Crosspost form an article on my tooooootally amaaaaaaaazing blog that you should definitely check out!
I’ve spent a few recent articles arguing that PEPFAR is really valuable and attempts to cut it would be disastrous. PEPFAR is an international program that combats HIV—it’s saved many millions of lives. Probably the most common response has been roughly the following: “sure PEPFAR saves a few kids from diseases, but it doesn’t address the root cause of the problem which is [gestures vaguely at whatever bit of one’s ideology explains why bad things happen].”
Now, when it comes to PEPFAR, this is simply factually wrong. It is addressing the root of the problem. You can see this if you look at a graph of HIV deaths over time:
People also make the same objection to effective altruism. They’ll say: “effective altruism only is a palliative solution, that doesn’t address the root of the problem which is capitalism/communism/corrupt sclerotic government/international Jewery/archons of this eon.” I think this is a very bad objection, made all the more irritating by how common it is.
Imagine you came across someone who had just been shot with a gun and was bleeding out. “Please help me,” he cries out. “Well,” you reply, “if we want to get serious about the gun violence crisis in this country, we’ll have to take on the fact that guns are very common. Thoughts, prayers, and calling ambulances are not enough. Thus, I will not help you—that would just be a partial solution that doesn’t address that root of the problem.”
This would be extremely dumb. Sure, saving the guy by calling 911 wouldn’t address the root of the problem, but it would stop a very bad thing from happening. I’m going to get in trouble for saying this, and I know it’s not politically correct, but bad things are bad and we should try to stop them! For those who get their political views by identifying which person is the chad in the wojak meme, the following example will help illustrate the principle:
Similarly, if a person gives to the against malaria foundation, they are not addressing the root cause of malaria. But so what? Jeffrey Dahmer was not the root cause of murder in the United States, but it was still bad that he went around killing and eating people. If one fewer child dies of malaria, even if you haven’t stopped all malaria in the world, you’ve done something really valuable. Will MacAskill has a good quote about this:
Sometimes we look at the size of the problems in the world and think, ‘Anything I do would be just a drop in the bucket. So why bother?’ But that reasoning doesn’t make any sense. It’s the size of the drop that matters, not the size of the bucket, and if we choose, we can create an enormous drop. That we can’t solve all the problems in the world doesn’t alter in any way the fact that, if we choose, we can transform the lives of thousands of people.”
When analyzing how good an action is, therefore, it makes sense to look at how much good one is doing not the percent of the problem that one is solving. If an action is effective and saves lots of lives, then it’s a good thing whether or not it solves the root cause of a problem.
But the slogan about addressing the root cause of problems is ill-conceived for another reason: solving a problem doesn’t require addressing the root cause of it!
What was the root cause of smallpox? Well, in a broad sense, it was evolution’s tendency to bring about horrifying viruses so long as the mechanism by which the viruses kill us allow them to survive and reproduce. The root cause of smallpox, therefore, is really something deeply woven into the evolutionary process. It’s not something we can easily get rid of.
But despite that, we got rid of smallpox. Smallpox killed hundreds of millions of people, and we simply got rid of it. It took a coordinated effort from the global health community, but it did not require addressing the root cause of smallpox. Bad things are effects; to address an effect, one doesn’t need necessarily to address its root cause. Or, once again for those who get their position by deciding who is the gigachad in the meme:
The root cause of starvation is the evolutionary competition for resources. But we didn’t have to solve that to end most starvation. All we had to do was build robust institutions to grow more food!
PEPFAR has been hugely successful in reducing the number of people killed by HIV. Antimalarial bednets have likewise been hugely successful in reducing malaria rates. Do they address the root cause of the problem? It depends on exactly what you define as the root cause. But eradicating a major problem doesn’t require addressing its root cause.
I don’t know the root cause of cannibalism, but arresting Jeffrey Dahmer did a lot to reduce cannibalism. For it to do that, it didn’t need to address whatever the ultimate cause of cannibalism was. And it would still have been good to arrest him even if there had been a bunch of other roaming cannibals, so that arresting Dahmer only stopped a small portion of global cannibalism.
Talk about addressing root causes is generally a fig-leaf for inaction. The root causes of most of the world’s ills are quite broad structural features of the world. They’re generally not the sorts of things that are easily solved. If you never plan to address concrete evils until you take on whatever highly general feature of the world explains why they exist, then you’re never going to take on evils. Talk about root causes often serves as an excuse to do nothing and be smug about it.
This is certainly how it’s treated among left-wing academics. Such people tend to criticize effective altruism on the grounds that it doesn’t address the capitalist system that causes all the bad things in the world; we know that capitalism causes all the world’s ills because it’s asserted by pompous, economically illiterate English professors at second-rate institutions whose primary research focus is the ecopolitics of queer sexuality in the writings of Derrida and Foucault, and who have been a visiting lecturer at clown college for three years. But even if you hold the stupendously false view that capitalism is responsible for all the bad things in the world, you shouldn’t do nothing as kids die because capitalism is the root cause of the kids dying. At the very least, you shouldn’t smugly condemn those who endorse doing something about those kids dying!
I do not know what the root cause of people thinking that it’s only worth addressing root causes is. Probably it’s some more general human irrationality. But hopefully this article has successfully dealt with this tendency, even without addressing its root cause!
I really appreciated this article and would have strong upvoted (I weak upvoted) it apart from this part which really turns me off...
"We know that capitalism causes all the world’s ills because it’s asserted by pompous, economically illiterate English professors at second-rate institutions whose primary research focus is the ecopolitics of queer sexuality in the writings of Derrida and Foucault, and who have been a visiting lecturer at clown college for three years."
Making personal, identity/political based attacks is both unnecessary and makes the article feel cheaper and weaker. I don't think you need to "tone down" the first half of the article (I love a bit of passion) but cutting bits like that out could make a big difference I think.
I appreciate you saying this Nick — I totally agree with you and couldn't have said it better myself.
I agree, it felt like a smug condemnation of anti-capitalism; followed by a statement about smug condemnations being bad!
"At the very least, you shouldn’t smugly condemn those who endorse doing something about those kids dying"
So, I clearly agree with you that cutting PEPFAR is an atrocity and that saving lives is good even if it doesn't result in structural changes to society.
However, I think the arguments in this essay are resorting almost to a strawman position of "root causes", and it might result in actual good objections being dismissed. You should absolutely sometimes address root causes!
For an example, imagine a cholera outbreak caused by a contaminated well. In order to help, Person A might say "I'm going to hire new doctors and order new supplies to help the cholera victims". Person B then says "that isn't addressing the root causes of the problem, we should instead use that money to try and find and replace the contaminated well".
Person B could easily have a point here: If they succeed, they end the cholera output entirely, whereas person A would have to keep pumping money in indefinitely, which would probably cost way more over time.
When people talk about "structural change", they are implictly making this sort of argument: that the non-structural people will have to keep pouring money at the problem, whereas with structural reform the problem could be ended or severely curtailed on a much more permanent basis, so the latter is a better use of our time and resources than the former.
Often this argument is wrong, or deployed in bad faith. Often there is no clear path to structural reform, and the effectiveness might be overstated. However sometimes it is correct, and the structural reform really is the correct solution. For example, the abolitionism of slavery. I don't want to throw the baby out with the bathwater here.
I feel like there's a bit of Motte-and-Bailey in this post.
The Motte is: "Things can be good without addressing root causes". I agree with the Motte, and I agree that sometimes shifting conversations towards root causes acts as "a fig-leaf for inaction".
The Bailey is: "EA is justified in neglecting root causes, to the extent that it does". This claim is much less obvious, because EA is about doing the most good one can, and there are opportunity costs to any given approach to doing good. I don't think you directly support the Bailey in your piece.
A personal example: when I was a young EA, I could have asked myself questions about how malaria vaccine manufacturing and distribution worked, and thought about how I might persuade people to effectively lobby for vaccine speedups. I didn't. But I think it's plausible that I'd have asked those questions if I'd taken the "root cause" framing a bit more seriously, and in the end have done more good than proselytising for and donating small amounts to AMF.
That said, I still upvoted the post; I think it's useful to have honest, unshackled expressions of (relatable) sentiments like: "for fuck's sake, please just focus on dying kids rather than exempting yourself from moral guilt via smug, self-serving anti-capitalist disquisitions". Someone needs to do that, because I think it's a common sentiment which deserves response. But I disagree-voted, because ultimately I think we can and should do better than that initial response.
Thank you for writing this, it is useful to see how some EA-ers might view me! I don't go around criticising EA for not addressing root causes, but I feel it is important we address them and I have queried the apparent lack recognition of them in EA. Alongside that I’d don’t deny the need for immediate interventions right now. It's not either/or.
I feel like the framing of an either/or choice in the post is reductive. The EA movement should be broad enough to have a more nuanced approach to look at root causes - it is possible these could have huge ripple effects - while acknowledging the need for continued direct interventions. We can, to continue your narrative, help the person who has been shot while also working on policy reform around gun control. Noting, you can follow a chain of root causes all the way to arguing the root cause is violent behaviour in a society which accepts such casual violence. Surely the key to doing the most good is finding the sweet spot of a tractable root cause?
If we ignore root causes and only focus on the immediate inventions there are a number of risks:
1. The underlying issues worsen and expand faster that we can address their symptoms. For example, if we only provide malaria nets without addressing climate change, rising temperatures and shifting rainfall patterns could expand malaria zones into new regions, overwhelming our capacity to help.
2. We might exhaust limited resources treating symptoms while the source of the problem continues to generate new case. Like trying to bail out a boat without fixing the leak – you’ll eventually get tired.
3. We miss a chance to prevent suffering entirely. Rather than treating waterborne illnesses let’s invest in the sanitation infrastructure to ensure no one becomes ill to start with!
4. Root causes interact and amplify each other, making problems more difficult to solve without addressing the underlying systems. For example, factory farming relies on antibiotics to keep animals healthy in crowded situations. The drive to maximise output and profits has led to concentrated animal feeding operations (CAFOs). Overuse of antibiotics (enabled by poor regulation of antibiotics) leads to drug-resistant bacteria which spread to humans through food, water and the environment. As antibiotic resistance grows treating infections becomes harder, threatening public health and increasing health care costs. Simply reducing antibiotic use without changing factory farm conditions would still leave animals vulnerable to disease, for example
This doesn’t mean EA should stop direct interventions – help is required now. But we need a balanced approach that includes immediate interventions and long-term systemic change.
I was gonna write something similar, but I think this comment nailed it (kudos KarenS). So I'll highlight two key arguments I endorse:
I would say that we need to address the root causes in areas that are too complex to solve with simple solutions, e.g. biodiversity loss, since it is interconnected with many other systemic challenges. According to the assessment report about Nexus, which is the interconnections between the following crises: Climate change, biodiversity, water, food and health. According to the report, there are 7 trillion USD in subsidies for the fossil fuel industry, and damages to nature for 10-25 trillion USD in unaccounted costs. Also, there are 35 times more resources going to causes that destroy our planet than supports our nature. In this case it is hard to find a solution that doesn't address the root causes. But for individual diseases or more simple challenges, there may not be any need to address the root causes.
This feels fairly strawman-y, and even if it weren't it is far too sweeping of a judgement to be actionable or useful. In some cases, root causes are very complex and hard to determine, agree on, or act upon, and pouring most or all resources into more palliative solutions can make sense, but that isn't always true. Titotal's cholera example is a great counterpoint.You can also think of something like toxic waste in the ground and water causing ilnesses. Would it be better to keep treating the people who are getting sick, constantly pouring resources into each new generation who is affected by the hazard, or to clean up the hazard and prevent further illness? A much more simple analogy can be drawn to a leaky boat. Is it better to hire a crew member to constantly dump buckets of water overboard to keep the boat from flooding or just plug the hole? Sometimes you can't plug the hole, so the bucket person is necessary; but if you reasonably think you can get it done not plugging the hole is counterproductive and extremely inefficient. Holding a blanket stance against addressing root causes can also be similarly inefficient and counteproductive, depending on the case.
I think a point that is frequently overlooked in this discussion is that this isn't necessairly an either-or situation. I think a lot of the reaction to some EA suggestions is partly heigthened because of the way EAs present their suggestions: the cost-benefit analysis that goes into these suggestions and the language used often explicitly or implicitly argues that a certain intervention is the best thing you can be putting your money or other resources behind, and I think having someone point out the need to address root causes in reaction to that is both necessary ans useful, if only as a kind of red teaming exercise to push us to think about how it may be possible to find permanent solutions that don't require constant upkeep or additional resources. Some of this kind of criticism will be useless or be made in bad faith, but so is some of the reaction to it (parts of this post included). For example,
I understand the use of this as a rhetorical device, but you can easily write an equivalently absurd version of this from the opposite position, particularly when you choose a convenient example: "No, we can't remove the toxic waste from your water supply, because we don't need to address root causes to solve a problem! We'll just keep giving you chemo for your cancer and hope that works. And besides, when you really think about it, the real root cause of cancer is biological evolution, so we couldn't address the root cause even if we wanted to!" Both are obviously not tenable positions to take, because most often you need a mix of both structural and palliative interventions to solve a problem. Treating HIV/AIDS is a hugely important and valuable intervention that needs to continue, but there should also be steps taken to, as much as possible, prevent the fırther spread of HIV/AIDS so that, hopefully, some day we won't need something like PEPFAR - which, incidentally, is a perfect example for why these woot cause approaches are valuable: when dealing with a problem is primarily accomplished through these palliative measures that require more or less constant maintenance, the moment you lose access to that because of a lack of funds, or political change, or any reason, the problem is no longer solved.
Thanks, Matthew! I wonder whether something somewhat similar applies to moral uncertainty. I feel this is often used as an ad hoc justification to pursue actions which are far from optimal in terms of increasing impartial welfare, such as donating to human welfare instead of animal welfare organisations.
Enjoyed this article a lot, and I think the framing of the "root problem objection" is an underrated one!
This isn't really a comment regarding the content of your post, but it made me think of it. I think EAs who write good forum posts should consider submitting them to large philanthropy magazines such as Stanford Social Innovation Review and the Chronicle of Philanthropy.
I think you make an interesting argument here but I can't help but feel you are preaching to the choir. It is important to make this argument to the people in philanthropy that complain that EA doesn't address root causes! And those people don't read the EA forum, they read SSIR and the Chronicle.
I do think the article would need some work and probably toned down a bit, but I don't think it's too much of a stretch that posts like this can be published in these other outlets. And more articles that defend EA principles in these other outlets can influence the exact people EA should be trying to influence.
Delightful article!