Global health & development
Global health
Improving public health, and finding new interventions to help the developing world

Quick takes

USAID has announced that they've committed $4 million to fighting global lead poisoning!  USAID Administrator Samantha Power also called other donors to action, and announced that USAID will be the first bilateral donor agency to join the Global Alliance to Eliminate Lead Paint. The Center for Global Development (CGD) discusses the implications of the announcement here.  For context, lead poisoning seems to get ~$11-15 million per year right now, and has a huge toll. I'm really excited about this news. Also, thanks to @ryancbriggs for pointing out that this seems like "a huge win for risky policy change global health effective altruism" and referencing this grant: In December 2021, GiveWell (or the EA Funds Global Health and Development Fund?) gave a grant to CGD to "to support research into the effects of lead exposure on economic and educational outcomes, and run a working group that will author policy outreach documents and engage with global policymakers." In their writeup, they recorded a 10% "best case" forecast that in two years (by the end of the grant period), "The U.S. government, other international actors (e.g., bilateral and multilateral donors), and/or national LMIC governments take measurable action to reduce lead exposure—for example, through increased funding for lead mitigation and research, increased monitoring of lead exposure, and/or enactment of regulations." We've reached this best case and it's been almost exactly two years! (Attributing credit is really hard and I have no experience and little context in this area — as far as I know this could have happened without that grant or related advocacy. But it's still notable to me that a CGD report is cited in Power's announcement.)
If you believe that: - ASI might come fairly soon - ASI will either fix most of the easy problems quickly, or wipe us out - You have no plausible way of robustly shaping the outcome of the arrival of ASI for the better does it follow that you should spend a lot more on near-term cause areas now? Are people doing this? I see some people argue for increasing consumption now, but surely this would apply even more so to donations to near-term cause areas?
The meat-eater problem is under-discussed. I've spent more than 500 hours consuming EA content and I had never encountered the meat-eater problem until today. (I had sometimes thought about the problem, but I didn't even know it had a name)
Im intrigued where people stand on the threshold where farmed animal lives might become net positive? I'm going to share a few scenarios i'm very unsure about and id love to hear thoughts or be pointed towards research on this. 1. Animals kept in homesteads in rural Uganda where I live. Often they stay inside with the family at night, then are let out during the day to roam free along the farm or community. The animals seem pretty darn happy most of the time for what it's worth, playing and galavanting around. Downsides here include poor veterinary care so sometimes parasites and sickness are pretty bad and often pretty rough transport and slaughter methods (my intuition net positive). 2. Grass fed sheep in New Zealand, my birth country. They get good medical care, are well fed on grass and usually have large roaming areas (intuition net positive) 3. Grass fed dairy cows in New Zealand. They roam fairly freely and will have very good vet care, but have they calves taken away at birth, have constantly uncomfortably swollen udders and are milked at least twice daily. (Intuition very unsure) 4. Free range pigs. Similar to the above except often space is smaller but they do get little houses. Pigs are far more intelligent than cows or sheep and might have more intellectual needs not getting met. (Intuition uncertain) Obviously these kind of cases make up a small proportion of farmed animals worldwide, with the predominant situation - factory farmed animals likely having net negative lives. I know that animals having net positive lives far from justifies farming animals on it's own, but it seems important for my own decision making and for standing on solid ground while talking with others about animal suffering. Thanks for your input.
Often people post cost-effectiveness analyses of potential interventions, which invariably conclude that the intervention could rival GiveWell's top charities. (I'm guilty of this too!) But this happens with such frequency, and I am basically never convinced that the intervention is actually competitive with GWTC. The reason is that they are comparing ex-ante cost-effectiveness (where you make a bunch of assumptions about costs, program delivery mechanisms, etc) with GiveWell's calculated ex-post cost-effectiveness (where the intervention is already delivered, so there are much fewer assumptions). Usually, people acknowledge that ex-ante cost-effectiveness is less reliable than ex-post cost-effectiveness. But I haven't seen any acknowledgement that this systematically overestimates cost-effectiveness, because people who are motivated to try and pursue an intervention are going to be optimistic about unknown factors. Also, many costs are "unknown unknowns" that you might only discover after implementing the project, so leaving them out underestimates costs. (Also, the planning fallacy in general.) And I haven't seen any discussion of how large the gap between these estimates could be. I think it could be orders of magnitude, just because costs are in the denominator of a benefit-cost ratio, so uncertainty in costs can have huge effects on cost-effectiveness. One straightforward way to estimate this gap is to redo a GiveWell CEA, but assuming that you were setting up a charity to deliver that intervention for the first time. If GiveWell's ex-post estimate is X and your ex-ante estimate is K*X for the same intervention, then we would conclude that ex-ante cost-effectiveness is K times too optimistic, and deflate ex-ante estimates by a factor of K. I might try to do this myself, but I don't have any experience with CEAs, and would welcome someone else doing it.
"UNICEF delivered over 43,000 doses of the R21/Matrix-M malaria vaccine by air to Bangui, Central African Republic, today, with more than 120,000 doses to follow in the next days. " - Link Pretty rookie numbers, need to scale. To be seen how this translates to actual distribution and acceptance. But sure did feel good to read the news, so thought I'd share! No takes yet, feel free to add. Also, "Around 4.33 million doses of RTS,S have been delivered to 8 countries so far – Benin, Burkina Faso, Cameroon, Ghana, Kenya, Liberia, Malawi, and Sierra Leone". 
The Happier Lives Institute have helped many people (including me) open their eyes to Subjective Wellbeing and perhaps even update us to the potential value of SWB. The recent heavy discussion (60+ comments) on their fundraising thread disheartened me. Although I agree with much of the criticism against them, the hammering they took felt at best rough and perhaps even unfair. I'm not sure exactly why I felt this way, but here are a few ideas. * (High certainty) HLI have openly published their research and ideas, posted almost everything on the forum and engaged deeply with criticism which is amazing - more than perhaps any other org I have seen. This may (uncertain) have hurt them more than it has helped them. * (High certainty) When other orgs are criticised or asked questions, they often don't reply at all, or get surprisingly little criticism for what I and many EAs might consider poor epistemics and defensiveness in their posts (for charity I'm not going to link to the handful I can think of). Why does HLI get such a hard time while others get a pass? Especially when HLI's funding is less than many of orgs that have not been scrutinised as much. * (Low certainty) The degree of scrutiny and analysis of some development orgs in general like HLI seems to exceed that of AI orgs, Funding orgs and Community building orgs. This scrutiny has been intense- more than one amazing statistician has picked apart their analysis. This expert-level scrutiny is fantastic, I just wish it could be applied to other orgs as well. Very few EA orgs (at least that have been posted on the forum) produce full papers with publishable level deep statistical analysis like HLI have at least attempted to do. Does there need to be a "scrutiny rebalancing" of sorts. I would rather other orgs got more scrutiny, rather than development orgs getting less. Other orgs might see threads like the HLI funding thread hammering and compare it with other threads where orgs are criticised and don't eng
Why did India's happiness ratings consistently drop so much over time even as its GDP per capita rose? Epistemic status: confused. Haven't looked into this for more than a few minutes My friend recently alerted me to an observation that puzzled him: this dynamic chart from Our World in Data's happiness and life satisfaction article showing how India's self-reported life satisfaction dropped an astounding -1.20 points (4.97 to 3.78) from 2011 to 2021, even as its GDP per capita rose +51% (I$4,374 to I$6,592 in 2017 prices):  (I included China for comparison to illustrate the sort of trajectory I expected to see for India.) The sliding year scale on OWID's chart shows how this drop has been consistent and worsening over the years. This picture hasn't changed much recently: the most recent 2024 World Happiness Report reports a 4.05 rating averaged over the 3-year window 2021-23, only slightly above the 2021 rating. A -1.20 point drop is huge. For context, it's 10x(!) larger than the effect of doubling income at +0.12 LS points (Clarke et al 2018 p199, via HLI's report), and compares to major negative life events like widowhood and extended unemployment:  Given India's ~1.4 billion population, such a large drop is alarming: roughly ~5 billion LS-years lost since 2011, very roughly ballparking. For context, and keeping in mind that LS-years and DALYs aren't the same thing, the entire world's DALY burden is ~2.5 billion DALYs p.a.  But – again caveating with my lack of familiarity with the literature and extremely cursory look into this – I haven't seen any writeup look into this, which makes me wonder if it's not a 'real issue'? For instance, the 2021 WHR just says That's it: no elaboration, no footnotes, nothing. So what am I missing? What's going on here?  A quick search turned up this WEF article (based on Ipsos data and research, not the WHR's Gallup World Poll, so take it with a grain of salt) pointing to * increased internet access -> pressure to port
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