more recent work of CE policy charities, including Mathias Bonde’s aid policy organization).
No worries! I’ll DM ya some additional thoughts :)
Thanks again!