Hey Nick, thanks for raising this question about the plausibility of chlorination’s effect of mortality and the need for more research to understand why. I’m a senior researcher at GiveWell and wanted to chime in with a little more context.
When we did our analysis, we agreed that the ~25%-30% headline figure from the Kremer et al. meta-analysis felt implausibly high. We end up with estimates of ~5%-15% depending on the country and program (e.g., ~6% for the Dispensers for Safe Water Program in Uganda and ~12% for the in-line chlorination program in Malawi).
A bit more on what we did:
These mortality effect estimates are really uncertain, though, so we’ve funded follow-up research (as Dan alluded to in his comment).
Thanks again for boosting this question — it’s something we’ve been thinking about a lot, and I’m glad it’s getting some more attention. I think we’d be open to hearing more thoughts about how we could learn more about the extent to which chlorination affects mortality and why, since we’re continuing to explore more grants to chlorination.
Hey, thanks for the question! I'm Alex Cohen, a researcher at GiveWell, and wanted to chime in.
We did say we'd include a 25th/75th percentile range on bottom line cost-effectiveness (in addition to the one-way sensitivity checks). We haven't added that yet, and we should. We ran into some issues running the full sensitivity analyses (instead of the one-way sensitivity checks we do have), and we prioritized publishing updated intervention reports and cost-effective analyses without them.
We'll add those percentile ranges to our top charity intervention reports (so the simple cost-effective analyses will also include a bottom line cost-effectiveness 25/75 range, in addition to one-way sensitivity checks) and ensure that new intervention reports/grant pages have them included before publishing. We think it’s worth emphasizing how uncertain our cost-effectiveness estimates are, and this is one way to do that (though it has limitations).
We're still not planning to base our decision-making on this uncertainty in the bottom line cost-effectiveness (like the “Change Our Mind Contest” post recommended) or model uncertainty on every parameter. To defend against the Optimizer's Curse, we prefer our approach of skeptically adjusting our inputs, rather than an all-in adjustment to bottom-line cost-effectiveness. We explain why in the uncertainty post.
Really appreciate you raising this. Sorry this has taken so long, and grateful for the nudge!