You may be interested in this 80,000 Hours podcast: https://80000hours.org/podcast/episodes/rachel-glennerster-best-buys-in-international-development/
Thanks for your comments.
Representatives actually are responsive to resident, not just citizens. If you don’t live in the US, you’re right that US representatives won’t be responsive. However, if you do live in the US, even if you’re not a US citizen, your voice does matter.
In terms of the counterfactual use of funds, our assessment is based on the belief that funding for vaccines, AIDS, tuberculosis and malaria (through GAVI and the Global Fund) is one of the most cost effective—if not the most cost effective—use of funds. It’s the same internal logic that Givewell uses when assessing Against Malaria Foundation vs. other development organizations. The causes that GAVI and the Global Fund work on are tractable, have a strong evidence base, and have room for more funding. Additionally, GAVI and the Global Fund have demonstrated results in making sustainable progress in these areas.These factors make us confident, on balance, that more money towards these organizations is a more optimal use of funding.