Executive summary: An exploratory, back-of-the-envelope evaluation by EA Salt Lake City argues that Wells4Wellness’s boreholes in Niger may avert disease at roughly ~$8 per DALY (or ~$4 per “DALY-equivalent” including economic effects), seemingly clearing Open Phil’s bar by a wide margin, but the authors stress substantial uncertainty and ask for feedback on key assumptions (effect sizes, costs, time-discounting).
Key points:
Method and core assumption: They proxy well water’s mortality impact using GiveWell’s chlorination estimates (12% U5 and 4% 5+ diarrhea-mortality reductions), reasoning Niger’s high diarrhea burden makes these figures conservative.
DALY estimate: With ~20% of the population under five, they derive ~39 DALYs averted per 1,000 people per year (corroborated by a second approach using 2016 Niger U5 diarrhea DALYs × 52% risk reduction → ~46/1,000/year; they adopt the lower 39 for conservatism).
Cost model: Assume an average $10k build cost (mix of basic and “chalet” wells), major repairs of $2k every ~10 years, a 50-year life, and 1,200 users per well → about $360/year totalized cost, ≈ $0.30 per person-year.
Cost-effectiveness: For 1,000 users/year at $300 totalized cost, ~$8/DALY; including GiveWell’s estimated economic/development spillovers roughly doubles benefits → ~$4 per DALY-equivalent.
Comparison to chlorination: A 2023 meta-analysis puts chlorination at $25–$65/DALY (best case ~$27/DALY in MCH settings), implying wells could be ~5–10× more cost-effective, aided by near-universal uptake vs. 30–50% adoption for many chlorination programs.
Open questions/uncertainties: Plausibility of the very low $0.30/person-year cost; appropriateness of treating benefits linearly over a 50-year horizon and how to discount future DALYs; whether using chlorination effects as a stand-in biases results; and how to value quality-of-life gains beyond DALYs/economic effects.
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Executive summary: An exploratory, back-of-the-envelope evaluation by EA Salt Lake City argues that Wells4Wellness’s boreholes in Niger may avert disease at roughly ~$8 per DALY (or ~$4 per “DALY-equivalent” including economic effects), seemingly clearing Open Phil’s bar by a wide margin, but the authors stress substantial uncertainty and ask for feedback on key assumptions (effect sizes, costs, time-discounting).
Key points:
Method and core assumption: They proxy well water’s mortality impact using GiveWell’s chlorination estimates (12% U5 and 4% 5+ diarrhea-mortality reductions), reasoning Niger’s high diarrhea burden makes these figures conservative.
DALY estimate: With ~20% of the population under five, they derive ~39 DALYs averted per 1,000 people per year (corroborated by a second approach using 2016 Niger U5 diarrhea DALYs × 52% risk reduction → ~46/1,000/year; they adopt the lower 39 for conservatism).
Cost model: Assume an average $10k build cost (mix of basic and “chalet” wells), major repairs of $2k every ~10 years, a 50-year life, and 1,200 users per well → about $360/year totalized cost, ≈ $0.30 per person-year.
Cost-effectiveness: For 1,000 users/year at $300 totalized cost, ~$8/DALY; including GiveWell’s estimated economic/development spillovers roughly doubles benefits → ~$4 per DALY-equivalent.
Comparison to chlorination: A 2023 meta-analysis puts chlorination at $25–$65/DALY (best case ~$27/DALY in MCH settings), implying wells could be ~5–10× more cost-effective, aided by near-universal uptake vs. 30–50% adoption for many chlorination programs.
Open questions/uncertainties: Plausibility of the very low $0.30/person-year cost; appropriateness of treating benefits linearly over a 50-year horizon and how to discount future DALYs; whether using chlorination effects as a stand-in biases results; and how to value quality-of-life gains beyond DALYs/economic effects.
This comment was auto-generated by the EA Forum Team. Feel free to point out issues with this summary by replying to the comment, and contact us if you have feedback.