I think I read somewhere that GiveWell doesn’t tend to report these figures because the QALY assessment system is so subjective; they instead, for charities focusing on morbidities other than death, report specific results such as “cost per case of blindness averted” or “cost per additional year of school.”
Hm interesting. It’s plausible this is a way to avoid utility monsterization?
Like hypothetically, let’s say an average high-income life is twice as enjoyable than a low-income life. If that were the case, then using cost-per-QALY might give an advantage to saving high-income lives—they were all set to have a fun life as a rich person until they happened to die from some disease. Whereas the low-income lives were going to have a miserable time anyway, so it “doesn’t matter as much if they die.” I am not endorsing this interpretation—just articulating what using QALYs might imply if we were to use them for comparison purposes.
I think I read somewhere that GiveWell doesn’t tend to report these figures because the QALY assessment system is so subjective; they instead, for charities focusing on morbidities other than death, report specific results such as “cost per case of blindness averted” or “cost per additional year of school.”
Hm interesting. It’s plausible this is a way to avoid utility monsterization?
Like hypothetically, let’s say an average high-income life is twice as enjoyable than a low-income life. If that were the case, then using cost-per-QALY might give an advantage to saving high-income lives—they were all set to have a fun life as a rich person until they happened to die from some disease. Whereas the low-income lives were going to have a miserable time anyway, so it “doesn’t matter as much if they die.” I am not endorsing this interpretation—just articulating what using QALYs might imply if we were to use them for comparison purposes.
You can read their GiveWell’s public document on DALYs here
A thing that might be worth noting is that according to GiveWell ~40% of AMF’s value comes from increasing the long-term income of children, not from health outcomes
Interesting. That is not apparently taken into account in the $4500/life figure they publish which is based exclusively on deaths averted.