Something I’ve been wondering about is that it seems like, if your goal is to reduce preventable deaths, the best way to do so would be to help a country develop more efficiently so that, in the future, the country’s people have the necessary resources to prevent such deaths. As such, I would expect that EAs would focus on global development rather than global health since global health would temporarily fix the problem whereas global development would permanently fix it.
At the same time, EAs also seem to invest far more money into global health than global development. For instance, Coefficient Giving’s fund for global health is much larger than their one for global development.
As such, I’m wondering why do EAs focus on global health over global development?
I think you’ve accurately identified a real tension here, and this connects with a fundamental critique of EA as a movement, which is that it is too often focused on measurable outcomes rather than systemic change. I tend to agree that this critique has teeth and applies to the way EA is often practiced.
I do want to highlight that Global Health work is not inherently a temporary fix. Global Health work frequently can (and should) focus on improving existing health systems, not just having a temporary impact. By addressing the root cause, you can make a more permanent difference (and be more cost-effective while you’re at it)
So why are more EAs focused on Global Health instead of Global Development relative to your expectations? In my opinion, two major reasons are
Some people are likely overly focused on measurable outcomes over systemic change.
Some types of Global Health work is more systemic than you give it credit for.
Gotcha, thanks! I appreciate the fast response.
I was inspired by my ties with the EA movement to go do a degree in public health, and while I did not specialize in global health, I did take several classes in global health while getting my master’s. One thing I want to say is that the division between global development and global health is much, much stronger within EA than it is in more mainstream global health. At least as taught at the UW, the intro global health class is just as much about international monetary policy and its effects, as it is about implementing specific scalable health interventions. And, income is one of the three most important social determinants of health globally (along with nutrition and education). This division is stronger in EA imo because it is easy to sell donors in our community on very specific, measurable, high-impact interventions, rather than engage with the politics that end up inherent in the development space. (And that’s not even necessarily a bad thing, if it moves money counterfactually). But, global health as viewed by EAs is not the whole of global health—and (controversial!) I think it’s good that we haven’t upended the entire global health space to the relatively narrow set of GiveWell-approved interventions.
talk to @David Nas and @Karthik Tadepalli ha. There’s increasing work within EA on development directly There are big questions around how tractable it is, how much EA influence can actually move the needle with huge money injectors active like the imf and world back, to and market forces as well.
And yeah like @Evan LaForge said to some extent development needs good health and education to happen (a bit of chicken and egg)
Here is an argument for why that might be better:
The evidence base behind EA’s preferred global health interventions (e.g. malaria nets) is much stronger than the evidence base behind virtually any global development intervention. There are more papers and more high-quality evidence (RCTs)
Health interventions are cheap because they focus on delivering commodities (nets, pills). Development interventions (that work) tend to have higher cost-per-person because they’re more high-touch and tailored (e.g. graduation programs)
But if you want the descriptive story of why it ended up this way, it goes more like this:
GiveWell focused on global health because they were searching for the cheapest and most evidence-backed interventions; other people followed suit
Early EA philosophers used global health interventions as evocative examples of how stark cost-effectiveness differences could be, and how that created a moral imperative (e.g. Toby Ord)
Global health had a much more established culture of considering cost-effectiveness than global development (which has since caught up somewhat), so it was much easier to find evidence of cost-effectiveness for health interventions