The first point seems to be saying that we should factor in the chance that a program works into cost-effectiveness analysis. Isn’t this already a part of all such analyses? If it isn’t, I’m very surprised by that and think it would be a much more important topic for an essay than anything about PEPFAR in particular.
The second point, that people should consider whether a project is politically feasible, is well taken. It sounds like the lesson here is “if you find yourself in a situation where you have to recommend either project A or B, and both are good, but A is better than B, but if you do activism for A it still won’t happen, but if you do activism for B your input will push it over the edge into happening, do activism for B.” I agree with this as far as it goes, but there seem like some important caveats:
You shouldn’t lie, for the normal reasons against lying. It sounds like some of these economists were just publishing reports or articles saying that antimalarials were better than PEPFAR, and I think if that was what they found, then publishing that in reports is correct regardless of the politics. Then when they put on their activist hats they can support whatever is most effective to support.
It’s a really hard problem to know whether to pursue less ambitious vs. more ambitious goals. If you’re a socialist, should you spend your time fighting for a $1 minimum wage increase, for Medicare For All, or for completely dismantling capitalism and replacing it with workers’ communes? I don’t think there’s an obvious answer, even though the first is clearly more likely to succeed than the second two. In retrospect it’s clear that PEPFAR worked politically, and if you say that more cost-effective options wouldn’t have worked politically at that time then I believe you, but I don’t want to conclude that therefore less ambitious political projects are always better than more ambitious ones, and I don’t know how else to apply the lesson from this story more generally.
Okay, so GWWC, LW, and GiveWell, what are we going to do to reverse the trend?
Seriously, should we be thinking of this as “these sites are actually getting less effective at recruiting EAs” or as “there are so many more recruitment pipelines now that it makes sense that each one would drop in relative importance” or as “any site will naturally do better in its early years as it picks the low-hanging fruit in converting its target population, then do worse later”?