Hey Joel, great report- overall, I am also pretty excited about interventions for hypertension. A couple of questions about your report:
You decided to narrow down on sodium policy taxation advocacy- whilst I think this is probably one of the more appealing interventions in this space, I wonder whether you considered other interventions e.g. community salt substitution, which was looked into by Givewell and recently had a very large RCT conducted.
The impact of sodium reduction extends beyond BP effects- Although the majority of the health effect of sodium reduction does seem to be through reducing BP, there are some other causal mechanisms that are suggested e.g. reducing oxidative stress, reducing sympathetic tone. I wonder whether you looked into/considered these
The cost of advocacy- it seems like you have by and large taken the cost of quite a lean charity doing this. I wonder whether it would be worthwhile looking at organisations that have previously successfully helped advocate for taxation policy, and estimated their size/cost. I would imagine this might be a higher cost by several factors
Are there good advocacy groups out there- I would be really interested to know whether there are highly effective organisations advocacy for sodium taxation policy already out there, that funders might be able to look int further + potentially fund!
(1) I didn’t look at community salt substitution at any real depth. My quick prioritization on tractable solutions (definitely the weakest part of the 5-day shallow research process) was that policy intervention via a tax would be more effective than direct delivery (including providing communities with free salt substitutes). And with GiveWell also less optimistic on this issue, there doesn’t seem to be a strong case for re-examination.
(2) Didn’t look at the other positive effects—will look to incorporate these in deeper research reports, as well as with the negative side effects (especially on how poorer families are likely to be affected—it’s going to be the thorniest part of the political case for sodium taxes)
(3) Good point! Will be looking to re-examine the costing, by talking to experts and orgs (especially WASSH) in the area, especially since the topline cost-effectiveness number is so sensitive to this. I think it’s very possible that my view is overly influenced by the implicit understanding that this will be an EA organization running on CE-style leanness, but I was also encouraged by the fact that WASSH didn’t have a monster budget or anything.
(4) The Thai Low Salt Network seems to be on the verge of success, and WASSH seemed successful in getting supermarkets to reduce product sodium content, but salt taxes are rare enough, and I don’t believe there will be many organizations (unlike for sugar) that have a strong track record here. Will definitely be doing a deeper dive on this—unfortunately, deeper case analysis (let along talking to experts) is just really hard to do within the 1-week shallow research stage
Hey Joel, great report- overall, I am also pretty excited about interventions for hypertension. A couple of questions about your report:
You decided to narrow down on sodium policy taxation advocacy- whilst I think this is probably one of the more appealing interventions in this space, I wonder whether you considered other interventions e.g. community salt substitution, which was looked into by Givewell and recently had a very large RCT conducted.
The impact of sodium reduction extends beyond BP effects- Although the majority of the health effect of sodium reduction does seem to be through reducing BP, there are some other causal mechanisms that are suggested e.g. reducing oxidative stress, reducing sympathetic tone. I wonder whether you looked into/considered these
The cost of advocacy- it seems like you have by and large taken the cost of quite a lean charity doing this. I wonder whether it would be worthwhile looking at organisations that have previously successfully helped advocate for taxation policy, and estimated their size/cost. I would imagine this might be a higher cost by several factors
Are there good advocacy groups out there- I would be really interested to know whether there are highly effective organisations advocacy for sodium taxation policy already out there, that funders might be able to look int further + potentially fund!
A great report- thanks Joel!
Hi Akhil! Hope you’re enjoying your new role!
(1) I didn’t look at community salt substitution at any real depth. My quick prioritization on tractable solutions (definitely the weakest part of the 5-day shallow research process) was that policy intervention via a tax would be more effective than direct delivery (including providing communities with free salt substitutes). And with GiveWell also less optimistic on this issue, there doesn’t seem to be a strong case for re-examination.
(2) Didn’t look at the other positive effects—will look to incorporate these in deeper research reports, as well as with the negative side effects (especially on how poorer families are likely to be affected—it’s going to be the thorniest part of the political case for sodium taxes)
(3) Good point! Will be looking to re-examine the costing, by talking to experts and orgs (especially WASSH) in the area, especially since the topline cost-effectiveness number is so sensitive to this. I think it’s very possible that my view is overly influenced by the implicit understanding that this will be an EA organization running on CE-style leanness, but I was also encouraged by the fact that WASSH didn’t have a monster budget or anything.
(4) The Thai Low Salt Network seems to be on the verge of success, and WASSH seemed successful in getting supermarkets to reduce product sodium content, but salt taxes are rare enough, and I don’t believe there will be many organizations (unlike for sugar) that have a strong track record here. Will definitely be doing a deeper dive on this—unfortunately, deeper case analysis (let along talking to experts) is just really hard to do within the 1-week shallow research stage