I’m a doctor working towards the dream that every human will have access to high quality healthcare. I’m a medic and director of OneDay Health, which has launched 35 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.
NickLaing
Karma: 8,570
I love this response. I would add the amount of money that GiveWell at least is looking to give out is unfortunately often more than local NGOs can absorb efficiently anyway.
I don’t quite understand what you mean by GiveWell supporting “small international NGOs”. They generally support at least medium size ones with budgets usually in the millions per year.
Given that the prevalence has reduced since 2015, I don’t think that makes sense.
Broadly Agree
Although I might have misunderstood and missed the point of this entire debate, so correct me if that is the case
I just don’t believe changing the future trajectory is tractable in say 50-100 years from now areas like politics, economics, AI welfare etc. I think its a pipe dream. We cannot predict technological, political and economic changes even in the medium term future. These changes may well quickly render our current efforts meaningless in 10-20 years. I think the effect of work we do now which is future focused diminishes in value exponentially to the point that in 20 years time it is probably almost meaningless. I could be convinced against this if you could show me interventions 20 years ago which were specifically future focus which are now still meaningful.
However I do believe it may be possible to reduce existential risk through direct, tangeble changes now which could prevent a disastrous one off event like a engnieered virus or AI apocalypse. Stopping a one off catastrophe though still exremely difficult seems much more realistic than influencing an overall global trajectory with so much uncertainty.This is unless you include general global health and development and animal welfare work which directly improves the lives of beings today, and will also likely improve beings lives in the future but probably in a far more minor way than this question is addressing. If you include the effects ofstandard EA GHD and animal welfare work under the banner “Improving the value of futures where we survive” then I would probably swing my vote the other way.
Me too Bella, see my comment above
Thanks so much for this writeup man, absolute music to my eyes here on the forum I wish we had more like this!
I think I agree (with low confidence) with your top 3 factors. The malaria prevalence graph is quite eye opening and based on that I would guess population growth as the number one factor here—especially given that prevalence has even dropped a little since 2015
I’m going to suggest a couple of other factors that I think are probably less important than your top 3, but I think likely to be more important than the ones you rightly dismiss as unlikely.
Artemisin resistance as I discussed here . Even small amounts of resistance to the drug almost universally used to treat malaria will cause more spread—imagine if the average malaria case was cleared 12 hours more slowly, that’s a lot of extra time for mosquitos to suck up parasites to spread malaria
The reduction in indoor residual spraying programs since 2015, which were expensive but had a big effect, some estimates have them accounting for 10ish percent of recents reduction in malaria prevalence. This does overlap with your “reduced funding” too though.
I guess this comment is now obsolete/wrong given Alexanders reply? I still appreciate it! Maybe worth flagging that with an edit or something?
Thanks @Alexander_Berger that all makes complete sense, appreciate the clear and comprehensive reply—all the best with this work. Predictably basic me especially likes the direct RandD on neglected Global Health :).
First great job getting other funders on board here I love that. I’ve got a coupke of queries here for things that I didn’t write understand
“We also think our housing policy work clears our internal bar for impact. Our current internal valuation on a marginal housing unit in a highly constrained metro area in the US is just over $400k (so a grant would be above the bar if we think it causes a new unit in expectation for $200)”
I don’t understand what this means, is there a report or something you could link to which explains it?
Also I read the report you linked on R and D where it didn’t clear the funding bar. That said 45x, you were pushing that up to 76x
“In a highly stylized calculation, the social returns to marginal R&D are high, but typically not as high as the returns in some other areas we’re interested in (e.g. cash transfers to those in absolute poverty). Measured in our units of impact (where “1X” is giving cash to someone earning $50k/year) I estimate the cost effectiveness of funding R&D is 45X. This is 45% the ROI from giving cash to someone earning $500/year, and 4.5% the GHW bar for funding. More.”
I understand that you think you can raise efficiency of certain types of R@D, but getting from 70x to 2100x means you would have to 30x the efficiency. I struggle to understand how that would be likely again any pointers here?
Thanks I absolutely love this, and would be willing to do this same thing with the same ratio with half the size of the donation (2500) - I just don’t have much money lol. I would also be willing to use a 5 billion global population threshold, although I doubt that makes much difference—if we go down to 5 billion we probably go down to 1...
I don’t really consider it a wager as such, more a donation trade or something (I’m sure others can think of a better name)
If I can help make AI Doom .000000000000000000000000000000000001 percent less likely while getting more return than market growth to the charity of my choice, what’s there not to love?
Quick question what do you mean by “inflation adjusted” on the 7500 exactly?
Nice one
Yep when I first saw it I assumed they meant
Economic growth in low income countries and...
Innovation around technology that would help people in low income countries (medical innovation, fintech, drone deliveries etc.
Then I saw it was all US based.
Again I don’t mind at all if open Phil has a non EA d based, US based philanthropy arm, that might be what the donors want to do and might even be a good strategic move for PR reasons. But might be good to be more explicit about that.
Maybe they are predicting not for long… ;)
J/k
Thanks this is super helpful. I was trying to get my head around this announcement and that really helps.
Also to state the maybe obvious, you are allowed to ask whatever you want, and they are allowed to answer it or not! I for one appreciated the question in and of itself regardless of whether it gets answered
Thanks this is excellent. My wife who’s a community organizer always said a small early win should be a almost non -negotiable aim for any advocacy group or organization. Like you said to boost motivation and self belief, increase hope and build confidence in the team and organization. Important stuff.
I think this question would have been b more effectively asked without going through your animal welfare argument for the upteenth time.
If you’re really asking a genuine and important question about the value of direct work vs donating, why not just keep the first paragraph which states your argument well enough, without your second paragraph (which contains most of the words in the question), which is a distraction from your main point which can easily alternate people like me and drag the discussion away from the question itself.
Love this Dylan and completely agree
I know we had a couple of disagreements about the content of your last post, but I really love the transparency and honesty here about your fundraising efforts and the unexpected increased cost of the facility@Anthony Kalulu, a rural farmer in eastern Uganda. It saddens me to say that level of transparancy quite unusula from my experience in Uganda so good on you for that.
Good on you and all the best with your development endeavors.
And like @MathiasKB🔸 said, advise against the crypto investment!
Also I suspect due to the style, and request in this post you might be downvoted quite a bit but dont be discouraged. This forum isn’t an easy place!
Wow amazing 2022 article by the way. I never saw it at the time, it was before I was on the forum!
After reading the thread I might fall marginally more on your side of the argument there, especially as inflation probably did contribute to the trump victory. But it is also yet another demonstration of how hard philanthropy gets, the higher level you get in politics or economics, with so much disagreement and uncertainty. There’s just so much disagreement from experts on almost every major issue, so it’s very hard to know on which side to push the money.
Taking a low percentage “hit based” approach on human welfare issues is one thing, but when it’s super unclear even if you make that hit whether its positive or negative EV is where I start to think why not just take a punt on something deeply uncertain but never negative EV like shrimp instead.
Sorry also to clarify I wasn’t saying you need to provide suggestions, more that there have been a few posts along these lines without any concrete suggestions yet and id love to see some.
Love the post a lot by the way, thoughtful and balanced. Nice one!
I like your point about careers and systemic change, and that it is harder to convert money directly into results. I also agree with @jackva though that measurement problems aren’t a likely reason for the lack of investment, Open Phil are investing in lots of speculative and almost impossible to measure things, I don’t think that’s the issue.
Yep 100% agree with all of that. And I absolutely love organisations that do only one thing, especially AMF obviously!