Hi everyone, I’m Phil. I have a background in engineering and biology, and am currently considering career paths. I started out working on infrastructure projects in the developing world as an undergrad, and then began to learn about development economics more broadly. This led me to read about J-PAL, IPA and then eventually to GiveWell, GWWC and 80,000 hours. My background makes me most interested in global health and development, but I also find arguments for existential risk mitigation and effective animal altruism pretty convincing. In general, I find it hard to find a group of people thinking along the same lines as effective altruists, so I’m glad to find this forum!
Phil_Thomas
I am not currently a GWWC member, but I intend to join in the future. This change wouldn’t have a large effect on me either way, but I would support it.
I have watched the EA movement evolve over the last few years, and it seems to be broadening its scope. This has been especially evident at with GiveWell’s Open Philanthropy Project (OPP). When I first became familiar with GiveWell, my initial reaction was that they were missing the big picture. The OPP has been a big positive for me because it addresses areas that could have massive impact, even if there is more uncertainty and attributing direct impact is difficult. I have also noticed 80,000 Hours broaden its message and career recommendations over the past year from mainly focusing on earning to give, to acknowledging that a high risk, high reward career with direct impact might also be a reasonable choice for certain people.
This broadening of scope is essential because it includes people who initially feel the movement is missing the bigger picture (even if they change their minds later). I think the EA community will incorporate more ideas from development economics and x-risk over the coming years, and that this is a good thing.
Yeah, reading some of the other comments on here leads me to think I might have a misconception of what EA includes, or how others define EA. This may be because I come from the global health/ development economics side of things. I wasn’t really sure what LessWrong or MIRI were for a long time, or how they related to the EA community. It might be pretty common for people to have an incomplete picture of what EA is depending on the intellectual route they took to get here. So even if the movement is more broad and inclusive, the public perception of the movement may turn people away.
Also, when I say “missing the bigger picture” I am not solely referring to x-risk, but also to approaches to global health and poverty reduction like R&D for infectious disease, infrastructure development, improving the business environment and generally trying to work around the edges of an economy to address market failures. It seems to me that there was a gap within the EA community for these types of solutions before the OPP, unless you include J-PAL and IPA.
Some of what I’m saying may not be specifically relevant to the above GWWC wording change, but reflect broader changes in the EA movement (or my understanding of it) that I am happy to see.
Note, the author is Eva Vivalt from AidGrade. They have a new blog post here saying they have new data and papers coming out over the next few weeks.
From the post:
We have a lot of new results coming out over the next few weeks – watch this space!
First up: updated data in the meta-analysis app. Data on 10 new interventions were added: >contract teachers; financial literacy; HIV education; irrigation; microhealth insurance; >micronutrients; SMS reminders; performance pay; rural electrification; and women’s >empowerment programs.
There is also an updated working paper of “How Much Can We Generalize from Impact >Evaluations?” on Eva Vivalt’s site.
Next up: working papers on each of the topics covered to date.
It’ll be interesting to see the working papers on each of the topics (especially the microhealth insurance).
Offering to match donations seems like it would be particularly effective. In that case, you’re acting alongside someone else rather than telling them to do something. Also, this could be even more effective if your company has a matching gifts policy.
This idea also reminds me a little bit of performance based incentives in aid, such as Cash On Delivery programs. Performance based incentives are relatively new, though, so I haven’t been able to find many impact evaluations, although initial reports are promising for health interventions (1, 2). There was even talk a few years ago of creating a stock market for charities, but I don’t think that has gone anywhere. Robert Shiller also proposed something called a Participation Nonprofit at one point where people would buy shares in a nonprofit then spend the returns on charities. All of those have elements of what you’re talking about, but don’t put it all together.
I get the general sense that the field of development economics is starting to ask the bigger questions again, often using different techniques than randomization. This is from an interesting blog post I read recently:
Economic development is about the transition of whole economies from low-productivity, poor places into high-productivity industrial economies. This transition encompasses several aspects: a move out of agriculture and into manufacturing or services, urbanization, declining fertility rates, integration with global markets. Current research in development economics – the RCTs and their like – does not study the transition. “What will make these people better off today?” is a different question than “What will make this economy develop?”.
This type of criticism has been around for a long time (Rodrik, Blattman), but it seems to be gaining more traction now.
Something like the efficient frontier in modern portfolio theory comes to mind, where you have a tradeoff between risk and return. We have nowhere near enough data, and don’t have a uniform metric of return, as the $/DALY seems too controversial, but I can still dream.
This actually isn’t a bad idea, something like the IT industry in India. Dani Rodrik keeps making the point that the labor force in many developing nations is making the transition directly from low productivity agriculture jobs to low productivity service jobs without going through high productivity manufacturing jobs that have traditionally led to the formation of a middle class. Some way to get people trained for high productivity service jobs, like in IT, could be really helpful for economic development, although there is probably a massive educational gulf to cover. The power grid would need some work to build a steady IT industry, too.
Rodrik’s talk on this and some of his writings (1) are the most informative I have seen in a while.
It’s not that a country is investing in low productivity industries, this is just what is naturally happening. Poor people from the countryside are moving to cities for a marginally better life, but they’re selling trinkets on the street when in the past they may have been manufacturing the trinkets. The point is to figure out how to encourage high productivity jobs, not just observe that they’re unavailable.
Once it is viable, capital is naturally invested where its marginal product is highest, which in turn increases the marginal product of its compliments, like labour.
I think the main challenge is finding out how to make investments viable, which is really hard for a number of reasons that are often grouped into the term “poor business environment”. It seems like the debate centers around whether anything can be done to improve the business environment, or if we’re better off treating the symptoms of poverty while economies sort themselves out.
What you describe above would happen in an efficient market, but stock markets barely exist in most sub-saharan countries so I think most SSA economies are operating far from efficiently. It seems like private equity deals, or doing due diligence for PE deals could have a big impact. Most private equity in SSA is growth equity rather than leveraged buyouts, and the counterfactual is probably some other risky investment that might not have as much development impact. This is an understudied area, but I’m excited to see the results of this research from IPA.
There was an interesting interview with Dean Karlan from Innovations for Poverty Action on PBS. Some excerpts:
Dean Karlan: I divide my thinking into short-run and long-run. For the long-run, I want to invest. I want to think about how we get better information, better evidence [for what we give], because we need to help future children, not just today’s children. In fact, there are many more children in the future than today so I put more money into the long-run. And for that, I support Innovations for Poverty Action which is doing research to figure out what works and what doesn’t.
But, I also do care about the short-run. So I also look at some of the things that we do have strong evidence on — where there have been really good tests to show that an idea works, and here’s a charity that’s doing it, so let’s support it.
This year there are three charities that stood out in the work that I was doing with my family, trying to think through what to support. One is called Trickle Up, which works a lot in West Africa and Latin America. A second is Seva Mandir which does work in India.
And a third is Evidence Action, an organization just started a year ago that is strictly committed to scaling up ideas that have been shown to work using randomized trials. They are doing two things right now. One is a de-worming program. This is a school-based de-worming program. De-worming, as in children who have intestinal worms, which gives them a distended belly and makes them lethargic and sick and not able to go to school. Taking a pill has been shown not only to improve their school attendance, but 10 years later, improve their income.
A second is a chlorine dispenser. . .
There are also some interesting findings on savings and crop insurance instruments that they discuss:
So, the striking insight was that it’s not that people weren’t credit constrained, but they were very risk-constrained, and there was a lot of under-investment going on simply because of risk. And this suggests that a scaled-up micro-insurance product that helps people absorb rainfall risk would be a very successful thing.
The host seems convinced at the end, and decided to donate 10% to Dean’s suggested charities.
I’m especially interested in coordinating with others, something like a crowdfunding site with prescreened projects would be great.
Otherwise, gambling’s cool too :)
I think GiveWell was initially much more critical of the Gates Foundation than they are today. Perhaps this is because during the OPP they found that what Gates does is (1) very difficult and that (2) Gates (or other foundations/govs) had already funded many of the most promising opportunities.
It’s probably best to evaluate the GF like a venture capitalist rather than on a project by project basis.
I just came across an interesting set of short, user friendly videos describing how QALYs are derived using the standard gamble or time tradeoff techniques. They mainly focus on applications in the US healthcare system, but I think they could be useful for anyone trying to communicate the ideas of cost effectiveness research.
Determining utilities using the standard gamble and time tradeoff techniques
Calculating QALYs, and applying them to the healthcare system
They’re written by Aaron Carroll, who regularly writes for the NYTimes, and blogs at The Incidental Economist. Their blog outlines the general concept behind EA here, so maybe they’d be open to consulting with an EA group? In general, I think healthcare economists have really interesting viewpoints to add to this movement.
I have also found Python to be very useful. I learned through Udacity’s Intro to Computer Science course, which was really user friendly.
Epicodus put their entire Ruby/Rails program online for free here. I don’t know enough to judge the quality, but it might be useful.
I’m glad to see some discussion of this topic here, I think it could be a pretty effective area for EAs to work. I have a few comments specifically related to electronic delivery of therapy. I’ve been following the area for awhile, although most of what I’ve read is in the context of anxiety and depression treatment so it might not be applicable to interventions focused on general happiness.
cCBT is as effective as in-person CBT for anxiety and depression in the context of a RCT. But when you change over to open access therapies, rates of adherence drop considerably, with estimates of 0.5% and 1% completion in the only two published studies I could find [1,2]. If your server time and ongoing development costs are low enough, though, cCBT could still be a cost effective approach despite poor retention. This assumes that those that fail to complete the training aren’t harmed, but evidence seems to suggest that even partial completion is helpful [1,2]. Note that in study [1], about 15.6% completed 2 or more of the 5 modules, so a larger portion of people at least partially complete the training. I haven’t done a $/DALY estimate, but it would be fairly easy to come up with one with the results from study [1].
One promising approach to improve retention is to offer health coaches, which interact with cCBT users and help them stay on track to completion. This would be more expensive, but could be a middle ground between cCBT and in-person therapy. Ginger.io is one startup using this approach, and I’m excited to see how things go for them. They offer cCBT, health coaches, and psychologists via video conferencing if needed. This approach could make it pretty seamless for those with mental illness to seek help. There are a few clinical trials testing their technology here, but I can’t find any results yet.
For a good overview of some of the other emerging startups in this space, see this article. It’s especially encouraging to see people with very strong academic credentials founding or on the boards of these startups, which suggests there is fairly good scientific support for the approach. If you want to read more of the literature, the faculty profiles at Australia National University e-health group and cbits at Northwestern are good place to start. ANU’s moodGYM has been around since 2001, so it has been tested in a number of RCTs.
How could effective altruists help in this area?
Now that a number of promising cCBT companies exist, their outcomes might be inevitable. But EAs could still help the therapies spread more quickly, fund RCTs to verify or improve effectiveness, or work directly for these research groups/companies. On the regulatory side, each state in the US has different licensing processes for mental health professionals, which prevents them from video conferencing with patients in other states. Relaxing this barrier would be especially helpful for rural patients. Getting a cCBT approved for Medicare/Medicaid in the US would also be a step forward, but I would think that stronger randomized evidence would be needed before that would happen. One interesting side note is that the UK, Australia, Denmark and Sweden found the evidence strong enough to approve cCBT years ago, so maybe the problem is that nobody has lobbied hard enough in the US?
[1] A Comparison of Changes in Anxiety and Depression Symptoms of Spontaneous Users and Trial Participants of a Cognitive Behavior Therapy Website. http://www.jmir.org/2004/4/e46/
[2] Usage and Longitudinal Effectiveness of a Web-Based Self-Help Cognitive Behavioral Therapy Program for Panic Disorder. http://www.jmir.org/2005/1/e7/
[3] The Law of Attrition. http://www.jmir.org/2005/1/e11/
[4] Adherence in Internet Interventions for Anxiety and Depression: Systematic Review. http://www.jmir.org/2009/2/e13/
What is the actual effect size of CBT run “in the wild” via a scalable delivery mechanism like an app? How much of depression can we expect it to mitigate? Is the main problem to solve here finding a good intervention, or distributing it (i.e. getting people to use the CBT app or whatever)?
From what I can tell, the problem is more with outreach and retention than with effectiveness. Most of what I’ve read shows that computer based cognitive behavioral therapy (cCBT) is as effective as in-person CBT for anxiety and depression in the context of a RCT. But “in the wild”, rates of adherence drop considerably, with estimates of 0.5% and 1% completion in the only two published studies I could find [1,2].
If your server time and ongoing development costs are low enough, though, cCBT could still be a cost effective approach despite poor retention. This assumes that those that fail to complete the training aren’t harmed, but evidence seems to suggest that even partial completion is helpful [1,2]. Note that in study [1], about 15.6% completed 2 or more of the 5 modules, so a larger portion of people at least partially complete the training. I haven’t done a $/DALY estimate, but it would be fairly easy to come up with one with the results from study [1].
[1] A Comparison of Changes in Anxiety and Depression Symptoms of Spontaneous Users and Trial Participants of a Cognitive Behavior Therapy Website. http://www.jmir.org/2004/4/e46/
[2] Usage and Longitudinal Effectiveness of a Web-Based Self-Help Cognitive Behavioral Therapy Program for Panic Disorder. http://www.jmir.org/2005/1/e7/
I’m relatively new to the area of existential risk, and come more from the development economics/ global health side of things. I find this argument really interesting, and have a few questions and comments.
(1) Economic development in emerging economies generally leads to a demographic transition where birth rates eventually stabilize at or below the replacement rate. It seems to me that if this transition were hastened, it could lead to a smaller steady state population in the long term and lower long term resource consumption (even if consumption is accelerated in the near term). I’m not sure about the moral implications of eliminating people from a theoretical future, but it seems to me it would be preferable to have a smaller population with a better quality of life, than a large population with a poor quality of life.
(2) You write: “With the possible exceptions of anthropogenic climate change and a particularly bad nuclear war, we barely even have the ability to really mess things up today: it appears that almost all of the risk of things going terribly and irrevocably awry lies in our future. Hastening technological progress improves our ability to cope with problems, but it also hastens the arrival of the problems at almost the same rate.” -Do know of any research that has tried to quantify the relative rates/magnitudes of problems generated vs. problems solved? -Large quality of life increases in developing economies could come from application of existing technologies where the risks, as you note, are relatively small/pretty well understood. Would you support the use of existing technology for development?
(3) Has anyone made an argument for existential risk mitigation based on recent history? For example, trying to look forward with the limited perspective of someone in 1900. Obviously this would be very speculative, but I think it could help make the concepts you are discussing more concrete to outsiders. Also, doing historical research into warnings about, say, the dangers of nuclear physics could help us understand the challenges of practically implementing policies that are theoretically correct.
I generally agree that more resources need to be devoted to existential risk mitigation, but I don’t have a very good idea of where the bottlenecks are—philosophy, theory, or practical implementation?