Thanks for the reply and for the edits made to your post.
To me this underlines the point that individual donors aren’t best placed to set priorities for what a countries or population needs.
I agree with this, but I don’t know what this implies in terms of my decisions about where to donate.
An example: let’s assume that, if we ignore the six key issues discussed in your paper, a donation of £5000 to the Against Malaria Foundation (AMF) will (in expectation) save one life.
If we now take into account the six key issues, what does that imply? If I understand correctly, the implication is that donations are creating negative externalities due to the impact on the institutions and decision-making of the recipient country.
Perhaps this means that donating to global health charities generally is (e.g.) 20% less cost-effective, and therefore for AMF we should assume it actually takes £6000 (in expectation) to save one life. That would be somewhat worse—but still very cost-effective compared to many donation opportunities. I’m not sure it would change the minds of individual donors interested in improving global health.
Alternatively, perhaps it is much, much more serious . Perhaps supporting charities like AMF are actually doing more harm than good overall, i.e. the six key issues causes by donations mean that donations are causing net harm—more lives and QALYs are lost because of donations. If true, this clearly should change the mind of every individual donor.
From very quickly skimming over your paper, I can’t tell where the reality lies. What would be your intuition? Mine is very much leaning towards the first position—assuming that donations are possibly a bit worse than the intervention-specific estimate implies, but not dramatically so (and, if GiveWell’s models take into account the influence on gov spending, perhaps their estimates have already partly adjusted for this).
Thanks again Matt. Yes, negative externalities could be a helpful way to think about at least some of those six challenges.
To your question, in the short term I wouldn’t advise individual small donors to change their behaviour. In absence of a coordinated effort to improve donor harmonisation, I support giving based on cost-effectiveness principles and my intuition is not that this kind of giving is a net harm. Our pitch is perhaps to global health institutions—including EA orgs like GiveWell and Open Phil—that we could do better. We don’t yet have the institutions that would allow individuals to support the kind approach we outline (essentially TA + harmonised support to marginal services), but perhaps that’s something we need… Of course that’s a trickier sell but I’m sure some smart strategic comms folk could help.
Thanks for the reply and for the edits made to your post.
I agree with this, but I don’t know what this implies in terms of my decisions about where to donate.
An example: let’s assume that, if we ignore the six key issues discussed in your paper, a donation of £5000 to the Against Malaria Foundation (AMF) will (in expectation) save one life.
If we now take into account the six key issues, what does that imply? If I understand correctly, the implication is that donations are creating negative externalities due to the impact on the institutions and decision-making of the recipient country.
Perhaps this means that donating to global health charities generally is (e.g.) 20% less cost-effective, and therefore for AMF we should assume it actually takes £6000 (in expectation) to save one life. That would be somewhat worse—but still very cost-effective compared to many donation opportunities. I’m not sure it would change the minds of individual donors interested in improving global health.
Alternatively, perhaps it is much, much more serious . Perhaps supporting charities like AMF are actually doing more harm than good overall, i.e. the six key issues causes by donations mean that donations are causing net harm—more lives and QALYs are lost because of donations. If true, this clearly should change the mind of every individual donor.
From very quickly skimming over your paper, I can’t tell where the reality lies. What would be your intuition? Mine is very much leaning towards the first position—assuming that donations are possibly a bit worse than the intervention-specific estimate implies, but not dramatically so (and, if GiveWell’s models take into account the influence on gov spending, perhaps their estimates have already partly adjusted for this).
Thanks again Matt. Yes, negative externalities could be a helpful way to think about at least some of those six challenges.
To your question, in the short term I wouldn’t advise individual small donors to change their behaviour. In absence of a coordinated effort to improve donor harmonisation, I support giving based on cost-effectiveness principles and my intuition is not that this kind of giving is a net harm. Our pitch is perhaps to global health institutions—including EA orgs like GiveWell and Open Phil—that we could do better. We don’t yet have the institutions that would allow individuals to support the kind approach we outline (essentially TA + harmonised support to marginal services), but perhaps that’s something we need… Of course that’s a trickier sell but I’m sure some smart strategic comms folk could help.