Hi Bruce, great to reconnect here! Thank you for all your thoughtful comments. I really appreciate your perspectives. Here are my responses to your points.
Yes, we are primarily a “life-improving” intervention rather than a life-saving one. While we do track suicidal ideation and believe we may have prevented several suicides, proving this counterfactually is challenging. So, when calculating our impact, we consider lives saved as a “bonus” rather than our primary measure of impact. As such, we don’t account for that in our cost-effectiveness estimates.
We are on track to improve our cost per person (but still not there). The $233 cost per person reported for 2023 included our total spending for the year, which involved significant consulting fees to Columbia University for their supervision in our first year. Excluding those fees, which are not recurring, our actual cost per person was $152 in 2023. We expect 2024 to be in that range.
Regarding your other notes:
The NBER paper was an incorrect reference—thank you for catching that. The link has been updated.
We don’t believe the Baird RCT is especially relevant to our work because 1) it focuses on adolescents, 2) it was delivered by non-specialist, age-peer providers (i.e., other adolescents), and 3) the “12-month follow-up surveys were conducted at the height of the pandemic.” A hard moment for everyone.
We also saw that update from GiveWell, although they noted, “we will be using our historic benchmark until we have thought it through.” So, we think it’s fair to continue using the historic benchmark until they switch.
So appreciate the thoughtful feedback, it helps us to refine our thinking and keep improving!
Thanks for the response, and likewise—hope you’ve been well! (Sorry I wasn’t sure if it was you or someone else on the account).
I agree that it is pretty reasonable to stick with the same benchmark, but I think this means it should be communicated accordingly, as VP are sometimes referring to a benchmark and other times referring to the GD programme, while GW are sticking to the same benchmark for their cost-effectiveness analyses, but updating their estimates of GD programmes.[1]
“This means that a $1000 donation to Vida Plena would produce 58 WELLBYs, which is 8 times more cost-effective than GiveDirectly (a charity that excels in delivering cash transfers—simply giving people money—and a gold standard in effective altruism)”[2]
I think people would reasonably misinterpret this to mean you are referring to the GD programme, rather than the GW benchmark.[3] Again I know this is a v recent update and so hadn’t expected it to be already updated! But just flagging this as a potential source of confusion in the future.
Separately, I just thought I’d register interest in a more up-to-date predictive CEA that comes before your planned 2026 analysis, in part because there’s decent reason to do so (though I’m not making the stronger claim that this is more important than other things on your plate!), 2026 is a while away, and because it’s plausibly decision relevant for potential donors if they’re not sure the extent to which HLI updates might be applicable to VP.
“Thus, we will be using our historic benchmark until we have thought it through. For now, you can think of our benchmark as “GiveWell’s pre-2024 estimate of the impacts of cash transfers in Kenya,” with GiveDirectly’s current programs in various countries coming in at 3 to 4 times as cost-effective as that benchmark.”
To VP’s credit, I think “eight times more cost-effective than the benchmark of direct cash transfers” in this post would likely be interpreted correctly in a high context setting (but I also think reasonably might not be, and so may still be worth clarifying).
Hi Bruce, great to reconnect here! Thank you for all your thoughtful comments. I really appreciate your perspectives. Here are my responses to your points.
Yes, we are primarily a “life-improving” intervention rather than a life-saving one. While we do track suicidal ideation and believe we may have prevented several suicides, proving this counterfactually is challenging. So, when calculating our impact, we consider lives saved as a “bonus” rather than our primary measure of impact. As such, we don’t account for that in our cost-effectiveness estimates.
We are on track to improve our cost per person (but still not there). The $233 cost per person reported for 2023 included our total spending for the year, which involved significant consulting fees to Columbia University for their supervision in our first year. Excluding those fees, which are not recurring, our actual cost per person was $152 in 2023. We expect 2024 to be in that range.
Regarding your other notes:
The NBER paper was an incorrect reference—thank you for catching that. The link has been updated.
We don’t believe the Baird RCT is especially relevant to our work because 1) it focuses on adolescents, 2) it was delivered by non-specialist, age-peer providers (i.e., other adolescents), and 3) the “12-month follow-up surveys were conducted at the height of the pandemic.” A hard moment for everyone.
We also saw that update from GiveWell, although they noted, “we will be using our historic benchmark until we have thought it through.” So, we think it’s fair to continue using the historic benchmark until they switch.
So appreciate the thoughtful feedback, it helps us to refine our thinking and keep improving!
Thanks for the response, and likewise—hope you’ve been well! (Sorry I wasn’t sure if it was you or someone else on the account).
I agree that it is pretty reasonable to stick with the same benchmark, but I think this means it should be communicated accordingly, as VP are sometimes referring to a benchmark and other times referring to the GD programme, while GW are sticking to the same benchmark for their cost-effectiveness analyses, but updating their estimates of GD programmes.[1]
E.g. the predictive CEA (pg 7) referenced says:
“This means that a $1000 donation to Vida Plena would produce 58 WELLBYs, which is 8 times more cost-effective than GiveDirectly (a charity that excels in delivering cash transfers—simply giving people money—and a gold standard in effective altruism)”[2]
I think people would reasonably misinterpret this to mean you are referring to the GD programme, rather than the GW benchmark.[3] Again I know this is a v recent update and so hadn’t expected it to be already updated! But just flagging this as a potential source of confusion in the future.
Separately, I just thought I’d register interest in a more up-to-date predictive CEA that comes before your planned 2026 analysis, in part because there’s decent reason to do so (though I’m not making the stronger claim that this is more important than other things on your plate!), 2026 is a while away, and because it’s plausibly decision relevant for potential donors if they’re not sure the extent to which HLI updates might be applicable to VP.
“Thus, we will be using our historic benchmark until we have thought it through. For now, you can think of our benchmark as “GiveWell’s pre-2024 estimate of the impacts of cash transfers in Kenya,” with GiveDirectly’s current programs in various countries coming in at 3 to 4 times as cost-effective as that benchmark.”
The summary table on the same page also just says “GiveDirectly”.
To VP’s credit, I think “eight times more cost-effective than the benchmark of direct cash transfers” in this post would likely be interpreted correctly in a high context setting (but I also think reasonably might not be, and so may still be worth clarifying).