My name is Emmanuel, and I am a lecturer in Nigeria who is interested in how climate change is making fungi in the environment to be fit to cause diseases. The case of Candida auris is one, C. auris is the first known pathogen that has emerged as a result of climate change and phage therapy as a means of combating antibiotic resistance.
I’ve been unsuccessful with open philanthropy grants and EA funds, possibly because I don’t understand what they actually fund or how to format my application to meet their requirements. In Nigeria, I recently established a phage bank with the goal of developing phage therapy-ready products that can be used to treat specific bacterial infections. A recent study has shown that western sub-Saharan Africa, has the highest all-age death rate attributable to resistance at 27·3 deaths per 100 000. We are beginning to see untreatable pathogens.
My first thought was that this is a good fit for the cause advocated by Open Philanthropy, but with few rejections. I’m having second thoughts. I’m proposing a lab that will produce phage-ready products for clinicians and will also develop low-cost phage-based solutions for treating water against Typhoid fevers and cleaning hospital environments. I’m wondering how to structure this so that it aligns with the goals of Effective altruism.
I require guidance. I’d like to speak with someone who is familiar with the process to get a head start, or can I obtain a sample of a successful proposal to use as a guide in the future? Who would be willing to review my proposal and offer suggestions for meeting EA objectives and making a maximum impact?
Hi Emmanuel. Firstly, I want to say that it is really cool that you’re engaging with effective altruism and I really appreciate your background and think you have a lot to add. The work you are doing sounds important and interesting.
The most important thing you can do for your project to make it meet EA objectives is to demonstrate that it is likely to be able to help address diseases in a very cost-effective way. The bar for cost-effectiveness in EA is very high—unusually high compared to other social movements and funders. EA’s relentless focus on this prioritization means that a lot of good work won’t get attention because it is not among the literal most cost-effective things in the world. It’s sad we don’t have enough funding to fund every good idea. This also means it is frequently impossible to take an existing idea and “make it EA”.
I think you’re definitely on to something valuable—antibiotic resistance and pandemic prevention are potential top areas for EA based on their neglectedness, importance, and tractability. It sounds like your proposal has established work on an important area, but how promising is your work from a “what a dollar accomplishes” perspective? Do you have figures on $/DALY?
Thanks for your comment. Yes! The recent disability-adjusted life-years projection for drug resistance just released showed a total of 4·95 million deaths associated with bacterial AMR in 2019, including 1·27 million deaths attributable to bacterial AMR. At the regional level, we estimated the all-age death rate attributable to resistance to be highest in western sub-Saharan Africa, at 27·3 deaths per 100 000 . Six pathogens contributed to the largest burden of AMR in 2019 (E coli, S aureus, K pneumoniae, S pneumoniae, A baumannii, and P aeruginosa) have been identified as priority pathogens by WHO. My goal is to isolate, characterize and have ready-for-use phage products in the store for use against these pathogens in Nigeria.
This is also important to the global community, because of the exchange of phages. For example, in Dhanvi’s story, a 7-year-old girl is scheduled for amputation as a result of drug resistance. The Australian group reached out to the global community for help with phages that is specific for the bacteria infecting Dhanvi, this was found in Israel and coincidentally had sent the phages to the US for use. The phage was used to save her legs.
Aside from quantifying how much you could achieve with extra funding, it might be worth thinking about what might make this work even more exciting from either an impact or cost-effectiveness perspective. For example—would this phage technology be used against a novel engineered virus? How quickly would a lab be able to create a ready-for-use a therapeutic phage product to a completely new virus in a pandemic setting, if at all possible? This would expand your possible intervention audience from [anyone affected by a resistant organism] to [anyone in the future who could be affected by a major pandemic].
On the other hand, it’s also useful to think about what might make this work even less exciting from an impact / cost-effectiveness perspective. Why doesn’t this technology already exist in the context you’re in? What are some barriers in making this happen? Are there better alternatives that exist for AMR / fungal infections? One example that comes to mind is—what would be a reason hospitals would prefer a phage-based cleaning product for cleaning hospital environments over say, bleach / other disinfectants that are currently being used?
That being said, I think EA objectives of trying to quantify impact and be as cost effective as we can be are ideas that should be useful even for cause areas that don’t currently hit various organisations’ funding bars. I’m happy to briefly look over a proposal and give fairly general feedback from my understanding of an EA lens (though I neither have expertise in phages nor a deep understanding of how the funding process works) - feel free to DM me if you think this would be useful, otherwise all the best!