I agree that small amounts of money could in theory have systemic side effects, but that is only if the money is spent on effecting something critical (say influencing the outcome of election etc..). Most of Give Well money is spent on health interventions which are far less likely to have critical systemic side effects.
The worst I could think of them is that they are insensitive/disrespectful to the local populations and have no health effect. Neither of these possible outcomes are critically negative in the systemic sense.
Two international health interventions are running into local resistance 1) Polio Vaccination in Pakistan 2) Ebola treatment in Democratic Republic of Congo neither of the efforts seem bad in my opinion.
Yes, there are plausible tipping points, but I’m not talkin about that. I’m arguing that this isn’t “small amounts of money,” and it is well into the amounts where international funding displaces building local expertise, makes it harder to focus on building health systems generally instead of focusing narrowly, undermines the need for local governments to take responsibility, etc.
I still think these are outweighed by the good, but the impacts are not trivial.
I’m arguing that this isn’t “small amounts of money,”
I am not convinced. In proportion to the needs, the amount seems small, also the money is spent in several countries and hence per capita spending is low (I doubt it goes above $10 per person per year in any of the health interventions SMC is at $7).
undermines the need for local governments to take responsibility, etc.
local governments do take responsibility, what they can achieve in their circumstances is limited though. hence the need for money and outside support.
it is well into the amounts where international funding displaces building local expertise
I am not sure I understand why international funding should displace local expertise, why are the international funders, not funding local organizations? and building local leadership? taking help from local expertise? I think local partners and leaders should take front seat
makes it harder to focus on building health systems generally instead of focusing narrowly
This part I agree, but if overall funding is limited then it makes sense for individuals to look for narrow effects. Give Well is good at this for EA movement, since EA is small compared to the needs.
By the same token Give Well type analysis makes less sense at a government to government level when entire health departments are supported. The building of those health institutions takes a long time, the results come slowly with a time lag of 10+ years. Even then they have interactions with the rest of societal institutions like education, economy.
Again, I don’t think that’s relevant. I can easily ruin systems with a poorly spent $10m regardless of how hard it is to fix them.
I am not sure I understand why international funding should displace local expertise...
You’re saying that these failure modes are avoidable, but I’m not sure they are in fact being avoided.
The building of those health institutions takes a long time, the results come slowly with a time lag of 10+ years.
Yes, and slow feedback is a great recipe for not noticing how badly you’re messing things up. And yes, classic GiveWell type analysis doesn’t work well to consider complex policy systems, which is exactly why they are currently aggressively hiring people with different types of relevant expertise to consider those types of issues.
I can easily ruin systems with a poorly spent $10m regardless of how hard it is to fix them.
I understand, Give Well recommendations are not going down a path of destruction. So I am not worried. I would be really worried when they try to influence policies.
Also in the big picture I think AID helps if directed well, but it is a small part of the budgets of poor countries and can only be expected (in the big scheme of things) to have small effects. Most of the improvement has come from people/national governments improving their countries.
I agree that small amounts of money could in theory have systemic side effects, but that is only if the money is spent on effecting something critical (say influencing the outcome of election etc..). Most of Give Well money is spent on health interventions which are far less likely to have critical systemic side effects.
The worst I could think of them is that they are insensitive/disrespectful to the local populations and have no health effect. Neither of these possible outcomes are critically negative in the systemic sense.
Two international health interventions are running into local resistance 1) Polio Vaccination in Pakistan 2) Ebola treatment in Democratic Republic of Congo neither of the efforts seem bad in my opinion.
Yes, there are plausible tipping points, but I’m not talkin about that. I’m arguing that this isn’t “small amounts of money,” and it is well into the amounts where international funding displaces building local expertise, makes it harder to focus on building health systems generally instead of focusing narrowly, undermines the need for local governments to take responsibility, etc.
I still think these are outweighed by the good, but the impacts are not trivial.
I am not convinced. In proportion to the needs, the amount seems small, also the money is spent in several countries and hence per capita spending is low (I doubt it goes above $10 per person per year in any of the health interventions SMC is at $7).
local governments do take responsibility, what they can achieve in their circumstances is limited though. hence the need for money and outside support.
I am not sure I understand why international funding should displace local expertise, why are the international funders, not funding local organizations? and building local leadership? taking help from local expertise? I think local partners and leaders should take front seat
This part I agree, but if overall funding is limited then it makes sense for individuals to look for narrow effects. Give Well is good at this for EA movement, since EA is small compared to the needs. By the same token Give Well type analysis makes less sense at a government to government level when entire health departments are supported. The building of those health institutions takes a long time, the results come slowly with a time lag of 10+ years. Even then they have interactions with the rest of societal institutions like education, economy.
Again, I don’t think that’s relevant. I can easily ruin systems with a poorly spent $10m regardless of how hard it is to fix them.
You’re saying that these failure modes are avoidable, but I’m not sure they are in fact being avoided.
Yes, and slow feedback is a great recipe for not noticing how badly you’re messing things up. And yes, classic GiveWell type analysis doesn’t work well to consider complex policy systems, which is exactly why they are currently aggressively hiring people with different types of relevant expertise to consider those types of issues.
And speaking of this, here’s an interesting paper Rob Wiblin just shared on complexity and difficulty of decisionmaking in these domains; https://philiptrammell.com/static/simplifying_cluelessness.pdf
I understand, Give Well recommendations are not going down a path of destruction. So I am not worried. I would be really worried when they try to influence policies.
Also in the big picture I think AID helps if directed well, but it is a small part of the budgets of poor countries and can only be expected (in the big scheme of things) to have small effects. Most of the improvement has come from people/national governments improving their countries.