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

Quick takes

46
2mo
Striking paper by Anant Sudarshan and Eyal Frank (via Dylan Matthews at Vox Future Perfect) on the importance of vultures as a keystone species.  To quote the paper and newsletter — the basic story is that vultures are extraordinarily efficient scavengers, eating nearly all of a carcass less than an hour after finding it, and farmers in India historically relied on them to quickly remove livestock carcasses, so they functioned as a natural sanitation system in helping to control diseases that could otherwise be spread through the carcasses they consume. In 1994, farmers began using diclofenac to treat their livestock, due to the expiry of a patent long held by Novartis leading to the entry of cheap generic brands made by Indian companies. Diclofenac is a common painkiller, harmless to humans, but vultures develop kidney failure and die within weeks of digesting carrion with even small residues of it. Unfortunately this only came to light via research published a decade later in 2004, by which time the number of Indian vultures in the wild had tragically plummeted from tens of millions to just a few thousands today, the fastest for a bird species in recorded history and the largest in magnitude since the extinction of the passenger pigeon.  When the vultures died out, far more dead animals lay around rotting, transmitting pathogens to other scavengers like dogs and rats and entering the water supply. Dogs and rats are less efficient than vultures at fully eliminating flesh from carcasses, leading to a higher incidence of human contact with infected remains, and they're also more likely to transmit diseases like anthrax and rabies to people. Sudarshan and Frank estimate that this led to ~100,000(!) additional deaths each year from 2000-05 due to a +4.2%(!) increase in all-cause mortality among the 430 million people living in districts that once had a lot of vultures, which is staggering; this is e.g. more than the death toll in 2001 from HIV/AIDS (92,000), malaria
86
8mo
1
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.)
3
5d
I saw the following quote from Bill Gates in an interview that he recently did with Dylan Scott from Vox: "The idea of these chickens that lay a lot of eggs or cows that make a lot of milk, the beauty of that is once you improve the genetics of the African cows, that’s a gift that keeps on giving. That’s a teaching a man to fish type thing where, as we mix the super productivity of Western dairy cows together with the heat and disease tolerance that African cows have, you can get something that’s 75 percent as productive as a [dairy cow], which is four times the milk productivity of the cows that are in Africa today. It’ll take five years before, say, half the cows in Africa get that, but that’s a gigantic thing because that’s income for women, that’s milk for the kids where malnutrition, vitamin deficiency, and protein deficiency are gigantic. Cheap eggs, cheap chickens, and cheap milk are a big part of this. We’ve already cut the cost of eggs in Ethiopia in half. We see the poorest households actually using twice as many eggs as they used before because they’ve become a lot more affordable. Those egg factories and milk factories, getting those into Africa in the hands of the smallholder farmers, that’s pretty powerful." This seems like a worrying and salient example of the meat-eater problem. It also seems like there are lots of cost-effective Global Health & Development interventions that don't involve this trade-off with animal welfare that the Bill and Melinda Gates Foundation could be pursuing.
48
6mo
7
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. https://forum.effectivealtruism.org/topics/meat-eater-problem (I had sometimes thought about the problem, but I didn't even know it had a name)
48
9mo
13
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.
18
3mo
9
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?
27
6mo
13
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.
48
1y
22
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
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