Loved this post. Like sawyer wrote—it made me emotional and made me think, and feels like a great example of what EA should be.
There actually is a non-profit I’m aware of (no affiliation) that hits a lot of the criteria mentioned in the comments—https://saveachildsheart.org/, they treat life-threatening heart disease in developing countries, often by paying for transportation to Israel where the children receive pro-bono treatment from a hospital the nonprofit has a partnership with. From a (very) quick look at their financial statements and annual report, it looks like it costs them around ~$6,300 to save a life, although that number could be significantly off in either direction (by looking through the annual report, it looks like the nonprofit is not especially focused on the most cost-effective parts of its programming, and does many activities that look like PR, which is probably morally good if it allows them to scale. On the other hand, it’s not clear from the AR what the severity of the disease is in the children treated, and what share of their treatments are actually life saving).
Your post, and nonprofits like this, make me think of something EA often misses from it’s birds-eye approach to solutions—leverage. Both you and saveachildsheart use their leverage (your proximity, their partnership with a first world medical institution) to be impressively cost-effective, but leverage is hard to spot in a-priori spreadsheets.
Could you say a bit more about the ~$6,300 figure? I have 547 lives saved from the annual report (p. 5) and about $9.5MM USD in expenses from the financial statements. Admittedly, most of this is related to the establishment of a “Children’s Hospital at Wolfson”—but it’s not clear to me that these costs should be excluded. I suppose that the organization is doing its current work without said hospital existing yet, but the presence and magnitude of that expenditure makes me wonder—at a minimum—whether they have room for more funding at ~$6,300.
By rough analogy, it wouldn’t be appropriate for an organization to fundraise separately for bednets and for distribution costs, and quote a cost-effectiveness figure to distribution-cost donors of (distribution costs / total impact).
Thanks for this source, ezrah! These 6,3k seem to possibly be a bit misleading to me. Without taking a closer look, it sounds like the costs of the treatment (currently covered by the hospital’s CSR funds or donations?) are hidden from the total costs as someone had the great idea of splitting the true costs into two different donation opportunities, both of which on each side suggest that “if you give to this opportunity, the other side is covered”. But given the high-quality medical facility/treatment the children receive, the true cost of donations consumed per patient are probably much higher. Am I mistaken here?
From what I understand, the per-patient treatments costs are both quite low and are given pro-bono, so given how GiveWell understands leverage (which @Mo Putera pointed out in the response below), they should be strongly discounted from the costs. The question of how to incorporate the infrastructure costs, ie—the hospital, staff training, etc—that enable the program to operate, is quite interesting, and I honestly don’t have a great idea how that fits into the model.
something EA often misses from it’s birds-eye approach to solutions—leverage.
I’d be curious as to what you mean here, since my impression was always that EA discourse heavily emphasises leverage – e.g. in the SPC framework for cause prioritisation, in career advice by 80,000 Hours and Probably Good, in GiveWell’s reasoning (for instance here is how GW’s spreadsheet adjusts for leverage in evaluating AMF).
Great question! I realize that I really wasn’t clear, and that it probably does exist more in EA than my instinctive impression (also—great links, I hadn’t been familiar with all of them).
What I meant by leverage was more along the lines of “the value of insider’s perspective and the ability to leverage individual networks and skill sets”. In these cases, Nick was able to identify potential cost-effective ways to save lives because of both his training and location, and SACH is able to similarly have a cost-effective program because of their close connections with a hospital. I have a few other examples as well, such as NALA’s WASH on Wheel’s program (which essentially trains a team a plumbers and provides access to clean water to hundreds of program, leveraging the existing infrastructure), and anecdotes I’ve heard about people on the ground being able to provide crucial solutions during the current Israel-Hamas crisis.
I have a sense that the classic EA (and I could very much be strawmanning here) thinks along the lines of: big problems, good solutions, niche area—but doesn’t think about who is best placed to identify or implement even better solutions that can come up because the world is messy.
After thinking about it, the “leverage” I’m referring to is probably more common than I thought, but maybe not so very well defined.
Loved this post. Like sawyer wrote—it made me emotional and made me think, and feels like a great example of what EA should be.
There actually is a non-profit I’m aware of (no affiliation) that hits a lot of the criteria mentioned in the comments—https://saveachildsheart.org/, they treat life-threatening heart disease in developing countries, often by paying for transportation to Israel where the children receive pro-bono treatment from a hospital the nonprofit has a partnership with. From a (very) quick look at their financial statements and annual report, it looks like it costs them around ~$6,300 to save a life, although that number could be significantly off in either direction (by looking through the annual report, it looks like the nonprofit is not especially focused on the most cost-effective parts of its programming, and does many activities that look like PR, which is probably morally good if it allows them to scale. On the other hand, it’s not clear from the AR what the severity of the disease is in the children treated, and what share of their treatments are actually life saving).
Your post, and nonprofits like this, make me think of something EA often misses from it’s birds-eye approach to solutions—leverage. Both you and saveachildsheart use their leverage (your proximity, their partnership with a first world medical institution) to be impressively cost-effective, but leverage is hard to spot in a-priori spreadsheets.
Could you say a bit more about the ~$6,300 figure? I have 547 lives saved from the annual report (p. 5) and about $9.5MM USD in expenses from the financial statements. Admittedly, most of this is related to the establishment of a “Children’s Hospital at Wolfson”—but it’s not clear to me that these costs should be excluded. I suppose that the organization is doing its current work without said hospital existing yet, but the presence and magnitude of that expenditure makes me wonder—at a minimum—whether they have room for more funding at ~$6,300.
By rough analogy, it wouldn’t be appropriate for an organization to fundraise separately for bednets and for distribution costs, and quote a cost-effectiveness figure to distribution-cost donors of (distribution costs / total impact).
Thanks for this source, ezrah! These 6,3k seem to possibly be a bit misleading to me. Without taking a closer look, it sounds like the costs of the treatment (currently covered by the hospital’s CSR funds or donations?) are hidden from the total costs as someone had the great idea of splitting the true costs into two different donation opportunities, both of which on each side suggest that “if you give to this opportunity, the other side is covered”. But given the high-quality medical facility/treatment the children receive, the true cost of donations consumed per patient are probably much higher. Am I mistaken here?
From what I understand, the per-patient treatments costs are both quite low and are given pro-bono, so given how GiveWell understands leverage (which @Mo Putera pointed out in the response below), they should be strongly discounted from the costs. The question of how to incorporate the infrastructure costs, ie—the hospital, staff training, etc—that enable the program to operate, is quite interesting, and I honestly don’t have a great idea how that fits into the model.
I’d be curious as to what you mean here, since my impression was always that EA discourse heavily emphasises leverage – e.g. in the SPC framework for cause prioritisation, in career advice by 80,000 Hours and Probably Good, in GiveWell’s reasoning (for instance here is how GW’s spreadsheet adjusts for leverage in evaluating AMF).
Great question! I realize that I really wasn’t clear, and that it probably does exist more in EA than my instinctive impression (also—great links, I hadn’t been familiar with all of them).
What I meant by leverage was more along the lines of “the value of insider’s perspective and the ability to leverage individual networks and skill sets”. In these cases, Nick was able to identify potential cost-effective ways to save lives because of both his training and location, and SACH is able to similarly have a cost-effective program because of their close connections with a hospital. I have a few other examples as well, such as NALA’s WASH on Wheel’s program (which essentially trains a team a plumbers and provides access to clean water to hundreds of program, leveraging the existing infrastructure), and anecdotes I’ve heard about people on the ground being able to provide crucial solutions during the current Israel-Hamas crisis.
I have a sense that the classic EA (and I could very much be strawmanning here) thinks along the lines of: big problems, good solutions, niche area—but doesn’t think about who is best placed to identify or implement even better solutions that can come up because the world is messy.
After thinking about it, the “leverage” I’m referring to is probably more common than I thought, but maybe not so very well defined.