High Impact Medicine and Probably good recently produced a report on medical careers that gives more in-depth consideration to clinical careers in low and middle income countries- you can check it out here: https://www.highimpactmedicine.org/our-research/medicalcareers
Akhil
Karma: 2,001
What you can do to help stop violence against women and girls
New cause area: Violence against women and girls
Cause area report: Antimicrobial Resistance
Introducing Cause Innovation Bootcamp
A fund to help prevent violence against women and girls
High Impact Medicine, 6 months later - Update & Key Lessons
How much of this decision for the sponsored projects to spin out was at the request of the individual organisations, and to what extent was it initiated by EV?
I think that comparisons about which is a greater scale and which is more neglected is unlikely to be solved in this thread.
I focused on violence against women and girls because the root causes, types of violence and interventions for violence against women and violence against men were sufficiently different that it did not make sense to consider them together.
However, I would certainly be interested in seeing a report on violence against men; I have relatively little knowledge on the field, so don’t feel qualified to make claims about whether it might be a promising cause area.
Thanks for raising this question!
Undernourishment (not getting enough and the right types of caloric intake, a subset of malnutrition) is a massive issue currently, affecting 660 million people; especially in children,[1] it can have significant long-term health sequelae e.g. stunting. And you are right, as a consequence of the war in Ukraine, it is likely to get worse.
Although cash transfers do have a positive impact on degree and rates of undernourishment, it likely isn’t the most directly cost-effective way of addressing this issue.[2]
There are a couple things that we could do (disclaimer: have read about this area before, spent 10 minutes on this):
Fund and scale up CMAM programs around the world- A couple of reviews, including this pretty good one by Save the Children, rate community management of acute malnutrition or CMAM, as one the most cost-effective intervention. CMAM involves treating severe acute malnutrition (SAM), especially in young children, via therapeutic feeding in predominantly outpatient facilities.
Cautiously increase funding in other interventions that are promising- There are several other interventions that may be very cost-effective for undernutrition and malnutrition- Large Scale Food Fortification, Multiple Micronutrient Supplementation for pregnant women, and small-quantity Lipid-based Nutrient Supplementation for children 6-23 months.
Work with governments to create healthier and more resilient food systems- this has a slightly longer ToC but can be quite effective e.g. Reductions in childhood stunting in Peru, from a rate of 29.8% in 2005 to 18.1% in 2011, have been attributed to improved policy and institutional coordination, pooled funding for nutrition and binding nutrition targets, as well as the creation of a civil society platform, the Child Malnutrition Initiative[3]
- ^
More info on the Our World in Data page on undernourishment
- ^
There is mixed evidence here. Some studies have shown it to be reasonably cost-effective (e.g. this one in Pakistan, but this one in Burkina Faso did not)
- ^
Directly from Aid Forum: http://www.aidforum.org/topics/food-security/four-ways-to-reduce-malnutrition/
Potential new cause area: Obesity
Equity should be a part of effectiveness evaluations
Yeah great question! There were some similarities and differences from our normal research process
Similarities
We predominantly looked for ideas where there were good feedback loops to measure the impact of the charity and the good that it was doing
Our research process largely worked and could be adapted to biosecurity as a cause area
We considered the potential of the negative impact of our ideas, and ideas where this was more likely were far less likely to pass through our research stages
Differences
We had to very seriously consider information hazards in our idea, which is not a consideration we had given much weight on or considered at all for other cause areas
Had to rely a bit more on expert opinion and ‘lower’ quality forms of evidence like theoretic evidence, case studies
We had a lot more uncertainty about our cost-effectiveness analyses, since estimates vary a lot depending on priors about likelihood of future pandemics and how bad they could be; to an extent, these uncertainties were multiplicative, which made quantification particularly challenging
We had to coordinate and talk a lot more to EA biosecurity folk- the space is small and growing, and it was important to coordinate to make sure we were not duplicating something that was already happening in a way that might be harmful
We are happy to chat to anyone interested in biosecurity who might want to start a charity and wants to talk more about our research process and the ideas we are most excited about in this space
Great post!
I think I would separate out two parts of this post
FMT and being an FMT donor as an effective way to do good
Being an FMT donor as a means of earning money, hopefully to give
On the first, I would be a lot more hesitant about some of the claims that are being made. The evidence for FMT is young, and relatively weak. I think it is far from being a potential treatment of a broad range of chronic diseases; FMT is currently approved for recurrent C. difficile infection in the UK. Things we do not know:
Is it helpful for other chronic diseases? If so, how much and is it cost-effective?
Can it be safely administered at home? You make the claim that donation and use of FMT can happen outside of the hospital setting; this is currently not recommended.
Do we need super donors? There is a growing literature around the effectivneess of autologous FMT (use of your own stool for transplantation) may be as effective as a donation from someone else (one paper I am aware of, but I am sure there are many more). I would be hesitant in putting too much stock in one apprpoach early on in the R&D of this area.
On the second, I don’t have strong opinions. I think it is worth more explicitly flagging that a super donor is quite a rare statistical occurrence, and that the activation energy and cost to be accepted and donate stool for the first time might not make net positive from a cost-effectiveness perspective ( I have not modelled this, but I wouldnt be surprised if this was the case
As someone who occupies a ‘leadership’ position in EA, what is your mentality and approach to fostering a new generating of EA leaders, and making sure that we have a bigger, stronger and more diverse group of ‘leaders’ within the community?
*I don’t necessarily love the use of the words leader and leadership, but think it is a helpful and simple shorthand in this instance.
There is also an active High Impact Medicine community in Aus, with about 15 members and two fellowship cohorts currently running!
Teaching secondary school students about the most pressing issues for humanity’s long-term future
Values and Reflective Processes, Effective Altruism
Secondary education focuses mostly on the past and present, and tends not to address the most pressing issues for humanity’s long-term future. I would like to see textbooks, courses, and/or curriculum reform that promote evidence-based and thoughtful discourse about the major threats facing the long-term future of humanity. Secondary school students are a promising group for such outreach and education because they have their whole careers ahead of them, and numerous studies have shown that they care about the future. This may serve a significant benefit in making more young people care about these issues and support them with either their time or money
Great post Luke! I just wanted to add another argument to point 8:
8. We need to be careful how we talk about ambition (or we might overload and disappoint people)
I think another related aspect to this (in my experience with High Impact Medicine) is that you also want to be careful about this because even though people might be ambitious, their personal and professional situation might preclude them from taking an ‘ambitious’ leap. Even though on the whole I think it is net positive to encourage people to be ambitious, we should also caveat this with an appreciation of different career and life situations. I think a failure to inadequately do this can make people feel like they are not doing or are enough.
Given the uncertainty in the chronology of events and nature of how authorship and review occurred, would it have not made sense to reach out to Cremer and Kemp before posting this? It would make any commentary much less speculative and heated. If the OP has done this and not received a reply, they should make that clear (but my understanding is that this was not done, which imo is a significant oversight)